Maryland dental hygienists' knowledge and opinions of oral cancer risk factors and diagnostic procedures.

OBJECTIVES: To examine Maryland dental hygienists' (DHs) knowledge of oral cancer risk factors and diagnostic procedures, as well as opinions about the currency and adequacy of their oral cancer knowledge, educational preparation, interest in, and preferred types of, continuing education courses. METHODS: Seven hundred DHs were randomly selected from a registry of 2677 Maryland licensed dental hygienists. A mailed survey instrument provided baseline data on 331 (RR = 60%) DHs. Stratified tabular and logistic analytical techniques were employed (alpha level < or =0.05). RESULTS: Most correctly identified tobacco use (99.7%) and alcohol use (89%) as risk factors; however, 31% incorrectly identified poor oral hygiene as a risk factor. 64% of DHs correctly identified older age as a risk factor, yet only 16% identified that the majority of oral cancers are diagnosed in the 60+ year old age group. Nearly 91% correctly identified the examination procedures of the tongue for oral cancer detection; while only 16% of DHs correctly identified erythroplakia and leukoplakia as the conditions most likely associated with oral cancer. CONCLUSIONS: Gaps in knowledge exist and strongly suggest the need for continuing education courses to clarify risk factors and diagnostic procedures associated with earlier oral cancer detection and prevention.

Maryland dental hygienists' assessment of patients' risk behaviors for oral cancer.

PURPOSE: This study examined Maryland dental hygienists' knowledge of tobacco and alcohol use as oral cancer risk behaviors; the practice of obtaining comprehensive medical histories regarding patients' current, past, and type/amount of alcohol and tobacco used; and their opinions about the adequacy of their tobacco and alcohol cessation educational preparation in a state that ranks unusually high for oral cancer mortality rates. METHODS: The data source was the Maryland Oral Cancer Survey of Dental Hygienists conducted in November 1997 (MDOCSDH, 1997) with a simple random sample of 700 dental hygienists selected from a registry of 2,677 licensed dental hygienists in Maryland. Data were collected with a 40-item self-administered mailed questionnaire. Unweighted data from 331 returned surveys (response rate = 60%) were analyzed using SAS and SUDAAN Software. Stratified and logistic data analysis techniques were utilized, and the results were evaluated statistically using a .05 level of significance. RESULTS: Nearly all of the responding dental hygienists knew that tobacco is an oral cancer risk factor. Most probed their patients' present use of tobacco in medical histories; however, fewer assessed patients' past use and type/amount of tobacco used. Very few believed that they were adequately prepared to provide tobacco cessation education, although the majority agreed that dental hygienists should be prepared to provide this type of information. The majority of respondents also knew that alcohol use is an oral cancer risk factor; however, less probed their patients' present use of alcohol in medical histories compared to assessing present tobacco use. Even fewer assessed patients' past use and type/amount of alcohol used. A very small minority believed that they were adequately prepared to provide alcohol cessation education. Yet, in contrast to tobacco cessation counseling preparation, few respondents believed that dental hygienists should be prepared to provide alcohol cessation education. There was a significant relationship (p < .05) between screening for all three aspects of tobacco use and agreement of dental hygienists that they were adequately prepared to provide tobacco cessation education. Of seven background characteristics, practice setting was the only one found to be positively associated (p < .05) with even one of three complete medical history screening indices--the practice of assessing all three tobacco screening items. CONCLUSION: There is a need to provide more complete and accurate information in tobacco and alcohol educational programs for Maryland dental hygienists. Additional research is needed to explore sources of noninterest or discomfort in assessing patients' use of these substances, since a substantial number of Maryland dental hygienists do not assess all aspects of patients' tobacco and alcohol usage and do not agree that dental hygienists should be prepared to provide tobacco and alcohol cessation education for their patients. Maryland dental hygienists' opinions regarding the adequacy of their tobacco and alcohol cessation education appear to accurately reflect their practice of obtaining comprehensive medical histories regarding these substances.

Maintaining the oral health of splinted teeth.

The combined and concerted efforts of patients and providers in poststabilization maintenance promote long-term health for the dental splint and its surrounding and supporting soft and hard tissues. Dental splints that are properly placed and contoured enable effective patient self-care and contribute to a positive prognosis. The provider's role in fabrication, placement, and oral hygiene instruction cannot be overemphasized. Professional follow-up concerning periodontal and caries risk assessment, periodontal débridement, and needed preventive interventions are critical to splint longevity. Continued success cannot occur without scrupulous patient self-care. The professional team must provide patients with comprehensive oral care instruction. A host of home care aids are available to assist patients in effective home care practices. With the combination of proficient clinical skill, appropriate dental material selection, good communication, and comprehensive health education, both providers and patients can benefit from esthetic, functional, and healthy dental splints.

Enhanced visualization during dental practice using magnification systems.

The practice of dentistry involves viewing and evaluating small details of teeth, soft tissues, restorations, casts, and instruments. Although normal vision often is adequate to view details to make treatment decisions, the use of magnification loupes provides the clinician with an increased image size for improved visual acuity and improved posture while practicing. There are many choices when selecting a magnifying system. This article recommends the use of a binocular surgical telescope, either a flip-up type or a fixed-lens system, because it affords the clinician more choices in power of magnification, working distance, field of view, depth of field, and working angulation for improved posture.

Enhanced visualization using magnification systems.

The purpose of this paper is to discuss the rationale for, practice benefits of, and criteria for selecting a magnification system in dental hygiene practice. Since dental hygiene procedures require seeing the finest of detail, visual acuity is essential to providing quality patient care. Magnifying loupes are a viable solution; the physical benefits include visual assistance for presbyopic dental hygienists and enhanced musculoskeletal health for all clinicians. Clinical benefits may include improved hard- and-soft tissue evaluation, calculus and periodontal pocket detection, and radiographic interpretation without compromising infection control. Head-band or protective-glass mounted, binocular surgical loupes with flip-up capability and 2 to 2.6x magnification are recommended. Although the initial investment for them is somewhat costly, the long-term returns are enhanced quality and comfort. Dental hygienists are encouraged to use magnification systems to enhance their musculoskeletal health, improve visual acuity, and continue providing quality patient care.