Prevalence of baseline hypocalcemia and symptomatic hypocalcemia during leukapheresis.

Symptoms of hypocalcemia are reported in up to 50% of patients undergoing leukapheresis procedures. There is no set standard of practice for administering calcium supplementation in the prevention or treatment of hypocalcemia symptoms. The goal of this descriptive, retrospective study was to determine the prevalence of baseline hypocalcemia and symptomatic hypocalcemia during leukapheresis with acid citrate dextrose solution A and to identify patient characteristics associated with symptomatic hypocalcemia. Three percent of patients were found to have hypocalcemia before leukapheresis with 35% experiencing hypocalcemia symptoms during leukapheresis. Older age, higher albumin levels, and longer procedure time were associated with increased risk of hypocalcemia symptoms.

Brushing behaviour changes and plaque removal with an electric toothbrush: A clinical trial.

OBJECTIVE: To evaluate changes in toothbrushing behaviour and plaque removal performance with usage of a next generation oscillating-rotating electric toothbrush (NG-OR). METHODS: This exploratory clinical study had a two-treatment, three-period, single-group, sequential design. Generally healthy adults with a screening whole mouth mean Turesky modified Quigley-Hein Plaque Index (TQHPI) score of at least 1.75 on a 0-5 scale and who were primarily OR brush users were enrolled. Participants used each OR toothbrush in A-B-B order, where a currently marketed OR brush with a traditional mechanical drive system (T-OR) was used in period A, and the NG-OR brush with a linear magnetic drive was used in period B. At Visit 1, qualifying participants brushed on-site with T-OR. After a 48 h washout, participants returned for Visit 2 and brushed on-site with NG-OR. Participants then used NG-OR for 1 week, twice daily, at home and returned for Visit 3 to brush on-site with NG-OR again. For all on-site brushings, participants were instructed to brush for 2 min without interactive features. Each toothbrush was tagged with a transmitter chip connected to a Motion Tracking System to record movements of the toothbrush and participant using infrared light transmission to determine Isochronicity (brushing time uniformly distributed across the dentition). Plaque was measured using TQHPI. Primary variables were Isochronicity and TQHPl whole mouth mean plaque reduction (pre-brushing minus post-brushing). RESULTS: Overall, 41 participants enrolled and received treatment; 40 completed the trial. NG-OR showed significantly greater Isochronicity after a single brushing (p = 0.043) and after a 1-week at-home use (p = 0.001) versus T-OR. NG-OR showed 41% greater whole mouth plaque removal than T-OR (p < 0.001) after a single brushing. Plaque reduction by region/surface was consistent with whole mouth results. CONCLUSION: The NG-OR brush showed greater brushing uniformity and plaque removal versus the T-OR brush.

High Patient Disease Burden in a Cross-sectional, Multicenter Contact Registry Study of Eosinophilic Gastrointestinal Diseases.

OBJECTIVES: Clinical features of eosinophilic esophagitis (EoE) have been well-described in the literature, however, characterization of features experienced by patients with other eosinophilic gastrointestinal diseases (EGIDs) is lacking. Using data collected from a patient contact registry, we sought to characterize and contrast patient-reported gastrointestinal and extragastrointestinal symptoms and comorbidities in non-EoE EGIDs, including eosinophilic gastritis, gastroenteritis and colitis, relative to EoE. METHODS: We conducted a cross-sectional study of contact registry data collected from 2015 to 2018. Statistical comparisons were made using chi-square (categorical measures) and the Mann-Whitney U test (continuous measures). Multivariable analyses were used to evaluate associations between treatment and feelings of isolation. RESULTS: Of the 715 reporting an EGID diagnosis (n = 525 EoE; n = 190 non-EoE EGID), a higher proportion of those with a non-EoE EGID reported more frequent specific and nonspecific gastrointestinal symptoms, including nausea, abdominal pain, diarrhea, constipation, and bloating (P < 0.01 for all). Participants with a non-EoE EGID were more likely to report higher frequency of fatigue, isolation, and deep muscle or joint pain (P < 0.01 for all). Specific food elimination and elemental formula treatments were associated with increased odds of more frequent (at least weekly) feelings of isolation for participants with EoE (adjusted odds rtaio [aOR]: 2.4; 95% confidence interval [CI]: 1.5--4.1 for specific food elimination and adjusted OR: 1.9; 95% CI: 1.2--3.3 for elemental formula). CONCLUSIONS: Significant differences exist in the symptoms and comorbidities experienced between those with EoE versus non-EoE EGIDs. Additional investigation is needed to elucidate the factors that may contribute to the high disease burden of these poorly understood conditions.

Improving periodontal outcomes: merging clinical and behavioral science.

New data indicate that periodontal diseases are much more prevalent than previously thought, which means that there are large numbers of patients who will need to be diagnosed and treated for periodontal disease in a general dental practice. Oral hygiene procedures performed by patients between office visits are important for gingival health. No particular type of toothbrush has consistently been shown to have superior plaque-removal ability over another. Although studies on powered brushes have shown evidence for efficacy of biofilm removal and increased patient compliance, they are of short duration, making evaluation of long-term effects difficult to achieve. Interdental cleaning with dental floss can be effective but it is technique-sensitive. Interdental brushes have been shown to be superior to floss in plaque index scores, but not in gingival inflammation reduction. A systematic review of oral irrigation reported a beneficial adjunctive effect on bleeding and gingival indices and pocket depth. Antimicrobials in mouthrinses and toothpastes have shown significant reductions in plaque and gingivitis when used correctly. Even though it is considered essential for patients to utilize biofilm-removal techniques on a frequent basis, studies on adherence show that approximately 30-60% of health information is forgotten within 1 h, and 50% of health recommendations are not followed. Incorporating psychosocial aspects of behavioral change, including well-established counseling strategies, such as motivational interviewing, may elicit improved patient outcomes.

Dental hygiene student perceptions of a school-based sealant program: A qualitative review.

PURPOSE/OBJECTIVES: The purpose of this 2021 study was to explore experiences acquired from a school-based sealant program (SBSP), to improve understanding of the relationship between SBSP and dental hygiene (DH) student outcomes, and to inform institutions of the value of educational experiences aiming to reduce disparities in access to dental care. METHODS: University of Missouri Kansas City School of Dentistry Senior DH students complete a community engaged course which includes participation in community projects and clinical activities targeting Kansas City's urban and surrounding rural environments. The SBSP is a component of this course. This investigation utilized a qualitative methodology to examine SBSP experiences through the experience of the primary investigator, on-site dentist, and DH students involved in the program. RESULTS: Data analysis resulted in consensus of five synthesized conceptual models and twenty-three emergent themes. The conceptual models include: competence, roles and responsibilities, social justice, value added, and lessons learned. CONCLUSION: Based on triangulated results, SBSPs improve access to care for children, save dental costs, and provide essential experiences for DH students.

Are adults with autism receiving regular preventive dental services?

PURPOSE/AIM: To investigate the frequency of preventive dental care among adults with autism and explore factors associated with receiving regular preventive care. MATERIALS AND METHODS: De-identified data was collected from electronic health records of 18-year-old or older patients with autism that had at least one preventive dental procedure recorded. The data was then analyzed to describe the frequency of preventive dental procedures provided for this population and investigate what variables are associated with regular care. RESULTS: Sample size was 119, 67% were males, average age was 30.8 years, and 58% had Medicaid. Average BMI was 42.8, the prevalence of diabetes and heart disease were 16% and 34%, respectively, and 86% reported mental health problems. Recreational drug use was 6.8%, alcohol use was 19%, and tobacco use 16%. Xerostomia was reported by 32%, and the average number of medications was 7.2 ± 5.5. The average number of preventive dental visits was 7.9 ± 10.6, and 35% of the patients had at least one preventive dental visit per year. Only number of medications had a statistically significant association with number of preventive dental visits. CONCLUSIONS: Only one in every three adults with autism had at least one preventive dental visit per year.

Brushing Behavior Changes and Plaque Removal with an Electric Toothbrush: A clinical trial.

Purpose To evaluate changes in toothbrushing behavior and plaque removal performance with usage of a next generation oscillating-rotating electric toothbrush (NG-OR).Methods This exploratory clinical study had a two-treatment, three-period, single-group, sequential design. Generally healthy adults with a screening whole mouth mean Turesky modified Quigley-Hein Plaque Index (TQHPI) score of at least 1.75 on a 0-5 scale and who were primarily OR brush users were enrolled. Participants used each OR toothbrush in A-B-B order, where a currently marketed OR brush with a traditional mechanical drive system (T-OR) was used in period A and the NG-OR brush with a linear magnetic drive was used in period B. At Visit 1, qualifying participants brushed on-site with T-OR. After a 48h washout, participants returned for Visit 2 and brushed on-site with NG-OR. Participants then used NG-OR for 1 week, twice daily, at home and returned for Visit 3 to brush on-site with NG-OR again. For all on-site brushings, participants were instructed to brush for 2min without interactive features. Each toothbrush was tagged with a transmitter chip connected to a Motion Tracking System to record movements of the toothbrush and participant using infrared light transmission to determine Isochronicity (brushing time uniformly distributed across the dentition). Plaque was measured using TQHPI. Primary variables were Isochronicity and TQHPl whole mouth mean plaque reduction (pre-brushing minus post brushing).Results Overall, 41 participants enrolled and received treatment; 40 completed the trial. NG-OR showed significantly greater Isochronicity after a single brushing (p=0.043) and after a 1-week at-home use (p=0.001) versus T-OR. NG-OR showed 41% greater whole mouth plaque removal than T-OR (p<0.001) after a single brushing. Plaque reduction by region/surface was consistent with whole mouth results.Conclusion The NG-OR brush showed greater brushing uniformity and plaque removal versus the T-OR brush.

Adherence and preexisting major protease inhibitor resistance mutations are associated with virologic failure of a dual-class antiretroviral regimen with inhibitors of HIV-1 viral protease and integrase.

OBJECTIVES: Novel treatment strategies are needed for treatment-experienced HIV-infected individuals. We retrospectively evaluated virologic outcomes on a dual-class, protease inhibitor (PI) plus raltegravir, antiretroviral (ARV) regimen. METHODS: Virologic success was defined by a plasma HIV-RNA level ≤200 copies/mL. Adherence was measured using pharmacy refill data. The association between adherence and virologic failure was assessed using bivariate logistic regression. RESULTS: In 39 individuals, median prior antiretroviral therapy (ART) exposure was 11 years. Of 39 individuals, 36 (92%) achieved an HIV-RNA ≤200 copies/mL. After a median follow-up of 328 days (interquartile range [IQR] 190-737 days), 74% maintained an HIV-RNA <200 copies/mL but only 44% had <50 copies/mL. Median adherence was 96.4% (IQR 83.3%-100%). For every 10% decrease in adherence, the odds of virologic failure increased by 90% (odds ratio [OR] = 1.9, 95% confidence interval [CI] 1.1-3.3). In all, 4 individuals had ≥2 preexisting major PI resistance mutations and all 4 had virologic failure. CONCLUSIONS: Most treatment-experienced individuals achieved virologic suppression on a dual-class regimen of a PI plus raltegravir. Success was limited by poor medication adherence and preexisting major PI resistance mutations.

Fidelity of motivational interviewing training for dental hygiene students.

Use of Motivational Interviewing (MI), a patient centered counseling strategy in the health professions, has demonstrated efficacy. Given the varied training associated with the delivery of health interventions, it is essential adherence and competence are equivocally assured. Motivational Interviewing Treatment Integrity (MITI) coding evaluated our recorded standardized patient oral assessment and planning sessions to identify the skills in which MI-trained students (n = 26) performed compared to student counterparts (n = 24) not trained in the MI curriculum. The full integration of MI in those receiving the MI curriculum resulted in the dental hygiene students with higher ratings for all global ratings, behavioral counts, and summary scores. MI-trained mean scores for evocation, collaboration, autonomy support, empathy, and direction ranged from 4.16(±0.43) to 3.85 (±0.67). All students receiving MI training reached competence in all 5 of the referenced MITI global variables: evocation, collaboration, autonomy support, empathy, and direction. The most substantial improvements for MITI behavioral and summary variables were in Giving Information, MI Adherence, and proportion of Open-Ended Questions. Complex Reflections, and subsequently Ratios of Complex Reflections to Open-Ended Questions were notably below proficiency in the MI group. Knowing which elements were adhered to well and which were lacking helps inform student MI learning outcomes. Results inform the design of MI training curricula to address areas of weakness and maximize performance across all MI fidelity domains.

Relationships Between Course Capture Systems and Student Performance in Dental Hygiene Education.

Purpose: The aim of this mixed-methods longitudinal study was to assess student perceptions of technology use, and to examine the relationship between technology use and performance as reflected by self-reported student grade point averages.Methods: Students (n=351) enrolled in a dental hygiene program within a dental school located in the mid-western United States were surveyed in three courses from 2008 through 2012 to gather their perceptions regarding usage of a lecture recording system (LRS). Additionally, self-reported grade point averages were collected over the same period of time. Data were analyzed using a statistical software program (IBM SPSS; Armonk, NY).Results: The response rate was 82%. Descriptive statistics demonstrated that students believed that the LRS increased their success and satisfaction in the course and would be useful in other courses. Students also reported they would not choose to miss class sessions based on the availability of the recorded lectures. Correlation statistics found no relationship between student GPA and students' perceptions regarding the LRS.Conclusion: Students reported LRS use and availability did not impact their attendance. No relationship was found between students' self-reported GPA and evaluation of the LRS use within the limits of this study.

Effectiveness of an Antigen-Specific Streptococcus mutans Chairside Test as Compared to a Culture-Based S. mutans Test.

Purpose: To compare the effectiveness of an antigen-specific Streptococcus mutans (S. mutans) chairside test to a culture based S. mutans test.Methods: Fifty-three patients receiving dental hygiene care at the University of Missouri-Kansas City, School of Dentistry were enrolled in the study. Stimulated saliva was collected from the patients and utilized for both bacteria tests. The antigen-specific test was compared to the culture-based bacteria test and to a caries risk assessment measuring sensitivity and specificity.Results: The majority of participants were male (53%) with high caries risk (60%). The culture based test results were primarily negative (62%); while the antigen-specific test had more positives (76%). The sensitivity and specificity comparing the antigen-specific test to the culture based test was high (88%, 95% CI = (78%, 97%) and low (25%, 95% CI = (13%, 37%), respectively. The sensitivity and specificity comparing the antigen-specific test to caries risk was high (83%, 95% CI = (72%, 93%) and low (38%, 95% CI = (24%, 51%) respectively.Conclusions: While the sensitivity of the antigen-specific test was high for both the culture-based test and caries risk, the specificity was low for both. These results suggest that the antigen-specific test tends to give a higher proportion of false positive results.

Evaluation of an academic service-learning course on special needs patients for dental hygiene students: a qualitative study.

The purpose of this study was to evaluate the outcomes of a service-learning course on special needs patients for dental hygiene students by considering student reflections, community site coordinators' feedback, and faculty reflections in a qualitative analysis. Twenty-three female dental hygiene students beginning their fourth semester in the program provided preventive oral health services at eight community sites serving six diverse groups of people having special health care needs. Students reflected on the experience via commentaries written in self-reflection journals. The investigators applied the constant comparative method to analyze and unitize the data, ultimately reaching consensus on three category topics: awareness, higher order thinking, and professionalism. End of course project assessments provided additional data that was used to triangulate with data from the reflective journals. Telephone interviews with the site coordinators and personal interviews with the course faculty provided data from multiple perspectives. The outcomes of this study suggest that service-learning pedagogy can facilitate a deeper understanding of the subject matter and provide an opportunity for students to use critical thinking strategies in addition to becoming aware of complex social and professional issues related to the oral health care of individuals with special needs.

Relationship between prereferral periodontal care and periodontal status at time of referral.

BACKGROUND: According to a recent study, the severity of periodontal disease of individuals referred for periodontal care is greater now than in 1980. Variability in the standard of periodontal care in general dental practices may result in less than desirable outcomes and consequences of poorer periodontal health. METHODS: A sample of 100 newly referred dental patients from three separate periodontal practices in the greater Kansas City, Missouri area participated in this study. Data were collected from three sources: 1) a clinical chart audit, 2) current periodontal disease status as determined by clinical examination, and 3) a patient response questionnaire on past professional care and personal oral care habits. Bivariate analyses were performed using a statistical package. RESULTS: Of the 100 subjects, 74 were diagnosed as periodontal case type IV at the point of referral, of which 29.8% were treatment planned by the periodontist for two or more extractions. Teeth treatment planned for extraction were significant as a function of disease severity (P = 0.0001). Periodontal treatment provided in general dental practices did not vary because of disease severity. The incidence of deep cleanings (scaling and root planing) was reported slightly higher (32.4%) for case type IV than for case type III (26.9%), but this difference was not statistically significant. The average number of cleanings received in the general dental office was less than the standard of care according to the severity of the disease. CONCLUSION: If one assumes that the data obtained in the Kansas City practices are representative of a larger geographic area, it indicates that dentistry may be failing to address issues of the timely diagnosis of periodontal disease, appropriate treatment, and/or timely referral for treatment.

Providing advanced degrees in dental hygiene via computer mediated distance learning: a model program.

A chief concern regarding distance education for the health professions is quality of the experience. Distance education has the potential for expanding student access, providing individualized instruction, and promoting active learning among geographically separated members of learning groups. Students and professors who have participated in distance learning platforms have expressed concerns about technical problems, inability to interact in real time with each other, and other frustrations related to this type of delivery. The Dental Hygiene program at the University of Missouri-Kansas City (UMKC) has addressed these issues and enhanced an already successful program by putting the professor, a technologist, and the student in the same space, at the same time, in real time. This enhancement has substantiated the ability of distance education to provide instruction among geographically separated members of learning groups, making it a plausible solution to the shortage of educators in healthcare professions.

Predictive validity of dental hygiene competency assessment measures on one-shot clinical licensure examinations.

The purpose of this study was to examine the predictive validity of traditional and nontraditional dental hygiene competency assessment measures on one-shot clinical licensure examinations in a baccalaureate dental hygiene program. Traditional assessment data including overall grade point average (GPA), Clinical GPA, National Board Dental Hygiene Examination (NBDHE) scores, and Central Regional Dental Testing Service (CRDTS) scores along with nontraditional assessment data in the form of Portfolio scores were collected from seventy-four students. Factor analysis and subsequent linear regression modeling were used to explore the ability of four variables (Overall GPA, NBDHE, Portfolios, and Clinical GPA) to predict one-shot clinical licensure examination (CRDTS) scores. A two-factor solution was obtained with one factor defined as dental hygiene cognition and the second factor defined as dental hygiene clinical performance. Factor scores were subsequently used in a linear predictive model to assess the shared and unique contribution of factors to the one-shot clinical licensure examination score. The shared contribution of both factors only accounted for 13.9 percent of variance in the outcome measure of one-shot clinical licensure examination scores. The lack of concordance between previously validated measures of dental hygiene student competency or predictors of student success (Overall GPA, NBDHE, and Portfolios) and a one-shot clinical licensure examination (CRDTS) raises serious concern about the validity of our current dental hygiene licensing procedure which uses the CRDTS clinical examination to make decisions about granting licenses to practice.

Dental Hygienists' Experiences with Motivational Interviewing: A Qualitative Study.

The effectiveness of Motivational Interviewing (MI) to change health behaviors is well documented. Previous studies support use of MI to change oral health behaviors in the areas of early childhood caries and periodontal diseases, but research is limited due to the sparse number of oral health care providers with training in MI. The University of Missouri-Kansas City (UMKC) formally integrated MI training into its dental hygiene curriculum five years ago. Summative program evaluation of UMKC's MI training shows that it effectively equips graduates with MI skills. The aim of this qualitative study was to use semi-structured interviews with nine program alumni to provide insight into the experiences of MI-trained dental hygienists in clinical practice. All interviews were captured with a digital voice recorder, were transcribed, and were resubmitted to the interviewees for checking. Five themes emerged from the data analysis: salience, best practices, barriers, facilitators, and lessons learned. These dental hygienists strongly valued and embraced the spirit of MI. They reported feeling strongly that it should be part of all dental hygiene curricula, and they upheld MI as a best practice. The participants approved of their MI instruction as a whole but felt it was difficult and sometimes not viable in practice. They reported that MI training had improved their communication skills and increased treatment acceptance. Time, difficulty, and managing patient resistance were the most often cited barriers, while a supportive climate and creating a routine were the most often cited facilitators.

Early childhood caries in an urban health department: an exploratory study.

PURPOSE: The purpose of this investigation was to assess the prevalence of early childhood caries (ECC) as a function of various ECC case definitions, in a population of children ages one to five, attending a Women, Infants, and Children (WIC) or well-child clinic at an urban health department. Additionally, the study examines the association of sociodemographic factors, caregiver's oral health perceptions, resources, feeding and oral care behaviors, and prenatal and perinatal histories as risk factors for early childhood caries. METHOD: A convenience sample of 74 children ages one to five years and their parent(s) or guardian(s) enrolled in the WIC and Well Child Services Program at the Kansas City Health Department participated in this study. Caries experience and developmental enamel defects of children were assessed utilizing the deft and linear enamel hypoplasia (LEH) indices. Additionally, the children's parents of guardians were asked to complete a questionnaire to collect data on predisposing risk factors. RESULTS: The proportion of all children with evidence of Type I ECC was high (31.5%), with all ethnic minority groups having a large proportion with caries. Four of the predisposing risk factor variables were related (p < 0.05) to presence of ECC-child's age, gender, age at weaning, and frequency of sweet drinks. Child's age and age at weaning were related to a significant increase in risk for caries when these effects were adjusted by the effect of other risk factor variables. The odds of having caries were increased by 2.3 times (95%, CI 1.4, 3.9) for each increase in child's age by year, and by 2.8 times (95%, CI 1.5, 5.2) for each incremental increase in age category for the child at weaning. CONCLUSION: This investigation lends further support to the contention that quantifying the occurrence of ECC is likely dependent and complicated by diverse case definitions. Caregiver's perceptions of their child's oral health were generally accurate, thereby supporting proponents for educational and preventive strategies aimed at the parent/guardian.

Validity and reliability of a dental operator posture assessment instrument (PAI).

PURPOSE: Basic operating posture is considered an important occupational health issue for oral health care clinicians. It is generally agreed that the physical posture of the operator, while providing care, should be such that all muscles are in a relaxed, well-balanced, and neutral position. Postures outside of this neutral position are likely to cause musculoskeletal discomfort. To date, the range of the neutral operator position has not been well-defined; nor have any specific instruments been identified that can quantitatively or semi-quantitatively assess dental operator posture. This paper reports on the development of an instrument that can be used to semi-quantitatively evaluate postural components. METHODS: During the first phase of the study, an expert panel defined the basic parameters for acceptable, compromised, and harmful operator postures and established face validity of a posture assessment instrument (PAI). During the second phase, the PAI was tested for reliability using generalizability theory. Four raters tested the instrument for reliability. RESULTS: Overall, total PAI scores were similar amongst three of the raters, with the fourth rater's scores being slightly greater than the other three. The main effect of the rater on individual postural components was moderate, indicating that rater variance contributed to 11.9% of total variance. CONCLUSIONS: The PAI measures posture as it occurs and will have numerous applications when evaluating operator performance in the dental and dental hygiene education setting. Also, the PAI will prove useful when examining the effects of operator posture and musculoskeletal disorders.

Fifteen years of portfolio assessment of dental hygiene student competency: lessons learned.

PURPOSE: Adoption of portfolio assessment in the educational environment is gaining attention as a means to incorporate self-assessment into the curriculum and to use evidence to support learning outcomes and to demonstrate competency. Portfolios provide a medium for students to demonstrate and document their personal and professional growth across the curriculum. The purpose of this literature review is to discuss the drivers for portfolio education, the benefits to both students and program faculty/administrators, the barriers associated with portfolio use, and suggested solutions that have been determined through several years of "lessons learned." The University of Missouri Kansas City School of Dentistry, Division of Dental Hygiene department has been utilizing portfolio assessment for over 15 years and has collected data related to portfolio performance since 2001. Results from correlational statistics calculated on the 312 dental hygiene students that graduated from 2001 to 2013 demonstrate a positive and significant relationship between portfolio performance and overall GPA as well as portfolio performance and NBDHE scores.

Analysis of patient factors impacting duration of periodontal maintenance appointments: an exploratory study.

PURPOSE: The periodontal maintenance (PM) appointment requires varying amounts of time and is absolutely essential for long-term successful periodontal therapy. This study assessed time requirements for PM and relative contribution of patient-level factors such as oral health status, complex medical history, maintenance compliance and demographics. METHODS: One hundred patients receiving PM in a graduate periodontal program at a dental school participated in this cross sectional, observational study and components of their PM were timed in minutes/seconds. Descriptive data were obtained for average total-time required for PM and relative time for each treatment component. Hierarchical multiple linear regression determined what patient-level factors demonstrated the greatest impact on total-time to complete PM. RESULTS: The average PM appointment interval, with radiographs, was 1 hour, 16 minutes, 23 seconds (SD 19:25 minutes). When cubicle preparation and disinfection was included, the total-time was 1 hour, 24 minutes, 31 seconds (±19:32 minutes). Multiple regression showed that BOP, dentist examinations, number of carious lesions and/or restorative defects, number of teeth/implants, taking radiographs, female gender and deposit aggregate (supragingival and subgingival calculus and stain) were significant predictors of total PM duration and explained 57% variance (p<0.05, R2=0.569). CONCLUSION: Based on the average comprehensive PM appointment time of 1:16 minutes, the typical appointment of 60 minutes is insufficient to achieve the goals of a comprehensive PM in this academic clinic setting. These findings suggest the need to utilize more customized models for scheduling PM in order to achieve time allocations that are individualized to address specific patients' needs.