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Making Product
Recommendations to Patients
By Christine A. Hovliaras, RDH, BS, MBA, CDE and Fotinos S. Panagakos, DMD, PhD
(Professional Savvy, LLC and Colgate-Palmolive Company)
It is well understood that a dental hygienist will draw upon both objective and subjective information when making a product recommendation to a patient. What role each
piece of information plays in the overall decision making progress is still not well understood. An on-line e-survey was conducted from September 24-28, 2009 on the
Hygienetown web site In order to learn more about how both objective and subjective
influencers impact this process. The objective of this e-survey was to gain insights from
dental hygienists from across the country to determine what elements were important to
them in recommending over-the-counter toothpaste products to their patients. The online
e-survey was sent out to 6500 dental hygienists and 349 respondents participated in this
online e-survey. The survey recipients were blinded to who sponsored the survey.
Important Elements That Influence Toothpaste
Recommendations
This survey assessed both objective and subjective elements that could influence what
dental hygienists recommend regarding over-the-counter (OTC) toothpaste product(s) to
their patients. Table 1 summarizes the responses received for the objective elements that
were asked in the survey. Respondents were asked to rank the various elements in order of
importance. The results indicate that the two most important objective elements that
respondents ranked as being most influential for hygienists when making an OTC toothpaste recommendation were that the product(s) provided an important benefit to patients
(89.5%) and that the claims a toothpaste product(s) make are substantiated with peer
reviewed published research (60.8%).
Almost half of the hygienists felt that they read the literature to ensure that clinical
support and product claims regarding a toothpaste product(s) ensure the claims were
valid and also validate that quality research was conducted on the product(s). Two other
relatively important objective elements were that the product was manufactured by a
respected company (38.5%) and that the toothpaste product should carry the ADA Seal
of Approval (36.4%). Of interest is that only 16% of dental hygienists indicated that they
would recommend a toothpaste product
if they saw an advertisement in a profesTable 1 OTC Toothpaste Products
sional publication
Objective Elements That Influence Dental Hygienists
This survey also looked at a series of
to Recommend
subjective elements that could influence
Elements
Top 2 Ranking
a dental hygienist’s recommendation of
an OTC toothpaste product(s). The
Product provides an important benefit to my patients
89.5%
results from this part of the survey are
Product claims are substantiated with peer reviewed published research
60.8%
summarized in Table 2. Personal trial
Read the literature to ensure that clinical support and product claims are valid
49.7%
was ranked the highest subjective eleProduct is manufactured by a respected company
38.5%
ment that could influence patient recProduct carries the ADA Seal
36.4%
ommendations at 57%, followed closely
Saw an advertisement in a professional publication
16.6%
by a recommendation made by a professional colleague at 45.9%.
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More than a third of the hygienists felt that
the taste of an OTC toothpaste product was
important as well as a recommendation made by
a speaker they heard at a continuing education
course presentation. Less than 25% of hygienists felt that price was an important element,
followed by seeing the OTC toothpaste product
at a dental convention (18.4%), product presentation by a sales representative (15.3%) and
lastly, that the patient informed the hygienist
about the toothpaste (10.5%).
Table 2 OTC Toothpaste Products
Subjective Elements That Influence
Dental Hygienists to Recommend
Top 2 Ranking
Elements
Personal trial
57.0%
Recommendation by a professional colleague
45.9%
Taste
37.7%
Recommended by a speaker during a continuing education course
34.7%
Price
23.0%
Attended a dental convention and saw/heard about product at booth
The Value of Clinical Claims
Almost half of hygienists in the survey indiProduct presentation by a sales representative during an office visit
cated that they reviewed and investigated cliniPatient informed me about the toothpaste
cal claims that OTC toothpaste product(s)
make in order to confirm the quality of the
research and to ensure that the research supports the product claims prior to them making a recommendation. The review of product claims research support helps hygienists to
address the efficacy of the product, determine if claims are valid, determine how the studies were conducted, and on what population of subjects, ultimately determining if the
studies referenced in the product information substantiate the claims being made.
In addition to the closed ended questions summarized above, the respondents were
also provided the opportunity to answer a series of open ended questions. Below are some
of the quotes taken from the returned surveys:
18.4%
15.3%
10.5%
Why do you review/investigate the clinical claims that
OTC toothpaste product(s) are making? What is important for you to know about the claims?
“Better understand the efficacy of the product.”
“Because if the claim is false the patient doesn’t benefit or is misled.”
“I don’t recommend a product without thoroughly researching it first.”
“I consider myself an educated professional and the quality of my advice to my
patients relies on this. My patients trust me to tell them which products are worth
the money. There are so many choices and I get overwhelmed at times, but knowing the science makes it easier to select products that aren’t just hype.”
Hygienists who reviewed and investigated the clinical claims that an OTC toothpaste product(s) make indicated that the following reasons impact their decision to recommend OTC toothpaste products to their patients:
• I need to know how the product works and the benefits it provides patients
• that it gives value to the hygienists recommendation
• the product does what it is intended to do
• that the product is intended to help certain patient types
• the product provides a benefit to patients versus other competitive products.
Some additional quotes from dental hygienists to the following question:
How do clinical claims impact your decision to recommend an OTC toothpaste product(s) to your patients?
“Because it does what it claims to do.”
“A great deal, I like to know that a product does what it says it does before I
endorse it.”
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“They do impact my decision to recommend a certain product over another.”
“Clinical claims and trial evaluations are extremely important to any product on the
market and not just on the related drug side.”
Clinical Studies and OTC Toothpaste Product
Recommendations
More than half of the respondents indicated that they would review and investigate
clinical studies that are published in a professional peer reviewed publication about an
OTC toothpaste product, while 35% of respondents indicated that they may review the
clinical studies.
Almost 75% of the respondents reported that they have read a peer reviewed published study about an OTC toothpaste product and learned that the product benefits and
claims being made about the toothpaste(s) are supported by research.
Consumer Advertising
Interestingly, only half of the respondents felt that consumer advertising might or might
not influence their desire to recommend an OTC toothpaste product. Over a third of the
respondents said that consumer advertising would probably not or definitely not influence
their decision to recommend and we see this correlation with the objective elements previously discussed in this article. Only 13.5% of respondents felt that consumer advertising
would definitely or probably influence their decision to recommend an OTC toothpaste.
Respected Companies with Best Information and
Published Studies
Dental hygienists felt the top five companies who provide the best information and
published studies to support their oral care product claims for the products they recommend to their patient are Colgate-Palmolive Company, Procter & Gamble/Oral-B, Philips
Sonicare, Johnson and Johnson and GlaxoSmithKline. A full listing of the rank order provided by the respondents is provided in Table 3.
Table 3
Companies
Best Information and Published Studies
Colgate-Palmolive
67.3%
Procter & Gamble/Oral-B
57.2%
Philips Sonicare
53.2%
Johnson & Johnson
33.6%
GlaxoSmithKline
30.0%
Sunstar Butler
27.2%
Teledyne Waterpik
23.5%
OMNI (A 3M ESPE Company)
22.9%
GC America
22.6%
Dentsply
15.9%
PDT Company
6.7%
Premier Dental
4.6%
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Conclusion
As we know, dental hygienists value
the benefits that over-the-counter toothpaste products provide to their patients
oral health for the prevention of oral diseases. This survey indicated that a certain set of objective and subjective
elements are most influential in the decision making process. Subjective elements, such as personal trail, taste, and
colleague recommendation are considered along with objective elements such
as product benefits, peer reviewed
research support and a review of the literature. The combination of these elements, plus the perception of the
company which manufactures the product come together and provide the dental hygienist the data necessary to make
an effective product recommendation
for his/her patient.