A discourse on dental hygiene education in Canada

Over the past decade, the discourse on dental hygiene education has gained momentum in Canada. This review provides insights into the evolution of dental hygiene education in Canada, briefly exploring the history and professional influences for diploma and baccalaureate education within the profession. The profession in Canada has yet to implement a national standardized entry-to-practice educational model, but the recent development of national educational competencies may prove to be a promising beginning. The review also discusses efforts to advance dental hygiene education in recent years, while exploring the political and professional pressures and challenges that remain. Further discourse on education and outcomes-related research can be effective in positively influencing governmental, professional and public opinions of higher entry-level education for dental hygiene which may ultimately result in regulatory change and improved client outcomes.     

Origins and benefits of dental hygiene practice in Europe

Origins and benefits of the practice of dental hygiene were investigated in order to provide guidelines to countries where initiatives are being taken to introduce the profession. In Europe, so far the profession has been introduced in the Czech Republic, Denmark, Great Britain, Finland, Italy, Latvia, Lithuania, the Netherlands, Norway, Portugal, Sweden, Switzerland and Spain. Programmes in Ireland, Poland, and Romania are not presented in this article. Information for this study was obtained using questionnaires and followed up by e-mail correspondence with additional experts, supporting studies and reference literature. All experts consulted are involved in the professional and educational organisation of dental hygiene in their countries. Results show that dentists and dental hygienists who had been inspired by the delivery of preventive care in the US, initiated the European dental hygiene movement. In some countries, opposition of organised dentistry had to be overcome. In countries where the population has limited access to qualified dental hygiene care, such as in Austria, Belgium, Germany and France, a high prevalence of untreated periodontal disease has been reported. There, the lucrative practice of delegating dental hygiene tasks to dental assistants without qualifying education has slowed efforts to implement the profession and resulted in negative health and vocational outcomes. This leads to the conclusion that an implementation of legislation governing the practice and the educational process of dental hygiene in the EU and beyond would contribute to an equitable standard of health care as well as to equal opportunities in education and employment.     

Independent dental hygiene practice worldwide: a report of two meetings

Objectives: Following a meeting at the EUROPERIO in Berlin in 2003, a forum on Independent Practice of Dental Hygienists was held at the International Symposium on Dental Hygiene (ISDH) in Madrid July, 2004. The forum was organized and moderated by Beate Gatermann, President of the German Dental Hygiene Association. The participants were asked to address the following issues: population of country/state; population of dentists; population of state recognized dental hygienists (Canada/USA etc.); number of hygienists with ‘Diploma’ (Europe); duration of dental hygiene education; cost of education (2/3 year base approximately); when and how independent practice began in the country and who must be consulted or approve the application for an independent office (e.g. Health Department); what services are allowed? Can dental hygienists administer local anaesthesia in the dental office, and if so, must a dentist be present? Can dental hygienists purchase the necessary medication for the injection? Does the dental hygienist require additional education to provide local anaesthesia? How are the patients charged? Does the country offer a service fee list? Do insurance companies pay claims of the dental hygienist? What is the approximate average fee per hour charged (€/$)? Do dentists refer patients to you? If so, do they need a letter of referral? Are dental hygienists allowed to take radiographs in independent dental hygiene offices?     

Dysphagia management in a 3-year dental hygiene education programme in Japan

Abstract:  This paper reports the development and evaluation of a dysphagia management course taught to the third year dental hygiene students during 2004–2005 as one framework of the new curriculum. The course consisted of lectures by specialists in each field, basic practice and clinical practice at a facility for the elderly. Evaluation of the course showed that improvements were found in students' understanding in certain subjects when compared with that during 2003–2004. Scores on the post-test were statistically significantly higher than those on the pre-test, showing that basic knowledge of the students had been improved. Introductory and follow-up lectures by dental hygiene instructors and appropriate basic practice enhanced the learning process of the students. In the clinical practice, the concept of 'dental hygiene process of care' was incorporated. The dental hygiene process facilitated the students in planning and implementing dental hygiene care that meets the needs of the individual clients. This active learning experience enhanced the students' understanding of dysphagia management. Although further improvements are necessary, this dysphagia management course should help dental hygienists in playing a greater role in the field of oral care and dysphagia rehabilitation.     

Dental hygiene residential care in a 3-year dental hygiene education programme in Japan: towards dysphagia management based on the dental hygiene process of care

Abstract:  This paper reports an evaluation of a residential care practice, which was part of a 'Dysphagia Management' course introduced into a 3-year dental hygiene curriculum in Japan. The clinical practice was performed at a care facility for the elderly people. Dental hygiene interventions, which consisted mainly of professional oral care, were implemented on a client who was bed-bound after suffering from a stroke. As the client had severe tension in muscles around oral cavity, it was difficult for the facility care workers to provide daily oral hygiene care. The goals of the dental hygiene care plan included decreasing tension of oral muscles and reducing periodontal inflammation and halitosis. The dental hygiene interventions were given once a month for 5 months. Evaluation in the fifth month demonstrated relaxation of oral muscles, decrease in plaque accumulation, and improvements in levels of gingival inflammation, indicating the partial achievements of the initial goals. Possibilities for revision of the care plan could call for more active involvement of the facility care workers and client-centered goal setting.
This learning experience provided an opportunity for continuing intervention and evaluation of dental hygiene care for the same client. The positive results of our limited interventions further confirmed the importance of professional oral care in organic and functional improvements in oral health for the elderly people.     

Quality assurance and dental hygiene

Abstract:  Dental hygiene in Canada has experienced significant growth. It has shifted from an emerging occupation to a regulated health profession in several jurisdictions. Many achievements may be attributed to this growth, including self-regulation and a national code of ethics. However, the majority of Canadian dental hygienists are relying on traditional, outdated and ineffective quality assurance mechanisms, such as mandatory continuing education requirements. In the interests of public protection, dental hygiene needs to ensure that the quality assurance activities required from its members are effective, valid and reliable. Quality assurance in health care continues to undergo modifications that better reflect the public's need for competent, ethical, safe and appropriate health care. Dental hygienists and dental hygiene regulatory bodies are challenged to find valid, reliable and effective methods of quality assurance. This paper discusses some of the developments in quality assurance in health care as well as some of the key and significant achievements of dental hygiene in Canada. The use of quality assurance mechanisms currently used in dental hygiene in Canada is also discussed. The paper concludes with a discussion on the potential barriers and issues that the profession may face when attempting to incorporate suitable quality assurance activities into daily dental hygiene practice.     

A dialectical analysis of an art of dental hygiene practice

Abstract: Objective: There has been little in the literature to date that speaks of an art of dental hygiene compared to science. Yet, science, conceived as the findings from research, does not apply itself; it is the knowledge, judgement and skill of practitioners to apply these findings in a particular setting that, at its highest level, informs artful dental hygiene practice. The purpose of this paper is to question whether an art of dental hygiene exists, if it is important, and how it relates to science. Methods: The method used in the analysis contained in this paper is a dialectical approach used to examine contrary positions, i.e. whether art exists or does not exist, by outlining the structure of each position and clarifying explicit and implicit similarities and dissimilarities. A framework of conceptualizations of art from nursing has been used to examine dental hygiene literature for evidence of art. Results: A preliminary conceptualization, substantiated within dental hygiene, sees the art of dental hygiene as abilities to grasp meaning in client encounters, establish meaningful connections with clients, perform dental hygiene actions skillfully and proficiently, rationally determine courses of dental hygiene action, and conduct dental hygiene practice morally and ethically. Conclusions: That an art of dental hygiene exists is not in doubt and the analysis is presented. To understand better how dental hygienists make practice decisions to develop this process to its optimum – the pursuit of perfection and excellence in dental hygiene practice, we must pursue understanding the art of dental hygiene practice.     

Dental hygienists in Europe: trends towards harmonization of education and practice since 2003

Abstract: Aim: The aim of this study was to investigate the trends in dental hygienists’ education and regulation in the European Union (EU) and European Economic Area (EEA) to examine whether, since 2003, there has been harmonization in dental hygiene education. Methods: Information and data were obtained via piloted questionnaires and structured interviews with delegates from the International and European Dental Hygienists’ Federations and representatives of the Council of European Chief Dental Officers and by literature review. Results: In the EU/EEA, dental hygienists are legally recognized in 22 countries. Since 2003, there has been an increase in the number of Bachelor degree programmes and in autonomous practice. Entry to the profession is now exclusively via a Bachelor degree in five EU/EEA Member States and pending in two more. Ten Member States have adapted their degree programmes to the European Credit Transfer System. Two Member States combine education for dental hygienists and dental therapists. However, dental hygienists are not recognized by EU law and in five Members States, the introduction of the profession has been opposed by dental associations. Conclusions: For the reasons of wide variations in the standards of preventive care and periodontal therapies, the formal recognition of the dental hygiene profession by EU legislation and agreement on a pan‐European curriculum for dental hygiene education leading to defined professional competencies and learning outcomes is required. To achieve this, there is a need for a better collaboration between competent authorities including governments, universities and dental and dental hygienists’ associations.     

The collaborative practice of dental hygiene

Abstract:  This paper discusses the collaborative practice of dental hygiene, primarily using examples from California and New Mexico. Several advantages are discussed, including an increased access to all populations and more respect for the field. The earliest roles of a dental hygienist reflect common components of a collaborative practice. Responsibilities of dental hygienists today as educators and preventive dental providers are also tied to this type of practice. Currently, few states in the USA allow such practices; however, benefits are discussed and the positive effects noted. Opposition to these practices exists, although the concerns have not been proven accurate. Collaborative dental hygiene practices are shown to be a positive avenue through which the population can gain access to noted provider shortages, as well as a rewarding option for the field of dental hygiene.     

Establishing dental hygiene education in Germany: current facts and future perspectives

Abstract:   As there is a marked need to increase the number of dental hygienists (DHs) working in German dental practices, efforts are being made to establish dental hygiene education in accordance with international standards. However, as current German legislation does not envisage a perennial full-time training programme, dental hygiene education may currently be provided within a modular concept only. The basic qualification for enrolment in a modular hygienist training programme of this kind is accredited vocational training as a dental assistant (DA), followed by board-certified continuing education as an oral prophylaxis assistant. Thus, the current system of advanced training for qualification as a DH is subject to at least 6 years' work experience in the field of dentistry. A 950-h full-time advanced training course, meeting all the requirements of this concept, was established by the Westphalia–Lippe Dental Association in cooperation with the University of Münster. The curriculum underlying this programme was outlined considering the recommendations for dental hygiene education issued by the European Federation of Periodontology, although reduced in standards to comply with current German legislation. In addition, the recommendations for American Dental Hygiene education by the American Dental Association were used as a guide for programme development. The contents and implementation of the Münster Dental Hygienist Curriculum may allow the professional competence generated during practical work experience to be linked with international requirements of dental hygiene education.     

Introduction and evaluation of computer-assisted education in an undergraduate dental hygiene course

To cite this article:
Int J Dent Hygiene 10 , 2012; 61–66
DOI: 10.1111/j.1601‐5037.2011.00528.x
Yoshida N, Aso T, Asaga T, Okawa Y, Sakamaki H, Masumoto T, Matsui, K, Kinoshita A. Introduction and evaluation of computer‐assisted education in an undergraduate dental hygiene Abstract: Objective: This paper introduced newly developed computer‐assisted learning materials and reports of a survey of junior college dental hygiene students who have used them. Methods: We authored new educational material to promote students’ basic dental hygiene practice skills using a simulation software generator. A set of five developed materials were tested by 43 female second‐year dental hygiene students during the second semester at a college in Chiba, Japan. The evaluation was conducted in the form of a questionnaire including open‐ended questions. Students’ opinions were analysed using characteristic diagrams, a troubleshooting tool that can be used to visually illustrate the causes and effects of a problem. Result: The overall results of the evaluation were positive. The students were given five sets of simulation learning materials (SLMs). Eighty‐three percent of the students felt that they could carry out independent study of clinical practice better after the virtual practice. Ninety‐three percent of them felt that the exercises should be continued in the future, and eighty‐eight percent of them felt that this virtual practice deepened their interest in other classes and training sessions. All of the students found the virtual practice beneficial for their learning. Discussion: The present results suggest that the students became conscious of their lack of knowledge through SLMs. These findings indicate that SLMs for practicing basic clinical procedures is beneficial.     

Basic sciences education in the dental curriculum in Southern Europe

A survey was conducted to determine the current status of the basic sciences education in Southern European dental schools. Responses were collected from schools in Malta, Greece, Portugal, Italy, France and Spain. The results show that there is some uniformity across Southern Europe, even if there are some variations among dental schools both within one country and among the different countries. The links with Medicine seem to be strong. Most basic sciences dental educators have a medical degree and usually have their main appointment in a medical school. The only exception to this is found in France, where the faculty, who are mostly dentists, have their main appointment in a dental school. In half of the countries, courses are given jointly to both dental and medical students. There is, in general, poor coordination between the basic science subjects and other subjects in the dental curriculum. All the surveyed schools maintain traditional curricula and teaching methodologies. However, there is an increased movement towards self-directed learning, computer-assisted learning and improved coordination with clinical subjects.     

Survey of dental practice/dental education in Victoria. Part III. Trends in general dental practice

The responses of practising dentists in regard to clinical time spent and demand trends in dental practice were combined with recent graduates' views of the emphasis given to various disciplines during their undergraduate training in order to provide information which might assist the undergraduate curriculum review. The greatest proportion of clinical time spent by general practitioners on various clinical disciplines was reported to be restorative, preventive, diagnostic and endodontic services. There was evidence to suggest that there is an increasing demand for a broad range of clinical services, particularly in country locations, and that general practitioners appear to be expanding their range of services, including those traditionally offered by specialists. Highest increasing demand over the past five years were for recent advances in 'aesthetic dentistry', endodontics, preventive services, orthodontics, periodontics and fixed prosthodontics. High rates of referral were reported only for fixed orthodontics and major oral surgery. Almost twice as many practitioners overall reported an increase (44 per cent) rather than a decrease (26 per cent) in volume of patients over the last five years. This trend was much more evident in country practices, however, with 55 per cent and 22 per cent compared with Melbourne city, 37 per cent and 29 per cent, increasing and decreasing, respectively. Although dental educators are challenged to ensure that graduates are adequately prepared clinically to meet the demands of dental practice there is mounting pressure to support the introduction of an intern year prior to full registration.     

Oral hygiene levels and behaviour in pre-clinical and final-year dental students

The oral hygiene levels and behavior in pre-clinical and final-year dental students attending Birmingham University 1977 were investigated. Gingival inflammation, bacterial plaque and calculus accumulations were clinically recorded. Tooth cleaning habits were assessed by a questionnaire. Oral hygiene habits differed between the two groups and an improvement in oral hygiene levels was evident in the final-year students. Statistically significant differences (P is less than 0.05) were found between the plaque index scored of the pre-clinical and final-year students, and for the gingival and calculus index scores of the male students. Thus in this investigation it was possible to show that improvement in oral hygiene does occur between the pre-clinical and final year of the undergraduate course.     

Views of dental patients about the education and practice of dentists

Abstract – The opinions of 253 adult U.K. dental patients were sought as to the scope of dental education. Most appreciated this was a university education and that it exceeded 3 yr. Nearly one half believed that apprenticeship was involved and one quarter believed that postgraduate experience in hospital was mandatory. Few acknowledged the wide breadth of training and a majority would consult a physician rather than a dentist regarding problems such as oral ulceration.