Understanding the Knowledge-to-Practice Gap in Oral Microbiome Counseling
The oral microbiome—home to hundreds of bacterial species, fungi, viruses, and archaea—plays a pivotal role not only in dental health but also in systemic diseases. In Saudi Arabia, where non-communicable diseases are prevalent, translating microbiome science into everyday dental care is urgent. A mixed-methods study assessing knowledge, confidence, and counseling practices among 286 dental practitioners reveals a notable gap between what professionals know and how often they counsel patients about the oral microbiome.
Key Findings: Knowledge, Confidence, and Barriers
Practitioners demonstrated moderate-to-high objective knowledge (average 9.14 out of 13), with most clustered in the medium knowledge category. However, confidence in counseling was only moderate; only about a quarter reported high or very high confidence to engage patients on the topic. Several predictors of greater counseling confidence emerged:
- Prior microbiome training markedly increased confidence (odds ratio ≈ 3.21).
- Regular participation in CPD activities correlated with higher self-assurance.
- Frequent use of journals and scientific sources also predicted better confidence (odds ratio ≈ 2.15).
Barriers to counseling were substantial and multi-faceted: lack of formal training (52.6%), time constraints during clinical practice (17.9%), and patient disinterest (29.5%). In terms of learning preferences, practitioners relied more on journals and social media than on the formal dental curriculum, signaling a mismatch between education and clinical needs.
Qualitative Insights: Why Counseling Remains Limited
Open-ended responses highlighted four themes shaping practice: professional barriers (notably insufficient microbiome training), time/workflow constraints, patient-related barriers (low interest or awareness), and conditional motivation (counseling more likely when patients are at higher risk). These insights align with Bandura’s self-efficacy theory—confidence drives practice—but also point to systemic gaps that impede translation from knowledge to action.
Implications for Saudi Vision 2030
Saudi Arabia’s Vision 2030 emphasizes preventive, value-based healthcare. Integrating oral microbiome counseling into routine care could strengthen preventive approaches, especially for patients with diabetes, cardiovascular risk, or other systemic conditions linked to oral health. The study’s findings offer a blueprint for aligning microbe-focused care with national health objectives, reducing the public health burden of chronic disease.
Recommended Strategies to Close the Gap
The study proposes a practical, three-pronged implementation framework tailored to dental settings:
- Curriculum Integration and CPD: Embed microbiome science into dental education and develop case-based CPD modules. Training predictors suggest strong returns in practitioner confidence and patient counseling.
- Microbiome Moments: Introduce brief, two-minute counseling interventions during routine cleanings, reinforced by electronic health record (EHR) prompts for high-risk patients to save time and standardize messaging.
- Patient Engagement and Support Tools: Train auxiliary staff to initiate conversations and use visual aids to improve patient interest. Leverage mobile microlearning and EHR prompts to provide just-in-time education and streamline workflow.
These actions, supported by ongoing CPD and system-level prompts, could markedly increase counseling frequency and practitioner confidence, advancing preventive care in line with national goals.
What This Means for Clinicians and Policymakers
For clinicians, prioritizing microbiome education and engaging patients through concise, evidence-based counseling can improve care without overburdening schedules. For policymakers and educators, the results underscore the value of targeted curricula, CPD accessibility, and EHR-enabled decision support to operationalize microbiome-informed dentistry across Saudi Arabia.
Conclusion
The gap between knowledge and practice in oral microbiome counseling is evident among Saudi dental practitioners. By enriching education, leveraging brief in-clinic conversations, and deploying practical tools, the dental workforce can better translate microbiome science into preventive care, supporting Saudi Vision 2030 and contributing to the country’s broader public health objectives.
