Prevention with purpose: How dental hygienists can ethically introduce emerging preventive therapies through patient-centered care

Preventive dentistry is evolving rapidly, and dental hygienists are often the first clinicians tasked with explaining new, noninvasive therapies to patients, all while building trust and ethical communication. While new innovations offer promising opportunities to intervene earlier and preserve tooth structure, patients frequently express hesitation when presented with treatments they have never heard of. It also introduces uncertainty for providers alike.

These conversations require confidence, transparency, and realistic expectations. As hygienists, we should navigate these conversations carefully, balancing enthusiasm for prevention with honesty about limitations and the need for ongoing evaluation. Ethically introducing emerging preventive therapies is not about persuading patients to accept new products, but about guiding informed, realistic conversations that respect patient autonomy while addressing early disease.

This article explores how hygienists can ethically introduce emerging preventive options, address patient hesitation, manage reassessment conversations, and apply realistic, patient-centered oral hygiene instruction across diverse patient populations.

Understanding patient hesitation toward preventive therapy

Patient hesitation is often rooted in unfamiliarity rather than resistance. Many preventive dental therapies, though supported by scientific research, can feel experimental to patients when first introduced chairside. Emerging preventive therapies are often not new to dentistry, but new to specific practices or patients.

Take for instance a resin infiltration designed to inhibit early caries progression, a modern sealant system, and other minimally invasive remineralization therapies. While these innovations are evidence-based and effective, many are unfamiliar, which can increase hesitation or skepticism when they are first proposed. When patients hear about a treatment for the first time, especially one that carries an out-of-pocket cost, they naturally question its necessity and effectiveness.

Trust plays a critical role in acceptance. Studies consistently show that patients are more likely to accept recommendations when they feel heard, informed, and their autonomy respected. Hygienists play a critical role in bridging this gap. By acknowledging patient concerns and validating their questions, hygienists can create a space for open dialogue rather than defensiveness.

It is also important to recognize that the term “new” carries emotional weight. For some patients, it signals innovation and progress; for others, it suggests risk. Understanding this emotional response allows the conversation to be framed in a way that educates, reassures, and empowers patients. This perspective allows emerging prevention to fit naturally into an ongoing care plan rather than being viewed as a standalone promise. Additionally, effective communication requires understanding where each patient falls on that spectrum and tailoring education accordingly. Clear explanations focused on early intervention help contextualize options without pressure.

Ethical communication without overpromising outcomes

Ethical communication is the foundation of patient trust. When discussing emerging preventive therapies, it is essential to avoid language that implies certainty or guarantees. Prevention is inherently proactive, not predictive. Hygienists should clearly differentiate between intended outcomes and assured results.

Transparency strengthens credibility. It is appropriate to explain that some therapies are newer to the US market while also noting that they may have been utilized internationally or supported by existing research. Patients appreciate honesty, particularly when clinicians acknowledge that long-term outcomes continue to be evaluated.

Confidence does not require absolute certainty. Hygienists can confidently explain the rationale behind a preventive recommendation, the science supporting it, and the plan for monitoring progress. Phrasing such as, “This approach is designed to help arrest early changes before they progress,” conveys professionalism without overstatement. By maintaining ethical boundaries in communication, hygienists protect both patient autonomy and professional integrity.

Clinical tips for discussing emerging preventive options

• Lead with clinical observations, not cost.
• Use neutral, nonabsolute language (avoid “will,” “always,” “guaranteed”).
• Avoid overloading patients with ideal routines.
• Support oral health choices rather than creating obligations or guarantees.
• Set realistic expectations.
• Emphasize follow-ups, reassessment, and adjustment over time.
• Support patient autonomy.
• Remember: Trust is built over time, not in one visit.

Prevention as an ongoing process

Preventive care extends beyond initial treatment. Reassessment and monitoring are essential components of disease management. It is also important to inform patients that prevention is a process rather than a one-time solution. Follow-up appointments and diagnostic imaging may be recommended to evaluate effectiveness and progression.

When patients express concern about radiographs, hygienists should respond with empathy and education rather than persuasion. Discussing ALARA (As Low As Reasonably Achievable) principles and explaining the clinical purpose of imaging fosters informed decision-making, while respecting patients’ autonomy.

Expanding the preventive toolkit: Interventions hygienists can recommend

Emerging prevention extends beyond resin infiltration and sealant therapy. Dental hygienists have access to a growing range of minimally invasive, evidence-supported interventions that can be tailored to individual risk profiles and disease patterns. When introduced, these therapies enhance outcomes while reinforcing patient autonomy and informed decision-making. Here are some examples:

• Fluoride varnish: for patients with elevated caries risk or early demineralization
• Xylitol-based therapies: support salivary flow and pH balance
• Calcium phosphate technologies (CPP-ACP, ACP): support enamel repair
• Silver diamine fluoride (SDF): noninvasive option for arresting caries (disease control)
• Nutritional counseling: addresses frequent snacking and acidic beverage intake
• Motivational interviewing: supports behavior change
• Sealants: decrease caries, protect exposed dentin, and reduce sensitivity
• Antimicrobial mouth rinses: adjunctive use in reducing inflammation and plaque accumulation
• Interdental preventive aids: water flossers, electric toothbrushes, and floss alternatives useful for orthodontic patients, implants, bridges, or those with limited dexterity
• Recare intervals: frequent maintenance for high-risk patients, allowing earlier intervention and reassessment of emerging therapies

One size does not fit all: Realistic prevention

Effective prevention requires individualized care. Oral hygiene instruction should reflect each patient’s age, abilities, lifestyle, and health status. What is appropriate for a pediatric patient may be unrealistic for a geriatric individual, and vice versa. Geriatric patients may experience reduced dexterity, cognitive changes, and medication-induced xerostomia. Simplified routines and adaptive tools often yield better compliance than complex regimens. Pediatric patients benefit from caregiver involvement and age-appropriate education, while young adults may require guidance that addresses lifestyle habits rather than technical instruction.

Overloading patients with idealized expectations can undermine adherence. Hygienists should prioritize achievable goals that empower patients rather than overwhelm them. Realistic prevention meets patients where they are and evolves as their needs change.

Conclusion

The future of dental hygiene lies in ethical prevention, individualized care, and transparent communication. As technologies and preventive therapies continue to emerge, hygienists must balance innovation with realism, confidence with humility, and education with empathy. By embracing patient-centered approaches and acknowledging the evolving nature of prevention, hygienists can lead meaningful change in oral health outcomes with integrity.