Real, Lasting Change Happens on the Patient’s Terms

It’s mid-day and your third patient is nodding along politely, just as she has at the last few appointments. Nothing has changed. Still no regular interdental cleaning, unless you count the occasional toothpick clearing a stubborn food trap. Despite your best efforts, the traditional patient education you’ve been providing isn’t sticking.

What do you do when you realize that sharing information alone isn’t enough for behavior change?

Why Behavior Change Matters in Dental Hygiene

What makes dental hygienists uniquely positioned to uncover the hidden motivators behind patient behaviour change? Oral diseases remain the most common chronic conditions globally, affecting nearly 3.7 billion people, yet most are preventable through behavior change.¹ Daily decisions, such as brushing, interdental cleaning, diet, and habits such as vaping or tobacco use, carry significant weight in achieving and maintaining optimal oral health.  In addition, patient adherence to recommended hygiene appointment intervals is equally essential, serving as a critical touchpoint for prevention, reassessment, and reinforcement of positive behaviors.

Changing behavior is notoriously difficult, but evidence shows it is possible. Of all health professionals, dental hygienists often spend more time with patients and are uniquely positioned to help coach patients in their efforts to make sustainable changes achieving oral and overall health. Beyond time spent, dental hygienists also play a key role in engaging patients in conversations revealing their values, goals, and efforts they are willing to make for their oral health. Through effective coaching, dental hygienists can guide patients to make informed, evidence-based decisions that support lasting improvements in oral health.

Evoking Change on the Patient’s Terms

What makes involving patients in every step of needed change so important? Motivation is at the heart of every successful behavior change, yet it can’t be handed out like a brochure or built by explanation and demonstration alone. True motivation comes from within the patient, not from the clinician. Research shows that people are more likely to make lasting changes when they are listened to, supported, and in control of their own health care decisions.

Gillam and Yusuf² discuss how care guided by the patient’s perspective and active participation results in improved clinical and behavioral outcomes. One of the most effective ways to evoke change is by asking powerful questions. More specifically, open-ended questions (ie, those that begin with “what,” “how,” or “tell me about,”) invite dialogue rather than one-word answers. These two-way conversations allow patients the opportunity to explore their own habits, motivations, and barriers in a way that yes-or-no questions simply can’t.

Partnership and patient autonomy are at the heart of patient-centered communication. Asking for permission before sharing information or recommendations signals respect for patients’ rights to make their own decisions. This small yet powerful step can transform interactions into true collaboration. Recent research highlights how patients with periodontitis prefer to be informed as well as share decision-making responsibilities equally with their oral health professionals, reinforcing the importance of partnership, transparency, and autonomy in achieving sustainable outcomes.³

The difference between one-way patient education and coaching behavior change is involving patients in the conversation and developing their own health plan.  

Chairside Application for the Dental Hygienist

How can you bring patient-centered communication to life in the operatory? Within a time-limited environment, the objective is to employ intentional language that transforms routine interactions into meaningful, collaborative discussions. 

As you read the following examples, consider how might your patients respond? Reflecting on possible responses can help you anticipate where curiosity and motivation may be uncovered and how to guide the discussion with intention.

• What do you know about gingivitis?
• Would it be okay if I shared a bit more about what I’m seeing in your mouth today and what it might mean for your oral health?
• What do you think might be causing this infection in your mouth?
• Would it be okay if I shared a few ways, we could work together to treat the infection and stop it from progressing?

These examples demonstrate how a dental hygienist can combine open-ended questions with permission-based communication to engage the patient in a collaborative discussion. The dental hygienist begins by inviting patients to share their understanding, then responds respectfully by asking permission before offering information. This approach fosters trust, supports patient autonomy, and creates a foundation for effective behavior change.

The Power of Visual Technology in Supporting Behavior Change 

How can seeing what we see change the way patients get involved and take ownership in their oral health? Among the key strategies dental hygienists can use to strengthen patient-centered communication, visual technology stands out as one of the most effective tools for inspiring curiosity and collaboration. Intraoral cameras, three-dimensional (3D) scans, and digital imaging provide patients with a tangible view of their oral health, transforming a clinical discussion into a shared learning experience and supporting greater ownership of their oral health status.

When patients can see what we see, the dialogue shifts from explanation to exploration. Following an intraoral image or 3D scan, asking an open-ended question such as, “What do you see?” invites reflection, curiosity, and self-assessment, strengthening trust and shared decision-making.

Evidence supports this connection between visualization and behavior change. A 2016 randomized controlled trial published in Clinical, Cosmetic and Investigational Dentistry evaluated the effect of intraoral camera images on patients with gingivitis and found significant improvements in psychological, behavioral, and clinical outcomes, including oral hygiene behaviors and gingival health indicators.⁴

When dental hygienists intentionally ask permission to collect and share visual information, it reinforces trust and respects patient autonomy. This collaborative approach transforms the experience from “being examined” to “being engaged,” the foundation of sustainable behavior change.

Building Strategies Into the Practice Culture

How can you and your practice team work toward keeping patient-centered communication part of daily patient interactions? Regardless of how long you’ve been working chairside, any change in communication style takes practice. If you notice yourself slipping back into traditional educational approach, pause, re-adjust, and re-engage your patient in the discussion. Sometimes, it can be as simple as pausing to ask, “Can you tell me more about that?” Even brief moments of mindful communication can create lasting impact when practiced consistently.

Commit as a team to keeping this approach top of mind. During a team huddle, take just 5 minutes to focus on reviewing patient-centered communication that invites patients to participate, such as open-ended questions. Practice it together, share quick examples from patient interactions, and learn from each other’s experiences. Small, consistent efforts like these build team alignment and confidence.

After all, teams that learn together grow together and patients benefit most when everyone is committed to communicating with intention.

At your next appointment, what open-ended question could you use to help you better understand what matters most to your patient and what they feel ready to change?

References

1. Nagdeo KP. The missing piece in chronic disease prevention: dental caries. Prev Chronic Dis. 2025;22:E48.
2. Gillam DG, Yusuf H. Brief motivational interviewing in dental practice. Dent J (Basel). 2019;7:51.
3. Jung JY, Ko KA, Strauss FJ, Lee JH, Kim JH, Lee JS. Patient-centred preferences for autonomy and information-seeking among periodontal patients in dental decision making. J Clin Periodontol. 2025;52:960–970.
4. Araújo MR, Alvarez MJ, Godinho CA, Pereira C. Psychological, behavioral, and clinical effects of intra-oral camera: a randomized control trial on adults with gingivitis. Community Dent Oral Epidemiol. 2016;44:523–530.