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Principle #3 Listen first: When hesitancy surfaces, guide, don't persuade.

When a parent raises a concern, shift from explainingto listening

Continuing to persuade or “convince” can increase resistance. Yourrole becomes guiding the conversation in a way that preserves trust and supports informed decision-making.

Core Behaviour

  • Pause when a concern is expressed
  • Invite the parent to explain what worries them
  • Listen without interrupting or correcting
  • Acknowledge the concern is worth discussing
  • Ask permission before sharing information
  • Respond briefly and check understanding

This approach keeps the conversation collaborative rather than confrontational.

QuickTalking Tips

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

DOThis

(Guiding, autonomy-supportive approach)

Use language that opens space for dialogue and shows respect:

  • “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 responses:

  • Reduce defensiveness
  • Signal respect for parental autonomy
  • Keep the clinician in a trusted, guiding role

AVOIDThis

(Persuading, correcting, or debating)

Avoid language that escalates resistance or sounds dismissive:

  • “There’s nothing to worry about.”
  • “That’s not true.”
  • “You don’t need to be concerned.”
  • “The internet is full of misinformation.”
  • “Let me explain why you’re wrong.”

These responses unintentionally:

  • Minimise parental concerns
  • Shift the conversation into debate
  • Undermine trust, even when factually correct

Standard Chairside Language

“What worries you most about fluoride?”

“That’s a very common concern, especially with what’s shared online.”

“Would it be okay if I shared what the evidence shows?”

“With the right amount and supervision, fluoride is safe and helps strengthen teeth before cavities start.”

“How does that sound? Does that help answer your question?”

General Delivery Tips

  • Pause after the parent speaks
  • Nod or acknowledge before responding
  • Keep your body open and relaxed
  • Avoid multitasking (typing, turning away) during concerns
  • Do not rush to respond
  • Avoid long explanations unless requested
  • Use simple language
  • Let silence do some of the work

Listening is communicated as much non-verbally as verbally.

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

Guiding is slower than persuading, but more effective.

Evidence Base

Research on preventive care communication shows that motivational interviewing–informed approaches reduce resistance and support acceptance when concerns are expressed. Fluoride hesitancy is often driven by fear, uncertainty, or exposure to alarming messages rather than outright opposition.

Switching from persuading to guiding:

  • Respect parental autonomy
  • Reduce confrontation
  • Improve engagement and satisfaction
  • Prevents escalation
  • Allows concerns about safety, ingestion, or “chemicals” to be addressed calmly
  • Keeps fluoride framed as protective care, not a contested issue

 

Key evidence:
  • Gagneur A et al. Motivational Interviewing: A Promising Tool to Address Vaccine Hesitancy. Vaccine, 2018.
     Demonstrates that MI techniques improve acceptance and reduce resistance. https://pubmed.ncbi.nlm.nih.gov/32281992/

  • Purcell R et al. Communicating With Vaccine-Hesitant Parents: A Narrative Review. Academic Pediatrics. https://pubmed.ncbi.nlm.nih.gov/33958087/
    Recommends reflective listening and permission-based information sharing.

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.