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Purpose Health care professionals (HCPs) working collaboratively can improve patient outcomes and also increase their understanding of each other's professional roles. This descriptive study aimed to explore dental hygienists' perceptions of collaboration with dentists and intraprofessional educational (IntraPE) experiences. Methods A convenience sampling method was used to assess DHs perceptions of collaboration with dentists using the Interprofessional Collaboration Scale (ICS), a validated scale that measures perceptions of communication, accommodation, and isolation among HCPs. One open-ended question was added to explore IntraPE. Demographics, work characteristics and responses from the ICS were analyzed using frequency, mean, standard deviation, Pearson's correlation, t-test, ANOVA, and multivariable regression. Responses from the open-ended question were transcribed, organized, and coded. Themes were identified using the Delve Qualitative Analysis Tool. Results Of the 264 participants, the average age was 38.9, and most identified as female (98.9%). Data analysis revealed that DHs had positive perceptions of collaboration with dentists. Significant relationships were found between ICS factor accommodation and the average number of patients treated per day ([r.sub.s] = -0.242, p Conclusion Dental hygienists in this study had an overall more positive than negative perception of collaboration with dentists. Dental and dental hygiene programs should focus on intraprofessional education experiences to continue to enhance collaboration. Keywords Intraprofessional education, Collaboration, Dental hygienist, Dentist, Intraprofessional collaboration, interprofessional collaboration scale NDHRA Priority Area, Professional education: Development (Interprofessional education). Submitted for publication: 2/23/2024; accepted after revision: 7/10/2024, INTRODUCTION Collaboration among health care professionals has been shown to improve the quality of patient care. (1) Lack of interprofessional collaboration has been associated with lower quality patient care as [...]

In the dental hygiene discipline, evidence-based practice serves as a cornerstone for delivering high quality patient care and moving professional standards forward. As practitioners delve deeper into research to inform clinical decision making, the integration of robust survey methodologies becomes imperative. However, the complexities of survey design, implementation, and analysis pose notable challenges, particularly in ensuring the reliability and validity of research outcomes. This short report provides brief practical guidance about the basics of survey research methodologies for dental hygiene professionals. Keywords survey methods, survey methodology, survey design, questionnaire, dental health surveys NDHRA priority area, Professional development: Education (evaluation). Submitted for publication: 4/4/2024; accepted: 7/10/2024, INTRODUCTION Survey research is a strategy to gather information from a sample by asking a series of questions or items that may be used to make inferences more broadly in [...]

Purpose Social media has created an environment providing readily available information that impacts how individuals seek information and make product decisions. The purpose of this study was to examine adult consumer use of social media for information seeking and the effect on intention to purchase oral health care products. Methods A cross-sectional study design with a non-probability sample of adult consumers recruited through crowdsourcing with Amazon's Mechanical Turk (MTurk) was used to examine the effect of social media on purchasing of oral health products. Data collection included demographic, social media use, and the Information Acceptance Model (IACM) which measured information acceptance from friends and customer reviews from social media. Descriptive statistics, subgroup analysis of demographic variables, and multivariable linear regression were used to assess the relationship among variables. Results Participants (n=308) were mostly males (56.2%), average age 37 years, held bachelor's degrees (68.8%), from the southern United States, and had been to the dentist within the last two years (72.8%). Instagram (40.6%) was the most frequently used platform and social media was frequently used (36.7%) to obtain information on oral health care products. Findings from the IACM information subscale indicated high scores for information from friends and customer reviews (p Conclusion Results provided some initial insights into the way consumers may use social media for information about oral health products and the influences on them choosing to purchase the products. Oral health care providers can use this information to educate and guide patients to credible information sources in their search for oral health care products. Keywords social media, purchase intention, oral health care products, consumer information seeking, electronic word-of-mouth NDHRA priority area, Client Level: Oral health care (health promotion, treatments, behaviors, products). Submitted for publication: 2/16/2023; accepted after revision: 6/11/2023, INTRODUCTION The availability of enormous amounts of information and communication through social media has impacted all aspects of life. Web 2.0, the most recent internet version, is more user driven [...]

Purpose Increased use of technology, including social media, has led to a new phenomenon of workplace cyberbullying, specifically within the health care professions. The purpose of this study was to measure the prevalence of workplace cyberbullying among clinical dental hygienists and identify relationships between these behaviors and demographic characteristics. Methods A cross-sectional survey research design was used with a non-probability sample of clinical dental hygienists (n = 714) recruited via social media. The validated Workplace Cyberbullying Measure (WCM) survey instrument was used for data collection which included work-related (10 items) and person-related (7 items) subscales. Data analysis included descriptive statistics and correlations. Results The completion rate was 88.8% (n = 634). The prevalence of workplace cyberbullying among participants was 19%, with the highest frequency of negative acts occurring now and then. When comparing the two subscales among different workplace settings corporate dental/Dental Service Organizations (DSOs) had a higher work-related subscale score (M = 1.84, SD=0.78) than private practice (p = 0.03), but not community/public health clinical settings (p=0.69). Community/public health clinics had a higher work-related subscale score (M = 1.78, SD=0.68) than private practice (p Conclusion Dental hygienists (20%) report experiencing workplace cyberbullying in the past 6 months especially in corporate dental/DSOs and community/public health settings. Corporate dental/DSOs may need to investigate educating personnel on WCB. Employers, particularly corporate/DSOs and public health agencies, need to have policies in place to manage WCB. Keywords workplace cyberbullying, bullying, dental hygienist, social media, electronic communication NDHRA priority area, Professional Development: Occupational Health (determination and assessment of risks), INTRODUCTION Technology and social media use has expanded in recent years and become a more accepted and essential modality for both personal and professional communication. (1) Workplace stressors have also [...]

Purpose: The COVID-19 pandemic interrupted dental care for individuals due to dental practice closures beginning in March 2020. The purpose of this study was to investigate the relationships between fear or stress related to COVID-19, dental anxiety and attending dental visits among adults in the United States (US). Methods: A cross-sectional survey research design was used with a non-probability sample of adults residing in the US. Three validated scales, the COVID-19 Stress Scale (CSS), Fear of COVID-19 Scale (FCV-19S) and Modified Dental Anxiety Scale (MDAS), were used for the electronically delivered survey instrument. A crowd sourcing platform was used to recruit participants over the age of 18, residing in the US. Descriptive, correlation, and multiple regression tests were used for data analysis. Results: A total of 308 participants opened the survey with a 97% completion rate (n=299). Time since the last dental visit was positively correlated with all measurement scale scores (p Conclusion: Individuals with dental anxiety were more likely to exhibit higher levels of fear and anxiety about COVID- 19 transmission, resulting in delays in seeking dental care. Dental professionals should address patient concerns about the safety of dental settings and the infection control measures in place to prevent the transmission of COVID-19 in dental settings. Public health entities and professional organizations need to promote messaging about the measures in place to deliver safe oral health care. Keywords: COVID-19, coronavirus disease, pandemic, fear of COVID-19, dental anxiety, health-related behavior, health care seeking behavior, Introduction Severe acute respiratory syndrome coronavirus 2 (SARSCoV-2) is a highly infectious respiratory virus with mild to severe symptoms and may lead to death. (1,2) Coronavirus disease (COVID-19) was first [...]

Ask any leader in the U.S. Army to list attributes that encompass either a successful organization or a successful individual and trust will be high on the list. Trust is [...]

Editor's Note: This article is an update to a previous piece the author wrote titled 'Trust: New Formulation of a Fundamental Principle.' View the original article at https://www.moore.army.mil/infantry/magazine/issues/ 2022/Fall/PDF/10_Vineyard.pdf. It [...]

Exegesis. While this may not be a word that is often or ever used in everyday conversations, it is a very important word. A very basic definition of exegesis is [...]

Purpose: Health disparities in the United States (US) are widespread, especially among racial and ethnic minorities populations. The purpose of this study was to assess whether oral health care knowledge and acculturation were associated with utilization of oral health services among the Latino and Hispanic population in Massachusetts. Methods: A cross-sectional survey research design was used with a convenience sample of Hispanic or Latino adults (n=315) residing in Massachusetts. The survey consisted of three validated instruments: New Oral Health Literacy Instrument for Public Health, the American Dental Association's Health Policy Institute survey, and the Short Acculturation Scale for Hispanics survey (SASH). Oral health utilization was assessed using descriptive statistics, relationships between variables were assessed using t-tests. Results: The survey had a completion rate of 73% (n=230). Participants with dental insurance had a higher mean number of correct oral health knowledge responses as compared to those without insurance (p=0.003). Females and participants who were married or in a civil union had a higher mean knowledge score. Participants with dental insurance were more likely to have visited the dentist in the last 12 months, and have a dental home compared to those without (p Conclusion: Improving access to affordable dental coverage, promoting the establishment of a dental home, encouraging cultural sensitivity among the dental team, and providing resources to those with limited English proficiency could improve utilization of oral health services among Latino and Hispanic populations. Keywords: dental utilization, health disparities, minority health, oral health knowledge, access to care, population health This manuscript supports the NDHRA priority area, Population level: Access to care (vulnerable populations). Submitted for publication: 9/29/20; accepted: 2/9/21, Introduction Health disparities in the United States (US) are widespread, especially among racial and ethnic minorities populations. (1) In 2017, the US Department of Health and Human Services (HHS) published [...]

Purpose: Workplace violence (WPV) and inappropriate patient sexual behavior (IPSB) have become increasingly prevalent in the United States. Previous research has shown health care professionals are at a 16-times higher risk of experiencing WPV and IPSB than other occupations, however, there is a lack of research in the field of dental hygiene. The purpose of the study was to examine the experiences of dental hygienists with IPSB in the workplace. Methods: A cross-sectional survey research design was used with a purposive sample of clinical dental hygienists recruited through social media sites (n=471). The validated survey was comprised of demographic and IPSB-related questions, with one open-ended question to expand on experiences with IPSB. Descriptive statistics, Pearson's correlation, t-tests and multiple regression analysis were used to analyze the data. Results: The survey completion rate was 49% (n=232). Career occurrence of IPSB was 85.8% and occurrence within the last 12-month period was 63.5% among the respondents. Participants who experienced all three categories of IPSB severity had the lowest median number of years in clinical practice (Md.=5.0) as compared to those who reported two categories (Md.=7) and those with only one category (Md.=10), p=0.01. Themes from the open-ended questions included types of patient perpetrating IPSB; type of IPSB behavior; and approaches to management of the IPSB. Conclusion: The high prevalence of IPSB events among dental hygienists in this study warrants increased practitioner education, improved workplace policy and support for management of IPSB. Keywords: dental hygienists, workplace violence, inappropriate sexual behavior, sexual harassment, professional-patient relations This manuscript supports the NDHRA priority area: Professional development: Occupational health (methods to reduce occupational stressors). Submitted for publication: 7/31/20; accepted:12/l4/20, Introduction According to the National Institute for Occupational Safety and Health (NIOSH), 71% of workplace violence (WPV) reported in the US has occurred in health care and social assistance settings. [...]

Purpose: The purpose of this study was to explore the knowledge, attitudes, practices and barriers faced by dental health care professionals (DHCP) regarding the Centers for Disease Control and Prevention (CDC) infection control guidelines in dental settings and summary (2003, 2016) prior to onset of the SARS-CoV-2 (COVID-19) pandemic. Methods: A descriptive, cross-sectional study design was used to create a 42- item electronic survey. A convenience sample of dental assistants registered dental hygienists, and dentists (n=397) was recruited through professional dental social media groups, face-to-face recruitment, and snowball sampling. Descriptive statistics were used to analyze the data. Results: The completion rate was 66.7% (n=265). The mean knowledge score for the CDC infection control guidelines was 58%. Less than half (39%) of the respondents were able to correctly identify hand hygiene as the most important measure in preventing the spread of infections among patients and DHCP. One third (33%) of the respondents were unaware of the CDC guidelines regarding respiratory hygiene/cough etiquette measures in dental settings. Participants indicated that the greatest barrier in following infection control guidelines was a heavy workload (37%), followed by time restraints (25%), and expense (15%). Conclusion: Although DHCPs reported familiarity (perceived knowledge) with 2003/2016 CDC infection control guidelines in dentistry, their knowledge and practices were inadequate. This information may serve as a baseline for future consideration of infection control continuing education as a requirement for licensure, particularly given the impact of the COVID-19 pandemic. Keywords: dental health care providers, infection control, knowledge, attitudes, infection control practices This manuscript supports the NDHRA priority area, Professional development: Education (Evaluation). Submitted for publication: 4/19/20; Accepted: 10/17/20, Introduction One of the most noteworthy influences on the oral healthcare profession was the emergence of the human immunodeficiency virus (HIV) in 1981. (1) This epidemic transformed the clinical oral [...]

Purpose: There is limited research about the job satisfaction (JS), burnout (BO), and intention to leave (ITL) amongst dental hygienists in clinical practice providing patient care. The purpose of this study was to explore current trends and the factors influencing JS, BO, and ITL among dental hygienists in their current positions. Methods: A cross-sectional research study was conducted with a convenience sample of dental hygienists recruited via social media sites. The web-based survey consisted of three previously validated instruments (Job Satisfaction Survey, Oldenburg Burnout Inventory, and Turnover Intention Scale). Descriptive statistics were used to analyze the data. Results: The survey completion rate was 77% (n = 554). Job satisfaction and burnout were associated with five factors related to ITL: frustration, achieving personal-work related goals, considering leaving, accepting another job, job satisfying personal needs, and looking forward to another day at work. Findings indicated that higher levels of JS ([beta] = -0.95, p Conclusion: Findings suggest there is overall job satisfaction amongst dental hygienists in clinical practice with the exception of the lack of fringe benefits and opportunities for promotion. Employers may need to identify ways to address these concerns to retain qualified dental hygienists. In addition, employers need to be proactive in addressing factors impacting burnout and dental hygienists' intent to leave their positions. Keywords: dental hygienists, burnout, job satisfaction, intention to leave, career longevity, occupational health This manuscript supports the NDHRA priority area, Professional Development: Occupational Health (Career satisfaction and longevity) Submitted for publication: 5/19/20; accepted: 9/8/20, Introduction Dental hygienists play an important role in oral health promotion and disease prevention by serving in a multitude of roles that include the provision of patient care in a [...]

Purpose: Individuals with intellectual and developmental disabilities (IDD) have a higher risk of oral disease and require assistance in performing oral self-care. The purpose of this study was to measure the impact of an oral health education program in improving caregivers' oral health knowledge, attitudes, behavior, and self-efficacy in providing oral health care to clients with IDD, residing in intermediate care facilities. Methods: A non-probability sample of new hire caregivers (n=47) for clients with IDD residing in an intermediate care facility was used for this quasi-experimental study. A one-group repeated measures design was used to explore the effectiveness of an oral health education program. All variables were examined using summary statistics and evaluated for normality and statistical assumptions. Results; Forty-seven participants attended the oral health education program intervention and completed the pre- and post-intervention questionnaire. Seventy percent (n=33) completed the four-week post-questionnaire. A statistically significant (p=0.004) improvement in knowledge between the baseline questionnaire and four-week questionnaire was identified. Findings demonstrated slight increases in knowledge for caregivers with Conclusion: Increased knowledge alone is not adequate to bring about and maintain positive oral health behavior change. Longer-term caregiver interventions, in addition to on-site support for oral care, are warranted to evaluate outcomes for individuals with IDD with the goal of reducing the burden of oral disease. Key words: caregivers, oral health, oral health education, developmental disabilities, intellectual disabilities, intermediate care facility, oral care This manuscript supports the NDHRA priority area, Population level: Access to care (interventions). Submitted for publication: 1/13/20; accepted: 8/15/20, Introduction Sixty-one million adults (25.7%) in the United States (US) are defined as having a disability under the Americans with Disabilities Act. (1,2) Developmental disabilities (DD) are defined as mental [...]

Purpose: Little is known about the self-care practices of dental hygiene students. The purpose of this study was to explore the self-care practices among dental hygiene students to examine the relationships between self-care practices, work hours, and caregiver responsibilities. Methods: The validated Health-Promoting Lifestyle Profile [HPLP II] survey was used to assess a convenience sample of dental hygiene students (n=416) in the United States (US) and Canada. The survey instrument consisted of 61 items in six subscales; spiritual growth, nutrition, interpersonal relations, health responsibility, physical activity, and stress management and was distributed to dental hygiene students through program directors and student social media sites. Data was analyzed using correlation, Mann-Whitney U, Kruskal-Wallace and regression to explore relationships between the variables. Results: Eighty-one percent of the target population opened the link and completed the survey (n=337). Mean scores for interpersonal relations (M=3.00) and spirituality (M=3.03) subscales indicated respondents were often engaging in these behaviors. Mean scores for physical activity (M=2.26), stress management (M=2.31), nutrition (M=2.44), and health responsibility (M=2.30) sub-scales suggested respondents sometimes practiced these health promoting behaviors. Respondents working more off-campus hours reported stress management behaviors less frequently (p Conclusion: Outcomes from this study identified the need for improvement in health promoting behaviors related to nutrition, physical activity, and stress management in dental hygiene students. In addition, students with off-campus work and caregiver obligations may need additional assistance with self-care and stress management strategies to support academic success, given the academic and clinical rigors of the dental hygiene program. Keywords: dental hygiene students, self-care, wellness behaviors, stress management, health promotion This manuscript supports the NDHRA priority area: Professional development: Education (evaluation). Submitted for publication: 3/5/20; accepted: 8/9/20, Introduction Self-care, actions taken by an individual to support their personal well-being, is essential to prevent disease and maintain health. (1,2) Individuals who engage in self-care and health-promoting activities have [...]

Purpose: Identifying individuals at risk for developing periodontal disease helps to prevent, treat, and manage this condition. The purpose of this study was to explore the knowledge, attitudes, and practice behaviors of dental hygienists regarding the use of periodontal risk assessment tools. Methods: This cross-sectional survey study used a convenience sample of dental hygienists recruited through social media and snowball sampling. The validated electronic survey included items related to demographics, knowledge, attitude, and practice behaviors regarding the use of periodontal risk assessment tools in the clinical setting. Descriptive statistics were used to analyze the data and outcomes were represented through frequencies and percentiles. Results: Two-hundred eighty-two of the respondents (n=282) (n=530) met the inclusion criteria, for a participation rate of 53%. A majority (88%) 'agreed' or 'strongly agreed' that periodontal risk assessment tools improve communication and increase educational opportunities with patients and 50% reported completing periodontal risk assessments during a patient's scheduled appointment. Significant relationships existed between 'frequently' or 'always' reviewing periodontal risk assessment outcomes and the participants age, place of employment and number of continuing education (CE) hours completed (p=0.004). Participants who were members of the American Dental Hygienists' Association (ADHA) were more likely to correctly answer three or more knowledge questions (p=0.01), and more likely to measure and record pocket depths in a periodontal risk assessment tool (p=0.005). Conclusion: Although dental hygienists reported periodontal risk assessment tools were helpful for patient communication and education, only 50% reported regular completion while providing patient care. Continuing education on the value of periodontal risk assessment tools and better understanding of the barriers to routine implementation, could expand their use. Keywords: dental hygienists, clinical practice, periodontal risk assessment, periodontal risk assessment tools, periodontal disease, periodontal probing This manuscript supports the NDHRA priority area, Client level: Basic science (clinical decision support tools). Submitted for publication: 12/20/19; accepted: 6/25/20, Introduction Periodontal disease is a significant oral health problem in the United States (U.S.), affecting approximately 46% of all adults. (1,2) Periodontal disease plays an important role in an individual's [...]

Purpose: Depression is a rising global health concern manifesting bidirectional relationships between chronic disease conditions such as type 2 diabetes and oral health. The purpose of this study was to explore the knowledge, attitudes, and practices of oral health care professionals towards individuals with depression. Methods: A 24-item, validated Knowledge Attitudes and Practices (KAP) survey was used for this descriptive, cross-sectional study. Non-probability, convenience and snowball sampling was used to recruit oral health care professionals (dentists, dental hygienists and dental assistants) to participate in an electronic survey. Descriptive statistics were used to analyze the data. Results: A total of 288 oral health care professionals (n=288) met the inclusion criteria. Age of the provider was positively correlated with reviewing or assisting in reviewing patient's depression history during routine dental visits (r=.16, p=.007), and referring or assisting in referring a patient to a mental health specialist (r=.30, p Conclusion: Age, lack of practice experience and education may influence oral health care professionals' attitudes and practices when providing care for patients with depression. Mental health and its relationship to oral and systemic health may be an appropriate addition to dental program curricula. Oral health care providers should consider modifying routine practices to include the special needs of patients with depression. Keywords: depression, depressive disorders, oral health care professionals, oral health promotion, oral systemic disease, Introduction Depression is a rising global health concern characterized by decreased energy, sadness, feelings of guilt, low self-esteem, insomnia, chronic fatigue, and thoughts of death or suicide. (1-4) Signs and [...]

Is one immoral act or one immoral Soldier able to change the perception of an entire unit or organization? The seemingly obvious answer is yes. Nationally, ethics is a hot [...]

Purpose: Oral and craniofacial conditions or diseases can impact an individual's health and quality of life. The purpose of this study was to assess the perceived oral health related quality of life (OHRQoL) of children, and evaluate the reported level of agreement between caregivers and their children. Methods: Purposive sampling was used to recruit children ages 8-15, and their caregivers from a dental clinic in a pediatric hospital for this descriptive, cross-sectional study. A modified version of a validated measure, Child Oral Health Impact Profile-Short Form (COHIP-SF), was used for a 22-item questionnaire encompassing three subscales: oral health, functional well-being, and social emotional well-being. Two additional items were included to assess child/caregiver's level of agreement. A dental chart review was also conducted to assess the child's overbite, overjet, and decayed surfaces. Data were analyzed through descriptive statistics and examined for assumptions of normality and linearity. Results: Sixty child/caregiver pairs (n=120) participated in this study. Overbite, overjet and decayed surfaces were not found to be related to any OHRQoL variable, including child/caregiver ratings and overall agreement (p>.05). Average OHRQoL scores for caregivers found to be more positive those of their children (p=.02). Agreement between caregivers and the child's gender was shown to be significant (p=.01). Female child scores differed significantly from males with respect to their caregiver responses (p=.02). Caregivers rated a higher OHRQoL for female children, thus overestimating their female child's reported OHRQoL. Conclusions: The moderate level of agreement found between children and caregivers reinforces the importance of including the child, as well as the caregiver, when assessing OHRQoL. Keywords: oral health, pediatric oral health, oral health related quality of life, public health, child/caregiver concordance This manuscript supports the NDHRA priority area, Client level: Basic science (diagnostic testing and assessments). Submitted for publication: 3/9/19; accepted: 10/17/19, Introduction In 1948, the World Health Organization redefined the term 'health' to incorporate aspects of physical, mental, and social well-being. (1) Physical well-being encompasses an individual's ability to perform everyday [...]

Purpose: Untreated and poorly controlled diabetes causes increased levels of blood glucose associated with poor periodontal disease outcomes. Dental hygienists can play a significant role in screening patients for diabetes mellitus, leading to referral and early diagnosis. The purpose of this study was to determine the knowledge, attitudes, practices, and barriers faced by clinical dental hygienists regarding diabetes risk assessment and screenings. Methods: A mixed method design was used with a convenience sample of dental hygienists in clinical practice (n=316). A 32 item, electronic survey was validated at item-level, and participants were recruited through multiple dental hygiene Facebook groups. Descriptive statistics were used to analyze the data. The survey also included two open-ended attitude questions that were interpreted using thematic analysis to pinpoint common patterns within the data. Results: Dental hygienists had high knowledge scores regarding diabetes and oral health, although many were unaware of their states' specific statutes and regulations for screening practices. Nearly all (95.9%), were likely to educate and refer patients (82%), although fewer than half (40.9%), were likely to perform chairside screening for diabetes. Emergent themes for barriers to screening were time, money, patient acceptance/willingness, lack of education, not having the proper tools, and states' rules and regulations. Conclusion: Despite high knowledge scores regarding diabetes and oral health, there is a gap in regards to dental hygienists' willingness to perform diabetes screenings in a clinical setting. Dental hygienists should be capable of integrating chairside diabetes screening practices into the process of care with proper training. Keywords: diabetes mellitus, diabetes risk assessment, diabetes screening, dental hygienists, HbA1c testing This manuscript supports the NDHRA priority area, Client level: Oral health care (Health promotion:treaments, behaviors, products). Submitted for publication: 6/18/19; accepted:10/18/19, Introduction Diabetes is the seventh leading cause of death in the United States and the estimated financial burden related to the disease in 2017 was 327 billion dollars. (1) There [...]

Purpose: Numerous oral health promotion programs are directed at reducing the prevalence of early childhood caries. Smartphone applications (app) may be beneficial in oral health promotion. The purpose of this study was to evaluate the effect of a smartphone app, based on the Theory of Planned Behavior (TPB), on the oral health behaviors of the parents of preschoolers. Methods: A two-phase, sequential, embedded mixed methods design explored how the app influenced the attitudes, beliefs, perceived behavioral control, and intentions of parents of pre-schoolers. Phase 1 was a quasi-experimental, one-group pretest-post-test design. Parents of preschool aged children (n=26) participated in the 4- week intervention. Phase 2 consisted of qualitative interviews with a purposive sample of parents from Phase 1 (n=11). Results: Parents' behavioral intentions or oral health behaviors with their preschoolers did not significantly change from pre- to post- intervention (p>.05). Social norms (SN) and perceived behavioral control (PBC) predicted behavioral intentions pre-intervention and behavioral change post-intervention. Thematic analysis revealed that parents' belief in the importance of establishing oral health habits and brushing reminders and videos delivered via a mobile application supported efforts to form oral health habits. Conclusion: The use of TPB constructs in the development of oral health promotions aimed at parents of preschoolers was partially supported. Intention and behavior were not affected post- intervention, but SN and PBC emerged as significant predictors of intentions and behavior. A dental smartphone app may aid parents to make good oral health habits part of their preschooler's daily routine. Keywords: early childhood caries, smartphone apps, mobile apps, oral health, health promotion, health behavior theories This manuscript supports the NDHRA priority area Client level: Oral health care (health promotion: treatments, behaviors, products). Submitted for publication: 10/8/18; accepted 3/29/19, Introduction Dental caries is the most common chronic childhood disease in the United States (U.S.), with an estimated 14% of children suffering from untreated caries. (1) Race, ethnicity, and socioeconomic [...]