The Effects of Oral Health Instruction, and the Use of a Battery-Operated Toothbrush on Oral Health of Persons with Serious Mental Illness: A Quasi-Experimental Study.

People with a diagnosis of serious mental illness (SMI) have a greater incidence of poorer oral health as compared to the general population. The aim of this quasi-experimental study was to determine the effect that a combination of the use of a battery-operated toothbrush and a related educational intervention may have on the oral health of individuals with serious mental illness. Key findings include that the battery-operated toothbrush resulted in a significant improvement in the mean change in gingival index, a common indicator of oral health. The study also found that oral home care instructions, smoking and level of negative symptoms did not have an effect on the mean change in plaque or gingival indices. This project suggests that the implementation of a relatively simple, cost effective measures such as a battery-operated toothbrush may have a positive impact on the oral health in this population.

Head Start Oral Health Assessment.

PURPOSE: A Head Start program located in Paterson, New Jersey considered establishing a school-based dental clinic to address unmet oral health needs such as access to care and the need for restorative treatment. The purpose of this study was to establish the oral health status of Head Start children, their treatment needs, and parents' interest and willingness to utilize a school-based dental clinic. DESCRIPTION: School-based dental care has been used to address access to care issues, particularly among children who live in underserved areas. A 21 item survey was used to correlate the results of an oral exam performed on the Head Start children and the parents' preferences, beliefs and access patterns. Fisher's exact test and Chi squared test were used to study the association among variable with significance levels set at 0.05. Assessment The oral exam revealed a high caries rate amongst all of the children. Parental responses indicated strong support for the establishment of a school-based clinic and identified the need for further parental education. Having a regular source of care was found to be unrelated to treatment needs. CONCLUSION: Further education of the parents regarding the child's oral health is critical to the success and viability of this school-based clinic.

Dental pre-doctoral student perceptions about serious mental illness: Concerns and role clarification.

PURPOSE/OBJECTIVES: Little is understood about dental student perspectives providing care to people with serious mental illness (SMI), a population with significant oral health disparities. This study explored student perceptions, questions and beliefs about people with SMI using the Social Ecological Model as a framework to better understand perspectives and identify potential educational needs in dental medicine curricula for providing care to this population. METHODS: Survey data was collected in spring of 2021 from predoctoral dental students (n = 126) enrolled in a required course at a mid-Atlantic university. Ninety-nine percent of the students completed the survey. The IRB approved qualitative study examined student responses to a six question survey using content analysis. An iterative coding process was used and included reflexivity memos, data dictionaries and consensus building among the four coding researchers to identify recurring concepts and ultimately identify themes. RESULTS: Four primary themes were identified: Concerns and Stereotypes; Uncertainties; Professional Role and Responsibilities; and Learning Preferences. Participants expressed fear and discomfort in working with people with SMI. They also noted multiple questions about providing clinical care, referrals and the interaction of oral health and mental health. Lastly, they offered ideas about educational strategies to improve learning on the topic. CONCLUSION(S): Pre-doctoral dental students have concerns about providing care to people with SMI and limited understanding of dental professional role and responsibilities about care for this vulnerable population. Predoctoral dental curriculum should be expanded to address professional roles when working with this population to improve student competency and comfort, and ultimately improve care to people with SMI.

Developing a Relevant Taxonomy to Assess Dental School Clinic Patient Complaints.

The aims of this study were to categorize and analyze the most frequent patient complaints at the Rutgers School of Dental Medicine (RSDM) clinic in an effort to identify areas in need of improvement. A retrospective review of patient complaints reported to the RSDM Office for Clinical Affairs from July 1, 2011 to June 30, 2015 was conducted. A total of 148 unduplicated patients were selected for evaluation because they made at least one official complaint. In total, 193 patient complaints were made during this period. A published complaint taxonomy was used to categorize RSDM patient complaints into domains, categories, and subcategories, highlighting frequent issues of complaint. Of the 193 complaints made, 256 issues were identified. The results showed that the most frequent domain of complaint was Management, followed by Clinical, then Relationships. Institutional Issues and Quality were the most recurring categories coded. Of the 26 subcategories, nearly 70% of the complaints were coded into one of four: Finance and Billing, Delays, Patient Journey, and Quality of Care. While the results were effective in identifying broad areas of improvement, there were limitations to using the traditional taxonomy in the dental school setting. Based on these data, the RSDM Patient Complaint Taxonomy, specific to the needs of a dental school environment, was created in an effort to gain increased specificity and further enhance quality improvement measures. It is the hope of the research team that this tool will be used across dental schools, opening the door for future collaborations and ultimately improving patient care.

HIV stigma: perceptions from HIV-positive and HIV-negative patients in a community dental clinic.

Background. In the medical sense, stigma has been defined as the collection of negative attitudes and beliefs that are directed at people living with a particular condition or disease process. A cohort study was conducted to explore the HIV stigma that is perceived by HIV-positive individuals versus that perceived by the general population within a community-based dental clinic. Methods. Two separate and independent cross-sectional surveys, the Berger Stigma Scale and the Rutgers-Modified Berger Stigma Scale, were employed in order to analyze the stigma factors of an HIV-positive population versus an HIV-negative general population, respectively. The HIV stigma factors studied included personalized stigma, disclosure concerns, negative self-image, and concern with public attitudes. Results. The total stigma scale scores for the studied HIV-positive population were significantly lower than the total stigma scale scores for the studied HIV-negative population (P < 0.05). Conclusion. Interestingly, there is a misplaced expectation by the general population that HIV-positive individuals experience more stigma than the HIV-positive population in the clinic actually reported. Interventions to reduce HIV stigma should be an integral component of comprehensive care for all patients.

Designing and implementing a school-based dental program for students with developmental disabilities.

Students with developmental disabilities in Atlantic County Special Services School District (ACSSSD) receive on-site dental care through a program created by UMDNJ-New Jersey Dental School (NJDS). The program's goal was to coordinate dental school resources with those of a school district, county agencies and the Delta Dental Foundation to provide quality dental services to the students, aged 3-21 years. The University developed a Needs Assessment Survey and distributed 450 surveys to the students' parent/guardian(s). Completed surveys were returned by 131 respondents. Of the 131 children represented, 75 had not been seen by a dentist within the past year. In response to guardian reported access problems, UMDNJ-NJDS and ACSSSD developed a school-based dental care delivery system and a program for health promotion and disease.

Dental students' HIV/AIDS-related knowledge, attitudes, and intentions: impact of the U.S. Health Resources and Services Administration's community-based dental partnership program.

Access to oral health care for vulnerable populations is one of the concerns addressed by the U.S. Health Resources and Services Administration HIV/AIDS Bureau's Community-Based Dental Partnership Program (CBDPP). The program introduces dental students and residents at several dental schools to care for vulnerable patients through didactic and clinical work in community-based dental settings. This study of the dental students and residents in this program answered three questions: 1) What are their HIV knowledge, attitudes, and behaviors? 2) How has participation in the CBDPP impacted their knowledge, attitudes, and behaviors? 3) Has the intervention affected their work placement decisions and attitudes after graduation, particularly with respect to treating people living with HIV and other underserved populations? A total of 305 first- through fourth-year dental students and first- and second-year residents at five dental schools across the United States completed surveys before and after a community-based rotation and following graduation. Response rates at each of the five schools ranged from 82.4 to 100 percent. The results showed an increase in the participants' knowledge and positive attitudes regarding treatment for patients with HIV and other vulnerable populations post-rotation compared to pre-rotation. Results after graduation found that most respondents were practicing in private settings or in academic institutions as residents but were willing to treat a diverse patient population. These findings support the role of training programs, such as the CBDPP, for expanding the dental workforce to treating vulnerable populations including people living with HIV/AIDS.