Allied Dental Students' Perceived Knowledge, Confidence, and Attitudes Regarding Disaster Victim Identification Topics.

Purpose Disaster victim identification (DVI) service requires knowledge, confidence, and an attitude (KCA) of readiness. The purpose of this study was to assess allied dental students' perceived KCA regarding DVI skills and topics.Methods A convenience sample of senior dental hygiene students (n=27) and senior dental assistant students (n=14) were recruited by email then presented mismatched simulated antemortem (AM) and postmortem (PM) bitewing radiographs and asked to indicate correct matches. Collectively, participants made 205 radiographic matches and indicated 205 degrees of certainty binarily as "positive" or "possible" (one per match). Participants also completed a researcher designed pretest/posttest electronic survey with seven 3-point Likert-scale items with answer options of "slightly", "moderately", or "extremely" regarding self-perceived knowledge. Statistical analyses were conducted with R software using an α=0.05 significance level.Results A total of n=41 students participated, yielding a response rate of 85.4%. A one-sided linear trend test revealed statistically significant increases of perceived confidence in knowledge from pretest to posttest regarding forensic odontologists' role in DVI (p<0.0001), DVI applications for mass fatality incidents (MFI) (p<0.0001), role of dental radiology in DVI (p<0.0001), and dental morphology applications for DVI (p<0.0001). Participants indicated moderate or extreme confidence in personal clinical skillsets to assist forensic odontologists with DVI. A one-sided Fisher's exact test revealed a statistically significant (p<0.05) positive association between expressed degree of certainty (confidence) and correct radiographic matches. A one-sided linear trend test revealed statistically significant (p<0.0001) improvements in attitude regarding participants' perceived importance for their respective professions to volunteer in DVI.Conclusion Participants of this study reported significant improvements of self-perceived KCA regarding DVI skills and topics. These characteristics may encourage allied dental professionals to pursue further DVI educational opportunities and future service when support is needed for MFI.

Populational Variations of Cheiloscopy Patterns: A cross-sectional observation pilot study.

Purpose Lip prints are unique and have potential for use as a human identifier. The purpose of this study was to observe possible cheiloscopy differences of individuals with and without parafunctional oral habits such as smoking, vaping, playing a wind instrument or using an asthma inhaler.Methods This IRB approved blinded cross-sectional observation pilot study collected lip prints from sixty-six individuals, three of which were excluded. Participants cleansed their lips, then lipstick was applied to the vermillion zones of the upper and lower lips. Adhesive tape was applied to the lips and prints were transferred to white bond paper for viewing purposes. Each set of included lip prints was divided into quadrants and dichotomized into a group of those with an oral parafunctional habit or with no such habits. Each quadrant sample was then manually analyzed and classed according to the gold standard Suzuki and Tsuchihashi system.Results A total of 252 dichotomized lip print quadrants (with habits n=76, 30.2%, and without habits n=176, 69.8%) were analyzed. Type II patterns were the most common for examined quadrant samples; however, no statistically significant differences (Pearson's chi-squared test, p=0.366) were observed between pattern classifications of samples with and without parafunctional oral habits.Conclusion There is no statistically significant difference of lip print patterns between individuals with and without parafunctional oral habits. Further research on populational variations is needed for cheiloscopy to aid in human identifications.

Dental Hygiene and Dental Assistant Students' Simulated DVI Radiographic Match Accuracy: A pilot study.

Purpose Allied dental health care professionals have served on disaster victim identification (DVI) teams; however, the literature is void of statistical measures regarding transferable skills and disaster preparedness. The purpose of this study was to assess second year dental hygiene and dental assistant students' match accuracy for simulated DVI radiographs and compare the match accuracy between the student groups.Methods Five patient cases were chosen at random to retrospectively collect sets of digital bitewing radiographs from two time periods. The five retrospectively selected sets of images served as simulated antemortem (AM) and postmortem (PM) radiographs. A convenience sample of second year dental hygiene and dental assistant students from two institutions (n=48) were invited to participate in this IRB-exempt descriptive observational study. The previously selected AM and PM images were randomly mismatched, and participants were asked to visually compare the image sets and indicate the matches using a drag and drop feature in an electronic survey instrument. Descriptive statistics were used to analyze the data; the significance level was set at α=0.05.Results A total of 41 dental hygiene and dental assistant students agreed to participate for a response rate of 85.4%. Eighty-five percent of the participants accurately matched five out of five sets while the remaining 15% accurately matched three out of five sets. A one-sample binomial proportion test revealed that 80% of the participants were able to match at least four out of five sets (p<0.001). Dental hygiene students demonstrated increased matching performance as compared to dental assisting students (p=0.013).Conclusion Both dental hygiene and dental assistant students demonstrated transferable DVI skills to accurately match simulated AM and PM radiographs. Future research is needed in a larger sample to develop and assess best practices of DVI training to build on existing skills for allied dental health care professionals.

Use of a Simulated-Virtual Training Module to Improve Dental Hygiene Students' Self-Reported Knowledge, Attitudes, and Confidence in Providing Care to Children with Autism Spectrum Disorder: A pilot study.

Purpose: Autism spectrum disorder (ASD) is a developmental disorder affecting an individual's ability to communicate, interact, behave, and learn. The purpose of this study was to determine knowledge, attitudes, and confidence of dental hygiene students in providing care to children with ASD as a mechanism for evaluating dental hygiene curricula for patients with special needs.Methods: A simulated-virtual training (SVT) intervention was developed as an interactive approach for educating dental hygiene students on providing care to a child patient with ASD. The SVT intervention consisted of a scenario in which the clinician "interacted" with a child with ASD who was having difficulty in the dental environment. Pre- and post-test surveys measured students' knowledge, attitudes, and perceived confidence related to providing dental hygiene services to children with ASD prior to and following the intervention. The Wilcoxon Signed Rank was used to determine statistical significance at the p=.05 level.Results: Thirty-three second year dental hygiene students completed the pre- and post-test surveys for a response rate of 97%. Statistically significant differences were observed for self-reported confidence to provide care to patients with ASD upon graduation, assessment of the unique needs of children with ASD, and an understanding of the dental needs for children with ASD (p<0.05). Participants' confidence with performing dental hygiene services on children with ASD greatly increased, with statistically significant difference found for almost all services (i.e., oral exam, oral hygiene instruction, oral photos, radiographs, scaling, fluoride treatment; p<0.05) except selective polishing. Most (90%) agreed that there is a need for additional/elective resources to help increase comfort in providing care to children with ASD.Conclusion: Results indicate the SVT intervention increased students' knowledge, attitudes, self-perceived confidence, and comfort. Dental and dental hygiene curricula could include technologies and intervention methods to advance access to dental care by children with ASD.

Postmortem Dental Records Identification by Dental Hygiene Students: A pilot study.

Purpose: Dental hygienists have the potential for filling critical roles in multidisciplinary victim identification teams. The purpose of this pilot study was to evaluate the accuracy of dental hygiene students utilizing dental charting, bitewings, and skull dentitions for the purpose of making identification matches.Methods: Thirty senior dental hygiene students (n=30) independently viewed an asynchronous online multimedia-based presentation on the procedures used for collecting and recording forensic dental evidence. Following the presentation participants attempted to chart and match three bitewing radiograph sets to three human skull dentitions by correlating matches/exclusions. Immediately following the activity, each student completed a questionnaire rating the difficulty of the exercise, as well as their confidence, and willingness to volunteer as a forensics team member. Descriptive statistics were used to analyze the data.Results: Of the total sample 36.7% (n=11) reported having prior experiences with dental radiography; while the majority (63.33%, n=19) reported no prior experience. Participants' accuracy scores for dental charting ranged from 91.23% (SD=9.42) to 99.06% (SD=3.60), with no statistically significant difference based on prior experience (p>0.05). The average interrater reliability was 86% (p<0.0001), indicating a high level of agreement with charting skulls and radiographs. No statistically significant differences were found for charting time, perceived difficulty, or level of confidence when comparing experience among the participants (p>0.05).Conclusions: Regardless of previous experience, dental hygiene students were able to match postmortem dentitions and radiographs with good interrater reliability and did not differ statistically for charting time, perceived difficulty, or confidence. Results suggest dental hygienists can work as effective victim identification team members when educational programs are implemented.

Radiation Safety Practices of Dental Hygienists in the United States.

Purpose: The As Low As Reasonably Achievable (ALARA) principle was developed to promote awareness and minimization of radiation exposure and is supported by radiation control and professional organizations. The purpose of this study was to determine licensed dental hygienists' current radiation safety practices.Methods: Data were collected with a 22 item, online survey administered to a convenience sample of 1,500 dental hygienists in the United States. Questions focused on respondents' use of the American Dental Association (ADA) radiographic examination selection guidelines, their individual dental practice policies, and hand-held portable x-ray device use and training. Cross tabulations were obtained using logistic regression and general linear models for significance at a 0.05 level.Results: A response rate of 38% (n = 566) was obtained. A majority of respondents had an associate's degree (62%), were over the age of 55 (41%), and had over 30 years of experience. Respondents with more years of experience were more likely to follow the ADA selection criteria for radiographic need (p=0.0340; SE=0.1093) and respondents with a bachelor's degree or higher were more likely to use techniques to reduce radiation exposure than those with an associate's degree (p=0.0080; SE=0.0169). Respondents who had recently taken dental radiation safety continuing education courses were significantly more likely to wear a clinician lead apron when using a hand-held x-ray device (p=0.0093; M=1.571; SD=1.222).Conclusion: Dental hygienists with more years of experience, a higher level of education, and recent CE course work were more likely to follow ADA radiographic examination selection guidelines and use appropriate techniques to reduce exposure to ionizing radiation.

Workplace Bullying: A survey of Virginia dental hygienists.

Purpose: Workplace bullying in health care has been identified as a problem that negatively affects career satisfaction, career longevity and patient outcomes. The purpose of this pilot study was to determine the prevalence of workplace bullying in a convenience sample of dental hygienists in the state of Virginia.Methods: Two hundred and forty Virginia dental hygienists attending a continuing education seminar were invited to participate. Using the Negative Acts Questionnaire-Revised (NAQ-R), respondents were asked to indicate how often they had experienced 22 negative acts or behaviors according to rate of occurrence (never, now and then or monthly, weekly or daily). Bullying was defined as experiencing two or more of the specified negative behaviors over the past 6 months. The negative behaviors were categorized into three subgroups: work-related bullying, personal bullying and physical intimidation.Results: The response rate was 64%. Data revealed almost one fourth (24%) of respondents experienced workplace bullying. The most frequent behaviors experienced by those being bullied were having their opinions and views ignored (73%), experiencing unmanageable workloads (68%) and having their work excessively monitored (68%), on a weekly or daily basis.Conclusions: Results from this study suggest approximately 1 out of 4 Virginia dental hygienists responding to this survey experience workplace bullying. Education and support to ensure identification of bullying may be helpful in promoting proactive awareness, prevention strategies and a healthier work environment leading to greater job satisfaction.

Testing a Novel 3D Printed Radiographic Imaging Device for Use in Forensic Odontology.

There are specific challenges related to forensic dental radiology and difficulties in aligning X-ray equipment to teeth of interest. Researchers used 3D printing to create a new device, the combined holding and aiming device (CHAD), to address the positioning limitations of current dental X-ray devices. Participants (N = 24) used the CHAD, soft dental wax, and a modified external aiming device (MEAD) to determine device preference, radiographer's efficiency, and technique errors. Each participant exposed six X-rays per device for a total of 432 X-rays scored. A significant difference was found at the 0.05 level between the three devices (p = 0.0015), with the MEAD having the least amount of total errors and soft dental wax taking the least amount of time. Total errors were highest when participants used soft dental wax-both the MEAD and the CHAD performed best overall. Further research in forensic dental radiology and use of holding devices is needed.

Assessment of Mass Fatality Preparedness and Response Content in Dental Hygiene Education.

When mass fatality incidents (MFIs) occur, they can quickly overwhelm local, state, and government agencies, resources, and personnel. It is important to have a rapid and effective response with skilled, multidisciplinary victim identification teams since specific skill sets are necessary to participate in mass fatality preparedness and response. The aims of this study were to determine the extent of formal education related to mass fatality preparedness and response training in U.S. dental hygiene programs and to assess program directors' perceptions of the need for such training. A 23-item cross-sectional survey was emailed to 319 U.S. dental hygiene programs in 2015. Survey questions addressed if the program offered mass fatality preparedness and response training to its students and how much training was given, as well as collecting respondents' demographics and opinions regarding education and training. An overall response rate of 36% was obtained, with 111 program chairs completing the survey. The results showed that only a small percentage of responding programs incorporated coursework related to mass fatality and preparedness in their curricula. Of the responding programs, 84% had no formal instruction on the role of a dental hygienist in MFIs; however, 53 of 69 program directors agreed or strongly agreed that the role of dental hygienists in MFIs should be covered in dental hygiene curricula. The top three barriers to incorporating such training reported by respondents were time requirements, lack of faculty expertise, and lack of equipment. Future research is needed to establish standardized competencies for mass fatality preparedness and response in dental hygiene education.

Interventions for the Reduction of Dental Anxiety and Corresponding Behavioral Deficits in Children with Autism Spectrum Disorder.

PURPOSE: Autism Spectrum Disorder (ASD) can greatly inhibit a child's communication and social interaction skills, impacting their comfort during dental hygiene treatment and services. Children with ASD may exhibit sensory sensitivities, fear of the unfamiliar and lack of socio-cognitive understanding, leading to anxiety and corresponding behavioral deficits. Since the prevalence rates for ASD have risen significantly in the past decade, increased emphasis has been placed on educational and behavior guidance techniques, which can be helpful for children with ASD because of their increased capabilities in visual-processing. The purpose of this literature review is to summarize the interventions available to reduce dental anxiety in children with ASD, and to determine which strategies are best suited for implementation by the dental hygienist. Advancements in technology and socio-behavioral interventions were assessed for appropriate use, efficacy and engagement in the target population. Interventions were categorized into the following groups: picture cards, video technologies and mobile applications.

Performance of Dental Hygiene Students in Mass Fatality Training and Radiographic Imaging of Dental Remains.

PURPOSE: Mass fatality incidents can overwhelm local, state and national resources quickly. Dental hygienists are widely distributed and have the potential to increase response teams' capacity. However, appropriate training is required. The literature is void of addressing this type of training for dental hygienists and scant in dentistry. Hence, the purpose of this study was to assess one facet of such training: Whether the use of multimedia is likely to enhance educational outcomes related to mass fatality training. METHODS: A randomized, double-blind, pre- and post-test design was used to evaluate the effectiveness of comparable educational modules for 2 groups: a control group (n=19) that received low media training and a treatment group (n=20) that received multimedia training. Participants were second-year, baccalaureate dental hygiene students. Study instruments included a multiple-choice examination, a clinical competency-based radiology lab scored via a standardized rubric, and an assessment of interest in mass fatality education as a specialty. ANOVA was used to analyze results. RESULTS: Participants' pre- and post-test scores and clinical competency-based radiology lab scores increased following both educational approaches. Interest in mass fatality training also increased significantly for all participants (p=0.45). There was no significant difference in pre- and post-test multiple choice scores (p=0.6455), interest (p=0.9133) or overall competency-based radiology lab scores (p=0.997) between groups. CONCLUSION: Various educational technique may be effective for mass fatality training. However, mass fatality training that incorporates multimedia is an appropriate avenue for training instruction. Continued research about multimedia's role in this specialty area is encouraged.

Mass Fatality Incidents and the Role of the Dental Hygienist: Are We Prepared?

PURPOSE: Dental hygienists can fill critical roles during mass fatality incidents in the area of disaster victim identification, providing much needed support to forensic odontologists. The purpose of this paper is to bring awareness that research is needed to assess current dental hygiene programs, continuing education opportunities and the type of approach being used to develop and implement pedagogy in the forensic specialty area, specifically mass fatality preparedness and response for the dental hygienist. Because of the threat of terrorism in the U.S. and natural disasters like hurricanes, the need to prepare dental professionals in disaster response and fatality management is real. The authors' recommendations are to incorporate training in the areas of risk management and infection control in the mortuary setting, antemortem and postmortem records comparison, safe usage of portable radiographic equipment, and proper radiographic technique for the deceased victim. Disaster victim identification training in these areas is necessary for the accurate, efficient and dignified identification of disaster victims while minimizing errors and increasing responder safety. The dental hygiene professional can assist disaster mortuary response efforts in a way that leverages multidisciplinary teams, if effective training programs are implemented.

Vital tooth whitening effects on oral health-related quality of life in older adults.

PURPOSE: The purpose of this study was to determine if vital tooth whitening affects oral health-related quality of life (OHRQOL) in adults age 50 years and older, and if tooth whitening causes increased participation in social activities. METHODS: Using a 2 group, single blind, randomized, pre-test, multiple post-test design, 62 participants were enrolled. The experimental group used a whitening product twice daily for 3 weeks. The control group used no whitening products. The Oral Health Impact Profile (OHIP) served as the pre- and post-test measure. The OHIP measures OHRQOL on 7 subscales: functional factors, psychological disabilities, psychological discomforts, physical disabilities, social disabilities, handicaps and physical pain. Additional questions measured the subjects' social activities at baseline, 3 weeks and 3 months. Data from 53 participants, who completed the study, were analyzed using paired t-tests and ANOVA at p=0.05. RESULTS: Statistical significance was observed for the OHIP physical pain subscale (p=0.0029) and the handicap subscale (p=0.05). Pre- to post-test means of the physical pain subscale increased in the experimental group (4.84 to 7.10), suggesting a lower OHRQOL, most likely related to tooth sensitivity experienced by the experimental group. Means from pre- to post-test of the handicap subscale (1.96 to 1.19) reveal that the experimental group reported an improved OHRQOL and felt they were more willing to work. Repeated measures ANOVA and Tukey's post-hoc tests revealed that the experimental group reported significantly less (p=0.04) social activities at the 3 month post-test (3.92 to 3.45). No statistically significant between-group differences were observed in the overall OHIP score for functional factors, psychological disabilities, psychological discomforts, physical disabilities and social disabilities. CONCLUSION: Results indicate that vital tooth whitening does not improve overall OHRQOL in older adults.