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.

Cheiloscopy patterns in individuals with and without parafunctional oral habits: 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 66 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 analysed 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 analysed. 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. CONCLUSIONS: 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.

Dental hygiene students' matching accuracy when comparing antemortem dental radiographs and oral photographs to simulated postmortem WinID3® odontograms.

Matching dental antemortem (AM) and postmortem (PM) data for human identification is especially challenging when the workforce is limited. Dental hygienists have served mass fatality incidents (MFIs) due to dental-related expertise. However, forensics within dental hygiene education and research on transferable skills is limited. This qualitative balance design study assessed senior dental hygiene students' match accuracy of simulated cases varying in dental identifiers based on AM full mouth series (FMS) radiographs and oral photographs to PM WinID3® odontograms to demonstrate possible disaster victim identification (DVI) transferable skills gained during formal education. A convenience sample of senior dental hygiene students (n = 31) was presented information on WinID3® interpretation, then presented with 5 mismatched cases and asked to visually interpret each to make 10 total matches; five based on AM FMS with simulated PM WinID3® odontograms and five based on AM photographs with PM WinID3® odontograms. Match accuracy scores ranged from 41.9% to 58.1% for cases with 1-10 identifiers, and 77.4% to 93.5% for cases with 11-40 identifiers. Accuracy when matching AM radiographs to PM odontograms versus AM photographs to PM odontograms was compared and revealed no statistical differences in match accuracy depending on image type (p = 0.388 to 1.000). Results of this pilot study suggests transferable match accuracy skills resulted from the participants' dental hygiene formal education. These baseline skills with additional specialized training support the rationale for dental hygienists serving on DVI teams. More research is needed in education and practice when preparing dental hygienists for forensic-based service.

Orofacial Manifestations of Lyme Disease: A systematic review.

Purpose: Orofacial manifestations of Lyme disease can affect head and neck anatomical structures that are frequently examined by dental professionals. The purpose of this systematic review was to examine the literature for types and frequencies of orofacial manifestations documented in populations in the United States (US) with Lyme disease.Methods: Four electronic databases (Dentistry and Oral Sciences, PubMed, Cinahl Plus, and Medline) were systematically searched during the summer of 2019 using keywords and MeSH terms to identify relevant studies. Search term alterations and synonyms were cross-checked using the US National Library of Medicine Unified Medical Language System Metathesaurus. Full-text, English language studies were included if they reported on US populations with Centers for Disease Control and Prevention confirmed cases of Lyme disease. The review followed guidelines set forth in Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA). Quality was assessed with a modified version of the Cochrane Data Collection Form for Randomized Control Trials and Non-randomized Control Trials. Extracted data was organized by themes of manifestations and the frequencies were calculated.Results: An initial search extracted 217,381 articles; 43 met the inclusion criteria and were further reviewed for quality. Twelve articles published from 1992-2017 were deemed appropriate for inclusion. All were from non-dental journals and fewer than half (n=6) reported on Lyme disease endemic states. Eight incidences of orofacial manifestations within head/neck regions were documented in Lyme disease patients (n=951) and included: headache (39.5%), facial palsy (42.5%), temporomandibular joint arthralgia (42.0%), altered taste (11.0%), stiff neck (13.6%), sore throat (3.0%), neck pain/arthralgia (7.5%), and erythema migrans rash (5.2%).Conclusion: Eight orofacial manifestations of Lyme disease were revealed by this systematic review. Future research regarding the orofacial manifestations of Lyme disease is needed so this medical condition can be better understood by oral health care providers and result in improved health outcomes for infected patients.

The effects of static seated and standing positions on posture in dental hygiene students: a pilot study.

Background: Musculoskeletal disorders (MSDs) are highly prevalent among dental hygiene professionals. The purpose of this pilot study was to evaluate and compare seated and standing postures during simulated dental hygiene practice to determine ergonomic risks associated with each posture. Methods: A convenience sample of 35 female second-year dental hygiene students with no history of musculoskeletal disorders was enrolled in this IRB-approved study. In 2 separate sessions, 1 seated and 1 standing, participants instrumented 1 quadrant of the mouth in a simulated oral environment. Two images per session, per participant, were taken to evaluate biomechanical demands of each posture using the Rapid Upper Limb Assessment (RULA) tool. The same 4 calibrated researchers scored all images independently and mean scores for each posture were analysed. Results: Thirty-four students completed the study. Results revealed statistically significant (p = 0.001) differences in mean RULA scores between seated (M = 3.91, SD = 0.77) and standing (M = 4.50, SD = 1.00) postures, although these differences may not be clinically relevant. Discussion: When postures were independently assessed, seated postures were more acceptable on average compared to standing postures, yet both were in the unacceptable range. Lack of training in standing postures may have impacted the results. Conclusion: Results support the need for additional ergonomic training in dental hygiene curricula. Less than ideal posture when seated or standing could increase MSD risk. Future research should examine biomechanical loads of seated and standing postures, as well as the combination of these postures, for more insight into their ergonomic benefits and associated MSD risks.

Contexte: Les troubles musculosquelettiques (TMS) sont très répandus parmi les professionnels de l'hygiène dentaire. Cette étude pilote visait à évaluer et à comparer les postures assise et debout dans le cadre de simulations de la pratique de l'hygiène dentaire afin de définir les risques sur le plan de l'ergonomie liés à chacune de ces postures. Méthodes: Dans le cadre de cette étude approuvée par un comité d'examen institutionnel, on a examiné un échantillon de commodité réunissant 35 étudiantes en hygiène dentaire de 2e année sans antécédents de troubles musculosquelettiques. À l'occasion de 2 séances distinctes, une effectuée en position assise et une effectuée en position debout, les participantes ont travaillé sur un quadrant de la bouche dans un environnement oral simulé. On a pris 2 images par séance et par participante pour évaluer les exigences biomécaniques de chacune des postures à l'aide de l'outil d'évaluation rapide des membres supérieurs (RULA). Les 4 mêmes chercheurs calibrés ont attribué une note à toutes les images de façon indépendante. On a ensuite analysé la moyenne de ces notes pour chacune des postures. Résultats: Trente-quatre étudiantes ont participé à l'étude jusqu'à son terme. Les résultats ont révélé des différences statistiquement significatives (p = 0,001) dans les moyennes des notes de l'outil RULA entre les postures assise (M = 3,91, ET = 0,77) et debout (M = 4,50, ET = 1,00). Toutefois, ces différences pourraient ne pas être pertinentes sur le plan clinique. Discussion: Dans le cadre de l'évaluation indépendante des postures, en moyenne, la position assise était plus acceptable que la position debout. Cependant, les 2 postures se trouvaient dans la fourchette de valeurs inacceptables. Il est possible que le manque de formation en position debout ait une incidence sur les résultats. Conclusion: Les résultats confirment la nécessité d'une formation supplémentaire sur l'ergonomie dans les programmes d'hygiène dentaire. Une posture non idéale en position assise ou debout pourrait entraîner une hausse du risque de TMS. À l'avenir, des études devraient examiner les charges biomécaniques des postures assise et debout, ainsi que la combinaison de ces postures, afin de renforcer la compréhension de leurs avantages ergonomiques et des risques de TMS connexes.

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.

Sexual Harassment Issues Among Virginia Dental Hygienists.

Purpose: The "#MeToo" movement has increased awareness of sexual harassment in the workplace and its detrimental effects on the work environment. The purpose of this study was to determine the prevalence of sexual harassment in a convenience sample of dental hygienists in the state of Virginia (VA).Methods: A cross-sectional research design was used to determine the experiences of VA dental hygienists with sexual harassment in the workplace occurring over the previous twenty-four months. The revised Sexual Experiences Questionnaire (SEQ-W) measured three constructs: gender harassment, unwanted sexual attention, and sexual coercion and was administered electronically to a convenience sample of 238 dental hygienists attending a continuing education conference. Chi-square was used to determine significant associations between survey scores and demographics.Results: A total of 161 dental hygienists completed the survey (n=161) for a response rate of 68%. A little more than one-quarter of the respondents (27%) reported at least one experience of sexual harassment in the previous 24 months. Of the three constructs measured, 27.3% of participants reported gender harassment, 18.6% unwanted sexual attention, and 6.8% sexual coercion. The most commonly reported items were being told offensive sexual jokes or stories (21%) and hearing someone make crude and offensive sexual remarks (18%). A definition of sexual harassment was provided and participants were asked, "During your career as a dental hygienist, have you experienced sexual harassment?" to which 24.2% (n=39) responded yes.Conclusion: Sexual harassment is a contemporary problem in dental hygiene employment settings in the state of Virginia. Effective training and policies in sexual harassment is needed to prevent these behaviors from occurring in the workplace.

Disaster Preparedness and Response: A Survey of U.S. Dental Hygienists.

Purpose: The purpose of this study was to assess dental hygienists' interests, current involvement, formal education, views, comfort levels, and intentions for involvement with disaster preparedness and response.Methods: Dental hygienists (n=400) were asked to respond to a 21-item online survey. Data was analyzed using descriptive statistics, chi-square goodness-of-fit tests, and a paired-samples t-test. Common themes were identified and categorized from open-ended questions.Results: A response rate of 84% (n=334) was obtained. Most respondents (97%) reported no involvement with disaster preparedness and response; however, a majority (86%) reported interest. Of those who indicated an interest in disaster preparedness and response, 92% had intentions for becoming involved. A majority of dental hygienists (93%) had not received formal education in disaster preparedness and response; yet, 95% shared the view that dental hygienists could have a vital role in this specialty area. Although results indicated a mean difference of 9% increased comfort with activities not requiring physical contact with human remains, dental hygienists were relatively comfortable with activities requiring contact: taking photographs (76%, n=254), taking radiographs (83%, n=273), resecting the mandible (55%, n=184), cleaning skeletonized remains (67%, n=221).Conclusion: Dental hygienists view themselves as professionals who could have a vital role in disaster preparedness and response. Efforts should be made to increase dental hygiene formal education in disaster preparedness and response with needed curriculum models and competencies for best outcomes when dental hygienists are serving their communities.