Overview
The oral microbiome, a complex ecosystem of bacteria, fungi, viruses, and archaea, influences both oral and systemic health. In Saudi Arabia, where diabetes and cardiovascular disease are prevalent, translating microbiome science into dental practice is critical. A recent convergent mixed-methods study (n=286) evaluated knowledge, confidence, and counseling practices among dental practitioners, aiming to identify predictors and barriers to clinical application of microbiome-informed care.
Key Methods
Participants included general dentists, specialists, and academics from across Saudi Arabia. A 23-item questionnaire assessed objective knowledge (13 items), beliefs and confidence (8 items), and barriers, plus 2 open-ended questions. Quantitative data underwent descriptive statistics, chi-square tests, and binary logistic regression. Qualitative data from open-ended responses were analyzed to reveal contextual factors shaping practice.
Main Findings: Knowledge, Confidence, and Barriers
Knowledge was moderate-to-high: the mean objective knowledge score was 9.14 out of 13. Based on categorization, 28.3% of practitioners achieved high knowledge, 55.9% were medium, and 15.7% were low. Confidence in counseling the patient about the oral microbiome was more variable, with 39.6% reporting high or very high confidence, 30.8% moderate, and 28.2% lower levels. Importantly, training mattered: practitioners with prior microbiome training were over three times more likely to report high counseling confidence (odds ratio 3.21; 95% CI: 1.82–5.65). Regular CPD participation and frequent journal use also predicted higher confidence (CPD: OR 2.15; 95% CI: 1.25–3.70).
Despite awareness of the microbiome’s clinical relevance (73.3% agreed that nutritional counseling can influence the oral microbiome; 63.2% acknowledged the oral–gut axis), several barriers hinder translation into practice. The top obstacles were lack of formal training (52.6%), patient disinterest (29.5%), and time constraints (17.9%). Sources of microbiome knowledge leaned toward journals (30.5%), social media (24.2%), and workshops/CPD (23.5%), with dental curricula contributing only 14.4% as a learning source. A striking 89.1% updated their microbiome knowledge monthly or less, underscoring a gap in ongoing education.
Qualitative Insights
Open-ended responses (N=30) revealed four themes: professional barriers, time/workflow constraints, patient-related barriers, and conditional motivation. Respondents emphasized the need for structured curricula, practical counseling protocols, and support tools to integrate microbiome discussions into routine care without overburdening workflows. Motivation to counsel often depended on patient risk factors, highlighting a risk-stratified approach to implementation.
<h2 Implications for Practice and Policy
The knowledge-to-practice gap identified in this Saudi study aligns with global observations: knowledge alone does not guarantee clinical translation. To accelerate microbiome-informed dentistry, the following actions are recommended:
- Curriculum and CPD reform: Integrate microbiome science into dental curricula and develop case-based, just-in-time CPD modules. The strong association between formal training and confidence supports this strategy.
- Microbiome moments: Introduce brief 2-minute counseling moments during routine visits, supported by EHR prompts, particularly for high-risk patients.
- Engage staff and patient education: Train auxiliary staff to initiate microbiome conversations and employ visual aids to boost patient interest and understanding.
- Leverage technology: Deploy mobile microlearning platforms for quick refreshers and ensure EHRs prompt counseling for targeted risk groups.
These approaches dovetail with Saudi Vision 2030’s preventive-care objectives, aiming to reduce systemic disease burdens by embedding oral health into routine care. By aligning education, workflow, and patient engagement, practitioners can close the knowledge-to-practice gap and enhance microbiome-informed counseling.
Conclusion
While Saudi dental practitioners show solid foundational knowledge of the oral microbiome, significant barriers limit counselling in everyday practice. Prior institutional training, ongoing CPD, practical tools, and supportive EHR prompts are essential to translate knowledge into patient care. Implementing these strategies can improve preventive outcomes, supporting national health goals and the broader understanding of microbiome–systemic health connections.
