Surgical magnification in dental hygiene practice

Abstract:  The potential for improving the occupational health of dental clinicians has expanded as increasingly sophisticated equipment enters the marketplace, yet there has been little improvement to the ergonomics with which dental hygienists operate. The use of surgical magnification has great potential to increase the quality of dental hygiene clinical care and to support the musculoskeletal health of dental hygienists. Although the research evidence to support a relationship between the use of surgical magnification and increased quality of dental hygiene care is extrapolated from parallel studies in dentistry, specific dental hygiene studies suggest that the integration of surgical magnification would be helpful in reducing the incidence of musculoskeletal symptoms experienced by dental hygienists. This is not to suggest that the integration of surgical magnification is a panacea for the musculoskeletal problems experienced by dental hygienists. In fact, improperly selected or adjusted surgical magnification systems can promote positions that place clinicians at increased risk for such problems. Clinicians must first determine the optimal working position that supports their musculoskeletal health and then select magnification systems that will support that position. The working distance, depth of field and optical declination angle of the chosen system must correspond to the musculoskeletal needs of the clinician.     

The independent practice of dental hygiene

Dental hygienists are health care professionals specially trained and licensed to provide preventive oral health care and information to patients. In 49 of the 50 states, dental hygienists practice their profession under some type of supervision by a dentist. They are prohibited by state law from practicing independently in their own dental hygiene offices. The independent practice of dental hygiene and the controversial issues concerning dentists and dental hygienists are the issues examined in this article.     

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.     

Developing cultural competence and social responsibility in preclinical dental students

Dental student development of cultural competence and social responsibility is recognized by educators as an important element in the overall shaping of minds and attitudes of modem dental practitioners. Yet training modalities to achieve these competencies are not clearly defined, and outcome measurements are elusive. This article shows an effective method to meet these desired outcomes. Sixty-one freshmen (class of 2005) participated in forty hours of nondental community service, and reflective journals were completed by the end of second year. Competency outcomes were measured by selecting key words and phrases found in the individual journals. Key phrases were related to compassion, righteousness, propriety, and wisdom. Also, phrases had to be accompanied by written indications of direct program causation. The combination of active-learning (based upon service learning models) in public health settings outside of the dental realm, accompanied by reflective journaling, enhanced cultural understanding and community spirit in the majority of students.     

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.     

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.     

Moving research knowledge into dental hygiene practice

Dental hygiene, as an emerging profession, needs to increase the number of intervention studies that identify improvements in oral health outcomes for clients. Historically, dental hygiene studies have typically been atheoretical, but the use of theoretical frameworks to guide these studies will increase their meaningfulness. Rogers' theory of diffusion of innovations has been used to study research utilization across many disciplines, and may offer insights to the study of research use in dental hygiene. Research use is an important component of evidence-based practice (EBP), and diffusion of research knowledge is an important process in implementing EBP. The purpose of this paper is to use diffusion of innovations theory to examine knowledge movement in dental hygiene, specifically through the example of the preventive practice of oral cancer screening by dental hygienists, considered as an innovation. Diffusion is considered to be the process by which an innovation moves through communication channels over time among a social network. We suggest diffusion theory holds promise for the study of knowledge movement in dental hygiene, but there are limitations including access to and understanding research studies as innovations. Nevertheless, using a theoretical framework such as Rogers' diffusion of innovations will strengthen the quality of intervention research in dental hygiene, and subsequently, health outcomes for clients.     

Exploring dental students' perceptions of cultural competence and social responsibility

The improvement of basic cultural competency skills and the creation of a greater community-minded spirit among dental students are important parts of dental education. The purpose of our study was to assess changes in dental students' attitudes and beliefs about community service and changes in cultural competencies after participation in a two-year program of non-dental community service (Student Community Outreach Program and Education, SCOPE). During 2003-07, two identical twenty-eight-item surveys were administered to SCOPE participants/completers. In the first, students reported on their attitudes after program completion. In the second, students reported retrospectively on their attitudes prior to starting the program. One hundred twenty-six post- and pre-intervention surveys were matched and assessed for changes in student attitudes after program participation. Based on factor analysis, four distinct scales were identified: 1) community service, 2) cultural competence, 3) communication, and 4) treatment perspective. Over time, statistically significant changes (p<.05) in student attitudes and beliefs were found for scales 1 (p=.017), 2 (p=.001), and 3 (borderline significance, p=.057). Scale 4 showed no significant difference (p=.108). These scales indicate main focus areas to help guide future dentists in acquiring relevant sociocultural competencies and enabling community-minded attitudes. Overall, this study provides support for the addition of a non-dental community service-learning program into the preclinical curriculum.     

Attitudes to independent dental hygiene practice: dentists and dental hygienists in Ontario

This study examined Ontario dentists' and dental hygienists' attitudes to independent dental hygiene practice and changing the scope of practice. Data were collected from a mail survey of a systematic, stratified sample of Ontario dentists (483 respondents) and dental hygienists (437 respondents) conducted in the winter and spring of 2002 to assess what practising dentists and dental hygienists think about independent practice and other professional issues. Contrary to previous research, this study found that male and female dentists did not differ in their attitudes to independent dental hygiene practice and university education for dental hygienists: both strongly opposed the former and tended to support the latter. Similarly, few differences in attitude amongst dentists by specialty were found. Dental hygienists were generally supportive of independent practice and of expanding their scope of practice. On some measures, however, sex and age differences in attitudes were evident: at times dental hygienists who were older or male seemed to be stronger advocates for professional change than others.