Magnification loupes influence on neck and trunk flexion of dental hygienists while scaling-A pilot study.

OBJECTIVE: Work-related musculoskeletal disorders (MSDs) are common in the dental hygiene profession. Awkward postures contribute to MSDs and magnification loupes have been suggested to reduce this risk factor and minimize MSDs. METHODS: After IRB approval, 24 hygienists were enrolled in the study: twelve hygienists wearing loupes with a standard manufacturer determined declination angle (control) and 12 hygienists wearing loupes with a custom measured declination angle (experimental). To measure changes in neck and trunk flexion, accelerometers were placed on the occipital region of head, cervical vertebrae C5, and thoracic vertebrae T5 and baseline posture was recorded. Typodonts with artificial calculus simulated the oral environment. Participants were randomly assigned to wear their designated loupes during the first or second trial of the experiment and scaled in each quadrant (UR, LR, UL, LL) of the mouth for two minutes. Participants completed the scaling task twice: in the loupes and no loupes condition in a counterbalanced order. Three-way mixed design ANOVA was used to determine posture differences in neck and trunk posture. RESULTS: Those wearing custom loupes (M = 16.52, SD = 6.40) had significantly less trunk flexion while scaling compared to hygienists wearing standard loupes (M = 22.27, SD = 6.40), F(1, 22) = 7.14, P = .01. Neck flexion was not significantly affected while scaling between loupes vs no loupes or loupes type condition, (P's > .05). CONCLUSION: Posture was partially impacted by loupes type. Custom loupes resulted in less trunk flexion. Neck flexion was not affected by either loupes type.

Color-Blind Racial Attitudes in Practicing Dental Hygienists.

Purpose: Individuals who subscribe to a color-blind racial ideology may not be aware of differences or differential treatment based on race which may be related to racial inequality in the delivery of oral health care. The purpose of this study was to determine color-blind racial attitudes in a convenience sample of clinical dental hygienists.Methods: A convenience sample of practicing dental hygienists recruited through social media via snowball sampling was invited to participate in this cross-sectional survey study. The Color-Blind Racial Attitudes Scale (CoBRAS), a valid and reliable measuring instrument, was used to determine unawareness of racial attitudes and stereotyping. Three subscales (Racial Privilege, Institutional Discrimination, and Blatant Racial Issues) were measured by the survey. Descriptive statistics and separate one-way between-subjects ANOVA were used to analyze the data.Results: Two-hundred and thirty-three (n = 233) dental hygienists in clinical practice completed the survey. ANOVA revealed statistically significant differences in overall CoBRAS scores when comparing age groups and ethnicities. Participants aged 18-29 had significantly lower overall CoBRAS scores compared to participants aged 60 and over (x = 49.41, x = 59.17, respectively; p = .019). African American participants scored significantly lower on overall CoBRAS scores compared only to those in the Other ethnicity category (x = 42.27, x = 62.08, respectively; p = .029).Conclusion: Participants possessed moderate levels of color-blindness, suggesting unawareness of racism and a need to understand the implications of racism as a means of promoting equity and improve oral health care delivery. Findings emphasize a need for more research examining color-blind ideology and how it affects oral health care delivery to diverse patient populations.

Attitudes of Virginia Dental Hygienists Toward Dental Therapists.

Purpose: The state of Virginia faces a reported dental health professional shortage affecting approximately half of its residents.The purpose of this study was to assess the opinions and attitudes of dental hygienists in Virginia toward a mid-level dental provider model, dental therapists (DTs), and to determine whether current education level and years of practice affected opinions regarding the education requirements for DTs.Methods: A 22-item questionnaire was distributed online to a convenience sample of Virginia dental hygienists (n=910). Items assessed attitudes of participants toward the DT using a seven-point Likert-type scale ranging from 1 (strongly disagree) to 7 (strongly agree). Participants were asked to provide demographic information and to respond to open-ended questions regarding potential advantages and/or disadvantages to DTs. Independent samples t-tests and chi-square analyses were used to analyze the data.Results: A response rate of 22% was obtained (n=200). Most respondents agreed a DT was needed in Virginia (M=5.78, p<0.001) and supported the concept that dental therapy could be a solution to the problem of access to care issues in Virginia (M=5.97, p<0.001). While most respondents agreed it was important for Virginia to adopt legislation for a dental therapy model (M=5.89, p<0.001), most disagreed that DTs' practice should be restricted to acknowledged underserved areas in the state (M=3.19, p<0.001). No significant association was found between years of practice and opinions toward education requirements for DTs; however, a significant association was found between current education level and opinions toward education requirements for DTs (Fisher's Exact Test=34.17, df=9, p=.000, Cramer's V=.28).Conclusion: Results revealed Virginia dental hygienists had overwhelmingly positive attitudes toward DTs. Research with a larger sample could provide more insight into opinions of the Virginia dental hygienist population regarding this mid-level oral health care provider.

Color-Blind Racial Attitudes in Dental Hygiene Students: A pilot study.

Purpose: Color-blind racial attitudes and biases have been linked to racial prejudice which may potentially affect dental hygiene care to diverse patients. The purpose of this pilot study was to determine the color-blind racial attitudes of dental hygiene students.Methods: A 20-item, Color-Blind Racial Attitudes Scale (CoBRAS) electronic survey was sent to a convenience sample of 41 first-year and 30 second-year dental hygiene students (n=71) in a dental hygiene program in Virginia. The CoBRAS instrument measures contemporary racial attitudes and stereotyping in three subcategories: Unawareness of Racial Privilege, Institutional Discrimination, and Blatant Racial Issues. CoBRAS scores range from 20-120, with higher scores indicating elevated levels of denial of racism. Descriptive statistics were used to analyze the data.Results: Of the 71 students invited to participate, 70 completed the survey (n=70) for a 98.6% response rate. The majority of respondents were White females (70%, 98% respectively), aged 18-29 (90%). Results indicated an overall average CoBRAS score of 64.89. No statistically significant findings were identified between the two groups in regards to overall scores (p>0.05).Conclusion: A majority of the participants in this pilot study possessed moderate levels of color-blind racial attitudes, suggesting rejection of the concept of racism. Color-blind racial attitudes and biases have been linked to a lack of awareness of White privilege. Further education in this area may foster improved interactions with diverse patient populations.

Interprofessional Education in Dental Hygiene: Attitudes, barriers and practices of program faculty.

Purpose: Interprofessional education (IPE) experiences are an essential component in preparing dental hygiene students to participate in future interprofessional (IP) collaborations to support comprehensive patient care. The purpose of this study was to determine the attitudes, barriers and IPE practices in a national sample of dental hygiene faculty.Methods: A 25-item, researcher-designed, electronic survey was sent to 1,800 dental hygiene faculty members to determine attitudes, collaboration and practices involving interprofessional education (IPE). Descriptive statistics, Mann Whitney U and the Kruksal Wallis Test of Independent Samples were used to analyze and compare data.Results: The response rate was 22% (n=449). Results suggest faculty have positive attitudes toward IPE and most faculty (73%) incorporated IPE in their programs; however, time constraints were reported as the greatest barrier to IPE participation. A majority (85%) of respondents indicated a desire for greater emphasis on IPE in the curricula. Ethics (37%) was ranked as the most important IPE competency and teamwork the least (19%). Respondents from bachelor's degree programs were more likely to agree that learning with students in other health professions helps students become more effective members of a healthcare team than those from associate's degree programs (p = 0.025). Additionally, respondents from bachelor's degree programs were less likely to agree that clinical problem solving can only be learned when students are taught within their individual schools than those from associate degree programs (p = 0.022).Conclusion: Most of the dental hygiene faculty surveyed considered IPE important, incorporated it into student experiences, and wanted greater curricular emphasis on IPE. Time and institutional support may limit expansion of IPE activities and more collaboration amongst program faculty may be needed.

A Study of Visible Tattoos in Entry-Level Dental Hygiene Education Programs.

Purpose: The purpose of this study was to survey entry-level dental hygiene program directors in the United States (U.S.) to assess their perceptions of dental hygienists with visible tattoos as well as to determine current policies related to dress codes in U.S. dental hygiene programs.Methods: Data was collected with an online survey emailed to 340 dental hygiene program directors yielding a 43% (n=141) response rate. Participants indicated their opinions of visible tattoos on the basis of professionalism and school policy satisfaction.Results: Eighty percent of respondents reported their program as having dress code policies on visible tattoos, with the majority (97%) requiring visible tattoos to be covered. Results revealed both students (M=5.57, p<.0005) and faculty (M=5.76, p<.0005) with visible tattoos were perceived as significantly less professional. Most participants agreed that dental hygiene faculty should discuss the impact of visible tattoos on future employment opportunities, and that the community would view the school as less professional if students had visible tattoos (p<0.0005). Personal tolerance toward tattoos (p< 0.001), but not age, (p = 0.50), was significantly associated with satisfaction concerning program tattoo policies. A lower tolerance towards visible tattoos (p < 0.001) was associated with an increased likelihood that the dental hygiene program dress code included policy on visible tattoos.Conclusion: Study results showed that visible tattoos were not perceived favorably and that personal perceptions of dental hygiene program directors may have influenced school dress code polices regarding visible tattoos. These findings provide evidence based information for dental hygienists, students, faculty, administrators and hiring managers for formulating policies relating to body art.

The Effect of Magnification Loupes on Dental Hygienists' Posture while Exploring.

Purpose: The purpose of this study was to determine the effects of dental magnification loupes on posture during instrumentation.Methods: A convenience sample of 27 right-handed dental hygienists, with no prior history of injuries or disabilities of the head, neck, or trunk region, enrolled in the study. Baseline posture calibration was taken and tri-axial accelerometers were placed on four locations of the head and trunk (occipital region of head; cervical vertebrae C5; thoracic vertebrae T5; lumbar vertebrae L1) to measure acceleration and the orientation of the body to gravity. Participants were randomly assigned to wear self-supplied magnification loupes during either the first or second half of the session. Dental chair mounted typodonts, prepared with artificial calculus, were used to represent a simulated oral environment. Participants were asked to explore all areas of the mouth using an ODU 11/12 explorer. Mean accelerations of the three axes were used to compute average forward/backward (AP) and side to side (ML) tilt of each accelerometer recorded during the instrumentation sessions. An end-user opinion survey was completed by each participant at the conclusion of the session.Results: No statistically significant differences in posture were revealed between the sessions with the participants wearing their loupes and not wearing loupes. However, data from the end-user survey indicate that 74% of all the participants strongly agreed that magnification loupes made exploring easier and 67% strongly agreed that they felt that magnification loupes improved their posture.Conclusion: While the majority of participants perceived that their magnification loupes enhanced their posture and made exploring easier, data from this study provided little evidence to suggest that wearing loupes leads to improved body orientation. Future research needs to examine the declination angle of ergonomic loupes and its relationship to neck and trunk flexion.

Effects of Instrument Handle Design on Dental Hygienists' Forearm Muscle Activity During Scaling.

Purpose: The purpose of this study was to determine the effects of 4 different commercially available instrument handle designs (A. 16 grams and 12.7 mm diameter, B. 23 grams and 11.1 mm diameter, C. 21 grams and 7.9 mm diameter and D. 18 grams and 6.35 mm diameter) on the muscle activity of four forearm muscles during a simulated scaling experience.Methods: A convenience sample of 27 (n=27) dental hygienists used a Columbia 13/14 curet with four different instrument handles to scale artificial calculus from typodont teeth. Each participant's muscle activity was measured using surface electromyography (sEMG).Results: Similar muscle activity was generated when scaling with instruments at 16, 18, and 21 grams with varying diameter handles. Instrument B generated significantly more muscle activity when compared to each of the other instrument handle designs (p=0.001, p=0.002, p=0.039). The lower left quadrant displayed significantly less muscle activity during scaling than the upper and lower right quadrants (p=0.026, p=0.000), although no significant interaction effect was found with instruments within quadrants. Most participants (62.96%) preferred instrument A, which was rated more comfortable based on weight when compared to the other instruments tested.Conclusions: Instrument handle design has an effect on forearm muscle activity when scaling in a simulated environment. The heaviest instrument with a relatively large diameter (B 11.1 mm and 23 g) generated significantly more overall mean muscle activity compared to the other three instruments. Similar amounts of muscle activity were produced by instruments weighing between 16 and 21 g. Participants' instrument preferences were more affected by handle diameter than weight. Results support the need for further research to determine the impact of these findings on muscle load related to risk of musculoskeletal disorders in a real-world setting.

Fibromyalgia syndrome: considerations for dental hygienists.

PURPOSE: Fibromyalgia syndrome (FMS) is a neurosensory disorder characterized by widespread musculoskeletal pain. Typically persistent fatigue, depression, limb stiffness, non-refreshing sleep and cognitive deficiencies are also experienced. Oral symptoms and pain are common, requiring adaptations in patient management strategies and treatment interventions. Appropriate dental hygiene care of patients suffering with this disorder is contingent upon an understanding of disease epidemiology, pathophysiology, clinical characteristics, oral signs and symptoms, as well as treatment approaches. With this information dental hygienists will be better prepared to provide appropriate and effective treatment to patients with FMS.

Cold plasma technology: bactericidal effects on Geobacillus stearothermophilus and Bacillus cereus microorganisms.

INTRODUCTION: Cold plasma, also known as Low Temperature Atmospheric Pressure Plasma (LTAPP) is a novel technology consisting of neutral and charged particles, including free radicals, which can be used to destroy or inactivate microorganisms. Research has been conducted regarding the effect of cold plasma on gram-positive bacteria; however, there is limited research regarding its ability to inactivate the spore-formers Geobacillus stearothermophilus and Bacillus cereus. PURPOSE: The purpose of this study was to determine if cold plasma inactivates G. stearothermophilus and B. cereus vegetative cells and spores. METHODS: Nine hundred eighty-one samples were included in this study (762 experimental and 219 controls). Experimental samples were exposed indirectly or directly to cold plasma, before plating and incubating for 16 hours. Control samples were not exposed to cold plasma. The percentage-kill and cell number reductions were calculated from Colony Forming Units (CFU). Data were statistically analyzed at the .05 level using one-way ANOVA, Kruskal Wallis and Tukey's tests. RESULTS: There was a statistically significant difference in the inactivation of G. stearothermophilus vegetative cells receiving indirect and direct exposure (p=0.0001 and p=0.0013, respectively), as well as for B. cereus vegetative cells and spores (p=0.0001 for direct and indirect). There was no statistically significant difference in the inactivation of G. stearothermophilus spores receiving indirect exposure (p=0.7208) or direct exposure (p=0.0835). CONCLUSION: Results demonstrate that cold plasma exposure effectively kills G. stearothermophilus vegetative cells and B. cereus vegetative cells and spores; however, G. stearothermophilus spores were not significantly inactivated.

Effects of ultrasonic scaling and hand-activated scaling on tactile sensitivity in dental hygiene students.

PURPOSE: This study was conducted to determine if tactile sensitivity varies in dental hygiene students who use the ultrasonic scaler, as compared to those who scale with hand-activated instruments. METHODS: A two-group, randomized subjects, pretest-posttest design was carried out mid-semester for five weeks on 40 first-year dental hygiene students who met the inclusion criteria of this study and who agreed to participate. A convenience sample of 40 consenting, first-year dental hygiene students were randomly assigned to one of two groups (experimental or control). After establishing a baseline tactile sensitivity score with the Vibratory Sensory Analyzer (VSA), experimental group subjects used the ultrasonic scaler to remove 4 cc's of artificial calculus from a typodont in a controlled, simulated clinical setting for 45 minutes, while each control subject manually scaled 4 cc's of artificial calculus on a typodont in a controlled, simulated situation for 45 minutes. Immediately following exposure to either the ultrasonic scaler or hand-activated scaling instruments, tactile sensitivity scores were obtained using the VSA. Analysis of variance with one repeated measures factor was used to determine between group and within group differences on the pretest and posttest tactile sensitivity scores. RESULTS: Results revealed that tactile sensitivity increased after a 45-minute scaling session with the ultrasonic scaler. Pretest to posttest changes in tactile sensitivity for the ultrasonic scaling group exhibited a much larger threshold as compared to those in the hand-activated scaling group, supporting a gain in students' level of sensitivity with stimulus (vibration). Tactile sensitivity decreased in those who used hand-activated scaling instruments. The thumb, index, and middle fingers of students in both groups showed similarities in tactile sensitivity, with the index finger being the most sensitive. CONCLUSION: Tactile sensitivity decreases with hand-activated scaling and increases with ultrasonic scaling over a 45-minute period. Short-term vibration exposure from the ultrasonic scaler is insufficient to negatively affect tactile sensitivity.