The effects of professional oral health care on patients in the subacute stage of emergent neurosurgical disorders

This study evaluated the effectiveness of professional oral health care (POHC) on patients who were in the subacute stage of neurosurgical disorders. Forty subjects (26 male, 14 female) with acute cerebrovascular disorders or neurotrauma were randomly divided into two groups. The intervention group (n = 21) received POHC treatment by dental hygienists, and the control group (n = 19) did not. To evaluate the change in oral health status of the subjects, an oral examination was carried out at baseline and four weeks later. For the subjects in the intervention group, periodontal condition, oral hygiene status, and oral function improved statistically significantly. The detection rate for methicillin‐resistant Staphylococcus aureus (MRSA) was statistically significantly lower in the intervention group than in the control group. These results suggest that POHC performed by dental hygienists in collaboration with nurses plays an important role in the promotion not only of oral health but also of general health.     

International employment in clinical practice: influencing factors for the dental hygienist

Purpose: To assess demographics, job characteristics, geographical regions, resources and commitment, which influence dental hygienists seeking international clinical practice employment opportunities. Methods: Questionnaires were mailed to a convenience sample of members of the Dental Hygienists’ Association of the City of New York. Statistical analyses were conducted and frequency distributions and relationships between variables were calculated. Results: Seventy‐two percent of respondents reported that they are or may be interested in working overseas. Italy and Spain (67%) were the regions of most interest. Salary (65%) was cited as the most influencing factor in selection, whereas non‐compliance with the equivalency to Occupational Safety and Health Administration standards (74%) was the most frequently perceived barrier. Multiple language fluency was statistically significant (0.003) regarding interest in overseas employment. Conclusion: Policy makers, employers and educators need to be aware of these findings should recruitment be a possibility to render urgently needed oral hygiene care in regions where there is a perceived shortage of dental hygienists.     

Dental hygiene regulation: a global perspective

Abstract:  Occupational regulation of health personnel is important to professional associations and their members, the public that relies on their services and the regulatory agencies responsible for their conduct. There is increasing interest in ensuring that dental hygiene regulation fosters the continuing evolution of the profession and its contribution to oral health. The keynote address for the 2007 Regulatory Forum on Dental Hygiene, this paper discusses the rationale for and issues pertaining to occupational regulation, outlines the evolvement of dental hygiene and identifies regulatory options for the profession. Professional regulation exists to ensure public safety, health and welfare. However, negative political-economic side effects coupled with environmental pressures have resulted in increased scrutiny for health professionals. One such profession is dental hygiene. Its evolution has been dramatic, in particular over the past few decades, as illustrated by its rapidly increasing numbers and broader distribution globally, gradual shift to the baccalaureate as the entry-level educational requirement and increase in postgraduate programs and expanding scope of practice and increased professional autonomy. Regulatory changes have been more gradual. Regulation is mandatory for the vast majority of dental hygienists. Of the options available, the practice act – the most rigorous type, is predominant. Globally, regulation tends to be administered directly by the government ( n  = 9 countries) more so than indirectly through a dental board ( n  = 4) or self-regulation ( n  = 3). Whether regulated directly or indirectly, dental hygienists increasingly are seeking a greater role in shaping their professional future. Self-regulation, its responsibilities, misperceptions and challenges, is examined as an option.     

Dental hygienists-independent practice and pain control services

Abstract – In 1990, 78 dental hygienists who were members of the Dutch Dental Hygiene Association and working in an independent practice received a questionnaire (response rate: 79%) about the administration of local anesthesia. The main aim of this study was to dertermine the need for this service prior to deep scaling. The results of the survey showed that the need to administer local anesthesia for this purpose is limited in spite of the large number of patients with periodontal problems treated in independent dental hygiene practices. In most circumstances the cooperation with the dentist is satisfactory. However, 83% of the respondents indicate a limitation in the pain control services.     

Evidence-based practice and the professionalization of dental hygiene

The application of knowledge is fundamental to human problem solving. In health disciplines, knowledge utilization commonly manifests through evidence-based decision making in practice. The purpose of this paper is to explore the development of the evidence-based practice (EBP) movement in health professions in general, and dental hygiene in particular, and to examine its relationship to the professionalization agenda of dental hygiene in Canada. EBP means integrating practitioner expertise with the best available external evidence from research. Proponents of EBP believe that it holds promise for reducing a research-practice gap by encouraging clinicians to seek current research results. Both the Canadian and American Dental Hygienists Associations support practice based on current research evidence, yet recent studies show variation in practice. Professionalization refers to the developmental stages through which an organized occupation passes as it develops traits that characterize it as a profession. The status conferred by professionalization privileges a group to make and monitor its own decisions relative to practice. Dental hygiene's success in acquiring attributes of a profession suggests that transformation to a profession is occurring. This paper compares the assumptions and challenges of both movements, and argues the need for a principal focus on the development of a culture of evidence-based dental hygiene practice.     

Changes in the professional domain of Dutch dental hygienists

To cite this article:
Int J Dent Hygiene  8 , 2010; 301–307
DOI: 10.1111/j.1601‐5037.2009.00418.x
Jerkovic K, van Offenbeek MAG, Slot DE, Van der Schans CP. Changes in the professional domain of Dutch dental hygienists. Abstract: Objective: This study’s purpose was to compare the scope of practice of Dutch dental hygienists educated through a two‐ or three‐year curriculum (‘old curriculum dental hygienists’ [OCDHs]) with that of hygienists educated through a new extended four‐year curriculum leading to a bachelor’s degree (‘new curriculum dental hygienists’ [NCDHs]). Methods: In 2005 and 2007, we obtained surveys from 320 OCDHs and the first 67 NCDHs, respectively, in which respondents were asked to complete a questionnaire and score how often they performed certain dental tasks. By means of factor analysis, these tasks were grouped into nine activity groups and 5 remaining single activities. T‐tests and Mann‐Whitney U‐tests were used to compare the scope of practice between OCDHs and NCDHs. Results: NCDHs worked more often in dental offices (instead of being self‐employed) and generally worked more hours per week than OCDHs. They performed more often tasks dealing with caries diagnosis and treatment and less often tasks dealing with prevention and periodontology. These differences were statistically significant. However, in dental offices the differences between OCDHs en NCDHs were far less pronounced. In those practices OCDHs performed dental sealants, small corrections of dentures and/or restoration and caries diagnosis during dental check‐up no less frequently than NCDHs. Conclusions: Although prevention remains the core domain (or role) of all Dutch dental hygienists surveyed, the scope of practice substantially differed. This, however, depended not only on education, but also on type of practice. The new curriculum answers to and legitimates an already developed practice of task delegation.     

Working practices and job satisfaction of Victorian dental hygienists

BACKGROUND: Increasing demand for dental services and a projected shortage in the oral health workforce in Victoria has focused attention on dental hygienists as one mechanism for increasing the supply of dental services. Understanding the dental hygienist workforce is essential in order to plan effectively for the future delivery of dental services in Victoria. METHODS: A postal survey of a random sample of Victorian dental hygienists was undertaken in 2006. Data on hygienists' demographic characteristics, current dental practice, history of career breaks, aspects of clinical practice and job satisfaction were collected. RESULTS: A response rate of 77 per cent was achieved. A total of 94.0 per cent of hygienists were currently working as a dental hygienist, working an average of 28.7 hours per week. Younger hygienists worked longer hours than their older colleagues. Career breaks were common, with 44.8 per cent reporting a career break of greater than one month, predominantly for child rearing, with a mean career break of 20.1 months. Hygienists reported a high level of satisfaction with most aspects of their employment. CONCLUSIONS: Victorian hygienists worked predominantly in private practices in metropolitan Melbourne, providing a range of preventive and periodontal services. Understanding the working patterns of dental hygienists is critical as hygienist numbers expand in the future, in order to undertake thorough evidence-based workforce planning.     

Child abuse and dental neglect: the dental team's role in identification and prevention

Abstract:  Health, education and social services are placing increasing emphasis on preventing abuse and neglect by early intervention to support families where children and young people may be at risk. Dental hygienist and dental assistants, like all other health professionals, can have a part in recognizing and preventing children from those who would cause them harm. They should be aware of the warning signs, recognizing what to consider as abuse or dental neglect and know how to deal with these young patients, and to fulfil their legal and ethical obligation to report suspected cases.
The purpose of this report is to review the oral and dental aspects of child abuse and dental neglect thus helping the dental team in detecting such conditions. In particular, this report addresses the evaluation of bite marks as well as perioral and intraoral injuries, infections, early childhood caries and diseases that may be indicative of child abuse or neglect.
Emphasis is placed on an appropriate protocol to follow in the dental practice to best treat and protect children who may have suffered abuse, helping the team in the diagnosis and documentation.     

Factors Associated with Job and Career Satisfaction Among Dental Hygienists

Information concerning dental hygienists' job and career satisfaction is dated and incomplete. Because satisfaction may be important in retention of dental hygienists, a survey of all active dental hygienists in private practices in North Carolina was performed to ascertain dimensions and levels of job and career satisfaction, as well as factors associated with these constructs. Of 2,099 eligible hygienists, 51 percent responded to a survey instrument containing 202 items addressing overall satisfaction, as well as satisfaction with a variety of work-related factors. Factor analysis was used to develop scales for job and career satisfaction, and for the work-related factors. Final reduced regression models indicated that the constructs of job and career satisfaction are separate and that each has distinct general and intrinsic dimensions. Models for general job and career satisfaction had R2 values of .45 and .27, respectively, and included a variety of work-related factors such as supervisory style and satisfaction with salary. Models for intrinsic job and career satisfaction were not as strong, with R2 values of .06 and .09, respectively. These models also included work-related factors such as satisfaction with hours of work, office safety arrangements, and supervisory style. These results suggest that general job and career satisfaction levels should be amenable to change through management interventions.     

Motivation for a career in dentistry: the views of dental students in the United Arab Emirates

Objectives: To investigate final-year dental students’ perceived motivation for choosing dentistry as a professional career at one dental school in the United Arab Emirates (UAE). Method: Final-year dental students of Ajman University (n = 87) completed a questionnaire. Univariate and multivariate analysis of the data were undertaken using statistical software. Results: A response rate of 82% (n = 71) was achieved, 65% of whom were female. Students ranged from 21 to 29 years of age. Motivation to study dentistry was led by a ‘desire to work in health care’ (93%), ‘wish to provide a public service’ (88.7%) and because ‘degree leads to a recognised job’ (84.5%). Males were significantly more likely to report ‘high income’ (84% vs. 67%; P = 0.01) and females ‘influence of family’ (80% vs. 60%; P = 0.02) as motivating influences. The reliability and internal consistency of the instrument as calculated by Cronbach’s alpha was 0.82. Eight factors explaining the 71% of the variation were: ‘professional job factors’ (11.7%), ‘experience and advice’ (9.8%), ‘business and financial with independence’ (9.7%), ‘careers, advice and possibilities’ (8.9%), ‘knowledge and job security’ (8.8%), ‘health care, people and public service’ (8%), ‘family and friends’ (7.2%) and ‘career in dentistry’ (6.9%). Gender was a significant predictor of ‘business and financial’ factor (b = −0.76; P = 0.003) and age for ‘careers in dentistry’ (b = −0.18; P = 0.03). Conclusion: Students are motivated by a wide range of factors similar to those found in other studies; however, business features and family influences were significantly associated with gender.     

Understanding the motivation: a qualitative study of dental students' choice of professional career

Background: Given the changing nature of the dental workforce, and the need to retain the services of future members, it is important to understand why current dental students perceive that they were motivated to study dentistry. Qualitative research provides the opportunity to explore the underlying issues in addition to informing subsequent quantitative research. The objectives of this research were to investigate final‐year dental students’ motivation for studying dentistry and how they perceive this has been modified during their undergraduate degree programme. Methods: Purposive sampling of a representative group of 35 final‐year dental students at King’s College London Dental Institute to participate in audio‐taped focus groups. Qualitative data were analysed using Framework Methodology. Results: The findings suggest a strong emphasis on having a career, providing ‘professional status’, ‘financial benefits’, ‘job security, flexibility and independence’ and ‘good quality of life’. Students reported being attracted by features of the job, supported to a greater or lesser extent by personal experience, family and friends. It appears however that students’ initial motivation is being tempered by their experiences during their undergraduate degree programme, in particular, the ‘responsibilities of an intensive professional education’, their ‘mounting student debt’ and the perception of ‘feeling undervalued’. This perception related to dentistry in general and National Health Service dentistry in particular, being undervalued, by government, patients, the public and members of the dental profession. Conclusions: Students’ vision of a ‘contained professional career’ within health care, providing status and financial benefits, appears to have influenced their choice of dentistry. Pressures relating to student life and policy changes are perceived as impacting on key components of professional life, particularly status in the social and economic order. The implications for educators, professional leaders and policy makers are explored.     

Task division between dentists and dental hygienists in Norway

Abstract – Objective: The aim of the study was to investigate the attitudes among dentists and dental hygienists to the policy objective in Norway of delegating more dental work from dentists to dental hygienists. Method: A questionnaire was mailed to a random sample of 1111 dentists and 268 dental hygienists in 2005. The response rates were 45% (504) among the dentists and 42% (112) among the dental hygienists. The survey sought to explore any discrepancies between current and preferred mix of different work tasks, as well as attitudes to the idea of substituting dentists with dental hygienists for certain work tasks. Logistic regression was used to analyse how answers differed by respondent characteristics. Results: Dentists spent only half of their total working hours on complex dental services, i.e. tasks that only dentists are skilled to undertake. Nearly 40% of their time was spent on tasks that dental hygienists are qualified to perform; examinations, screening and basic treatments. Still, the mix of work tasks that dentists preferred would involve slight changes: on average only 2% points more complex treatment and 3–4% points less of those tasks that dental hygienists are permitted to provide. Seemingly contrary, as many as 60% of dentists answered that it was ‘desirable to delegate’ more tasks to dental hygienist. However, only 21% of the dentists agreed that dental hygienists should be the entry point for dental services. Dental hygienists would prefer to do relatively more basic treatments and fewer examinations and screening, and the vast majority among them supported the idea that they could be the entry point for dental services. Conclusion: The results suggest that there will not be major changes in the division of labour between dentists and dental hygienists in Norway, if dentists are to be held responsible for taking such initiatives. Although dentists agree that more of their current work could– in principle – be delegated to dental hygienists, they do not prefer to reduce much of their own current activity of those work tasks that dental hygienists are qualified to perform.     

Attitudes to dental hygienists: evaluation of the Dental Hygienist Beliefs Survey in a Swedish population of patients and students

Abstract:  Objectives: The aim was to evaluate and test the psychometric properties of the Dental Hygienist Beliefs Survey (DHBS) in a Swedish sample of different patient groups and students. It was hypothesized that negative dental hygienist beliefs would discriminate between fearful and non-fearful study groups. The DHBS was distributed together with the revised Dental Beliefs Survey (DBS-R) and the Dental Anxiety Scale (DAS). The study sample included 394 subjects (130 students, 144 general dental patients, 90 periodontal patients and 30 patients on a waiting list for dental fear treatment). The results verified that the DHBS discriminates well between dentally fearful and non-fearful study groups. The DHBS had high internal consistency (Cronbach's α  = 0.96−0.98) in all the groups. The correlation between the DHBS and the DBS-R was high ( ρ  = 0.82, P  < 0.001). Furthermore, the DHBS correlated significantly with the DAS, as well as with a low but significant correlation to age (more negative attitudes in younger age groups) and gender (more negative attitudes amongst women). Regression analysis showed that gender and the DHBS items: 23, 16 and 28, i.e. items related to feeling helpless, worries/fears not being taken seriously and fear about 'bad news' possibly preventing treatment, were the most important predictors of dental fear. The results suggest that the DHBS may be a valid and reliable scale to use in order to assess patient's specific attitudes to dental hygienists. However, the psychometric properties including test–retest analysis and the underlying factor structure of the DHBS need to be further explored.