Search

Purpose: Vaccinations represent an important public health tool for mitigating dangerous diseases; nevertheless, there is concern and hesitancy regarding vaccinations including those for COVID-19. The purpose of this study was to determine the intentions and hesitancy among dental hygienists in the United States (US) toward COVID-19 vaccination. Methods: Dental hygienists in the US were surveyed from 1/4/21 to 8/16/21 regarding their intentions to get vaccinated and whether they received a COVID-19 vaccine. The vaccination questions were part of an anonymous, ongoing longitudinal web-based survey of dental hygienists' employment and infection control trends. Willingness or actual COVID-19 vaccination versus vaccine hesitancy were analyzed by differences in demographic characteristics using multivariable logistic regression and X² and Fisher's exact tests. Results: Full COVID-19 vaccination rates in US dental hygienists rose sharply from 2/5/21 to 3/5/21 (26.0% to 53.9%) and leveled off to 75.4% by 8/30/21. The highest rates of vaccine hesitancy were among dental hygienists aged 26-39 years and those who had contracted COVID-19 during the time of the survey. The lowest vaccination hesitancy rates were seen among Non-Hispanic Asians and individuals 65+. When controlling for age, race/ethnicity, and years practiced, dental hygienists who had contracted COVID-19 had higher odds of being vaccine hesitant (adjusted Odds Ratio (aOR): 1.847, 95% Confidence Interval (CI): 1.274, 2.678). Having contracted COVID-19 was also associated with respondents changing from being hesitant to be vaccinated to being willing to be vaccinated (aOR: 4.071, 95% CI: 1.652, 10.030). Conclusion: Although vaccine acceptance is high among dental hygienists in the US, vaccine hesitancy remains an ongoing concern. Dental hygienists are key prevention specialists who should promote adherence to vaccination recommendations for the health of the public. Further education in virology, epidemiology, and vaccination education is recommended. [ABSTRACT FROM AUTHOR]

Purpose: Complex physiological changes occur during pregnancy thus increasing the risk of periodontitis and potentially adverse pregnancy outcomes. The purpose of this study was to assess prenatal health care professionals' levels of knowledge regarding oral health and its effect on pregnancy outcomes, examine their current practices in evaluating oral health, and determine their attitudes towards a multidisciplinary approach to providing comprehensive prenatal care. Methods: Data was collected from a web-based survey administered to a convenience sample of prenatal health professionals in a healthcare organization located in the Midwestern United States. Responses were summarized with descriptive statistics. A knowledge score was utilized to compare midwives and nurse practitioners to physicians and residents. Results: Seventy-six prenatal health care professionals (n=76) agreed to participate for a response rate of 37%, with the majority (80%) of respondents considering oral health to be an important component of prenatal care. In regards to the inclusion of oral health in current practice, only 6% of the respondents "always" include an oral health history interview and only 7% "always" include a dental screening as part of prenatal care. A moderate correlation was found between the knowledge score and the frequency of including oral health history interviews during prenatal visits (correlation = 0.36, p=0.002). Conclusion: The majority of prenatal health care professionals surveyed were knowledgeable about oral health as it relates to prenatal care; however, a deficit was identified in current practice in regards to oral health history interviewing and conducting dental screenings. There is a need to implement best practice guidelines that include routine dental screenings and to engage pregnant women in oral health prevention practices. Optimal oral health requires a multidisciplinary approach in which dental hygienists can play a significant role by educating women's healthcare providers and raising awareness of the connection between oral health and pregnancy outcomes. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this pilot study was to examine the experiences of novice dental hygiene faculty when transitioning from private practice into clinical teaching roles. Methods: A phenomenological qualitative study was performed using focus groups; data was collected from the responses provided from clinical faculty members during semi-structured interviews. Focus groups were comprised of three to four members. Participants were asked open-ended questions regarding their experiences, and to identify helpful strategies which assisted them as they entered the clinical teaching setting. Results: Participants were both female (n=16) and male (n=1), ranging from 25 to 60+ years of age, with clinical teaching experience ranging from 1 to 5 years. Emergent themes, identified from an analysis performed on the participant's responses, revealed numerous strategies encountered by novice faculty as they entered clinical teaching roles. Strategies found to be helpful during the transition into clinical teaching included: shadowing experienced faculty, availability of resources such as textbooks and course materials for use as teaching aids, and orientation sessions held prior to the beginning of each semester. Few challenges were identified from the participants' responses, however, younger novice faculty members shared challenges in regards to being taken seriously by students due to their age. Older faculty members found relearning course content and terminology to be challenging. Conclusion: Increased understanding of the unique experiences of novice clinical faculty, and identification of the successful strategies and challenges encountered by these individuals, may aid in developing effective approaches and programs for novice faculty as they enter clinical teaching roles. [ABSTRACT FROM AUTHOR]

Purpose: Research indicates that geriatric education continues to be inadequate across the health professions and graduates are unprepared to care for the increasing numbers of older adults. The purpose of this study was to explore dental hygiene practitioners' perspectives regarding whether their dental hygiene education prepared them to treat older adults in community and institutional settings. Methods: A qualitative phenomenological study design was utilized to conduct in-depth interviews with a purposive sample of dental hygienists currently providing care for older adult patients in alternative practice settings. Results: Fifteen dental hygienists from across the U.S. working with older patients in alternative settings, met the inclusion criteria (n=15). Common themes related to dental hygiene practice emerged from the qualitative data included: adapting patient care to alternative settings; emotional toll on the practitioner; physical challenges; outcome goals for treatment; need for hands-on clinical experience in alternative settings as dental hygiene students; and working as part of an interprofessional team. Conclusion: Participants generally agreed that they were not prepared to care for dependent older adults in alternative settings as part of their dental hygiene education. Clinical experiences working with older adults in alternative settings, as part of the dental hygiene clinical curriculum, are needed to prepare graduates to care for this growing population. [ABSTRACT FROM AUTHOR]

Purpose: Fear of dental treatment is a significant problem in the United States, impacting patients as well as oral health care providers. The purpose of this study was to identify the already-acquired knowledge, attitudes, and level of confidence of practicing dental hygienists with respect to the treatment of patients with dental anxiety. Methods: A paper survey was developed, pilot tested, and administered at a state-wide annual dental hygiene continuing education (CE) course in North Carolina. The survey domains studied included demographics, practice setting, practice behaviors, dental anxiety awareness, and opinions and attitudes. Item responses included multiple choice, a Likert Scale ranging from "extremely frequent to never" and "strongly agree to strongly disagree," and free response questions. Results were tabulated and descriptive statistics were performed. Results: Of the 157 attendees, 153 met the inclusion criteria (n=153) for a participation rate of 97%. Dental anxiety questionnaires were used "often" or "always" by 20% of the respondents. Less than half (43%) of the respondents stated that they knew the common signs and symptoms of a patient suffering from dental anxiety. However, 92% of the respondents (n=140) indicated confidence in their ability to perceive whether a patient felt stressed. A little more than half (58%) believed their dental hygiene education prepared them for treating patients with mild dental anxiety, 38% with moderate dental anxiety, and 22% with severe dental anxiety. Conclusion: Although the majority of dental hygienists in this study felt confident in their abilities to perceive stress in patients seeking dental care, they were less knowledgeable in recognizing the full range of signs and symptoms of dental anxiety. Questionnaires designed to specifically identify this population were used infrequently. Dental hygiene curricula and continuing education programs should include content on anxiety management for patients exhibiting all levels of dental anxiety. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this study was to assess dentists' and dental hygienists' current motivation, attitudes, and knowledge regarding volunteering in a non-profit dental setting and the opportunity for earning continuing education (CE) credits. Methods: This cross-sectional study surveyed a convenience sample of dental and dental hygiene professionals from the state of Michigan. A 20-question paper survey was developed and pilot tested. The survey was disseminated to attendees at various component meetings of the dental and dental hygienists' associations in southeastern Michigan. Results: Out of the 274 surveys that were distributed, 182 (n=182) were completed, yielding a 66% response rate. Eighty percent of the participants were unaware of the opportunity for earning CE by volunteering and 79% were unaware of the volunteering site approval requirement by the Michigan Board of Dentistry. Thirty percent of participants were unable to determine how many unpaid days per year they were willing to volunteer and a similar percentage, (28%), were unable to determine how many paid days. The most common motivating factor to volunteer was to give back to the community (60%) while the greatest barrier was lack of time (62%). Conclusion: The opportunity to earn CE credit for volunteerism is seen as a benefit, however, it needs to be better promoted to potential volunteers, through dissemination of information by professional associations and in educational settings. Community-based clinics also need to be made aware of how to become a CE provider. Further research on the longitudinal impact of CE for volunteerism in community-based clinics is warranted. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of the study was to assess the knowledge, education, attitudes, confidence, and practice of dental hygienists providing dental care to adult patients with dental anxiety (DA). Methods: A purposive sample of dental hygienists, using a snowball sampling technique, were recruited through social media sites. Inclusion criteria were limited to actively practicing, registered dental hygienists in the United States (U.S.). The validated survey had 29 questions regarding dental hygienists' knowledge, education, attitudes, confidence, and practice in regards to patients with DA. Regression analysis and chi square tests were performed on the data with research outcomes represented through frequency tables and percentiles. Results: A total of 417 participants attempted the survey; 355 participants (n=355) completed the survey yielding a participation rate of 87%. A majority, 73%, of the respondents reported DA as a "somewhat serious" to "extremely serious" issue when treating patients. Forty-eight percent of the respondents indicated that their education had prepared them to address DA but also reported the need for additional education in this area. Dental hygienists indicating higher levels of confidence in addressing DA in their patients also allowed for extra time in their schedules to treat patients with DA. Conclusion: Increased DA education in the undergraduate dental hygiene curriculum as well as post-graduate education opportunities may increase dental hygienists' confidence and capability in the management of DA. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this study was to assess the awareness of registered dental hygienists (RDHs), licensed in the state of Maine, regarding the midlevel dental hygiene therapist (DHT) provider model and to gather data regarding the degree of interest in enrolling in a DHT program. Methods: A quantitative cross-sectional study design with a non-probability purposive sampling of actively practicing RDHs in the state of Maine (n=1,284) was utilized for the web-based survey. Survey questions included awareness in the passage of DHT legislation, level of interest pursuing education and licensure in this midlevel provider model. Data was collected over a three-week period. Descriptive statistics and thematic analysis were used for data analysis. Results: Response rate was 21% (n=268). Sixty-five percent of respondents expressed interest in enrolling in a DHT program and 40% of those respondents stated a willingness to enroll in a DHT program within the coming year. Although willing to travel 25-50 miles, a majority of respondents preferred programs incorporating online components combined with clinical training completed in nearby communities. Themes emerging from the open-ended question regarding DHT program feasibility and appeal included: convenience, flexibility, cost/affordability, and independent or collaborative practice. Conclusion: Study outcomes indicated interest exists among Maine RDHs regarding the DHT provider role and enrollment in a DHT program. Although there are no DHT programs currently being offered in the New England states, results suggest further investigation is warranted regarding the development of a DHT program in the Northeastern United States. [ABSTRACT FROM AUTHOR]

Purpose: Limited data document dental hygienists' preparedness for intimate partner violence (IPV) screening and response. The aim of this study was to assess dental hygienists' readiness to screen for IPV and provide baseline information for the realization of action toward addressing IPV. Methods: The Domestic Violence Healthcare Provider Survey (DVHPS) instrument was distributed online to all members of the Texas Dental Hygienists' Association (n=1100). Four hundred fifteen emails were opened and 114 (n=114) surveys were returned for 28% response rate. This validated survey measures six scales: perceived self-efficacy, fear of offending patients, victim personality/traits, professional role resistance, perceptions of victim disobedience causing IPV, and psychiatric support. Descriptive statistics were used to calculate mean scores for each scale. Specific criteria were applied to interpret the level of readiness based on the scale scores. Results: A little more than one quarter of the respondents (28%) reported having had course content related to IPV as students in their dental hygiene program curriculum, while 27% reported completing continuing education on IPV. A significant proportion of participants, 40%, were uncertain if routine IPV screening was within their professional role. They did not perceive self-efficacy in their screening capabilities (m=3.08 with 5.0 as the strongest), however they reported possessing a strong knowledge regarding IPV victims' personality/traits and did not blame the victims (m=1.92 and 1.48 respectively with 1.0 as the strongest). Conclusion:. Results confirm earlier studies indicating the need for IPV training for oral health care professionals. Specifically, there is an evident need for training to increase dental hygienists' self-efficacy regarding IPV screening. Dental hygienists play a critical role in IPV screening and should be prepared to face the challenges presented by IPV and be available to meet the needs of IPV victims through referral to the appropriate support services. [ABSTRACT FROM AUTHOR]

Purpose: This study examined the knowledge, attitudes, and practices of dental hygienists, licensed in the state of California, regarding polypharmacy and off-label drug use for purposes in dentistry. Methods: A cross-sectional design was used to assess the knowledge, attitudes, and practices (KAP) related to off-label drug use and polypharmacy via an online survey tool. The study sample included licensed dental hygienists, who were members of the Long Beach and Tri-County Dental Hygienists' Associations located in Southern California (n=360). Descriptive statistics were used to assess the participant characteristics. ANOVA was used to assess differences in knowledge, attitudes and practices when compared to three key variables: highest academic/professional degree, experience and license type. Results: One hundred seven electronic surveys (n=107) were returned for a 34% response rate. Over half of respondents (53%) held an associates' degree for their license, most (72%) worked in a general dentistry setting and 46% had practiced 15 years or less. Regarding knowledge of polypharmacy and off-label drug use, the results demonstrated very low knowledge, with 25% of the respondents unable to answer any of the knowledge questions correctly. No significant differences in practices related to off-label drugs or polypharmacy were found based on type of licensure, highest degree achieved, or years of experience. However, participants holding a baccalaureate degree or higher were significantly more confident (p =.011) in discussing polypharmacy with patients and colleagues. Conclusion: Participants showed a general low-level of knowledge related to polypharmacy and off-label drug use in dentistry regardless of their level of education, years of experience, or type of dental hygiene licensure; indicating a need for increased pharmacology content in both entry-level dental hygiene programs and continuing education courses. [ABSTRACT FROM AUTHOR]

Purpose: Research indicates clinicians face barriers when attempting to utilize evidence-based protocols for periodontal disease and periodontal disease diagnosis often varies between dental providers. The purpose of this study was to identify and better understand dental hygienists' perceived barriers and experiences during the process of diagnosing periodontal disease in clinical practice. Methods: This study used a qualitative design and a purposive sample of dental hygienists (n=20). Utilizing a virtual videoconferencing platform, participants logged into focus group sessions to discuss their experiences with diagnosing periodontal disease in clinical practice. Focus group sessions were recorded and transcribed. Thematic analysis involved the use of inductive coding to draw themes from the data. Results: Dental hygienists reported being responsible for periodontal disease diagnosis, and that they utilized similar classification systems, and agreed with colleagues' periodontal disease diagnoses. However, participants reported the lack of a standardized periodontal classification system was confusing when communicating outside of their dental practice and described both intrinsic and extrinsic barriers to diagnosing disease. A common theme expressed by participants was that patients' lack of acceptance of their periodontal disease status and inability to fund treatment interfered with providing an evidence-based diagnosis and treatment plan. Newly licensed dental hygienists felt somewhat prepared to diagnose periodontal disease upon completion of their education but reported increased confidence in their skills and knowledge with years of practice and continuing education. Conclusion: Study data indicates dental hygienists feel the lack of a standardized periodontal classification system causes confusion and inconsistencies when communicating with other oral health care providers outside of their clinical practice setting, and dental hygienists face barriers when diagnosing periodontal disease. These findings may be instrumental in assisting educators in preparing students for clinical practice. [ABSTRACT FROM AUTHOR]

Purpose: Increasing childhood obesity rates present a significant threat to public health. The purpose of this study was to explore dental hygienists' (DH) beliefs, attitudes, knowledge, current practices, and barriers for assessing and educating patients about childhood obesity. Methods: A random sample of DHs (n=13,357) was selected and emailed a link to the validated survey. Of the 1046 respondents who accessed the survey, 919 completed the survey for a completion rate of 89%. Results: A majority of the respondents understood the risk of chronic disease and obesity (99%), role sugar-sweetened beverages (SSBs) play as added sugar content in the diet (76%), and the amount of SSBs consumed by youth (91%). Participants felt current research showed an association between obesity and periodontal disease (62%), but were unsure of the association between obesity and dental caries (51%). Most respondents never measure height and weight (91%) or plot BMI (94%). Fifty-one percent always provide nutritional counseling to reduce consumption of SSBs, but only sometimes provide nutritional counseling for healthy eating (61%). Respondents had a slightly positive attitude (mean score=4.15, SD=14.58) about assessing and educating for childhood obesity. Major barriers reported were time constraints (63%), and fear of offending the patient or parent (47%). Regression showed attitudes towards patient's nutrition, exercise, and weight predicted the dental hygienist behavior. Conclusion: DHs have some understanding of the risks of obesity and general/oral health, but lack adequate training, knowledge, and confidence to provide obesity counseling in clinical practice settings. There is a need for further education to address the lack of knowledge about nutritional guidelines and practitioners' beliefs regarding addressing childhood obesity without offending the patient or parent. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this study was to evaluate whether current educational strategies at a dental institution in the United States made a difference in dental hygiene (DNHY) and dental students' (D3) learning outcomes in the four domains of evidence-based practice (EBP), knowledge, attitude, accessing evidence, and confidence (KACE), following a 12-week research design course. Methods: All participants DNHY (n=19) and D3 (n=96) enrolled in the research design course at Loma Linda University completed a paper KACE survey distributed on the first day of class. Students completed the KACE survey once more at the end of the 12-week course. Pre- and post-survey results were compared both within and between the DNHY and D3 student groups to identify the learning outcomes in the four domains of EBP; knowledge, attitude, accessing evidence, and confidence in EBP. Descriptive statistics were conducted to profile all variables in the study; the level of significance was set at α=0.05. Results: All DNHY students (n=19) completed the pre and post KACE surveys; of the D3 (n=96) students enrolled in the course 82% (n=79) competed the post-survey. Comparison of the survey results showed that both DNHY and D3 students demonstrated statistically significant increases in their level of knowledge and attitude (p < 0.05) towards EBP. In the attitude domain, DNHY students indicated more positive attitudes towards EBP (p < 0.001) than their D3 student cohorts. Neither group demonstrated significant changes in confidence in applying EBP (p > 0.05). Conclusion: DNHY and D3 students increased their knowledge and developed more positive attitudes towards EBP following a 12-week research design course. Study results identify improvement areas for EBP knowledge acquisition including determining levels of evidence, analysis of study results, and evaluating the appropriateness of research study designs through the use of validated EBP survey instrument. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this study was to survey entry-level dental hygiene program directors in the United States (U.S.) to assess their perceptions of dental hygienists with visible tattoos as well as to determine current policies related to dress codes in U.S. dental hygiene programs. Methods: Data was collected with an online survey emailed to 340 dental hygiene program directors yielding a 43% (n=141) response rate. Participants indicated their opinions of visible tattoos on the basis of professionalism and school policy satisfaction. Results: Eighty percent of respondents reported their program as having dress code policies on visible tattoos, with the majority (97%) requiring visible tattoos to be covered. Results revealed both students (M=5.57, p<.0005) and faculty (M=5.76, p<.0005) with visible tattoos were perceived as significantly less professional. Most participants agreed that dental hygiene faculty should discuss the impact of visible tattoos on future employment opportunities, and that the community would view the school as less professional if students had visible tattoos (p<0.0005). Personal tolerance toward tattoos (p< 0.001), but not age, (p = 0.50), was significantly associated with satisfaction concerning program tattoo policies. A lower tolerance towards visible tattoos (p < 0.001) was associated with an increased likelihood that the dental hygiene program dress code included policy on visible tattoos. Conclusion: Study results showed that visible tattoos were not perceived favorably and that personal perceptions of dental hygiene program directors may have influenced school dress code polices regarding visible tattoos. These findings provide evidence based information for dental hygienists, students, faculty, administrators and hiring managers for formulating policies relating to body art. [ABSTRACT FROM AUTHOR]

Purpose: Many states are exploring alternative provider models and examining the role of the dental hygienist to address access to care challenges as the United States continues to face increasing demands for oral healthcare services. The purpose of this study was to assess dental hygienists' opinions in the state of Oregon regarding the current limitations of dental hygienists' scope of practice, perceived need for a mid-level provider in Oregon, and personal interest in becoming a mid-level provider. Methods: In December 2013 a survey was mailed to a sample of 1,231 dental hygienists registered in Oregon representing 30% of the licentiates. All licentiates holding expanded practice permits (EPP) were included in the sample (n=351). The following categories were included in the 32-question survey: scope of practice, mid-level provider, current practice, and demographics. Results: A total of 440 surveys were returned for a response rate of 36%. Of the EPP holders, 51% responded to the survey. Over half of respondents (59%) believe that a mid-level provider is needed in the state. Respondents holding membership in the American Dental Hygienists' Association, as well as EPP holders, were significantly more likely to respond that a mid-level dental provider was needed in the state (p<0.0001). Ninety-one percent (n=400) of respondents agreed or strongly agreed that if a mid-level provider was introduced in Oregon, the new provider should be a registered dental hygienist model. Forty-three percent (n = 186) of respondents were interested in becoming mid-level providers and 47% (n=203) of respondents believed that the minimum education for a mid-level provider should be a bachelor's degree. The majority, 74% (n = 137), of those interested in becoming a mid-level provider indicated a preference in completing their education through online teaching combined with a clinical internship. Conclusion: There is strong support from dental hygienists in Oregon that a need exists for a mid-level dental provider and that this provider model should be dental hygiene based. Individuals interested in developing a curriculum for a mid-level provider should consider including online teaching components with a clinical internship component. [ABSTRACT FROM AUTHOR]

Purpose: Human Papillomavirus (HPV) has been identified as a causal agent for oropharyngeal cancers, suggesting a new role for dental hygienists in HPV-related cancer prevention strategies. Health literacy assessment is an approach that can be used to understand providers' informational assets and needs for educating and discussing HPV prevention with patients. This study aimed to understand dental hygienists' level of health literacy regarding HPV-related oropharyngeal cancers. Methods: Four focus group sessions with dental hygienists (n=48) were conducted at a national conference. The constant comparison method, with a priori codes for health literacy competencies (i.e., access/understand/appraise/apply), was utilized for this qualitative study. Results: Participants mentioned a variety of modes (e.g., magazines, journals) for accessing HPV- information; however, descriptions of understanding HPV and its relationship to oropharyngeal cancer varied. Participants considered patients' personal characteristics, the dental practice environment, and professional factors to appraise HPV-related information. Additionally, participants self-described themselves as being "prevention specialists." These factors influenced how dental hygienists applied primary and secondary prevention of HPV-related care issues with their patients (e.g., education and oral-cancer screenings). Conclusions: Dental hygienists recognized the importance of HPV and oropharyngeal cancer prevention efforts, including oral-cancer screenings and promotion of the HPV vaccine. The study findings identified opportunities for intervention focusing on primary prevention. [ABSTRACT FROM AUTHOR]

Purpose: Silver diamine fluoride (SDF) is an inexpensive, non-invasive, antimicrobial liquid used to treat carious lesions and decrease sensitivity. The purpose of this study was to assess the perceptions of registered dental hygienists in alternative practice (RDHAP) regarding the use of SDF to treat dental caries. Methods: A 16-item survey designed to evaluate RDHAP's familiarity and perceptions of SDF was electronically distributed to 222 RDHAPs practicing in the state of California. A survey research software program collected and tabulated responses, calculated response frequencies for each survey item, and determined statistical relationships among variables, using cross tabulation analysis. Results: The response rate was 46% (n=103). Over half the respondents, 54%, were unfamiliar with SDF. After describing SDF's properties and uses, 78% of respondents agreed that applying SDF to treat dental caries would be within the scope of practice of a RDHAP. Respondents agreed that patients or parents of patients would be interested in using SDF because it provides an alternative to removing tooth structure with a dental drill in order to place restorative material (82%), less expensive than restorative treatment (82%), applied like a varnish and time efficient (86%), and utilized without local anesthesia (91%). Over 56% of the respondents agreed that many patients or guardians of patients would object to the permanent black staining of the carious lesion treated with SDF. The respondents' employment/ practice settings were related statistically (p<0.01) to their agreement that SDF is within the RDHAP scope of practice and their disagreement the question that patients would not accept SDF treatment due to the black staining (p=0.03). Eighty-eight percent of the respondents felt that the advantages of SDF outweigh the disadvantages for their patient populations. Conclusions: SDF would be a useful therapeutic agent for the treatment of dental caries for RDHAP practitioners treating underserved populations. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this study was to determine the effects of dental magnification loupes on posture during instrumentation. Methods: A convenience sample of 27 right-handed dental hygienists, with no prior history of injuries or disabilities of the head, neck, or trunk region, enrolled in the study. Baseline posture calibration was taken and tri-axial accelerometers were placed on four locations of the head and trunk (occipital region of head; cervical vertebrae C5; thoracic vertebrae T5; lumbar vertebrae L1) to measure acceleration and the orientation of the body to gravity. Participants were randomly assigned to wear self-supplied magnification loupes during either the first or second half of the session. Dental chair mounted typodonts, prepared with artificial calculus, were used to represent a simulated oral environment. Participants were asked to explore all areas of the mouth using an ODU 11/12 explorer. Mean accelerations of the three axes were used to compute average forward/backward (AP) and side to side (ML) tilt of each accelerometer recorded during the instrumentation sessions. An end-user opinion survey was completed by each participant at the conclusion of the session. Results: No statistically significant differences in posture were revealed between the sessions with the participants wearing their loupes and not wearing loupes. However, data from the end-user survey indicate that 74% of all the participants strongly agreed that magnification loupes made exploring easier and 67% strongly agreed that they felt that magnification loupes improved their posture. Conclusion: While the majority of participants perceived that their magnification loupes enhanced their posture and made exploring easier, data from this study provided little evidence to suggest that wearing loupes leads to improved body orientation. Future research needs to examine the declination angle of ergonomic loupes and its relationship to neck and trunk flexion. [ABSTRACT FROM AUTHOR]

Purpose: The objective of this qualitative pilot study was to gain an in-depth understanding of dental hygienists and dentists perspectives regarding children's oral health and what needs to be done to prevent early childhood caries (ECC), the most frequent chronic disease of childhood. Methods: A skilled facilitator conducted four focus groups and four phone interviews with 20 dental hygienists and 17 dentists practicing in a variety of locations within the state of Maryland. The interview guide was based on results from previous state-wide surveys of dental hygienists and dentists. Sessions were recorded, transcribed, and reviewed by the PI and facilitator. Qualitative content analysis was used to identify and manually code themes. Results: Focus groups and interviews provided rich and insightful information for strategies to help solve the ECC problem in Maryland, which supplemented the earlier quantitative mail survey data. Three key themes emerged: challenges to preventing ECC among low-income families; necessary educational methods and practices; and, the need for inter-professional collaboration. Discussions focused on issues related to educating parents with low oral health literacy about how to prevent ECC and the value of including non-dental health care providers, such as pediatricians and school nurses, in the caries prevention process. Conclusions: Current approaches to educating low-income adults about caries prevention are insufficient to prevent ECC and dental care providers cannot accomplish this goal alone. Ensuring that all dental care providers have a science-based understanding of caries prevention is critical. Integrating science-based oral health preventive care into medical and nursing undergraduate programs could increase providers' knowledge and confidence towards incorporating oral health into patient care plans; improve the oral health literacy of providers and patients; and improve patient oral health outcomes. [ABSTRACT FROM AUTHOR]

Purpose: A total of 40 states to date have expanded the role of dental hygienists with the goal of improving access to basic oral health services for underserved populations. In Kansas, legislative changes have resulted in the Extended Care Permit (ECP) designation. The purpose of this study is to describe the experiences of registered dental hygienists in Kansas holding ECP certificates (ECP RDH) as of July of 2014. Methods: Secondary data analysis was performed utilizing data collected from a survey conducted in 2014 by Oral Health Kansas. All registered ECP RDH's were sent the 32-item survey via Survey Monkey®. Descriptive statistical analyses consisted of frequency distributions, and measures of central tendency. Inferential analyses using t-tests and ANOVA were conducted to compare groups. Results: A total of 73 responses were received from the (n= 176) surveys that were e-mailed for a 41% response rate. Of the clinicians who responded, 80%, worked at least part-time and in school settings. The most consistent barriers to providing care were the inability to directly bill insurance (52%), financial sustainability (42%) and physical requirements (42%). Follow-up tests found significant differences between clinician groups when examining barriers. Conclusion: Although the ECP legislation appears to be expanding access to care for citizens in Kansas, significant barriers still exist in making this a viable model for oral healthcare delivery. [ABSTRACT FROM AUTHOR]

Purpose: The aim of this qualitative, phenomenological study was to explore the attitudes and perceptions of public health dental hygienists on providing preventive care to underserved populations in Massachusetts. Methods: Non-probability purposive sampling was used for initial participant recruitment, and snowball sampling occurred thereafter. Data collection occurred through semi-structured interviews. Qualitative analysis was conducted using Pitney and Parker's eight-step CREATIVE process. Results: Data saturation occurred with 10 participants (n=10), one-third of the public health dental hygienists who are practicing in Massachusetts. The majority of practice settings included school-based programs (70%), while programs for children with special needs (10%) were the least common. Two major themes emerged from the data; (a) the opportunity to be an oral health change agent and (b) barriers to practice. Six subcategories emerged from the data and are reviewed within the context of their associated themes. Additionally, career satisfaction emerged as an unintended theme, and was reported as the driving force for the majority of participants. Conclusion: This study revealed a better understanding of the public health dental hygiene workforce model in Massachusetts. Public health dental hygienists in Massachusetts perceive themselves as change agents within the health care profession, and although barriers to practice are plentiful, these oral health care professionals are committed to improving access to dental care. [ABSTRACT FROM AUTHOR]

Purpose: To explore dental hygienists' attitudes toward the obese population and to determine whether there are differences in attitudes among those with different self-reported body images. Methods: The study population was dental hygienists whose email addresses were in the database of the California Dental Hygienists' Association (CDHA). CDHA distributed the electronic message containing study information, informed consent, and a link to the survey. The survey consisted of 14 items from the Fat Phobia Scale, 13 items from the Anti-fat Attitudes Questionnaire (AFAQ), 3 demographic questions, and 1 question on body image. Frequencies of responses for each survey item were calculated, and Likert-like scale responses from the AFAQ were analyzed to determine significant differences among self-reported body images. Results: Of the 6,248 email addresses in the CDHA database, 518 hygienists or 8% responded. Mild fat phobia was indicated by 57% of the word pair scores on the Fat Phobia Scale being higher than 2.50. On the AFAQ, 84% agreed to the statement, "People who weigh too much could lose at least some part of their weight through a little exercise." Significantly (p<0.05) more respondents who self-reported as overweight than underweight agreed to "I feel disgusted with myself when I gain weight" and "I worry about becoming fat," while more in the overweight than underweight category significantly (p<0.05) disagreed with "Fat people make me somewhat uncomfortable." Conclusion: Dental hygienists exhibited mildly negative attitudes toward the obese population. Curricula specific to the role of the dental hygienist in addressing the health effects of obesity are recommended. [ABSTRACT FROM AUTHOR]

Purpose: To assess the perceptions and attitudes of dental hygiene (DH) educators at selected colleges and universities regarding the establishment of doctoral educational programs in DH in the United States. Methods: An online survey of DH educators at the 58 U.S. schools offering baccalaureate or master's degree programs was used to assess participants' perceptions and attitudes regarding the following: need to establish doctoral programs in DH, interests in supporting their development, potential barriers and facilitators, and goals/motivators of potential enrollees. Percentages of respondents selecting each response were calculated for each survey item and responses of selected items analyzed for significant differences. Results: Of 608 potential participants, 203 completed the survey for a 33% response rate. More than half the respondents strongly agreed and a quarter more agreed that a DH doctoral program was needed to relate equitably with doctoral graduates of other health-related disciplines and to expand the DH body of knowledge by conducting discipline-specific research. A majority indicated likely interest in supporting the development of both clinically oriented and research-based doctoral programs. Significantly (p<0.01) more respondents with doctorates were interested in developing doctoral programs than those with a master's degree as their terminal degree. Respondents identified shortages of qualified educators and interested enrollees as primary barriers. Facilitators included support from the American Dental Education Association and the American Dental Hygienists' Association. Becoming a better researcher and an institutional administrator were perceived as chief motivations. Conclusion: The majority of DH educators perceived that doctoral educational programs in DH are needed to advance the DH profession. [ABSTRACT FROM AUTHOR]

Introduction: Given its high prevalence, intimate partner violence (IPV) is an important public health issue. Oral health care providers (OHCPs) often encounter victims of intimate partner abuse in dental settings, but there is a lack of existing literature regarding OHCPs' attitudes toward and knowledge of IPV. Purpose: This study assessed OHCPs' knowledge and perception of preparedness in assessment and management for IPV. Methods: Using a validated survey tool called PREMIS, this study assessed a convenience sample of OHCPs' knowledge and attitudes about the identification, assessment, and management of IPV. Results: The survey results obtained from 117 OHCPs indicated 92% had had some form of IPV education, but 45% felt they did not have sufficient training to assist individuals who were victims of IPV. Other areas in which the respondents felt ill-prepared included identifying victims of IPV (61.5%) and appropriate referrals to social services (64%). Only 7 to 9% screen new patients or those with abuse indicators on the history or exam. Conclusion: This study explored OHCPs' attitudes and knowledge of IPV and provided insight into IPV screening practices and management in dental care settings. Because injuries to the head, neck, and face are very common in IPV, OHCPs have the opportunity to play a key role in managing "the silent epidemic" of domestic violence by routinely including screening of new and returning patients and having a referral resources available. [ABSTRACT FROM AUTHOR]

Purpose: To determine the perceptions of California dental hygienists (DHs) regarding mandatory continued competence requirements (MCCRs) as a condition for license renewal. Methods: A quantitative cross-sectional survey was distributed through email by the California Dental Hygienists' Association (CDHA). The CDHA agreed to send a link to the survey and informed consent information to DHs whose email addresses were in the CDHA database. The online survey consisted of 19 items. All survey responses were analyzed using frequency distributions for categorical variables and means for continuous variables. Chi-square tests assessed associations between variables and differences between groups. The Wilcoxon signed rank test assessed relationships between perceptions and support of MCCRs for license renewal. Results: Almost all (93%) believed that they have remained competent to deliver care since licensure. Over half agreed that continued competence should be verified throughout ones' professional career (53%). Most (81%) agreed that continued competence is important for patient safety and well-being. Less than half (47%) supported MCCRs as a condition of license renewal; however, 51% of those who agreed that competence is important for patient safety and well-being and 67% of those who agreed with verification of competence were in support of MCCRs. Conclusion: While California DHs agreed that continued competence is important for patient safety and well-being and verification of competence is important, less than half supported MCCRs. Prior to instituting mandate for license renewal in California, continued competence and methods to ensure continued competence throughout ones' career should be defined. [ABSTRACT FROM AUTHOR]

Purpose: To assess the influence of community oral health experiences during entry-level dental hygiene education on participation in community oral health events after graduation and the facilitators and barriers experienced by dental hygienists in participating in these programs. Methods: A 27-item survey, consisting of items related to community oral health experiences during and after entry-level education, was distributed by the California Dental Hygienists' Association to all dental hygienists whose email addresses were in their database. Frequencies of participants' responses to each survey item were calculated. Chi-square analysis was performed to identify significant relationships among variables. Results: Response rate was 8%, with 513 out of the 6,248 contacted having responded. Additionally, 95% of the respondents had participated, as entry-level students, in community oral health experiences such as school-based oral health educational programs. Respondents agreed that participation in these programs was valuable to their professional development and encouraged them to participate after graduation; both these variables were related (p<0.01) to their participation in community experiences as a licensed dental hygienist. Most (75%) respondents reported participation in community events after graduation. The most commonly reported facilitators, encouraging participation, were an interest in helping people (89%) and professional development (59%). Barriers included conflict with work (61%), family time commitment (52%), and no knowledge of existing programs (24%). Conclusion: Dental hygienists' involvement in school-based oral health programs is enhanced by their community experiences as a dental hygiene student. Barriers and facilitators need to be addressed to increase the number of programs and participants so that more children can benefit. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this cross-sectional, quantitative research was to examine if registered dental hygienists feel competent to work independently based on regulations of dental supervision. Methods: A stratified sample of 360 dental hygienists from 8 states completed the Dempster Practice Behaviors Scale survey. ANOVA and MANOVA analyses revealed how state dentist supervision level, age, degree of education, employment status, gender and years of clinical experience affect the perceived autonomy of professional dental hygienists. Results: The response rate included 360 dental hygienists from 8 states. According to the findings age, education level and gender affected the hygienist's level of autonomy. In all 8 states, the registered dental hygienists have a high level of autonomy and feel competent to work independently. Conclusion: The DPBS scores of the sample registered dental hygienists suggest that they feel prepared and competent to perform preventive dental hygiene services without dentist supervision. The attitudes of the dental hygienist sample from each of the 4 state dentist supervision levels supports a move toward achieving professional jurisdiction of preventive dental care within the U.S. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this descriptive study was to assess data pertinent to the Permit L local anesthesia license among practicing dental hygienists in Massachusetts, providing an overview of characteristics, practice behaviors, barriers for obtaining the permit and self-perceived competency. Methods: A convenience sample of dental hygienists (n=6,167) identified through a publically available data base were invited to participate in a web-based survey. The survey consisted of demographic and Permit L specific questions. Items regarding opinions were rated using a 5-point Likert scale while frequencies and percentiles were used to evaluate demographics and practice-based information. Spearman's Rank correlation was performed to determine association between variables. Results: A 10% (n=615) response rate was attained with (n=245) non-Permit L holders and (n=370) Permit L holders. Respondents reported significant differences in demographics and opinions between non-Permit L holders and Permit L holders (p<0.01) and between those certified through continuing education or curriculum based programs (p<0.01). Significant relationships were found in demographics (p<0.01) and practice (p<0.05) items in relation to the length of time the Permit L has been held. Themes from the data and comments indicate multiple factors influencing obtaining or not obtaining the Permit L. Conclusion: The results of this study provide an overview of Permit L local anesthesia administration that is generally comparable to previous studies and offers new insights into why some Massachusetts dental hygienists choose not to pursue certification. This study highlights the potential to increase the prevalence of the Permit L, address barriers to pursuing the Permit L, and further evaluate self-perceived barriers. [ABSTRACT FROM AUTHOR]

Purpose: There is a need for research to facilitate the widespread implementation, dissemination and sustained utilization of evidence-based primary care screening, monitoring and care coordination guidelines, thereby increasing the impact of dental hygienists' actions on patients' oral and general health. The aims of this formative study are to explore dental hygienists' and dentists' perspectives regarding the integration of primary care activities into routine dental care, and assess the needs of dental hygienists and dentists regarding primary care coordination activities and use of information technology to obtain clinical information at chairside. Methods: This qualitative study recruited 10 dental hygienists and 6 dentists from 10 New York City area dental offices with diverse patient mixes and volumes. A New York University faculty dental hygienist conducted semi-structured, in-depth interviews, which were digitally recorded and transcribed verbatim. Data analysis consisted of multilevel coding based on the Consolidated Framework for Implementation Research, resulting in emergent themes with accompanying categories. Results: The dental hygienists and dentists interviewed as part of this study do not use evidence-based guidelines to screen their patients for primary care sensitive conditions. Overwhelmingly, dental providers believe that tobacco use and poor diet contribute to oral disease, and report using electronic devices at chairside to obtain web-based health information. Conclusion: Dental hygienists are well positioned to help facilitate greater integration of oral and general health care. Challenges include lack of evidence-based knowledge, coordination between dental hygienists and dentists, and systems-level support, with opportunities for improvement based upon a theory-driven framework. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this study was to examine the knowledge, attitude and practice behaviors of dental hygienists' providing oral health care to pregnant women. Methods: Data was collected from an anonymous electronic survey administered to all Michigan Dental Hygiene Association (MDHA) members (n=1,047). The survey asked questions which assessed dental hygienists knowledge, behaviors and attitudes when providing oral care to pregnant patients. Statistical analysis was conducted correlating years in practice and years since dental hygiene degree with survey questions to identify any correlations. Results: The response rate was 14.4% (n=150). Results indicated that regardless of years of experience, or level of degree, the majority of the respondents surveyed (64%) desired more education about caring for a pregnant patient. Ninety percent of respondents reported willingness to provide care for pregnant women, and 85% indicated they or their employers agreed to accept referrals to treat pregnant women. Respondents' knowledge indicated the following treatments could be provided throughout pregnancy: Prophylaxis (95.8%), emergency care (92.7%), periodontal treatment (76.3%) and restorative care (61.5%). One question. "dental hygiene services should only be provided during the second trimester," was written in the negative, with a disagree rate of 85.6% indicated a high level of knowledge about this topic. Conclusion: Dental hygienists are in a position to use current findings, protocols and practice guidelines to provide preventive oral health care and advocate for the pregnant patient. This study found continuing education regarding oral health care and pregnancy was desired by many dental hygienists. [ABSTRACT FROM AUTHOR]

Purpose: Thirteen states in the nation authorize dental hygienists to satisfy re-licensure requirements in part, by performing pro bono oral health services in lieu of participating in continuing education courses This study compared registered dental hygienists' donations of time and professional expertise, perceptions of volunteerism and motivational orientations as they practice in both the presence and absence of a practice act statute intended to incentivize volunteerism. Methods: Volunteer behaviors, perceptions and motivational orientations of a non probability sample of 316 dental hygienists actively licensed by the states of Idaho or Utah, were assessed using an online survey which included the Self Determination Theory General Causality Orientations Scale (GCOS). Survey Monkey results were analyzed using Mann Whitney U tests, Chi-Square analysis and an Independent Samples t-test at the 0.05 level of significance. Results: No statistically significant differences were found between dental hygienists' volunteer behaviors, perceptions of volunteerism or scores on the GCOS Autonomy and Impersonal subscales in the 2 states studied. Statistical analysis of dental hygienists' mean scores on the GCOS measure of Controlled motivational orientation yielded a significant difference (p=0.001) among Utah and Idaho dental hygienists. Conclusion: Dental hygienists require evidence based practice statutes and regulations that keep pace with the need to provide universal access to comprehensive oral care. Additional research is required to determine the effectiveness of legislation intended to encourage registered dental hygienists' altruistic expressions. Dental hygienists are frequently unaware of opportunities to volunteer their services and how state practice act regulations impact those opportunities. [ABSTRACT FROM AUTHOR]

Problem: The COVID-19 pandemic has been character-ized by extreme uncertainty, stress, and anxiety. Mitigating risk of contracting and transmitting COVID-19 while remaining current with the ever-changing information and guidelines has been challenging. Dental hygienists need accurate knowledge about COVID-19 in order to protect themselves and their patients. Lack of knowledge and psychological health may impact behaviors including vaccination. Purpose: This pilot study aimed to gain insights on dental hygiene faculty and student COVID-19 knowledge, psychological health during the pandemic, and vaccination behaviors. Methods: This descriptive quantitative pilot study used a 26-item online survey to examine the impact of COVID-19 on psychological health (10 items), decision to receive vaccination (2 items), and knowledge of COVID-19 (10 items). The validated Patient Health Questionnaire 4 (PHQ 4) screened participants for depression and anxiety. Data collected between February 26 to March 1 were analyzed using descriptive statistical methods and t-tests. Results: The 52 participants in this convenience sample were knowledgeable about COVID-19; the faculty mean knowledge score of 8.78 out of 10 was significantly higher than students at 7.79 (p=0.021). Of the ten items, 69.2% of participants did not know if the Food and Drug Administration had approved any drugs to treat COVID-19, and 42.3% did not know if ultraviolet light could be used to disinfect surfaces. The PHQ-4 identified 38.5% of participants with elevated anxiety scores and 21.2% with elevated depression scores. The mean PHQ-4 scores of students (2.57) were higher than faculty (0.89) at a significant level (p=0.023). Participants were significantly more anxious about contracting (p=0.037) and unknowingly transmitting (p=0.002) COVID-19 to others during normal daily activities than during clinical treatment. Of the students, 19 (46.3%) had received at least one dose of the vaccine, 13 (31.7%) intended to vaccinate in the future, and 9 (21.4%) did not plan to be vaccinated. One (11.1%) of the eight faculty did not plan to be vaccinated. Participants who did not plan to be vaccinated listed concerns about limited research regarding adverse effects. Conclusion: In this pilot study, the majority of dental hygiene faculty and students were knowledgeable about COVID-19 and willing to be vaccinated, regardless of psychological health. It is essential for faculty to know the latest information and guidelines about COVID-19, and to educate students and patients. Further research with a larger sample is needed to determine if correlations exist between knowledge scores, vaccination behaviors, and/or psychological health. [ABSTRACT FROM AUTHOR]

Purpose: It is estimated that the older population, aged 65 and older, will make up over 20% of the U.S. population by the year 2030. Research acknowledges about 4% of the older population resides in long-term care facilities (LTCFs), where the long-term older patient (LTOP) is under the formal supervised care or custody of institutions with skilled nurses. By the year 2040, 4 million geriatric residents are predicted to move into LTCFs in the U.S. In 2000, the Surgeon General reported LTOPs in LTCFs have greater oral hygiene needs than any other segment of the population to include: root caries, periodontal disease, xerostomia, fungal infections and other oral health concerns. Serious systemic health conditions occurring at high incidence rates have been linked to poor oral hygiene in the LTOP. The purpose of this manuscript is to identify systemic health conditions, oral health conditions, barriers to oral care for LTOPs and to offer recommendations for increased access to care within LTCFs through the use of registered dental hygienists (RDHs). [ABSTRACT FROM AUTHOR]

The article presents abstracts on topics related to dental hygiene education including the survey on dental hygiene programs, the dental hygiene distance education and the use of ultrasonic instrumentation.

The article discusses a research concerning the development of dental hygiene scholarship in entry-level dental hygiene programs, research-oriented master's degree programs and in research-oriented doctoral degree programs. It highlights the essential information that needed to be considered in questions related to dental hygiene. It includes the hierarchy of knowledge, the scholarly identity and the imposter phenomenon.

Purpose: The purpose of this study was to survey dental hygienists to determine their knowledge, attitudes and practices regarding the implementation of caries risk assessment, particularly caries management by risk assessment (CAMBRA), in private dental practices. Methods: A 17 item survey was developed to evaluate dental hygienists' knowledge, attitudes and practices related to CAMBRA and perceived barriers to CAMBRA implementation in private dental practice. Surveys were mailed to a randomized sample of 1,000 dental hygienists licensed to practice in California. Responses were tabulated for each respondent, and the response frequency for each survey item was calculated. Respondents' comments to the open-ended question were compiled, according to themes. Results: The response rate was 18%. Only 66% of the respondents were familiar with the term CAMBRA, although 89% agreed with its underlying principles of risk assessment. CAMBRA protocol had been implemented in 40% of the respondents' employment sites. Respondents disagreed that time (45%) and cost of products (68%) were barriers to implementation. Many did not know their employers' knowledge or attitudes about CAMBRA and its implementation, as evidenced by a “don't know” response range of 29 to 48% for the 4 relevant statements. Respondents' comments included both successes and barriers implementing CAMBRA. Conclusion: CAMBRA protocol has not been widely implemented in private practice, although the current data do not indicate insurmountable barriers. Broader dissemination may be feasible if dental hygienists would obtain more comprehensive knowledge of evidence-based risk assessment protocols and would assume a leadership role in implementing CAMBRA protocols and procedures in private dental practices. [ABSTRACT FROM AUTHOR]

Purpose: Although cultural competence education is being incorporated into most health care curricula, content addressing sexual minorities is lacking or, if present, inadequate. This void can result in compromised health care and can contribute to the social stigma surrounding the lesbian, gay, bisexual and transgender (LGBT) community. Increasing the knowledge and demystifying sexual minority issues can enhance the confidence and attitudes of health care workers when treating LGBT individuals. Suggestions for creating a more welcoming health care environment for LGBT individuals in different health care settings such as private clinics, public health settings and school based programs are offered. The purpose of this literature review was to systematically review available literature on health care providers' delivery of culturally competent care to the LGBT community. The investigators searched electronic databases that included Medline (Ovid), Eric and PubMed with consultation from information specialists at the Health Sciences and Human Services Library at the University of Maryland. The information was categorized into content areas. Discussion of the findings and future directions regarding health care delivery for the LGBT community are provided. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this study was to determine the perceived level of preparedness Maine Independent Practice Dental Hygienists (IPDHs) received from their standard undergraduate dental hygiene education, and recognize areas necessary for further preparation in order to explore careers beyond the private practice dental model. Methods: A convenience sample of 6 IPDHs participated in a survey exploring their educational experience in public health and alternative practice settings. The survey also asked for their recommendations to advance dental hygiene education to meet the needs of those wishing to pursue alternative practice careers. Results: This study found that participants felt underprepared by their dental hygiene education with deficits in exposure to public health, business skills necessary for independent practice, communication training and understanding of situations which require referral for treatment beyond the IPDH scope of practice. Conclusion: As the dental hygiene profession evolves, dental hygiene education must as well. The IPDH participants’ recommendations for dental hygiene programs include increased exposure to alternative settings and underserved populations as well as elective courses for those students interested in alternative practice and business ownership. [ABSTRACT FROM AUTHOR]

Purpose: In 2003, Kansas addressed their access to oral health care needs with amended state dental practice act for registered dental hygienists. The Extended Care Permits (ECP) I, II and III have expanded the dental hygiene scope of practice, allowing dental hygienists to provide oral care to Kansans in different settings beyond the dental office. The purpose of this study was to examine the perceptions of Kansas ECP dental hygienists on change to oral care in Kansas. Methods: A questionnaire was mailed to all ECP dental hygienists (n=158) registered with the Kansas Dental Board. Questions were open-ended, close-ended and Likert scale. Information was sought regarding demographics, areas of employment, work related activities and impact to oral health care. Study exclusions included ECP providers no longer practicing in Kansas, practice more than 50% in another state or no longer practice dental hygiene at all. Results: A total of 69 surveys were returned,with 9 surveys excluded for exclusion criteria. Most respondents (92%) agreed the ECP is a solution to oral health care access issues in Kansas. Barriers to utilizing their permits fully included: difficulty locating a sponsoring dentist (12%), locating start up finances (22%), limited work space (14%) and difficulty with facility administrators (39%). Many respondents (62%) agreed the proposed registered dental practitioner would improve access to oral health care to Kansans. Conclusion: The Extended Care Permit providers in Kansas appear to be satisfied with their current employment situations and feel oral health care has improved for their patients served but they are unable to utilize their permits fully for various reasons. [ABSTRACT FROM AUTHOR]

Purpose: Frail elders and nursing home residents are vulnerable to poor oral health and frequently lack access to dental care. The purpose of this study was to determine why residents in Arkansas skilled nursing facilities have limited access to oral health care. Methods: This study utilized qualitative research methodology. Data was collected from oral health care personnel through open-ended responses in a written survey (n=23) and through telephone interviews (n=21). The investigators applied the constant comparative method to analyze and unitize the data and ultimately reach consensus. Results: Data analysis resulted in consensus on 2 emergent themes: policy and access. Conclusion: This qualitative case study suggests access to oral health care for residents living in both long-term care (LTC) and assisted living I and II facilities in Arkansas is affected by public and facility policies and access to oral health care as a function of the patient’s health status and availability of oral health care providers. Access for residents residing in assisted living I and II facilities is also limited by the residents’ inability to assume responsibility for accessing oral health care. The outcomes from this study may serve to inform policymakers and advocates for access to oral health care as they develop new policies to address this growing need. [ABSTRACT FROM AUTHOR]

Purpose: The objective of this study was to investigate knowledge and perceptions of executive directors of long-term care facilities in a large western state regarding oral health of residents, barriers to the provision of optimal oral health care and the collaborative practice role for dental hygienists. Methods: A descriptive, exploratory online survey research design was utilized. A purposive sample of executive directors of long-term care facilities in a large western state certified for Medicare/Medicaid reimbursement was used. An online survey was developed to investigate perceptions and knowledge regarding oral health of long-term care residents, protocol for provision of, and barriers to optimal oral health care, and support for employment of dental hygienists in long-term care facilities. Statistics used for data analysis included frequency distributions, Spearman’s rho correlation coefficient and the Mann-Whitney test. Results: Executive directors in long-term care facilities included in the study perceived oral health as an important aspect of general health; however, a knowledge deficit was identified related to oral disease as an exacerbating factor to systemic disease. Financial concerns and low interest among residents/families were identified as major barriers to accessing care. Executive directors supported interprofessional practice of nurses working with dental hygienists to optimize oral health care of residents. No significant associations were found between demographics and facility characteristics. Conclusion: Awareness of the knowledge and perceptions of executive directors providing leadership in these facilities can provide avenues to creating needed change, which can foster improvement in the oral and overall health status of long-term care residents. Support for interprofessional work of nurses and dental hygienists can open a door for innovative practice that optimizes oral health care of long-term care facility residents through the application of shared expertise. [ABSTRACT FROM AUTHOR]

Purpose: Currently, 37 states allow some type of alternative practice settings for dental hygienists. This qualitative study was designed to explore the experiences of the Extended Care Permit (ECP) dental hygienist in the state of Kansas. As a first ever study of this workforce model, a qualitative research design was chosen to illuminate the education and experiences of extended dental hygiene practitioners in order to understand the impact ECP legislation has had on increasing the public's access to oral health care services and define the advantages and limitation of this model as one potential solution to access to oral care. Snowball sampling was used to identify study participants who were actively engaged in extended care practice. Nine subjects, which included one ECP consultant and eight ECP providers, participated in this study. Data obtained via personal interviews and through document analysis data were subsequently coded and thematically analyzed by three examiners. An independent audit was conducted by a fourth examiner to confirm dependability of results. Seven major categories emerged from the data analysis: entrepreneur dental hygienist, partnerships, funding, barriers, sustainability, models of care and the impact of the ECP. The findings of this study revealed that ECP hygienists are making an impact with underserved populations, primarily children, the elderly and special needs patients. [ABSTRACT FROM AUTHOR]

Purpose: Lifelong control of disease processes associated with dental caries should be an essential part of the process of care for practicing dental hygienists. The purpose of this study was to identify the knowledge, attitudes and practice behaviors among dental hygienists regarding caries risk assessment (CRA) and management. Methods: Utilizing the American Dental Hygienists' Association (ADHA) Survey/Research Center database of all registered dental hygienists in the U.S., 2,500 actively licensed dental hygienists were randomly selected and sent a web-based survey via SurveyMonkey™. The survey included items about practice characteristics and questions regarding knowledge, attitudes and practice behaviors regarding CRA and management. Second and third emails were sent to non-respondents. A 4-point Likert type scale (1=never, 2=sometimes, 3=frequently and 4=always) was used to rate the occurrence of caries management recommendations used in the practice setting. Frequencies and percentiles were used to evaluate demographic, knowledge and attitude information. Results: The response rate was 9% (n=219) - 87% were ADHA members. Participants reported a high level of comfort (89%) in performing CRA, yet only 23% used an established CRA/management instrument. Over-the-counter fluoride dentifrices (70.1%), individualized oral hygiene instructions (86%) and individualized recare intervals (73.7%) were most often used as caries management recommendations, while low-dose fluoride rinses (45%) and prescription strength sodium fluoride gel or paste (42%) were used less frequently. Dental hygienists scored high on knowledge of CRA with the exception of white spot lesions as a risk factor (42%) and efficacy of chlorhexidine in caries management (61%). Conclusion: There is a need to improve practicing dental hygienists' knowledge and involvement in the active management of caries. Focused training in the use of established CRA/management tools should be designed to improve their knowledge and influence practice behaviors. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this paper is to provide an overview of current professional guidelines regarding oral health care through pregnancy and infancy stages, and to include risks associated with treatment, as well as health care providers' beliefs and attitudes surrounding treatment of these specific populations. Although dental treatment during the second trimester is ideal, there is no indication that preventive or restorative dental treatment during any trimester of pregnancy can cause harm to the mother or developing fetus. Despite these recommendations, routine dental care is often voluntarily avoided or postponed for the duration of pregnancy. Post-delivery, preventive oral care is typically postponed for a child until 3 years of age, years after the first tooth has erupted. While most health care professionals agree on the importance of good oral health in every stage of life, it is not being addressed. Whether it is based on misconceptions or lack of knowledge, health care providers are performing inadequate oral care for these patients. Recommendations to increase health care during pregnancy and infancy should include improved advocacy of the established oral health care guidelines within each professional organization. In addition, curriculum revision should occur at the university level, to ensure future health care professionals will have a strong oral health foundation. Lastly, a collaborative effort needs to occur between all health care providers to better treat the patient's overall health, not only the specifics of one professional discipline. As health care professionals we are all responsible for the complete well-being of our patients, and an interdisciplinary approach will better ensure we accomplish this task. [ABSTRACT FROM AUTHOR]

Purpose: In 2004, the attitudes toward and use of automated external defibrillators (AEDs) by Ohio dental professionals were examined. While willing to use an AED, most did not have access to one. With new AED-related legislation and increased awareness of the benefits of AEDs since the initial study in 2004, the purpose of this study was to document the prevalence of and attitudes toward AED usage in the dental setting 7 years following the initial study. Methods: A 2 page survey instrument was mailed to a random sample of 1,629 dentists and 1,801 dental hygienists in Ohio. Results: A 24% overall response rate was achieved (36% dentists and 64% hygienists). Data were analyzed using SPSS. Results indicate 16% of respondents experienced a cardiac emergency in their practice that required contacting emergency personnel. AEDs are available in 48% of dental practices. Comparing the 2004 and 2011 data, statistically significant differences were found between the responses of dentists and dental hygienists. Conclusion: While hygienists reported more positive attitudes toward AEDs than dentists, the majority of all respondents feel AEDs should be mandated in the dental setting. These findings suggest an increase in cardiac emergencies in Ohio dental settings, an increase in the prevalence of AEDs in Ohio dental settings and that the perceptions of dental professionals are changing in favor of the use of AEDs in the dental setting since the 2004 study. [ABSTRACT FROM AUTHOR]

Purpose: To assess knowledge, attitudes and practices of U.S. dental hygienists with infection control guidelines (ICG). Research has shown improved compliance with specific aspects of dental ICG is needed. This study supports the American Dental Hygienists' Association National Research Agenda's Occupational Health and Safety objective to investigate methods to decrease errors, risks and or hazards in health care. Data are needed to assess compliance, prevention and behavioral issues with current ICG practices. Methods: A proportional stratified random sample (n=2,500) was recruited for an online survey. Descriptive statistics summarized demographic characteristics and knowledge, attitudes and practicess responses. Spearman's rho correlations determined relationships between knowledge, attitudes and practices responses (p<0.05). Dominant themes were identified from open-ended responses. Results: A 31% response rate (n=765) was attained. Respondents agreed/strongly agreed with familiarity with ICG (86%) and believed ICG are relevant to their patients (88%). Responses indicated low compliance (rarely/never used) with handpiece sterilization (n=209, 31%), utility glove use (n=317, 47%), and pre-procedural rinsing (n=324, 48%). Significant relationships were found between ICG implementation and access to necessary supplies (rs=0.549), supervisors' expectations for using ICG (rs=0.529) and no time to use (rs=-0.537). Themes from comments indicated time is a barrier, and respondents' perceived a need for involvement of all co-workers. Conclusion: Dental hygienists are adhering with most aspects of the ICG. High compliance with ICG among respondents in this study was associated with positive safety beliefs and practices, whereas lower compliance with ICG was associated with less positive safety beliefs and practices. A safety culture appears to be a factor in compliance with ICG. [ABSTRACT FROM AUTHOR]

Purpose: The goal of this paper is to evaluate the PEARL Network's satisfaction with training/support and assess the relationship between practice research coordinators (PRCs) involvement and study participation. Methods: At the PEARL Network 2011 Annual Meeting, an evaluation form was completed by practitioner-investigators and PRCs who attended the annual meeting. Results from the paper evaluation form were entered into an Excel database, and analyzed using the statistical analysis software SPSS. The bivariate correlation test, Pearson Correlation, was conducted, and results were considered significant if p<0.05. Results: During a program evaluation among 84 network respondents, a positive correlation (p=0.004) was found between the number of PRCs and the number of studies in which a site participates. In addition, there was a positive correlation between satisfaction with the training, support and involvement of PRCs in organizing study activities (p=0.008). There was also positive correlation between satisfaction with training/support and the number of PRCs utilized by the office (p=0.039). Conclusion: Practice research coordinators are key members of the research team, and they are important to conducting clinical studies in everyday practice. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this study was to assess Maryland dental hygienists' knowledge, practices and opinions regarding dental caries prevention and early detection. Methods: A 30 item survey was mailed to 1,258 Maryland dental hygienists. Two follow-up mailings and email reminders were sent. Results: The response rate was 43% (n=540). Nearly all respondents were female (98%), and 58% practiced in solo settings. Knowledge and certainty of knowledge were moderate: sealants are needed regardless of topical fluoride use (55% certain, 40% less certain), newly erupted permanent molars are the best candidates for sealants (54%, 36%) and professionally applied fluorides are desirable in areas without fluoridated water (55%, 36%). Fewer were certain that incipient lesions can be remineralized before cavitation (23%, 69%), and dilute, frequently administered fluorides are more effective in caries prevention than concentrated, less frequently administered fluorides (6%, 24%). Opinions regarding effectiveness of protocols for 2 age groups from 6 months to 6 years, the challenges of early childhood caries (ECC), prevention practices regarding sealant and topical fluoride applications varied widely. Eighty-nine percent reported routinely assessing dental caries risk factors of child patients and 90% were interested in continuing education courses. There were no significant differences between different types of practice settings, year of graduation, race/ethnicity or gender. Conclusion: Knowledge of recommended guidelines for fluoride and sealant application support clinical decision-making and self-care counseling. Misinformation and lack of understanding of current research and recommendations identify a need for educational interventions in undergraduate dental hygiene programs and through continuing education for practicing hygienists. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this study was to investigate registered dental hygienists' attitude toward community service, sensitivity to patient needs, job satisfaction and their frequency to volunteer care for the underserved population. Methods: A 60 question survey instrument was developed and distributed to 306 participants. The survey instrument ad dressed the following variables: community service, sensitivity to patient needs, job satisfaction, social responsibility, spirituality and willingness to volunteer care. A total of 109 surveys were returned yielding a 33.9% response rate. SPSS version 19.0 was utilized for data analysis. Based on the factor analysis, the 6 original variables were reduced to 3 variables, which included attitude toward community service, job satisfaction and sensitivity to patient needs. Results: For registered dental hygienists their level of education, membership in their professional association, attitude toward community service and sensitivity to patients were associated with their frequency of volunteering care for the underserved population. Additionally, a discriminant analysis indicated a strong prediction among registered dental hygienists attitude toward community service and job satisfaction to their frequency of volunteering care for the underserved population. Conclusion: This research study of the factors that influence registered dental hygienists' frequency of volunteering care indicates how important oral health care preparatory norms and dispositions are to the underserved population. Understanding what persuades registered dental hygienists to volunteer care provides valuable information to registered dental hygienists, as well as dental hygiene programs regarding volunteering care for the underserved population and the importance of attitudes toward community service, sensitivity to patient needs and job satisfaction. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this study was to determine the financial management goals and practices of registered dental hygienists, their satisfaction with their current financial situations and their attitudes about savings, investments and retirement. Methods: A 40 question electronic survey was completed by 388 registered dental hygienists. The descriptive instrument assessed financial practices, attitudes, goals and beliefs, retirement mindset, savings habits, debt tendencies and demographic characteristics of respondents. Statistical analyses compared respondents' beliefs about their financial independence and security with their current financial practices. Analyses included: independent samples t-tests, chi-square analysis and ANOVA. Results: Most dental hygienists believed themselves to be financially independent and reported satisfaction with their current financial situation. Significant relationships existed between respondents' satisfaction with their current financial situations and their financial attitudes and practices (saving regularly and having limited debt). Those who indicated they had personally saved for retirement were more likely to view these savings as their largest source of income during retirement, as opposed to Social Security benefits. A majority agreed that financial management education should be included in the dental hygiene curriculum, and that they would attend a continuing education course on the subject if offered. Conclusion: The results of this study suggest that hygienists have confidence in their ability to provide secure financial futures for themselves. Hygienists who practiced sound financial planning, such as adhering to monthly budgets, having wills, lowering debt and saving regularly, reported a higher level of financial security than those who did not. Most respondents expressed interest in receiving education about financial management through the dental hygiene curriculum and continuing education courses. [ABSTRACT FROM AUTHOR]