Instruction on interdental cleaning - a survey among dental professionals

Introduction: Instruction on interdental cleaning at home (IC) is daily routine in the dental practice and mostly performed by dental professionals (DP). Recently published S3-guidelines (AWMF: 083–022/083–043) describe, among other things, the need and extent of patient-specific instructions on IC. However, since little evidence is available up to date regarding the DP’s recommendations to patients on IC or data on the level of knowledge of German DPs about IC, an exploratory survey study was initiated. Methods: At 2 evaluation time points in 2018 and 2021 (during and after the publication of guideline AWMF: 083–022/083–043), dental professionals with (DP+) and without (DP–) certified education in dental hygiene were surveyed at 3 German dental training institutes using an anonymized and validated online questionnaire (unipark.com, Tivian XI GmbH, Cologne, Germany). The probands answered 11 questions regarding personal details (including age, professional degree/experience, personal IC habits), the recommendations according to IC (including devices such as interdental brush/floss and additional use of toothpaste or interdental gel together with the IC devices), and the basis for their recommendations. The results were analyzed mainly descriptively.
Results: In total, 89 DPs participated in 2018 (DP–/DP+: 68/21) and 109 DPs in 2021 (DP–/DP+: 59/50), 2021 with a higher DP+ rate (p = 0.006). At both evaluation times, DP+ were more likely (2018/2021: 62 %/64 %) to report following scientific recommendations than DP– (2018/2021: 27 %/41 %). At the first evaluation date, 78 % of all DPs (2021: 73 %) reported recommending IC devices they themselves perceived as effective. Patient preferences were considered by DP+ 24 % in 2018 and 36 % in 2021. DP– considered patient preferences in 54 % (2018) and 39 % (2021). DPs predominantly reported to use interdental brushes (2018/2021: 75 %/77 %) and floss (2018/2021: 78 %/84 %) as their personal IC devices. A majority of DPs also recommended both devices in 2018/2021 with 99 %/95 % for interdental brushes and 75 %/78 % for floss.
Discussion: Despite the small number and special selection of DPs, the results of the exploratory survey study suggest that a basic knowledge of IC is present in all groups of DPs. The DPs surveyed were more likely to consider the selfperceived efficacy of IC devices than patient preferences or evidence-based recommendations, regardless of their level of certification.
Conclusion: The results suggest that there is a need for more intensive coaching of DPs regarding evidence-based and patient-specific instruction on IC at home.