Characteristics of Patients Seeking Care from Independent Dental Hygienist Practices

Objectives : This study determined demographic characteristics, satisfaction with care, and likelihood of follow-up dentist visits for patients seen in office-based, independent, dental hygienist practices. Methods : New patients were surveyed after their initial visits to independent hygienist practices to assess their demographic characteristics and satisfaction with care at both the beginning of practice operations and 18 months after the start of these practices. Follow-up surveys were sent to patients 12 and 24 months after their initial visits to the independently practicing dental hygienists to determine if patients had visited a dentist. Results : Most respondents were white, female, had attended some college, and reported high family incomes. Ninety-eight percent of respondents were satisfied with their dental hygiene care. Follow-up questionnaires revealed that over 80 percent of respondents visited the dentist within 12 months of receiving dental hygiene care in independent settings. This level of follow-up care with dentists was found both for respondents who reported having a regular dentist at their initial visits with the hygienists and for those who reported not having a regular dentist. Conclusion : Independent practice by dental hygienists provided access to dental hygiene care and encouraged visits to the dentist.     

Smoking Cessation Practices in Dental Offices

We have surveyed the health promotion efforts of dentists and dental hygienists in general dental practice in Chittenden County, Vermont, in relation to smoking. The response rate was 61 percent. Smoking issues were addressed by 76 percent of dentists and 81 percent of dental hygienists in approximately one quarter of their smoking patients. Although the majority of both dentists and dental hygienists advised their patients to change their smoking behavior, their advice was usually to cut down rather than to quit. Most of the respondents--78 percent of dentists and 93 percent of dental hygienists--considered it appropriate to give advice about smoking during visits for routine dental care and 68 percent and 89 percent, respectively, were willing to learn brief methods of advising their patients about smoking. Experience with giving advice about smoking and agreement that it was appropriate to give such advice were both strongly related to willingness to learn brief methods of giving such advice. In individual dental practices, there were virtually no correlations between the dentist's and the dental hygienist's behaviors as far as the proportion of patients from whom a smoking history was taken, the proportion of smokers advised about smoking, the content of the advice, or the nature of the advice. Only nine percent of dentists and 11 percent of dental hygienists were current smokers.     

Application of the Dental Hygiene Human Needs Conceptual Model and the Oral Health-Related Quality of Life Model to the dental hygiene curriculum in Japan

Abstract:  This paper reports the incorporation of the Dental Hygiene Human Needs Conceptual Model (DHHN) and the Oral Health-Related Quality of Life Model (OHRQL) into a dental hygiene curriculum in Japan. A simulated patient practice was offered to 67 dental hygiene students. In the practice activity, all students were introduced to the use of an OHRQL assessment tool. A DHHN assessment tool was utilized additionally only by the experimental student group. The statistical analysis of the post-practice survey showed that the OHRQL instrument was more helpful in assessment and problem identification than the DHHN instrument. By contrast, text-based analysis of dental hygiene diagnostic statements showed that the experimental group identified more domains of patients' human needs deficits than the control group. This suggested the possibility that the DHHN model helped them to see patients from broader perspectives. However, it was difficult for students to design care plans attending to the domains of the models. Also, in considerations to the cultural issues, the validity and equivalence of the Japanese versions of both models should be further investigated. Within the limitation of the present study, the results suggested that incorporation of the combination of the DHHN and OHRQL models can be useful in a dental hygiene curriculum, as each tool helps students expand the perspective from which they view client. Further improvements in learning strategies should facilitate the effective utilization of these models.     

Implementing a Tobacco Assisted Referral Program in Dental Practices

Objectives: The objectives of this study are to design and implement a system-level tobacco-control intervention in a large prepaid dental group practice and assess effects on staff performance measures and patient satisfaction. Methods: We matched 14 dental facilities on size, socioeconomic status, smoking rate, and periodontal status, and then randomly assigned them to intervention or usual-care control. We trained intervention staff in an Assisted Referral team approach for assessing tobacco use, providing tailored advice and brief counseling, and encouraging smokers to talk by telephone with a specially trained tobacco counselor. Patients could call from the office or ask that the counselor call them later. Telephone counselors helped patients explore motivations and barriers for quitting; review available cessation-support strategies, programs, and medications; and identify next steps. Results: During the 14-month study period, 66,516 members had annual- or new-patient examinations. Both intervention and control sites had high rates of tobacco assessment (97 percent) and advice (93 percent). Intervention patients were more likely than controls (69 percent versus 3 percent, P <  0.01) to receive additional chair-side tobacco counseling and assistance, and 11 percent agreed to receive additional telephone counseling. Intervention patients were more satisfied than controls with the dental team's tobacco-control efforts ( P <  0.03). Referral rates varied substantially for different staff. Conclusions: The Assisted Referral approach was successfully integrated into routine dental care, was well received by patients, and resulted in increased patient satisfaction. Because free telephone-based tobacco counseling is now available nationwide, the approach may be a practical strategy for most dental-care settings.     

Dental Hygienists in Nontraditional Settings: Practice and Patient Characteristics

The dental hygienist's role in the treatment of special populations in nontraditional settings is an important one. Little is known about the hygienist's practice characteristics in these settings, nor about the patients receiving care. To gain needed information, a representative sample of the entire population of licensed hygienists in the United States was screened (n = 38,380). This screening identified 1,205 hygienists practicing in nontraditional settings. These hygienists were sent comprehensive questionnaires examining practice and patient characteristics. Completed questionnaires were returned by 1,016 (84.3%) hygienists. This report describes reported hygiene practice characteristics; hygienist interactions with patients and providers; and patient characteristics, including age, medical/emotional/social conditions, and dental treatment needs. Major findings of respondents' reports reveal that: approximately 90 percent of patients were in need of dental/dental hygiene services with approximately one in four requiring only dental hygiene services; the dental hygienists perceived a high level of acceptance of their role by patients and providers; the majority of patients treated were categorized as generally medically healthy (65.7%); and the clinical practice of dental hygiene in nontraditional settings mirrors that of private practice.     

Prevalence of Nontraditional Dental Hygiene Practice

There is little knowledge of the number or the work characteristics of dental hygienists outside the private-practice setting. This survey was conducted to determine the percentage of hygienists practicing in nontraditional (nonprivate-practice) settings and the types of settings in which they are employed. Mail questionnaires were returned from a total of 21,847 (56.9%) of the hygienists in the survey sample. The percentage of active hygienists practicing in nontraditional settings was 11.8. Dental or dental hygiene schools, and government and nongovernment-supported clinics were the most frequent nontraditional practice settings. State supervision requirements were found to be associated significantly with the prevalence of nontraditional hygiene practice.     

Dental hygienists as a new element in the oral health service in Poland

A comparison of the number, employment, utilization and activities of dental hygienists in Poland between 1977 and 1982 is described. In spite of a distinct increase in number and better distribution in the country, the employment of hygienists in the oral health service is still low. However, the majority of dental hygienists are employed in the oral health service for children, working mostly as dental assistants doing fluoride prophylaxis and dental health education in addition. The percentage of operating dental hygienists is also low. The need for their preventive activity is great, as the dental caries rate in Polish children is generally high.     

Oral Hygiene Practices and Dental Service Utilization Among Pregnant Women

BackgroundDaily oral hygiene and regular dental visits are important components of oral health care. The authors&apos; objective in this study was to examine women&apos;s oral hygiene practices and use of dental services during pregnancy.MethodsThe authors developed a written oral health questionnaire and administered it to 599 pregnant women. They collected demographic information, as well as data on oral hygiene practices and use of dental services during pregnancy. They used χ² and multivariable logistic regression models to assess associations between oral hygiene practice and dental service use during pregnancy and to identify maternal predictor variables.ResultsOf the 599 participants, 83 percent (n = 497) reported brushing once or twice per day. Twenty-four percent (n = 141) reported flossing at least once daily; Hispanic women were more likely to floss than were white or African American women (28 percent [52 of 183] versus 22 percent [54 of 248] versus 19 percent [23 of 121], respectively, P < .001). Seventy-four percent (n = 442) of the participants reported having received no routine dental care during pregnancy. Hispanic women were significantly less likely than were black or white women to receive routine dental care during pregnancy (13 percent versus 21 percent versus 36 percent, respectively, P < .001). The authors found that being older than 36 years, being of Hispanic race or ethnicity, having an annual income of less than $30,000, flossing infrequently and receiving no dental care when not pregnant were significantly associated with lack of routine dental care during pregnancy (adjusted odds ratios, 95 percent confidence intervals: 2.56 [1.33–4.92]; 2.19 [1.11–4.29]; 2.02 [1.12–3.65]; 1.86 [1.13–3.07]; and 4.35 [2.5–7.69], respectively). A woman&apos;s lack of receiving routine dental care when not pregnant was the most significant predictor of lack of receiving dental care during pregnancy.ConclusionRacial, ethnic and economic disparities related to oral hygiene practices and dental service utilization during pregnancy exist.Clinical ImplicationsMedical and dental care providers who treat women of reproductive age and pregnant women need to develop policy strategies to address this population&apos;s access barriers to, and use of, dental care services.     

The Economic Contribution of Dental Hygienists'' Activities to Dental Practice: Review of the Literature

This article reviews studies of dental practice and essays on practice management that have included information on the economic contributions of oral hygiene services. Several studies found that these services were less remunerative than other services and recommended that dentists delegate these functions when possible. However, one study noted that performance time, as well as delegation, influenced practice productivity and also reflected the practice's concept of care. Some practice management authors indicated that poorly managed practices without an excess of patients do not benefit economically from hiring a hygienist; but for practices with good management capabilities and an excess of patients, a hygienist may be able to make a major contribution to practice productivity. The lower remuneration for hygiene services and the high percentage of practice time required to provide a complete prophylaxis once or twice a year to each patient led several authors to doubt that dentists would or could provide these services themselves. The data in the reported studies, however, are insufficient to support firm conclusions about the profitability of hygienists' activities in dental practice.     

Dental Sealant Usage in Virginia

This trend study reports the results of a survey designed to determine usage of dental sealants in Virginia. A total of 2,434 general dentists, dental hygienists, and pedodontists were sent questionnaires regarding usage, technics, products, educational experience, and public interest in dental sealants. Increases in the provision of sealant coverage and in public interest for this preventive measure were noted. Approximately three-fourths of general dentists and dental hygienists working in a general or pedodontic practice are offering sealants to their patients. Pedodontists are the largest group of providers, with nearly 100 percent of pedodontists applying sealants. Recent graduates are applying sealants more often than earlier graduates. Preference for Delton clear color, light-cured material was shown. In general, a lack of professional knowledge about sealants continues to exist. Professional organizations and academic institutions may want to plan additional continuing education offerings for practitioners and to consider increased dental education instruction for students.     

The Dental Hygiene Program in Portugal

Abstract: The Dental Hygiene Program is a fairly recent addition in the field of the health professions in Portugal. In the past 19 years, the programme has developed community activities alongside with clinical work. This programme provides an education that is responsive, scientific and professional, in a learning environment that is dynamic, student-centred and that encourages collaboration between students and faculty. The community activities play a major role in the curricula of the programme and allow the students to develop skills in working with a wide range of population groups and to attend to their specific needs. Dental hygienists are integrated in health teams and work under the supervision of a physician or a dentist. Among other responsibilities, the following functions are part of the scope of the profession: to participate in health education programmes and sensitise the population to the prevention of dental diseases, to participate in the planning, implementation, and evaluation of the public health programmes and to perform clinical treatment for prevention and control of gingivitis, periodontitis, and dental caries. An overview of the activities developed in the year 2002 and future perspectives are presented in this article.     

Oral Hygiene Instruction and Health Risk Assessment in Dental Practice

We studied oral hygiene instruction given to 109 patients in 19 Washington State dental practices to investigate the extent to which therapists targeted their efforts toward patients with high disease risk. Patients were examined prior to instruction and prophylaxes. Therapists' instructions were tape-recorded and their content analyzed: therapists' expectations were scored. There were no statistically significant associations between patients' initial plaque levels and the process/content of the oral hygiene instructions delivered. On average, therapists spent 9.4 minutes of each prophylaxis session discussing oral hygiene. Therapists were judged more genuine with those patients for whom they had higher expectations of compliance, i.e., those with less plaque and low disease risk. We conclude that dental practitioners were not employing effective risk assessment strategies in selection of patients most in need of intensive instructional efforts.     

A Symposium on the Future of Dentistry Report: Implications for the Public Sector: Impact on Dental Hygiene

This paper reviews the six recommendations as approved by the House of Delegates of the American Dental Association in 1983. Each recommendation is reviewed in relation to public health and preventive dentistry as well as the established goal of dental hygiene: "To improve the public's total health by increasing the awareness of and access to quality oral health care and to position the dental hygienist as the preventive oral health professional." To reach this goal it is recommended that dental hygienists seek out opportunities in the public sector where there is more job satisfaction, their professional roles have higher acceptance with both coworkers and patients, and there is a high level of interaction with other health-care professionals.     

Productivity in Minnesota Dental Practices with Increased Visits by Older Patients

There is little scientific information on the economic impact of treating increased numbers of older adults, despite the current growth in this population. To assess the impact of patient age on dental practice productivity, we evaluated an economic production function that included the proportions of patient visits in two older age groups (61–69 years, 70+ years) as factors that might affect the dental service production process. We used data from 12,818 patient visits to 31 Minnesota dental practices enrolled in the Minnesota Dental Practice Analysis System (DPAS) between 1980 and 1984. Ordinary least squares multiple linear regression was used to detect potential associations between practice productivity, measured in standardized time and monetary outputs, and the proportions of visits by older patients. We found that increases in the proportion of visits by patients aged 70 years and older were associated with decreases in productivity when we controlled for differences in the mix of services used. Our results support the notion that dental practices may be less productive when providing services to older patients compared to younger patients. These findings may have implications for personnel and policy planning. Further investigation of this issue is warranted because of the limited number of practices included in the study.     

Dental hygienists''influence on the patients''knowledge, motivation, self-care, and perception of change

The purpose of this study was to assess the success of the dental hygienist in the dental health education of dental patients in general dental practice. Special emphasis was laid on health education in the field of periodontics. The answers on a questionnaire of 159 dental patients who visited a dental hygienist were compared with the answers of 302 dental patients who had never visited a dental hygienist. The comparison was done by means of t-test and regression analysis on specially developed scales with regard to knowledge, motivation, self-care, and perception of change. On all scales the dental patients who visited a dental hygienist scored better. This difference remained when social demographic variables and the dentist's influence were taken into account. This indicates that the dental hygienist is successful in the behavioral aspect of her work.     

Advancing Education in Dental Hygiene

The changing health care environment and societal imperatives indicate the need for transformative change within the dental hygiene profession to serve the emerging needs of the public. The American Dental Hygienists' Association is leading the way toward meaningful change.Background and PurposeThe American Dental Hygienists' Association (ADHA) has as its vision the integration of dental hygienists into the health care delivery system as essential primary care providers to expand access to oral health care. This article provides data on current dental hygiene education programs and those in development. Also included is a discussion regarding how the dental hygiene profession can better serve the health and wellness needs of society by transforming the way graduates are prepared for the future.MethodADHA's dental hygiene survey center data, policies and a futuristic analysis plus a review of the professional literature describe the current state of dental hygiene education and the profession. A discussion of societal, health care and educational trends that creates the imperative for transformation of the dental hygiene profession is provided.ConclusionsUltimately, the purpose of advancing education in dental hygiene is to achieve better oral and overall health for more people. The profession's responsibility to the public includes evaluating its own ability to provide care and taking the steps necessary to ensure its maximum effectiveness. ADHA is leading this process for dental hygienists in diverse ways. It is imperative that the dental hygiene profession understands and embraces the changing health care environment. Through open dialog and the sharing of evidence the professional path will be determined along with forward movement for the benefit of society and the dental hygiene profession.