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Purpose Non-surgioal periodontal therapy (NSPT) is considered to be fundamental in the treatment of periodontal disease. Advanced area specific instruments were designed to increase the clinician's ability to effectively access root furcation areas during NSPT. The purpose of this study was to explore clinical dental hygienists' familiarity, utilization, and perceived efficacy of advanced instruments in root furcation areas during NSPT. Methods A randomized sample (n=3,500) of licensed dental hygienists in Michigan was invited to participate in a paper-based, mail survey. The 10-item instrument consisted of demographic, multiple choice, Likert scale, and open-ended questions. Descriptive and inferential statistics were used to analyze the data. Results A total of 1,156 surveys were returned; 858 met the inclusion criteria for a response rate of 24.5%. Respondents who graduated between 2010-2020 than those who graduated between 1990-1999 were more likely to utilize advanced instruments and those who graduated in 1989 or earlier (16.0% and 19.9% respectively). Respondents familiar with advanced instruments were more likely to use them in furcation areas during NSPT than those less familiar with the instruments (95% CI [18.1, 29.6], p Conclusion Familiarity with advanced instruments and perceived efficacy of these instruments for accessing root furcations increased the likelihood of clinical dental hygienists utilizing them during NSPT. Dental hygiene education and continuing education programs should continue to provide opportunities for students and practicing clinicians to learn NSPT instrumentation techniques utilizing advanced instruments designed for furcation access. Keywords non-surgical periodontal therapy, advanced periodontal disease, periodontal instrumentation, advanced area specific instruments, dental hygiene education, INTRODUCTION Non-surgical periodontal therapy (NSPT), also referred to as periodontal debridement or scaling and root planing, is considered the 'gold standard' for the treatment of periodontal disease. (1-3) The goal [...]

Purpose: Professional identity formation is positively influenced by roles models, mentors, and experiential learning. The purpose of this study was to investigate the role membership in the American Dental Hygienists' Association (ADHA) plays in developing and sustaining professional identity, and to explore whether differences exist between how students and licensed professionals perceive this role. Methods: A 48-item survey consisting of multiple choice, Likert scale, and open-ended items was created, and pilot tested before dissemination to student (SM) and licensed professional members (LM) of the ADHA via an electronic survey platform. Descriptive and inferential statistics were used to analyze the data. Results: Of the 31,479 surveys sent to ADHA members in the database, 1,983 were completed, for a response rate of 6.3%. Most respondents were licensed professionals (86%, n=1,699), female (98%, n=1,940) and White (84%, n=1,668). Over one-third were over 55 years of age (37%, n=727). Continuing Education and Evidence-based Research resources were identified as positively affecting professional identity (4.0 or higher means). Advocacy efforts, the Journal of Dental Hygiene, and Access Magazine had a significantly greater positive influence on LMs professional identity (p Conclusion: Member benefits in the ADHA positively influence the professional identities of students and licensed professionals. Dental hygiene students most value benefits that will support their roles as future health care professionals, while licensed professionals identified evidence-based resources and advocacy efforts as instrumental in sustaining their professional identity. Keywords: dental hygienists, professional identity, professional development, professionalism, dental hygiene education This manuscript supports the NDHRA priority area, Professional Development: occupational health (career satisfaction and longevity). Submitted for publication: 5/10/2021; accepted: 3/19/2022, Introduction Professional identity is the internal adoption of the norms of a profession. (1) The concept was first introduced in 1957 when Merton et al. reported that the goal of [...]

Purpose: Changes in dental hygienists' scope of practice in the United States (U.S.) are not independent of general dentists' attitudes and behavior related to dental hygienists' professional roles. The purpose of this study was to assess perceptions and knowledge of general dentists concerning the legally allowable duties of dental hygienists in their state versus the services they provide in their individual practices; the importance of dental hygienists' contributions to the practice; and how well dental hygienists interact with dentists and patients. The relationships between dentists' attitudes, and dental hygienists' actual behavior, the age of the dentist and the number of dental hygienists and dental assistants employed in the practice were also explored. Methods: Survey data were collected from 292 general dentists in the state of Michigan concerning their attitudes and behavior related to dental hygienists' scope of practice. Results: The average number of services dental hygienists provided in the practices surveyed were lower than the average number of services that dental hygienists are legally permitted to provide in the state of Michigan. The higher the importance dentists placed on dental hygienists' clinical and overall contributions to their practice and their patient management skills, the more diagnostic services and therapies the dental hygienists performed. The older the dentists were, the higher they rated the importance of dental hygienists' clinical contributions, their contributions for the provision of patient care, and the more often dental hygienists performed diagnostic and additional procedures. Conclusions: While dentists did not indicate delegating all of the legally allowable dental hygiene duties in their practices, they did indicate having a very high appreciation of the contributions of dental hygienists to their practice. The perceived value of dental hygienists' contributions correlated positively with the number of diagnostic and adjunctive services dentists delegated dental hygienists to perform in their practices. Keywords: dental hygienists, professional role, scope of practice, access to care This manuscript supports the NDHRA priority area Professional development: Regulation (scope of practice). Submitted for publication:2/10/17; accepted:5/29/17, Introduction Ever since the publication of the first United States (U.S.) Surgeon General's report on oral health in 2000, it has become common knowledge that certain segments of the U.S. [...]

Purpose: The purpose of this study was to investigate key factors associated with the economic sustainability of the Registered Dental Hygienist in Alternative Practice (RDHAP). Methods: An invitation to participate in a 38-question electronic survey was sent via postal mail to 440 RDHAP licentiate addressees obtained through the Dental Hygiene Committee of California (DHCC). Legal restrictions did not allow for obtaining the RDHAP licentiate email addresses from the DHCC. The survey was disseminated via email to the 254 RDHAPs who were members of the California Dental Hygienists' Association. Additional invitations to participate were made via flyer distribution at an RDHAP symposium, and on RDHAP only social media sites. Results: The response rate was an estimated 16%. While 44% of the RDHAPs reported some employment in a traditional dental practice, given the opportunity, 61% of these respondents indicated that they would practice exclusively as an RDHAP. With regard to practice strategic planning and alliances, 31% felt that dentists lacked knowledge of the RDHAP, and 25% indicated dentists were resistant to this workforce model. Regarding RDHAP practice staffing patterns, 75% indicated not having any employees. When asked about business systems, 64% had solo, portable practices and 16% had standalone practices. Economic sustainability challenges included practice business/equipment expenses (29%), insurance/ reimbursement issues (21%), patient flow (19%) and RDHAP visibility (14%). Conclusions: RDHAP practices face challenges including the need for strategic planning and intra- and inter-professional alliances, efficient and effective patient flow, optimal staffing patterns and effective business systems. Focus on enhancing RDHAP visibility within the dental and medical communities should be a priority. In addition, further research should explore RDHAPs aligning with community-based clinics, Federally Qualified Health Centers and Dental Support Organizations (DSOs) with a commitment to disease prevention in addition to the financial resources and staff to manage practice business systems. Keywords: Registered Dental Hygienist in Alternative Practice, oral care, direct access, sustainability, intraprofessional alliances, interprofessional alliances, patient flow, personnel staffing This manuscript supports the NDHRA priority area Population level: Access to care (vulnerable populations) Submitted for publication: 7/18/16; accepted 4/27/17, Introduction The 'silent epidemic' of oral disease affects one out of every five people in the United States. (1) This epidemic disproportionately affects racial and ethnic minorities and children who [...]

Purpose: This study sought to determine the ability of putative host and microbially-derived biomarkers to predict periodontal disease status from whole saliva and plaque biofilm. Problem Statement: Periodontal disease afflicts [...]

ABSTRACTChaperones are molecules found in all cells and are critical in stabilization of synthesized proteins, in repair/removal of defective proteins, and as immunodominant antigens in innate and adaptive immunity. Subjects with gingivitis colonized by the oral pathogen Porphyromonas gingivalispreviously demonstrated levels of anti-human chaperone Hsp90 that were highest in individuals with the best oral health. We hypothesized that similar antibodies to pathogen chaperones might be protective in periodontitis. This study examined the relationship between antibodies to P. gingivalisHtpG and clinical statuses of healthy and periodontitis-susceptible subjects. We measured the humoral responses (immunoglobulin G [IgG], IgA, and IgM) to peptides of a unique insert (P18) found in BacteroidaceaeHtpG by using a high-throughput, quantitative fluorescence enzyme-linked immunosorbent assay. Indeed, higher levels of IgG class anti-P. gingivalisHtpG P18 peptide (P< 0.05) and P18a, consisting of the N-terminal 16 amino acids of P18 (P< 0.05), were associated with better oral health; these results were opposite of those found with anti-P. gingivaliswhole-cell antibodies and levels of the bacterium in the subgingival biofilm. When we examined the same sera for IgA and IgM class antibodies, we found no significant relationship to subject clinical status. The relationship between anti-P18 levels and clinical populations and individual subjects was found to be improved when we normalized the anti-P18a values to those for anti-P18? (the central 16 amino acids of P18). That same ratio correlated with the improvement in tissue attachment gain after treatment (P< 0.05). We suggest that anti-P. gingivalisHtpG P18a antibodies are protective in periodontal disease and may have prognostic value for guidance of individual patient treatment.

Between January and March 1984, the first community outbreak of transient thyrotoxicosis in the United States was documented in a seven-county area of southeastern Nebraska; 36 of the total 49 patients resided in York County (2.4 cases per 1,000 population). The median age of patients was 36 years, range six to 82 years; 51 percent were women. By definition, all patients were symptomatic, visited a physician, and had a newly identified elevated serum concentration of thyroxine or triiodothyronine of unknown cause. None had a goiter or a painful thyroid gland. Low 131I uptake measurements were found in all nine patients studied. Six patients were hospitalized; none died. Investigation of all 12 household contacts of eight selected patients revealed five additional persons with thyrotoxicosis and four with asymptomatic hyperthyroxinemia. A case-control study revealed that illness was associated with a significantly higher frequency of a reported recent respiratory viral-like condition. In another case-control study, the HLA-DR3 antigen was present in more case subjects (39 percent) than control subjects (14 percent). In addition, a significantly higher proportion of patients than control subjects purchased beef from one of the three supermarkets in York Country. Concomitant with the outbreak, the supermarket implicated in the outbreak purchased an unusually large quantity of beef (7,000 pounds) from a nonregular supplier in Nebraska, which had reportedly instituted the practice of trimming gullets (a procedure that removes the muscles from bovine larynx for beef) about three months earlier. Thus, it is concluded that the Nebraska outbreak, like one in Minnesota that occurred 18 months later, probably resulted from patients having eaten ground beef that was contaminated with bovine thyroid gland. This form of thyrotoxicosis, perhaps misdiagnosed as painless thyroiditis in the past, probably represents a previously under-recognized public health problem.