Purpose: As more Americans use dietary supplements, the potential for increased adverse effects increases. The purpose of this study was to identify the current knowledge, attitudes and practice behaviors among California dental hygienists regarding herbal and dietary supplements (HDS).

Methods: A stratified random sample of 1,203 registered California hygienists were surveyed. The survey included items about personal characteristics as well as questions regarding knowledge, attitudes and beliefs and practice behavior about HDS. Three primary outcomes were analyzed: dental hygienists' knowledge about HDS, attitudes (confidence) about HDS and behavior practices (communication) regarding HDS. Confirmatory factor analysis was performed. Personal characteristics were assessed in stepwise multiple linear regression analysis for impact on knowledge scores.

Results: The response rate was 21% (n=249). Dental hygienists have low levels of knowledge and confidence about HDS, as well as poor communication practices related to HDS. California dental hygienists scored a low mean of 38% on their knowledge of HDS. On the confidence scale (standardized range of 0 to 10 possible), hygienists scored 3.67±2.03. On the communication practices subscales (standardized range of 0 to 10 possible), hygienists scored 4.21±2.99 on general communication practices and 1.25±1.66 on specific communication practices. Dental hygienists who were members of the California Dental Hygienists' Association and attended a continuing education course on HDS within the last year or who personally used HDS scored significantly higher in knowledge, confidence and communication practices than their counter parts. These 3 attributes were identified as significant predicators for higher knowledge about HDS.

Conclusion: There is a need to improve California dental hygienists' knowledge and involvement in the active management of patients who take HDS. Such actions can be expected to improve oral health outcomes. Focused training on HDS for hygienists should be designed to improve their knowledge and influence practice behaviors.

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