Dental radiography-prescribing practices: a nationwide survey of dental hygienists.

Potential harm from ionizing radiation has led to the development of guidelines to protect patients and practitioners from unnecessary radiation exposure; however, these guidelines may or may not be followed in practice. This study surveyed US dental hygienists with regard to radiology policies in the workplace. The survey, consisting of 62 knowledge and practice items regarding use of dental radiography, was based on the 2012 publication by the American Dental Association (ADA) and the US Food and Drug Administration (FDA): Dental Radiographic Examinations: Recommendations for Patient Selection and Limiting Radiation Exposure. The survey link was emailed to 10,000 subscribers of the Dimensions of Dental Hygiene magazine and posted on the magazine's Facebook page. Five hundred seventeen dental hygienists completed the survey. Data analysis included descriptive statistics, cross-tabulations, and chi-square analyses. Approximately 45.9% of respondents reported that the dentist determined the need for radiography, and 41.8% reported that the decision was made by the dental hygienist. The majority of respondents (82.4%) reported that there were times when a clinical examination was not performed before imaging, and 69.9% reported that images had been ordered on the basis of a set time interval. Approximately 35.6% reported that images had been requested on the basis of the patient's insurance reimbursement. For adult recall patients with no clinical caries and low caries risk, general and corporate dental practices made bitewing radiographs more frequently (every 12 months) compared with educational institutions (P < 0.05). In the case of children and adolescent recall patients without caries and with low caries risk, for children, corporate dental practices made bitewing radiographs more frequently (every 6 months) than educational institutions (P < 0.05); for adolescent patients, corporate and general dental practices preferred to make bitewing images every 12 months, whereas educational institutions preferred to make bitewing images every 18 months (P < 0.05). The findings suggest that some dental practices are not strictly following the ADA/FDA guidelines with regard to frequency of radiographic exposures.

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.

Resin Infiltration Therapy: A micro-invasive treatment approach for white spot lesions.

Purpose: The demand for esthetic dentistry has led to the development of new treatments for white spot lesions (WSLs). Microinvasive therapies, such as resin infiltration, have been used to treat demineralized enamel. Recently, resin infiltration using the active ingredient triethylene glycol dimethacrylate (TEGDMA), has been used to restore WSLs. The purpose of this narrative review is to evaluate the evidence on TEGDMA, an innovative resin that has been introduced, as an alternative dental material for treating WSLs.Methods: A review of the literature was conducted using key words pertaining to WSLs and resin infiltration including cosmetic dentistry; dental caries; dental materials; general dentistry; sealants; technology for patient care. Evidence was incorporated from biomedical data bases including PubMed and the Cochrane Library, which formed the framework for the review.Results: Based on the synthesis of the evidence, resin infiltration using TEGDMA is an effective alternative treatment option for WSLs. Studies suggest that the outcomes for micro-invasive procedures using resin infiltration may vary depending on the depth of the lesion.Conclusion: Resin infiltration, using TEGDMA, removes minimal amounts of enamel and preserves the hard tissue surrounding the WSLs. Additionally, TEGDMA restores the natural fluorescence, hardness, and texture of intact enamel. Future studies are needed to assess the long-term clinical effects of resin infiltration using this material on both permanent and primary dentition.

Smith-Lemli-Opitz syndrome: a review, case report and dental implications.

Smith-Lemli-Opitz syndrome (SLOS) is an autosomal recessive developmental disorder characterized by multiple congenital malformations, dysmorphic craniofacial features, and mental impairment. SLOS is caused by a deficiency of the enzyme 7-dehydrocholesterol delta7 reductase which converts 7-dehyrocholesterol to cholesterol. This error results in elevated serum levels of 7-dehydrocholesterol and decreased levels of serum cholesterol. This article describes the clinical features and medical treatment of SLOS. A case report is included, with recommended guidelines for providing safe and comprehensive dental care for individuals with SLOS.

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.

Monitoring pediatric blood pressure at dental appointments.

Numerous studies have tracked blood pressure from adolescence into adulthood. It is increasingly apparent that the recent increase in obesity and resultant end-organ effects of hypertension originates in childhood. Pediatric hypertension is a significant health concern that, if left untreated, can affect a child's cardiovascular, endocrine, renal, and neurologic systems. In 2004, the National High Blood Pressure Education Program Working Group on High Blood Pressure in Children and Adolescents recommended that bloodpressure should be monitored in pediatric patients who are at least 3-years-old and that this procedure should be a part of the health care visit in all health facilities, rather than just within the medical office. The purpose of this article was to emphasize the need for following these recommendations at oral care visits and suggest a simplified pediatric blood pressure table that dental clinicians can use to identify children who need referrals to medical facilities for evaluation of blood pressure.

A national survey of dental hygienists' infection control attitudes and practices.

PURPOSE: The objectives of this study were to: 1) investigate the infection control practices of practicing dental hygienists, 2) document the attitudes and practices of dental hygienists toward patients with infectious diseases, and 3) determine if professional affiliation affected the attitudes and/or practices of the respondents. METHODS: A 49-item survey consisting of eight demographic, nine attitudinal, and 32 practice questions was used for this study. A stratified sampling method was used, in which the United States was divided into four regions. Three states were selected from each region according to geographic location and population. Five percent of registered dental hygienists within each selected state were randomly selected for inclusion in the study. All analyses were conducted using the Statistical Package for Social Scientists (SPSS v.10, Chicago, IL). RESULTS: Of the 2,009 surveys mailed, 104 were undeliverable. A total of 856 completed surveys were returned from practicing dental hygienists for a response rate of 44.9%. Overall, this study found an increased use of barriers and personal protective equipment in comparison to previous studies. A majority of respondents (53.9%) felt that treating patients with HIV or AIDS increased their personal risk for contracting the disease. The majority of respondents also reported always using extra precautions with HIV/AIDS patients (63.5%) and hepatitis patients (60.1%). In addition, most respondents reported they would not use an ultrasonic scaler when treating HIV/AIDS (65.8%) or hepatitis (58.9%) patients, indicating an alteration in clinical practice habits. CONCLUSION: The majority of dental hygienists surveyed reported altering infection control practices and treatment techniques when treating HIV/AIDS or hepatitis patients. While there has been an improvement in compliance with recommended infection control guidelines, practitioners still have misconceptions, and possibly fear, regarding infectious diseases and disease transmission.