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Introduction: It is unknown whether interprofessional identity is able to explain interprofessional behaviours. Extended professional identity theory provides clues by combining two psychological identity approaches. The aim of this study is to investigate whether interprofessional identity is a source for intrinsic motivation towards interprofessional collaboration related to wider group membership. Methods: Participants of this double‐blinded study were 47 dentistry and 41 dental hygiene students (86.3% response) without interprofessional education (IPE) experience. Group productivity was used as indicator of group effort and equal communication as indication for interprofessional direction. The extended professional identity scale (EPIS) was used to measure interprofessional identity eight weeks prior to a mandatory IPE course. Based on EPIS levels, students were assigned to a low or high interprofessional identity group condition. Subsequently, 12 interprofessional teams (four to five members) were randomly composed per condition. Each group received eight problems (regarding roles, responsibilities and collaborative practice) for which they were expected to provide up to 10 solutions. Six trained psychologists rated the validity of solutions after which the percentage of solutions per group was calculated. Additionally, the psychologists rated interprofessional direction by observing team communication (asking questions, topic control, prosocial formulations, and speech frequency) during the second group meeting. Results: No interprofessional identity differences were found with regard to gender and profession. The mean difference between groups with low versus high interprofessional identity was 0.5 (M = 3.4; SD = 0.5 and M = 3.9, SD = 0.4, respectively), t = −5.880, p < 0.001. Groups with high identity generated more solutions compared to low identity groups (91.5% vs. 86.4%), t = −2938, p = 0.004. The correlation between individual interprofessional identity and group effort was significant, r = 0.22, p = 0.036. Groups with high identity showed more interprofessional direction, t = −2.160, p = 0.034. Discussion: Interprofessional identity has a positive effect on congruent interprofessional behaviours after 10 weeks. More research is required to understand interprofessional identity in relation to performance in education and work. Reinders and Krijnen show that interprofessional identity is a source of intrinsic motivation towards interprofessional collaboration, influencing problem solving as well as teamwork. [ABSTRACT FROM AUTHOR]

Objectives: This cross‐sectional study was to determine the coronavirus disease 2019 (COVID‐19) vaccination intention of clinical dental hygienists in South Korea and the factors that influence vaccination intention. Methods: COVID‐19 vaccination intention of the 500 participants was confirmed through a survey including the following options: 'I will vaccinate (VAC)', 'I will not vaccinate (NoVAC)' and 'I do not know if I should get vaccinated (UNK)'. A Chi‐square test was performed to determine whether there were differences in COVID‐19 vaccination intention according to the general characteristics of the participants, degree of infection control knowledge (Score‐K) and practice (Score‐P) in response to COVID‐19, fears over COVID‐19 (Fear‐C) and the level of anxiety before (GADBefore) and after (GADAfter) the COVID‐19 pandemic. Multiple logistic regression was performed to identify factors affecting VAC and NoVAC by setting the base category as UNK. The p‐values of <0.05 were considered statistically significant. Results: According to the analysis, 44.8%, 18.8% and 36.4% of participants selected VAC, NoVAC and UNK respectively. There were significant differences in vaccination intention according to age, monthly income, residential area, symptoms related to COVID‐19, Score‐K, Fear‐C and GADBefore. Compared to UNK, < $2000 monthly income, Score‐K and Fear‐C variables significantly influenced the opinion of VAC. Compared to the answer UNK, monthly incomes of $2000 to $2360 and $2360 to $2730 in residential areas significantly influenced the opinion of NoVAC. Conclusions: The variables influencing vaccination intention were monthly income, residential area, Score‐K and Fear‐C. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this study was to survey clinicians' choice of peri-implant instrument selection and the application used to probe dental implants as well as to evaluate peri-implant probing force and pressure applied compared with that reported in current literature. Materials and Methods: Forty-eight clinicians (16 periodontists/periodontal residents, 16 restorative dentists, and 16 hygienists) participated in the study. A questionnaire to determine the frequency and method of probing dental implants was provided and subject to the chi-square test. Each participant was given a choice of three periodontal probes (Marquis, UNC-15, plastic) to use on the typodont, and the probing force was recorded blindly. The probing force and pressure data were analyzed with analysis of variance (ANOVA) among subject groups as well as probe types per site; where statistical differences (P < .05) were detected, Tukey's post hoc test was applied. Results: The questionnaire resulted in a variety of answers, although the majority demonstrated an agreement on probing implants in everyday practice. There was no significant difference among provider groups in regard to instrument selection, probing forces, and pressure in both the maxilla and mandible, although the mean probing forces and pressures in all provider groups were higher than the suggested value reported in the literature. Conclusion: This study indicated that there are variations among clinical provider groups with regard to peri-implant probe instrument type used and forces applied, though these are not statistically significant. Probe tip diameter should be considered to avoid bleeding on probing false positives when probing dental implants, especially as the forces generally used by the clinicians may be higher than advised. [ABSTRACT FROM AUTHOR]

Objectives: This study aimed to clarify the relationship between the experience of receiving career education among final‐year dental hygiene students and their views regarding their work and profession, as part of research on the working style of dental hygienists. Methods: An anonymous, self‐administered survey was sent by post to all the 162 dental hygienist schools in Japan with dental hygiene students in their final year in November 2019. The main questions were regarding student attributes, career aspirations, their perspective on work and profession and whether or not they received career education at a dental hygienist training school. Analysis was conducted by cross‐tabulation and logistic regression. Results: Completed questionnaires were sent to us by 150 schools (response rate 92.6%), with a response from 6,270 students. The students who had received career education had significantly higher awareness and plans for the profession and a positive attitude towards the work (p < 0.01). Following adjustment for age, sex, educational attainment, length of the course of study and timing of class the results shows that there was a significant relation between the experience of the career education with having future plans (odds ratio = 2.11, 95% confidence interval = 1.88–2.38, p < 0.01). Conclusions: It was observed that the experience of receiving career education just before graduating from dental hygienist school was related to an increased positive attitude of the students towards their work and profession. Further long‐term investigations are necessary to evaluate the effects of career education among dental hygiene students and their attitude towards their profession. [ABSTRACT FROM AUTHOR]

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: To evaluate general dental practitioners' (GDPs) and dental hygienists' (DHs) assessment of prognosis, suggested treatment goals, and estimated number of treatment sessions in patients with varying severity of periodontal disease.Materials and Methods: Seventy-seven GDPs and fifty DHs in a Swedish county participated in a questionnaire study, based on three patient cases: a patient with generalised bone loss but no clinical signs of inflammation (well-maintained); a patient with clinical signs of inflammation and generalised bone loss (periodontitis); and a patient with clinical signs of inflammation but no bone loss (gingivitis). In open-ended questions, the clinicians assessed the prognosis in case of no treatment and proposed treatment goals. Furthermore, based on given fixed-alternative options, they estimated the number of treatment sessions needed for successful management of the condition.Results: Based on a response rate of 94%, the majority of clinicians expected a worsening of the periodontal condition in all three patients (well-maintained: 80%; periodontitis: 94%; gingivitis: 60%). The most common treatment goal in all 3 cases was to improve oral health awareness. The majority of clinicians estimated that the periodontitis case needed slightly more treatment sessions (mean: 3.04, 95% CI: 2.83-3.24) compared to the gingivitis (mean: 1.93, 95% CI: 1.75-2.11) or well-maintained patient case (mean: 1.84, 95% CI: 1.60-2.07).Conclusions: The majority of included clinicians did not perform an individualised risk assessment and did not individually match the number of appointments to the actual periodontal treatment needs of the patient. This may result in overtreatment in some cases and in undertreatment in others, and possibly in suboptimal use of resources. [ABSTRACT FROM AUTHOR]

As rates of human papillomavirus (HPV)-related oropharyngeal cancer (OPC) continue to rise, the dental community's role in primary prevention efforts related to HPV vaccination will become increasingly important. The aim of this study was to assess knowledge, beliefs, practices, and perceived barriers regarding HPV and HPV vaccine advocacy within the dental community. A sample of 266 dentists and dental hygienists completed an online survey, and responses were then analyzed using frequencies of responses, t tests, chi-square tests, and Spearman's correlations. Ninety percent of providers believe it is important to play an "active role" in their patients' general medical care, yet only 50% believe it is their responsibility to recommend the HPV vaccine. Only 50% feel knowledgeable enough to recommend the vaccine. 78.6% of providers rarely discuss HPV vaccination with their age-appropriate patients, and 82% rarely recommend the vaccine. The two most strongly agreed-upon barriers were "parent concerns about the safety or efficacy of the vaccine" (71.6%) and "parent opposition to HPV vaccination for philosophical or religious reasons" (72.6%). Dentists were more knowledgeable about HPV vaccination and more likely to recommend the vaccine than hygienists. Higher levels of HPV-related knowledge correlated positively with beliefs and practices that support HPV vaccine advocacy. We have identified multiple opportunities for intervention aimed at increasing vaccine advocacy among oral health providers. These include clarification of role from dental professional organizations, alleviation of concerns related to perceived parental objection to the vaccine, and educational interventions targeting knowledge deficits among oral health providers. [ABSTRACT FROM AUTHOR]

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Despite ample opportunity, dental professionals frequently fall short of connecting tobacco-using patients with effective cessation support, often citing lack of training as a barrier. To inform development of training options, the aim of this study was to quantify the preferences of practicing dental hygienists and dentists in California for continuing dental education (CDE) offerings related to tobacco and patient tobacco cessation. Two statewide surveys of California dental hygienists and dentists were conducted. In addition to providing their own and their practice characteristics, in a discrete choice experiment, participants indicated their preferences between pairs of randomly generated hypothetical tobacco cessation CDE offerings that differed in topic, cost, delivery modality, and duration. Ultimately, 641 dental hygienists (20.5% of the total invited minus those with undeliverable emails, n=3,129) and 654 dentists (8.5% of the total invited minus those with undeliverable emails, n=7,669) responded to at least one of the discrete choice items, and their responses were analyzed. The results showed that each CDE attribute was independently associated with preference. Cost and topic were more strongly associated with preference than were delivery modality and duration. Lower cost, shorter duration courses were generally favored. Alternative tobacco products and patient communication were the most popular topics for participating dental hygienists and dentists, respectively. CDE preferences differed according to participant characteristics: live webinars were the least preferred modality for more experienced dental professionals, and shorter courses were not preferred by dentists in non-urban locations. These findings showed that these dental professionals considered multiple attributes in selecting CDE courses. To reach the broadest audience, CDE providers should offer low-cost options across a range of delivery modalities, such as full-day workshops in rural areas and online webinars for earlier career professionals. [ABSTRACT FROM AUTHOR]

Purpose: Tobacco use is a major risk factor in oral and systemic diseases. Current national guidelines outline activities that positively contribute towards tobacco cessation. Little is known about dental hygienists' role in tobacco cessation activities. This study investigates dental hygienists' performance of tobacco cessation activities in the dental surgery and explores factors associated with this performance. Materials and Methods: Dental hygienists in south-east England on the register of the British Society of Dental Hygiene and Therapy completed a postal questionnaire survey in 2008. Results: A total of 439 (61%) questionnaires were returned, representing both part-time (66.7%) and full-time (33.3%) hygienists working in the private (69.5%) and non-private sectors (30.5%). Most hygienists recorded positive attitudes towards tobacco cessation. Overall, 162 (41.9%) reported performing four or more tobacco cessation activities. The less-commonly performed activities indicated to patients the value of attending NHS Stop Smoking Services for specia- lised help, with hygienists referring patients to the NHS Stop Smoking Services and offering assistance to those who do not wish to attend NHS stop Smoking Services. Higher reported numbers of tobacco cessation activities performed were statistically significantly associated with a higher number of positive attitudes held (P = 0.004), while socio-demographic and professional attributes were not. Conclusion: Tobacco cessation activities, as recommended by national guidelines, are not always performed by dental hygienists. Efforts are needed to promote the dental hygienist's role in tobacco cessation, especially in relation to referring patients to NHS Stop Smoking services. These efforts should focus on changing the attitudes of dental hygienists, especially on their effectiveness in promoting tobacco cessation. [ABSTRACT FROM AUTHOR]

Objective: The present study aims to gain knowledge about the dentist's use and choice of digital extraoral imaging methods, panoramic radiography and cone beam computed tomography (CBCT).Materials and Methods: A questionnaire sent to 2481 dentists within the Swedish Dental Society contained questions about the panoramic technique and CBCT technique used, education, clinic size and type of service. The response rate was 53%.Results: The study showed that 61% of the Swedish dentists had access to panoramic techniques and that 84% used a direct digital sensor, while 6% used storage phosphor plate techniques. Around 8% of the Swedish dentists had access to CBCT. It was also observed that group practices had two times higher odds of having panoramic equipment compared with solo practices. Approximately 40% of the dentists had undergone postgraduate education in oral radiology during the last 5 years. Dental nurses and dental hygienists exposed 92% of the panoramic radiographs and 75% of the CBCTs. Thirty per cent of those clinics with access to a panoramic unit exposed >30 panoramic radiographs per month and 56% of the clinics having access to CBCT did more than 75 examinations per year.Conclusions: Today 61% of Swedish dentists have access to panoramic radiography and 8% have access to CBCT. There is a greater likelihood of having access if the dentist works in the public dental health service or in a group practice and if the dentist has undergone any postgraduate course in oral radiology. [ABSTRACT FROM AUTHOR]

Objective: In order to adequately care for patients with dementia, it is necessary for dental hygienists to develop unprejudiced attitudes towards and obtain sufficient knowledge of dementia. The aim of this study was to assess attitudes towards and knowledge of dementia among Japanese dental hygiene students and identify related factors to the attitude and the knowledge. We compared the attitude and the knowledge between dental hygiene students and practising dental hygienists.Background: Dental hygienists are required to care for patients with dementia by developing appropriate attitudes towards dementia and gaining knowledge of dementia.Material and Methods: Between May 2016 and July 2016, 191 third-grade dental hygiene students and 64 registered dental hygienists were surveyed. We modified questionnaires to assess attitudes towards and knowledge of dementia. Ageism was assessed using the Fraboni Ageism scale. To determine potential dementia awareness factors, information regarding participants' experiences with dementia was collected.Results: Factor analysis revealed four factors in the attitude scale (Cronbach's α, 0.652-0.820). All item-total correlation coefficients for the knowledge scale were above 0.3, and Cronbach's α was 0.827. All awareness factors for dementia were significantly different between students and registered dental hygienists. Total scores of attitude and knowledge were higher among registered dental hygienists, indicating better attitude and knowledge, but total scores of ageism were lower among registered dental hygienists, indicating worse ageism. Multiple regression analysis revealed that the attitudes towards dementia correlated with years of experience, ageism, interest in dementia and desire to work with patients with dementia.Conclusion: Registered dental hygienists had more positive and more knowledge compared to dental hygiene students. Attitudes towards dementia, but not knowledge of dementia, were significantly positively correlated with ageism. [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]

Objective: Exploring the feasibility to understand changes in oral hygiene behaviour using the Health Action Process Approach (HAPA) model applied to qualitative research interviews in patients with diabetes and periodontitis undergoing standard periodontitis treatment. Methods: Patients with type 1/2 diabetes and chronic periodontitis (n = 8) received standard non‐surgical periodontal treatment accompanied with personalized oral hygiene instructions by a dental hygienist. Clinical indices (% bleeding on probing (BOP), probing depth (PD), clinical attachment level (CAL), % of sites with PD ≥ 5 mm, periodontal epithelial surface area (PESA) and periodontal inflammatory surface area (PISA) were recorded pre‐ and post‐treatment. At 3 months post‐treatment, patients were interviewed using a topic guide relating to oral health. A behaviour change framework was constructed from elements of the HAPA model and used directly to map interview data to evaluate oral hygiene behaviour in these patients. Results: Data from this feasibility study suggest a clinical improvement in periodontal status, albeit only monitored for 3 months. Application of the HAPA model highlighted the behavioural change pathway that diabetes patients undertake before, during and after periodontal treatment. The data suggest that patients move through all elements of the motivation phase and all elements of the volition phase except for the recovery self‐efficacy element. Conclusion: The novel approach of applying the HAPA model to qualitative research data allowed for the collection of richer data compared to quantitative analysis only. Findings suggest that, in general, patients with periodontitis and diabetes successfully manage to incorporate new oral hygiene behaviours into their daily routine. [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]

Most often, members of the dental team are educated in separate programs. These professionals then come together in practice to work as a team, often with limited knowledge about each other's roles. The aim of this study was to assess the perspectives of dental and dental hygiene students regarding collaborative learning after taking two courses together. Five years (2010-14) of survey data were collected from a convenience sample of dental and dental hygiene students. The dental hygiene students were in their first and second years (DH1 and DH2) at Eastern Washington University (EWU). The dental students were in the University of Washington (UW) Regional Initiative in Dental Education (RIDE) program, taking their first year of courses in Eastern Washington with EWU's dental hygiene and UW's medical students. Eight first-year dental (D1) students participate in the RIDE program each year, totaling 40 across the five years. Because the same D1 students take both courses, this target population was 80. The number of DH1 and DH2 students in these courses ranges from 32-36 each year, for a target population of 323 across the five years. A total of 193 survey responses were collected, for an overall response rate of 48%; the D1 response rate was 72%, and the DH response rate was 42%. In the results, students perceived that learning collaboratively helped them think positively about other dental professionals, benefitted their problem-solving skills, increased their understanding of clinical problems, helped them become better team members, improved trust and respect, and improved their understanding of course content. These results suggest that collaborative learning had a positive impact on both groups. In comments, students suggested they would benefit from more shared learning experiences in the clinic and agreed that collaborative learning would help them create a more cohesive team. [ABSTRACT FROM AUTHOR]

Objectives: Oral health in nursing homes for elderly is often unsatisfactory, and oral health education to nursing staff has not shown sufficient results why there is need for novel approaches. The aim of the study was to trial a new oral healthcare educational programme and to evaluate the effects on residents' oral health. In addition, attitudes among the nursing staff in the intervention nursing home were explored. Methods: In a controlled clinical trial, two comparable nursing homes were randomly assigned for intervention or control. Interventions included weekly theoretical and hands‐on guidance from dental hygienists on oral hygiene procedures and discussions on oral care routines. The residents' oral health, measured by the Revised Oral Assessment Guide (ROAG), dental plaque and gingival bleeding were evaluated at baseline and after 3 months. Attitudes among the staff to oral health care were measured at the intervention nursing home. Results: Revised Oral Assessment Guide gums and lips scores showed a tendency to decrease in the intervention group, but remained high in the control group. Plaque levels improved significantly after intervention, and a trend towards less gingival bleeding was observed. The intervention nursing staff seemed to be more aware of their own limitations concerning oral health care after intervention and valued more frequent contact with dental services to a greater extent. Conclusions: The oral healthcare situation for elderly people today is so complex that theoretical education at the group level regarding different aspects of oral health is not sufficient. Individual hands‐on guidance by dental hygienists on a regular basis in everyday care may be a new approach. [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]

Abstract: Objectives: The aim of this study was (i) to evaluate the visual performance of dental hygienists in their clinical environment and (ii) to analyse the relationship between self‐assessed and objectively measured visual acuity. Methods: The near visual acuity of 191 dental hygienists and dental hygiene students was self‐assessed with a visual analogue scale and objectively measured with miniaturized visual tests in a simulated clinical setting. The visual acuity was also measured with magnification aids if they were part of the individual clinical equipment. The influence of age and magnification on the near visual acuity was analysed. Results: The visual performance with respect to dental working distance showed a variability of 300% in the dimension of the smallest recognized structure. A weak positive correlation between the self‐assessed and objectively measured visual performance (Spearman's rank correlation = 0.27) and a highly significant impact of the test person's age and the use of loupes (both P < .0001) were found. Test subjects ≥40 years exhibited a similar visual acuity when using loupes compared to the visual acuity of test subjects <40 years without loupes. Conclusions: The visual performance with respect to dental working distance cannot be self‐assessed and varies individually. Dental hygienists and students of dental hygiene with a weak near visual acuity were not aware of their deficiencies. Optical aids should be used to compensate for individual visual deficiencies and are mandatory above an age of 40 years due to the effects of presbyopia. [ABSTRACT FROM AUTHOR]

There is a paucity of studies on Canadian baccalaureate dental hygienists. As discussions about the entry-level education required in dental hygiene continue on national and international platforms, examining outcomes of earning a dental hygiene baccalaureate degree is imperative. The aim of this study was to investigate the professional practice behaviors and career outcomes of graduates of the University of British Columbia (UBC), Canada, Bachelor of Dental Science in Dental Hygiene (BDSc) degree program. UBC dental hygiene entry-to-practice (ETP) and degree-completion graduates from 1994 to 2016 were invited to participate in an online survey with closed- and open-ended questions about practice behaviors and outcomes after earning the BDSc degree. Of the 365 BDSc alumni who received the email invitation, 116 responded, for a 32% response rate. The results showed that 45% of respondents worked outside of the traditional private dental practice setting, specifically in education (23%), administration (9%), public health (8%), and research (5%). Of the 77 degree-completion respondents, 75% reported that the BDSc degree had expanded their career opportunities. A greater proportion of degree-completion respondents practiced outside of the clinical setting (p<0.01) and had earned a graduate degree (p=0.04) compared with ETP respondents. Over 25% of total respondents had pursued graduate education. In comparison to results from the 2015 Canadian Dental Hygienists Association job market and employment survey, a significantly greater proportion of BDSc graduates practiced collaboratively with non-dental professionals (2.7 vs. 0.8, p<0.001), earned more than $80,000 annually (47% vs. 23%, p<0.001), and received more employment benefits (4.0 vs. 3.5, p<0.001). These results highlight the positive impact of baccalaureate education on dental hygiene practice behaviors and career outcomes. [ABSTRACT FROM AUTHOR]

Although HIV screening is needed at a wider range of sites, dentists have shown reluctance to incorporate screening in their practices, but dental hygiene settings may be better suited for such screenings. The aim of this mixed-methods study was to determine the feasibility and acceptability of point-of-care (POC) HIV screening in dental hygiene education community settings from the patient, faculty, and student perspectives. After training, dental hygiene students and faculty at a Canadian dental school offered POC HIV screening to patients as part of routine dental hygiene care over 36 weeks at four sites in 2015-16. Of the 199 patients offered screening, 78 agreed; no positive results were found. Of the 199 patients, 97 completed an 11-item survey (49% response rate), with 80 (82%) agreeing HIV screening was within the scope of practice of a dental professional. Of the 57 patients who were screened, 48 (84%) agreed POC HIV screening should be part of regular dental check-ups, and 52 (91%) perceived dental settings were appropriate sites for screening. The main reasons for patients' agreeing to screening were that it was free and convenient and the results were delivered quickly. Those who refused screening had been tested recently or did not perceive themselves at risk for HIV. In two focus groups with 12 dental hygiene students, one focus group with five faculty members, and individual interviews with five other faculty members, participants agreed on the importance of offering POC HIV screening in the dental setting as a public health service. Faculty members thought students were well prepared and increased in confidence with testing. Students expressed a desire to offer screening throughout their careers and to educate patients about the importance of HIV testing. [ABSTRACT FROM AUTHOR]

Objective: The purpose of this study was to design a structured treatment model focusing on all levels of adult's dental fear, the Jönköping Dental Fear Coping Model (DFCM). The aim was to study the DFCM from a dental health professional perspective.Material and Methods: The DFCM was studied by means of quantitative and qualitative analyses. Nine dental clinics participated in Period I (pre-intervention/standard care), and 133 dental health professionals (dentists, dental hygienists, dental assistants) and 3088 patients were included. After completion of Period I, four of the clinics were randomized to Period II (intervention), beginning with the professionals undergoing DFCM training. Following that, 51 dental health professionals treated 1417 patients according to the DFCM. The other five clinics served as controls.Results: Half or more of the dental health professionals assessed the model as better than standard care, regarding anamnesis and diagnostics, communication and contact, and understanding of patients and dental fear. The dental health professionals reported higher tension in their fearful patients in Period II compared with Period I, possibly due to their increased awareness of dental fear.Conclusions: The qualitative data suggest that dental health professionals find the DFCM beneficial in routine dental care. The model promotes a holistic approach to the treatment of adult patients. However, stress among the professionals was not reduced when measured, neither quantitatively nor qualitatively. It is important to evaluate the model in further studies to make it possible to draw generalizable conclusions. [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]

The dental setting is a largely untapped venue to identify patients with undiagnosed HIV infection. Yet, uptake of rapid HIV testing within the dental community remains low. This study sought to better understand the experiences of dental professionals who have administered the test and how these experiences might inform efforts to promote greater uptake of rapid HIV testing in dental settings. Qualitative interviews were conducted with United States dentists (N = 37) and hygienists (N = 5) who offered rapid HIV testing in their practices. The data revealed both the impeding and facilitating factors they experienced in implementing testing in their setting, as well as the reactions of their staff, colleagues, and patients. Overall, participants viewed rapid HIV testing favorably, regarding it as a valuable public health service that is simple to administer, generally well accepted by patients and staff, and easily integrated into clinical practice. Many had experience with a reactive test result. Participants described facilitating factors, such as supportive follow-up resources. However, they also cited persistent barriers that limit acceptance by their dental colleagues, including insufficient reimbursement and perceived incompatibility with scope of practice. The widespread adoption of routine HIV testing amongst dental professionals will likely require an expanded notion of the proper scope of their professional role in overall patient health, along with greater support from national dental organizations, dental education, and dental insurance companies, especially in the form of sufficient reimbursement. [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]

Abstract: Objectives: The dental hygiene profession in the U.S. is in the process of establishing a direct access model of care and contributing to the creation of the profession of a dental therapist. The objectives were to analyse the professional role perceptions of dental hygiene students and registered dental hygienists in these times of change. Specifically, it was explored whether dental hygiene students’ current professional identities differ (i) from their expected future identities, and (ii) from dental hygienists’ current and (iii) past identities. Methods: Survey data were collected from 215 dental hygiene students concerning their present and future role perceptions, and from 352 registered dental hygienists concerning their present and past professional identity perceptions. Results: Students’ future professional identity perceptions were even more positive than their very positive current perceptions of their professional role components. Students’ current perceptions of professional pride, professional ambition, work ethic and patient relations were more positive than dental hygienists’ current perceptions of these professional role components. A comparison of students’ current perceptions with dental hygienists’ current and retrospective descriptions showed that students were more positive than dental hygienists in each case. Conclusions: The fact that dental hygienists had less positive role perceptions than dental hygiene students might lead to the conclusion that a loss of idealism occurs over the course of a professional lifespan. However, dental hygienists actually improved their role perceptions over time and students’ future descriptions were more positive than their current descriptions, supporting the interpretation that realistic optimism dominates professional role perceptions in these times of change. [ABSTRACT FROM AUTHOR]

Background: Due to the declining birth rate and aging of Japanese society, the roles and responsibilities of dental hygienists are continuously expanding. Medical professionalism needs to be pursued continuously throughout one's career in order to improve dental care and treatment. Although conceptualising professionalism is essential to the education of health professionals, professionalism in the field of dental hygiene has not been defined or adequately examined in Japan. The purposes of this study are to investigate dental hygienists' perceptions of the constituent elements of professionalism and the factors affecting their perceptions. Methods: Semi-structured interviews were conducted with 18 dental hygienists in Japan. Drawing on the conceptualisation of professionalism in medicine described by Van de Camp et al., the transcribed data were thematically analysed. Results: The dental hygienists in this study perceived 70 constituent elements that were categorised into eight core competencies related to professionalism. These competencies were further classified into three main themes: intrapersonal, interpersonal, and public professionalism. There were three sociohistorical factors that affected their perceptions of the constituent elements, namely academic background (university or technical school), the contexts of any previously provided dental care (university hospital or dental clinic), and their social interactions with their colleagues during their engagement in dental practice (dental team or interprofessional team). Moreover, according to their sociohistorical backgrounds, the dental hygienists saw themselves variously as scholars (university graduates), facilitators (university hospital), skillful artisans (dental clinic), or collaborators (interprofessional team). Conclusions: Dental hygienists' perceptions of professionalism are multidimensional and context-dependent, so culture- and professional-specific elements need to be included in educational curricula and continuing professional development programmes. In particular, the conceptualisation of professionalism in the field of dental hygiene as described in this study can be a springboard for enhancing undergraduate education and clinical training. [ABSTRACT FROM AUTHOR]

Background: Dental practitioners agree that dietary counselling is essential for caries prevention; however, they provide advice infrequently due to a lack of confidence and competence. This study aimed to improve practises through an online training module exploring the use of a brief counselling method, and a diet assessment of caries risk form.Methods: Dental practitioners (N = 41) completed a survey on current practises and confidence in providing dietary advice, followed by an online training module. Ten practitioners were involved in recruiting patients, eliciting a diet assessment of caries risk, and using brief counselling techniques with these patients. Patients were followed up at 6 months for a risk assessment review. Dental practitioners also completed a 6-month follow-up survey exploring changes in confidence and perceived barriers.Results: Dental hygienists' confidence improved significantly following the intervention (P < 0.025). Patients showed a significant reduction in high-risk behaviour pertaining to quantity and timing of sugar intake, and significant trends in improvement of behaviours relating to frequency, exposure time and drinking style (P < 0.05).Conclusions: It appears that a simple online learning module can improve hygienists' confidence in dietary advice provision, and have a positive impact on patient behaviour change, within a relatively short time-frame. [ABSTRACT FROM AUTHOR]

Objectives Targeted screening for medical conditions in a dental setting can be an effective strategy for early identification of individuals at increased disease risk. Dentists, patients and physicians have a favourable attitude towards this strategy. Given that dental hygienists ( DHs) are involved in preventive and educational activities, this seems like a natural extension to their roles. We report on the attitudes of American DHs towards chairside medical screening. Methods A 5-point Likert scale (1 = very important/willing, 5 = very unimportant/unwilling) survey was mailed to a nationwide random sample of US practicing DHs. Descriptive statistics were used for all questions, and the Friedman nonparametric analysis of variance was used for multi-element questions. Results A total of 3133 respondents returned the completed questionnaires for an effective response rate of 49.2% and a margin of error 1.8%. The majority of respondents felt it was important to perform/conduct chairside screening for hypertension (94%), diabetes mellitus (89%), cardiovascular disease (85%), HIV (79%) and hepatitis infection (78%); were willing to refer a patient for medical consult (94%), conduct screening that yields immediate results (85%); and were willing to collect the data/samples needed (57-95%). The most important considerations were dentist/owner support (98%), training (97%), patient willingness (98%) and time (98%). Conclusion Similar to dentists, physicians and patients, the majority of the DHs had a favourable attitude towards chairside medical screening. Integrating the DH into screening activities is likely to require additional training and education regarding the diseases of interest, something that could be accomplished through continuing education courses and eventually incorporation into the educational curriculum. [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]

Students in many fields have been found to learn more the more they are engaged in both the academic and social aspects of the learning experience. The aims of this study were to determine the level of dental hygiene students' engagement in their educational programs and in student chapters of the American Dental Hygienists' Association (ADHA) and to assess the relationship of that engagement to students' success as measured by cumulative GPA. All 12,000 dental hygiene students (6,000 in the first year and 6,000 in the second year of two-year programs) enrolled in the 334 accredited U.S. dental hygiene programs were invited to participate in the survey. The ADHA electronically distributed the survey on behalf of the researcher to the students in February 2015. The response rate was 22% (N=2,649); the respondents had a survey completion rate of 94%. Three positive predictors were found to influence student success. The higher the responding students rated the quality of interactions with their faculty members and with their program directors, the higher was their mean GPA. In addition, holding a higher education degree was found to be a significant predictor of academic success. This study's results provide dental hygiene educators with a better understanding of how dental hygiene student engagement relates to academic achievement and may encourage faculty members to improve their strategies for delivering instruction. Future research should review enhanced student engagement practices as they relate to student success. [ABSTRACT FROM AUTHOR]

Interprofessional and intraprofessional education (when students from two or more professions or within the same profession, respectively, learn about, from, and/or with each other) is crucial for effective interdisciplinary collaboration. The aims of this study were to assess the effectiveness of a clinical intraprofessional education program for dental and dental hygiene students, based on students' expectations and satisfaction with the program and patients' satisfaction with the team-based care. The pilot program was developed at the University of Tennessee Health Science Center College of Dentistry, where dental hygiene students were paired randomly with dental students scheduled for prophylaxis, scaling and root planing, or periodontal maintenance. Surveys with questions about the students' expectations and satisfaction were distributed to 89 senior dental students and 27 senior dental hygiene students before and after team-based procedures. Another survey was distributed to 17 patients asking about their satisfaction with the team-based care. All 27 dental hygiene students (100% response rate), 51 dental students (57.3% response rate), and all 17 patients (100% response rate) participated in the surveys. The results showed that both the dental and dental hygiene students had high expectations and were overall satisfied with the intraprofessional education. The students' expectations and perceived educational gap (difference between expectations and satisfaction) differed for the dental and dental hygiene students (p<0.001). The male dental students were also more satisfied than the female dental students (p<0.01). Overall, the program met or exceeded the students' expectations, and the patients were overwhelmingly satisfied with the team-based care. These results suggest that this intraprofessional practice model provided an effective educational experience for both dental and dental hygiene students and patients. The differences between the dental hygiene and dental students' expectations will help in the design of more effective training that promotes intraprofessional and interprofessional teamwork. [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]

Introduction Recent legislation in Denmark has made it possible for dentists to delegate their tasks to dental hygienists. Previous studies have shown that Danish dental hygienists primarily were performing assignments within their own work field. These assignments include prophylaxis or instructing patients in oral health care. However, studies have also shown that Danish dental hygienists performed dental nurse assignments such as chair-side assistance, unit cleaning and disinfection of instruments. Objectives The objectives of this study were to investigate (i) the range of work assignments performed by Danish dental hygienists, (ii) the types of dentist tasks performed by Danish dental hygienists and (iii) job satisfaction among Danish dental hygienists. Design Dental hygienists graduating in 2004-2007 were invited to participate in this study. Methods Participants answered an email-distributed questionnaire. The questionnaire consisted of questions regarding job satisfaction, assignments performed, postgraduate course attendance, receiving assistance from a dental nurse and which work assignments Danish dental hygienists wish to perform in the future. Results The results of this study showed that 90% of Danish dental hygienists were satisfied with their job and 52% were performing dentists' tasks. Among dentists' tasks performed by Danish dental hygienists, invasive caries therapy was the most frequently performed task. Conclusion The type of assignments performed by Danish dental hygienists today appears to be changing compared to previous studies. From initially performing prophylaxis and chair-side assistance for the dentist, Danish dental hygienists today are performing a wider range of tasks which includes dentists' tasks. [ABSTRACT FROM AUTHOR]

Objectives The purpose of this cross-sectional study was to investigate whether dental hygienists are transferring their knowledge of oral cancer screening into practice. This study also wanted to gain insight into the barriers that might prevent dental hygienists from performing these screenings. Methods A 27-item survey instrument was constructed to study the oral cancer screening practices of licensed dental hygienists in Nova Scotia. A total of 623 practicing dental hygienists received the survey. The response rate was 34% ( n = 212) yielding a maximum margin of error of 5.47 at a 95% confidence level. Descriptive statistics were calculated using IBM SPSS Statistics v21 software (Armonk, NY: IBM Corp). Qualitative thematic analysis was performed on any open-ended responses. Results This study revealed that while dental hygienists perceived themselves as being knowledgeable about oral cancer screening, they were not transferring this knowledge to actual practice. Only a small percentage (13%) of respondents were performing a comprehensive extra-oral examination, and 7% were performing a comprehensive intra-oral examination. The respondents identified several barriers that prevented them from completing a comprehensive oral cancer screening. Conclusions Early detection of oral cancer reduces mortality rates so there is a professional responsibility to ensure that comprehensive oral cancer screenings are being performed on patients. Dental hygienists may not have the authority in a dental practice to overcome all of the barriers that are preventing them from performing these screenings. Public awareness about oral cancer screenings could increase the demand for screenings and thereby play a role in changing practice norms. [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]

Background Recommendations regarding caries-preventive self-care for children are provided by several health authorities. Objective To investigate recommendations given to the public regarding children's caries-preventive self-care by Norwegian dentists, dental hygienists, dental nurses and public health nurses. Methods Questionnaires were sent by e-mail and answered by 808 of 1132 persons who provide oral preventive promotion to children in dental services and health centres. The preventive advice was obtained through questions about the preferred preventive methods, fluoride recommendations and sources of knowledge on which the personnel based the advice about caries prevention in children. The responses were analysed using logistic regression. Results The majority (59-71%) in all professions judged oral hygiene education to be the most important caries-preventive method. Most personnel (84-98%) recommended all children to use fluoride toothpaste, and half of all personnel (53%) recommended fluoride lozenges for 50% or more of children. Multivariate analysis showed that dental nurses recommended lozenges to more children than dentists ( OR 2.5, 95% CI 1.7-3.7), while health nurses recommended lozenges to fewer children than dentists ( OR 0.5, 95% CI 0.3-0.8). The most important source of knowledge reported by dental personnel was professional education, while health nurses relied on information from dental personnel. Conclusions Health professions' recommendations regarding caries-preventive self-care for children were mainly similar, although variation existed both between and within professions. Collaboration between professions and awareness of the evidence base for preventive oral care may improve the consistency of information given by health professionals to the public. [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]