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Principle #2: Strong recommendations build trust

Make the recommendation clear, calm, and unambiguous

Parents take cues from how confidently and clearly a clinician recommends preventive care.

Core Behaviour

  • State the recommendation clearly and directly
  • Use affirmative, confident language
  • Avoid hedging words unless responding to an expressed concern
  • Speak as though the recommendation is important and routine
  • Do not dilute the message by overqualifying or apologising

QuickTalking Tips

Strong recommendations signal importance and safety, while hesitant language can unintentionally suggest doubt and uncertainty.

DOThis

(Clear, confident recommendation)

Use language that communicates certainty and professional confidence:

  • “Fluoride toothpaste is one of the most effective ways we have to prevent cavities in children.”
  • “This is an important part of protecting your child’s teeth.”
  • “We strongly recommend fluoride toothpaste for children.”
  • “Used correctly, fluoride is safe and very effective.”
  • “This makes a real difference in preventing decay.”

These statements:

  • Communicate that the recommendation is evidence-based
  • Reassure parents through professional confidence
  • Reduce ambiguity about the importance of fluoride

AVOIDThis

(Hedged or diluted recommendation)

Avoid language that sounds uncertain, apologetic, or optional:

  • “You might consider using fluoride toothpaste.”
  • “Some parents find fluoride helpful.”
  • “It may help prevent cavities.”
  • “I think fluoride is probably okay.”
  • “It’s just one option you could use.”

These phrases unintentionally:

  • Signal uncertainty about effectiveness or safety
  • Weaken the perceived importance of prevention
  • Suggest the clinician is not fully confident in the recommendation

Standard Chairside Language

“Fluoride toothpaste is one of the most effective tools we have to prevent cavities in children. Used in the right amount, it’s safe and works very well.”

“This is something we strongly recommend because it helps protect teeth before decay starts.”

“This is an important part of keeping your child’s teeth healthy.”

General Delivery Tips

  • Maintain steady eye contact while making the recommendation
  • Avoid rushed delivery or downward tone at the end of sentences
  • Pause briefly after the recommendation, allowing it to land
  • Speak in complete, declarative sentences
  • If concerns arise, shift approach (see Principle 3)
  • Let confidence be calm, not emphatic or defensive

Clear, strong recommendations:

  • Increase parental confidence in preventive care
  • Reduce confusion created by mixed messages online
  • Reinforce the clinician’s role as a trusted guide
  • Help parents feel reassured rather than pressured

Evidence Base

In paediatric preventive care, the strength and clarity of the clinician’s recommendation are among the strongest predictors of parental acceptance.

Parents interpret hesitation from clinicians (even symbolically by use of “hesitant words”  as uncertainty about safety).

 

Strong recommendations are associated with:
  • Higher uptake of preventive interventions
  • Lower persistence of hesitancy
  • Greater trust in clinical advice

 

Key evidence
  • Gilkey MB et al. Quality of Physician Communication About HPV Vaccine. Human Vaccines & Immunotherapeutics. 2016.
    Shows strong, unambiguous recommendations significantly influence parental decisions.  https://pmc.ncbi.nlm.nih.gov/articles/PMC4964668/ 
  • Brewer NT et al. Increasing Vaccination: Putting Psychological Science Into Action. Psychological Science in the Public Interest. 2017.
    Highlights clinician recommendation strength as a central driver of acceptance. https://pubmed.ncbi.nlm.nih.gov/29611455/ 

Other Principles

The Fluoriders campaign is an initiative of the International Association of Paediatric Dentistry (IAPD) designed to promote good oral hygiene habits in children.

The Fluoriders initiative is supported by an educational grant from Colgate’s Bright Smiles, Bright Futures® programme. All educational content is developed independently by IAPD.