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IntroductionWorkplace bullying is a problem associated with occupational health and safety, negative job satisfaction and overall adverse health effects. (1-12) Within healthcare, bullying is such a significant and persistent problem [...], Purpose: Workplace bullying in health care has been identified as a problem that negatively affects career satisfaction, career longevity and patient outcomes. The purpose of this pilot study was to determine the prevalence of workplace bullying in a convenience sample of dental hygienists in the state of Virginia.Methods: Two hundred and forty Virginia dental hygienists attending a continuing education seminar were invited to participate. Using the Negative Acts Questionnaire-Revised (NAQ-R), respondents were asked to indicate how often they had experienced 22 negative acts or behaviors according to rate of occurrence (never, now and then or monthly, weekly or daily). Bullying was defined as experiencing two or more of the specified negative behaviors over the past 6 months. The negative behaviors were categorized into three subgroups: work-related bullying, personal bullying and physical intimidation.Results: The response rate was 64%. Data revealed almost one fourth (24%) of respondents experienced workplace bullying. The most frequent behaviors experienced by those being bullied were having their opinions and views ignored (73%), experiencing unmanageable workloads (68%) and having their work excessively monitored (68%), on a weekly or daily basis.Conclusions: Results from this study suggest approximately 1 out of 4 Virginia dental hygienists responding to this survey experience workplace bullying. Education and support to ensure identification of bullying may be helpful in promoting proactive awareness, prevention strategies and a healthier work environment leading to greater job satisfaction.This manuscript supports the NDHRA priority area: Professional development: Occupational health (career satisfaction and longevity)Keywords: workplace bullying, workplace harassment, unprofessional behavior, psychological wellbeing, occupational healthSubmitted for publication: 1/26/18; accepted 6/6/18

Introduction Dental hygiene programs are required to make important decisions about appearance and dress code policies relating to both faculty and students. A contemporary aspect of professional appearance in healthcare [...], 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. Keywords: professionalism, dental hygiene, dental hygiene education, health care dress codes, tattoos, body art This manuscript supports the NDHRA priority area Professional development: Education (educational models). Submitted for publication: 12/19/2016; accepted: 9/5/2017

Introduction The physical stress of clinical practice is an occupational risk factor for developing musculoskeletal disorders (MSDs) in dental hygienists. MSDs are common in professions requiring fine repetitive movements and [...], 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. This manuscript supports the NDHRA priority area: Professional development: Occupational health (methods to reduce occupational stressors) Submitted for publication:12/20/16; accepted 3/3017

Introduction The importance of oral cancer screening is widely documented in the literature. (1) Oral cancer prevalence continues to increase every year, with an estimated 41,380 new oral cancer cases [...], Purpose: This study compared the effectiveness of the VELscope® Vx versus visual and tactile intraoral examination in detecting oral lesions in an adult, high risk population. Methods: The pilot study compared the intra oral findings between 2 examination types. The sample was comprised of 30 participants who were addicted to either cigarettes or a dual addiction (cigarettes plus hookah). High risk population was defined as males who were current cigarette smokers or had a dual addiction. Two trained and experienced licensed dental hygienists conducted all examinations. Throughout the study, all visual and tactile intraoral examinations were conducted first by one dental hygienist first, followed by the VELscope® Vx fluorescence examinations by the second dental hygienist. All subjects received an inspection of the lips, labial and buccal mucosa, floor of the mouth, dorsal, ventral and lateral sides of the tongue, hard and soft palate, and visual inspection of the oropharynx and uvula. Both evaluations took place in 1 visit in the Dental Hygiene Research Center at Old Dominion University and external sites. All participants received oral cancer screening information, recommendations, referrals for tobacco cessation programs and brochures on the 2 types of examinations conducted. Results: Participants were considered high risk based on demographics (current smokers and mostly males). Neither visual and tactile intraoral examination nor the VELscope® Vx examination showed positive lesions. No lesions were detected; therefore, no referrals were made. Data indicated the duration of tobacco use was significantly higher in cigarette smokers (14.1 years) than dual addiction smokers (5 years) (p > 0.005). The average numbers of cigarettes smoked per day were 13.5 compared to 14.2 cigarettes for dual addiction smokers. Conclusion: Results from this study suggest the visual and tactile intraoral examination produced comparative results to the VELscope® Vx examination. Findings from this study support that the VELscope® Vx is still considered an adjunct technology and cannot be used exclusively for oral cancer screening. Keywords: oral cancer, VELscope® Vx, dual addiction, oral potentially malignant lesions This study supports the NDHRA priority area, Clinical Dental Hygiene Care: Investigate how dental hygienists use emerging science to reduce risk in susceptible patients (risk reduction strategies).

Introduction Vital tooth bleaching, the act of using hydrogen peroxide or carbamide peroxide to whiten teeth, is the most commonly requested cosmetic dental procedure in the U.S. (1) The American [...], Purpose: The purpose of this study was to determine if vital tooth whitening affects oral health-related quality of life (OHRQOL) in adults age 50 years and older, and if tooth whitening causes increased participation in social activities. Methods: Using a 2 group, single blind, randomized, pre-test, multiple post-test design, 62 participants were enrolled. The experimental group used a whitening product twice daily for 3 weeks. The control group used no whitening products. The Oral Health Impact Profile (OHIP) served as the pre- and post-test measure. The OHIP measures OHRQOL on 7 subscales: functional factors, psychological disabilities, psychological discomforts, physical disabilities, social disabilities, handicaps and physical pain. Additional questions measured the subjects' social activities at baseline, 3 weeks and 3 months. Data from 53 participants, who completed the study, were analyzed using paired t-tests and ANOVA at p=0.05. Results: Statistical significance was observed for the OHIP physical pain subscale (p=0.0029) and the handicap subscale (p=0.05). Pre- to post-test means of the physical pain subscale increased in the experimental group (4.84 to 7.10), suggesting a lower OHRQOL, most likely related to tooth sensitivity experienced by the experimental group. Means from pre- to post-test of the handicap subscale (1.96 to 1.19) reveal that the experimental group reported an improved OHRQOL and felt they were more willing to work. Repeated measures ANOVA and Tukey's post-hoc tests revealed that the experimental group reported significantly less (p=0.04) social activities at the 3 month posttest (3.92 to 3.45). No statistically significant between-group differences were observed in the overall OHIP score for functional factors, psychological disabilities, psychological discomforts, physical disabilities and social disabilities. Conclusion: Results indicate that vital tooth whitening does not improve overall OHRQOL in older adults. Keywords: Tooth whitening, middle aged, oral health related quality of life (OHRQOL), Oral Health Impact Profile (OHIP) This study supports the NDHRA priority area, Health Promotion/Disease Prevention: Validate and test assessment instruments/strategies/mechanisms that increase health promotion and disease prevention among diverse populations.

Introduction Low temperature atmospheric pressure plasma (LTAPP), also known as 'cold' or nonthermal plasma, is an innovative technology that has the potential to destroy microorganisms. (1) Most of the visible [...], Introduction: Cold plasma, also known as Low Temperature Atmospheric Pressure Plasma (LTAPP) is a novel technology consisting of neutral and charged particles, including free radicals, which can be used to destroy or inactivate microorganisms. Research has been conducted regarding the effect of cold plasma on gram-positive bacteria; however, there is limited research regarding its ability to inactivate the spore-formers Geobacillus stearothermophilus and Bacillus cereus. Purpose: The purpose of this study was to determine if cold plasma inactivates G. stearothermophilus and B. cereus vegetative cells and spores. Methods: Nine hundred eighty-one samples were included in this study (762 experimental and 219 controls). Experimental samples were exposed indirectly or directly to cold plasma, before plating and incubating for 16 hours. Control samples were not exposed to cold plasma. The percentage-kill and cell number reductions were calculated from Colony Forming Units (CFU). Data were statistically analyzed at the .05 level using one-way ANOVA, Kruskal Wallis and Tukey's tests. Results: There was a statistically significant difference in the inactivation of G. stearothermophilus vegetative cells receiving indirect and direct exposure (p=0.0001 and p=0.0013, respectively), as well as for B. cereus vegetative cells and spores (p=0.0001 for direct and indirect). There was no statistically significant difference in the inactivation of G. stearothermophilus spores receiving indirect exposure (p=0.7208) or direct exposure (p=0.0835). Conclusion: Results demonstrate that cold plasma exposure effectively kills G. stearothermophilus vegetative cells and B. cereus vegetative cells and spores; however, G. stearothermophilus spores were not significantly inactivated. Key Words: Cold plasma, Low Temperature Atmospheric Pressure Plasma (LTAPP), bacteria, spores, sterilization

This study's purpose was to determine if vital tooth whitening affects oral health-related quality of life (OHRQOL) in adults < 50 years old, and if tooth whitening influences regular professional [...]

The purpose of this study was to explore the effects of vital tooth whitening on tooth color satisfaction, beliefs about dentofacial appearance, and self-esteem in a population 50 years of [...]

Cold plasma is a state of matter that contains a large number of particles that are electrically charged. Plasmas generate chemically reactive species and ultraviolet radiation making them useful in [...]

Introduction The purpose of this retrospective review was to document dental Hygienists' roles and contributions to improving the oral health of America. Step one in this process was to review [...], Purpose. The purpose of this literature review is to document the contributions dental hygienists have made over the past 3 decades to improve the nation's oral health. This historical review encompasses selected literature that acknowledged dental Hygienists' direct involvement in U.S. school-based or school-linked oral health programs from 1970-1999. Methods. Five researchers independently searched MEDLINE, PubMed, and other electronic databases to identify relevant literature for the years 1970-1999. The search aimed to locate articles authored by or that documented dental Hygienists' involvement as 'service provider' in U.S. school-based oral health programs. For the purpose of this review, service provider was defined as educator, administrator, clinician, examiner, or any other unspecified service performed by a dental hygienist. Results. Fifty-seven articles were retrieved, of which 36 (63%) directly linked dental hygienists to U.S. school-based activities. Twenty-seven articles specifically identified dental hygienists as service providers. Dental hygienists were listed as either primary or contributing author on 19 of these articles. Conclusion. The decade of the 1970s revealed very little literature documenting dental Hygienists' involvement in U.S. school-based oral health programs. The 1970s, however, were instrumental in laying the foundation for service in the years that followed. As public health initiatives expanded in the 1980s, dental hygienists were identified in the largest number of papers as key personnel in the areas of education, management, service provider, and author. The decade of the 1990s yielded less literature than the 1980s, yet recognized dental Hygienists' involvement in all aspects of oral health care delivery, program development and management, and authorship. The authors of this review theorize that dental hygienists were engaged in more school-based programs than reported and were involved in the authorship process more frequently than documented. Due to lack of credentials, or the omission of the words 'dental hygienist,' 'RDH,' or 'LDH,' in favor of 'health care provider,' 'auxiliary,' or 'trained health care educator,' it is unknown what portion of contributions made by dental hygienists remain undocumented. Keywords: School-based programs, dental hygienists, community health, school-linked programs

Introduction Bacterial plaque is the primary etiological cause of chronic gingivitis. (1) Many patients, due to difficulty maintaining thorough oral hygiene, accumulate significant amounts of bacterial plaque containing virulent pathogens. [...], Purpose. The purpose of this study was to determine the effects of two oral rinses-one 0.12% chlorhexidine rinse (CHX) and one herbal rinse (HBR)-on gingival health status over time. Methods. Sixty-three participants were randomly assigned to one of three treatment groups: CHX, HBR, or placebo. For three months, participants rinsed twice daily (morning and evening) with 1/2 ounce of allocated rinse after brushing and flossing. Individuals were given the same type of soft bristle toothbrush and whitening toothpaste. No attempt was made to modify participants' routine oral care, except they were advised to refrain from use of any other oral rinse for the duration of the study. Data were collected at baseline (B), month one (1), two (2), and three (3) utilizing the Gingival Index (GI), Plaque Index (PI), and bleeding on probing (BOP). A full mouth periodontal probing was performed at baseline and at the completion of the study. A soft tissue oral assessment was completed at each visit. CHX, HBR, and placebo data were compared between three time intervals, B-I, B-2, and 8-3. Statistical analysis was conducted by means of multiple regression using generalized linear models. Paired comparison tests--ANOVA followed by a post hoc Tukey test--were used to confirm results. Results. CHX was the only oral rinse to demonstrate a statistically significant effect on the reduction of mean GI, BOP, and PI scores when compared to placebo. CHX demonstrated a 31% reduction in the proportion of GI scores between B-2 and a 29% reduction between B-3 (p=.003 and p=.012, respectively). CHX demonstrated a 19% reduction of BOP sites between B-1, 32% reduction between B-2, and 29% reduction between B-3 (p=.028,p=.000, and p=.005, respectively). CHX demonstrated a 20% reduction in PI scores between B-I, and a 28% reduction between B-2 (p=.005 and p=.032, respectively). The effects of HBR on reducing mean GI, BOP, and PI scores were not statistically greater than placebo at any time during the study. Keywords: Dental plaque, gingivitis, chlorhexidine, oral rinse, herbal, mouthrinse

The article discusses the impact of dental hygienists on the overall oral health in the U.S. The effectiveness of dental hygienists in providing oral care services is influenced by a number of factors including restrictions imposed by state practice acts, education levels, economics, politics and other workforce issues, health care trends and preventive dental practices.