Current prescribing Practices for Antibiotic Prophylaxis: A Survey of Dental Practitioners.

AIM: Antibiotic prophylaxis guidelines have been developed for health care and dentistry. The authors examined whether dentists were following the 2007 American Heart Association (AHA) and the 2012 American Association of Orthopaedic Surgeons (AAOS) recommendations for antibiotic prophylaxis. MATERIALS AND METHODS: A survey was sent to 600 dentists in the south-central region of the United States. The survey examined dentists' prescribing practices for patients with cardiac and prosthetic joint replacements, antibiotic regimen prescribed, confidence in their prescription decisions, and dentistry's contribution to antibiotic resistance. RESULTS: The response rate was 28.7% (n = 172). Dentists followed the 2007 AHA guidelines for patients with a history of infective endocarditis (95%), and cardiac valves repaired with prosthetic materials (76%) or animal/donor tissue (61%). For prosthetic joint replacement, 72% prescribed antibiotic prophylaxis within the first 2 years after placement and 58% continued to prescribe after 2 years. Amoxicillin was the most frequently prescribed antibiotic for cardiac conditions (92%) and prosthetic joint replacements (77%). No significant differences were found in relation to dentists' gender (p = 0.75), year of graduation (p = 0.71), scope of practice (p = 0.30), and their confidence in their prescription decisions; 73% believed taking multiple doses of antibiotics leads to antibiotic resistance. CONCLUSION: The majority of dentists were following the 2007 AHA guidelines. Confusion regarding the 2012 AAOS guidelines for prosthetic joint replacement was evident. CLINICAL SIGNIFICANCE: Keeping current with changing antibiotic prophylaxis guidelines ensures dentists are providing the best evidence-based dentistry for their patients.

The prevalence of academic dishonesty in Texas dental hygiene programs.

The media has given much attention to the academic cheating crisis in America. A majority of college students believe that, in today's global environment, it is necessary to cheat in order to get ahead and to compete with their peers. The prevalence and attitudes concerning academic dishonesty of health professions students, including those in medical, dental, and nursing schools, have been extensively researched. No such studies exist in the discipline of dental hygiene. The purpose of this study was to investigate the prevalence of cheating in Texas dental hygiene programs. Four hundred surveys were mailed to twenty Texas dental hygiene schools for graduating students to complete. A total of 289 usable surveys was returned for a response rate of 72.25 percent. Data were analyzed using SPSS with frequencies and chi-square tests. Findings from this study reveal that 86.5 percent of graduating Texas dental hygiene students have cheated a minimum of one time during matriculation. Students identified the demands of what they considered academic overload as the primary justification for cheating behavior.

Relationship Between Dental Hygiene Students' Performance in an Oral Radiology Course and the National Board Dental Hygiene Examination: A Retrospective Study.

Dental hygiene students' performance in oral radiology courses may give an early indication of their readiness prior to taking the National Board Dental Hygiene Examination (NBDHE). The aim of this study was to determine the relationship between dental hygiene students' performance in an oral radiology lecture course and their performance on the NBDHE. Data were collected for all 117 dental hygiene students at Texas A&M University College of Dentistry from 2006 to 2009 who took the NBDHE during their second year of the program. Their final grades and scores on three written section examinations in an oral radiology course taken in their first year were compared with their overall NBDHE scores and raw scores on the oral radiology and case study sections. Moderate correlations (0.3

The Impact of Community Rotations on the Cultural Competence of Dental Hygiene Students in the State of Texas.

Purpose: Culturally competent health care providers understand cultural attitudes, values, beliefs and practices and are able to use this knowledge to guide patient care. Rising oral health disparities among racial and ethnic minorities require that dental educators emphasize the attainment of cultural competence in order to prepare students to effectively care for patients with backgrounds different from their own. This study investigated the role of community rotations on the cultural competence of second-year Texas dental hygiene students.Methods: A modified version of the validated self-assessing Clinical Cultural Competency Questionnaire (CCCQ) was given to students at twelve Texas dental hygiene programs with a 100% response rate (239/239). Data analysis was performed using the Kendall tau correlation for associations and Kruskal-Wallis and Mann-Whitney U tests for differences among and between groups.Results: Students scored highest in attitude (86th percentile). Time spent in community rotations (p=0.009), number of community rotations (p=0.028), racial/ethnic diversity of program clinic patients (p=0.042), and training hours (p=0.044) were associated with increased cultural competence scores. Students with over 50 community rotation hours (p=0.006) scored significantly higher than students with less than 50 hours. Generally, those with four rotations (p=0.002) scored highest. Those with public clinic (p=0.049) and school (p=0.044) rotations scored significantly higher than those without these experiences. Those with nursing home (p=0.009) and hospital (p=0.026) experience scored lower than those without these experiences. Students seeing the most racially/ethnically diverse patients in program clinics scored higher (p=0.014) than students seeing less diverse patients. Those with 6-10 training hours scored higher (p=0.013) than those with other training levels. Hispanics scored significantly higher than whites in skill and overall cultural competence (p≤ 0.005).Conclusion: Dental hygiene programs should invest time in cultural competence training and choose a robust program of community rotations, while considering the diversity of the student body and clinic patient pool to enhance graduates' cultural competence.

Effect of grade point average and enrollment in a dental hygiene National Board review course on student performance on the National Board Examination.

Passing the National Board Dental Hygiene Examination is a requirement for licensure in all but one state. There are a number of preparation courses for the examination sponsored by corporations and dental hygiene programs. The purpose of this study was to determine if taking a board review course significantly affected student performance on the board examination. Students from the last six dental hygiene classes at Baylor College of Dentistry (n = 168) were divided into two groups depending on whether they took a particular review course. Mean entering college grade point averages (GPA), exiting dental hygiene program GPAs, and National Board scores were compared for the two groups using a t-test for independent samples (p < 0.05). No significant differences were found between the two groups for entering GPA and National Board scores. Exiting GPAs, however, were slightly higher for those not taking the course compared to those taking the course. In addition, a strong correlation (0.71, Pearson Correlation) was found between exiting GPA and National Board score. Exiting GPA was found to be a strong predictor of National Board performance. These results do not appear to support this program's participation in an external preparation course as a means of increasing students' performance on the National Board Dental Hygiene Examination.

Attitudes towards students who plagiarize: a dental hygiene faculty perspective.

The purpose of this study was to examine baccalaureate dental hygiene faculty members' attitudes and practices regarding student plagiarism. An email containing a link to a thirty-two-item survey was sent to fifty-two baccalaureate dental hygiene program directors in the United States; thirty of those agreed for their faculty members to participate. Of the 257 faculty members who received the survey link, 106 completed the survey, for a response rate of 41.2 percent. The responding faculty members reported thinking plagiarism is a rising concern in their dental hygiene programs (54.5 percent, 54/99). The majority said they check for plagiarism on student class assignment/projects (67.1 percent, 53/79). For those who did not check for plagiarism, 45.8 percent (11/24) stated it took "too much time to check" or it was "too hard to prove" (16.6 percent, 4/24). The most frequent form of student plagiarism observed by the respondents was "copying directly from a source electronically" (78.0 percent, 39/50). Most respondents reported checking for plagiarism through visual inspection (without technological assistance) (73.0 percent, 38/52). Of those who said they use plagiarism detection software/services, 44.4 percent (16/36) always recommended their students use plagiarism detection software/services to detect unintentional plagiarism. For those faculty members who caught students plagiarizing, 52.9 percent (27/51) reported they "always or often" handled the incident within their dental hygiene department, and 76.5 percent (39/51) said they had never reported the student's violation to an academic review board.

The ethics of live patient use in dental hygiene clinical licensure examinations: a national survey.

A national survey of dental hygienists was conducted to explore ethical issues arising from the use of live patients for dental hygiene clinical licensure examinations. Data were collected regarding respondents' demographics, additional costs they incurred associated with their examination beyond the examination fees, delays in patients' treatment resulting from the examination, unethical candidate and/or patient behaviors they experienced, and provisions they made for patients' follow-up care related to the examination. Five hundred surveys were mailed to dental hygienists from two states in each of the five licensure examination regions. The response rate was 40.6 percent (n=203). Descriptive statistics were used to analyze the data. The results showed that the majority of the respondents spent additional money on examination-related expenses (69.2 percent). Sixty-one percent of the respondents reported paying their patients; however, only 50.5 percent felt such a practice was acceptable. More than half (53.1 percent) reported believing it was appropriate to delay treatment in order to have a patient participate in the examination, although only 16.4 percent reported actually delaying treatment. Informed consent was said to be obtained by 94.9 percent of the respondents. The majority (86.6 percent) said they referred patients for follow-up dental hygiene care. When asked if they felt the examination was an accurate assessment of their clinical skills, 78.7 percent of the respondents agreed that it was.

The nonmedical use of prescription stimulants among dental and dental hygiene students.

The purpose of this study was to determine the nonmedical use of prescription attention deficit disorder (ADD) stimulant medication among dental and dental hygiene students. A questionnaire was used to examine demographic information, student experiences, and perceptions of prescription stimulant medication and to determine if students used a prescription stimulant nonmedically. In 2008, 401 surveys were mailed to dental education institutions in the south-central region of the United States, and 243 surveys (61 percent) were returned. The survey found that 12.4 percent of these students used a prescription stimulant nonmedically and, of those, 70 percent took it to improve attention and/or concentration. The most commonly reported stimulant medication used nonmedically was Adderall (77 percent). The majority (87 percent) of the students obtained the medication through friends, and 90 percent began using the drug in college. Even though 74 percent of the students reported being stressed, chi-square analysis found no significant association between nonmedical use of ADD stimulant medication and stress level (p=0.585). Sixteen percent of the students surveyed felt it was easy to obtain stimulant medication for nonmedical use at their school, and 17 percent thought it was a problem within their institution. These results may help administrators and faculty members become aware of potential problems with the misuse of ADD stimulant medication.

Use of the Cross-Cultural Adaptability Inventory to measure cultural competence in a dental hygiene program.

PURPOSE: The purpose of this study was to determine changes in students' cross-cultural effectiveness using the Cross-Cultural Adaptability Inventory (CCAI). The inventory assessed strengths and weaknesses in 4 skill areas: Emotional Resilience, Flexibility/Openness, Perceptual Acuity, and Personal Autonomy. METHODS: The CCAI was administered to 30 dental hygiene students during Orientation. Age and dental assisting experience were recorded to determine if those variables affected skill areas. The inventory was re-administered at the end of the first and second years of the program. Data from the 3 time periods were analyzed using t-tests (alpha=0.05) for the 4 skill areas. These scores were totaled and used to determine differences due to dental assisting experience or age. RESULTS: T-tests found no significant differences (alpha=0.05) for the 4 skill areas and for total scores between administrations of the inventory. Age and dental assisting experience did not affect results. CONCLUSIONS: No significant improvement in students' cross-cultural effectiveness over the course of the 2-year curriculum was determined using the CCAI. Results of each student's performance, however, were not shared until graduation. Sharing results earlier would have allowed students to identify strengths and weaknesses in their cross-cultural effectiveness. This knowledge may have motivated them to improve their skills when exposed to patient experiences and curricular content promoting cross-cultural effectiveness. Programs which decide to use this inventory may want to consider using a strategy of surveying and sharing results at appropriate points during the curriculum.

Cross-cultural adaptability of Texas dental hygienists and dental hygiene students: a preliminary study.

This study sought to determine if statistically significant differences existed among and between licensed dental hygienists and first- and second-year dental hygiene students in Texas on a cross-cultural adaptability measure. The cross-cultural adaptability of licensed dental hygienists and of first- and second-year dental hygiene students attending five randomly selected dental hygiene schools in Texas was investigated. A sample of 289 individuals completed the fifty-item Cross-Cultural Adaptability Inventory (CCAI) and a brief demographic survey, resulting in 278 usable responses. The CCAI yields a total score and four individual subscale scores that describe a person's readiness to interact with people of different cultures. The results revealed no statistically significant differences among the licensed hygienists and students in the first and second years of study and CCAI scores. A statistically significant relationship (r=.148) was found between age and one of the four CCAI subscale scores: flexibility/openness. No other statistically significant relationships were found. The number of years to earn a degree, level of practice, ethnicity, and years employed may not play a significant role in enhancing cross-cultural adaptability. Further research needs to be conducted to determine differences and relationships between and among various dental hygiene groups and their cross-cultural adaptability performance.

What victims of domestic violence need from the dental profession.

Most dental schools teach students about domestic abuse, but it is unknown if this information is ever applied in practice. This study was conducted to determine whether domestic violence victims 1) visited dental offices when signs of abuse were present; 2) were asked about their injuries; 3) were given referrals or assistance; and 4) want the abuse recognized by and discussed with the dental professional. A survey was developed and mailed to fifteen shelters. Eleven (73.3 percent) shelters participated, with a total of 112 out of 165 (67.8 percent) surveys returned. Descriptive statistics were analyzed, and an ANOVA test was conducted to determine if a relationship existed between the incidence of abuse and ethnicity. Seventy-six percent of respondents had suffered physical abuse in the head and neck area. Over half of the participants had seen a dentist when signs of abuse were present, yet 88.6 percent were not asked about their injuries. In addition, 69.2 percent responded that they would have liked to have been asked about their injuries. It appears that the dental profession needs to take a more active role in the recognition of domestic violence in their patient populations. Raising dentists and dental hygienists' awareness of the problem and potentially increasing the number of referrals may help more victims.

Disciplinary actions associated with the administration of local anesthetics against dentists and dental hygienists.

PURPOSE: Research studies have demonstrated the need for and the ability of dental hygienists to provide local anesthetics for pain control and reduction of patient anxiety. Although two-thirds of state dental practice laws allow these services to be performed by dental hygienists, controversy exists between organized dentistry and dental hygiene regarding the administration of local anesthetics by dental hygienists. Some dentists believe the quality of care would be compromised and patient safety jeopardized because dental hygienists do not have adequate background knowledge to prevent complications and recognize emergencies caused by anesthetics. The purpose of this study was to collect quantitative data addressing safety when dental hygienists administer local anesthetics. RESULTS: Eighteen responses were received, for a response rate of 69%. These data showed, over a 10-year period, no reports of disciplinary actions against dental hygienists for the administration of local anesthetics. CONCLUSION: This study affirmed public safety, which should be helpful to states considering statutes to allow the administration of local anesthetics by dental hygienists. Results suggest that properly educated dental hygienists in the states surveyed have administered local anesthetics to patients without harm.