Finding the person behind caries disease: The dental caregivers' experiences of empowering patients to implement beneficial behavioral changes.

OBJECTIVES: This study aimed to elucidate dental professionals' experiences of how to empower patients at risk of developing new or additional caries to promote caries-related preventive behavioral changes. METHODS: Semi-structured in-depth interviews were conducted, audio-recorded, transcribed verbatim, and subjected to qualitative content analysis. To provide credibility and high-quality data, participant recruitment followed strategic sampling. The 10 participants included nine women and one man; six participants were dentists, and four were dental hygienists. In the data analysis, five descriptive and five strategic themes emerged that formed an overarching theme: Finding the person behind caries disease. RESULTS: The results indicated that by initially getting to know the person behind the patient, trusting relationships and knowledge can be generated to successfully influence patients' behaviors related to caries. The five descriptive themes included: Building a treatment alliance, Understanding habitual patterns, Motivating for changes, Implementing new behaviors, and Preserving behavioral improvements. The descriptive themes each revealed a strategy theme containing several strategy proposals for initiating and supporting caries-preventing behavioral changes. CONCLUSIONS: This study highlights the importance of establishing a treatment alliance to improve the patient's skills, knowledge, and motivation. It underscores the significance of recognizing the individual behind the patient, to facilitate optimal behavior change at the lowest possible level of treatment. CLINICAL SIGNIFICANCE: Our findings could assist in strengthening caries-related health promotion, caries prevention, and understanding of oral health literacy techniques.

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.

Challenges of Incivility in Dental Practice and Education.

Professional collaboration is a key component of patient care and a source of fulfilment for oral health care providers. However, reports of incivility in employment as well as education are increasing impacting individuals in all settings including patients. Uncivil behavior implies a disregard for others and creates an atmosphere of disrespect, conflict, and stress. In contrast, civility towards others implies polite, respectful behavior towards others. This short report presents case studies in dental hygiene clinical practice and in dental hygiene education with strategies for approaching uncivil behavior.

Dental care for older adults in home health care services - practices, perceived knowledge and challenges among Norwegian dentists and dental hygienists.

BACKGROUND: Providing dental services to dependent older adults might be challenging because of physical and cognitive decline. The present study aimed to explore current practices, knowledge, and experienced challenges related to the treatment of older adults in home health care services (HHCS) among dentists and dental hygienists in Norway. METHODS: An electronic questionnaire survey was distributed to Norwegian dentists and dental hygienists, inquiring about background characteristics, current practices, self-perceived knowledge, and challenges when providing oral health care for older HHCS patients. RESULTS: Four hundred and sixty-six dentists and 244 dental hygienists treating older HHCS patients responded to the survey. The majority were female (n=620; 87.3%) and worked in the public dental service (PDS) (n=639; 90%). When older HHCS adults attended the dental practice, the treatments provided were most frequently aimed at relieving acute oral problems, although dental hygienists reported to focus on improving oral health more often than dentists. Dentists reported to have more self-perceived knowledge than dental hygienists regarding patients with complex treatment needs, cognitive or physical impairment. Exploratory Factor Analysis (EFA) was carried out on the 16 items related to challenges, three factors were extracted and Structural Equation Models (SEMs) were performed. Challenges related to dental care for older HHCS adults were related to time, practical organization and communication. Variation within these categories was associated with sex, graduation year and country, as well as time used per patient and work sector, but not with professional status. CONCLUSIONS: The results indicate that dental care for older HHCS patients is time-demanding and more often aimed at relieving symptoms than improving oral health. A substantial proportion of dentists and dental hygienists in Norway lack confidence when providing dental care for frail elderly.

A national survey of dental hygiene faculty perspectives on diversity, equity, and inclusion.

PURPOSE/OBJECTIVES: To investigate potential unconscious bias among dental hygiene educators and identify baseline perceptions of race and racism. METHODS: Dental hygiene programs in the USA were clustered into 4 geographic regions from which 2 programs were sampled from each region. The 20-item, Color-Blind Racial Attitudes Scale (CoBRAS) electronic survey was sent to educators from each of the selected programs in 2022. The CoBRAS instrument measures contemporary racism and stereotyping in 3 subcategories: Unawareness of Racial Privilege, Institutional Discrimination, and Blatant Racial Issues. Scores range from 20-120, with higher scores indicating elevated levels of denial of racism. Descriptive statistics and one-way ANOVA were performed. The level of significance was set to α = 0.05. RESULTS: Of the 172 potential respondents, 89 (52%) completed all of the survey questions. The majority of the respondents were White, female and from the Northeast (74.2%, 93.3%, and 61.8% respectively). The mean CoBRAS score (55.73) indicated moderate levels of color-blind racial attitudes. Race was a significant variable in perceptions of racial dynamics and racism with statistically significant differences between groups by race and ethnicity as demonstrated by one-way ANOVA (F[6,82] = 3.469, p = 0.004). CONCLUSIONS: Moderate levels of color-blind racial attitudes among dental hygiene educators were found, indicating a presence of cognitive aspects of stereotyping related to race. The demographic data collected adds to the existing evidence of a lack of diversity among dental hygiene faculty.

Clinical Dental Hygienists' Experience Returning to Work After Closure of Dental Offices Due to COVID-19: A qualitative study.

Purpose: The impact of the COVID-19 pandemic on healthcare providers includes physical, psychological, financial, and childcare issues. The purpose of this qualitative study was to explore the experiences of dental hygienists returning to clinical practice after the March 2020 closure due to the COVID-19 pandemic.Methods: A qualitative phenomenological research design was used with virtual focus groups. Clinical dental hygienists who had worked a minimum of 3 days a week prior to dental practice closures in March 2020 and had returned to work in May 2020 were invited to participate through purposive sampling on dental hygiene social media sites. Demographic data was collected prior to a one-hour focus group session. Two investigators independently analyzed and coded the data using a qualitative data analysis software program. The themes identified were used to generate a description of the major findings.Results: Data saturation was achieved with (n=35) participants for a total of 13 focus groups. Most participants were female (89%), and the average age was 40 years. The following major themes were identified: physical issues; emotional; adherence to infection control protocols; fear of contracting/transmitting COVID-19; financial stress; our career was marginalized; and let's get back and make money.Conclusion: Dental hygienists experienced similar physical and mental health stressors as other health care professionals upon returning to work during the COVID-19 pandemic, however dental hygienists also reported feeling marginalized and undervalued. Results from this study suggest that dental hygienists need both personal and workplace support to manage the issues resulting from the COVID-19 pandemic in order to retain them in the workforce.

A qualitative assessment of dental hygiene educators' COVID-19 related burnout.

PURPOSE: The purpose of this study was to elicit ideas or concerns influencing dental hygiene educators' experiences of personal and professional burnout, burnout working with students, and teaching efficacy in an online/hybrid environment as a result of the COVID-19 pandemic. METHODS: A qualitative, content-analysis study included a convenience sample of dental hygiene educators emails. An invitation to participate in an August 2021 or October 2021 focus group was sent via Qualtricsxm with informed consent, and focus groups were held over Zoom. Conversations were audio recorded, transcribed, and de-identified. Consensus on a codebook by two coders achieved an 88% agreement. RESULTS: Fifty-three were invited to the August 2021 focus groups for a 26% (n = 14) response rate, and 116 were invited to the October 2021 focus groups for an 11% (n = 13) response rate. Contributing factors to experiences of burnout expressed were: (1) work-life balance (n = 59), including (a) overwork, (b) pressure to be available, and (c) lack of boundaries; (2) change (n = 34) involving (a) developing new protocols, (b) constant uncertainty, (c) COVID-19 requirements, and (d) new platforms; and (3) negative interactions (n = 32) with (a) students and (b) faculty. CONCLUSION: A lack of work-life balance from overwork, pressure to be available at all times, no boundaries with students, and an absence of a sense of connection for workplace vitality were contributors to burnout. Work-from-home flexibility, a work environment that supported wellness and mental well-being, and the ability to leave the workplace for periods of time were reported as helpful solutions to combatting burnout.

The impact of COVID-19 on the dental hygienists: A cross-sectional study in the Lombardy first-wave outbreak.

The impact of COVID-19 on socio-economical activities has changed everyday life. Dental hygienists, who perform aerosol generating procedures, have been strongly affected by changes in routine procedures. This cross-sectional study aimed at carrying out an online survey among dental hygienists in Lombardy. The survey was implemented after the first-wave lockdown focusing on the level of knowledge on COVID-19 and Sars-CoV-2, the virus-related changes in their attitude and working routine, and the socio-economic effects. In this report, we included 313 questionnaires of respondents (259 Females, and 54 Males; age = 33 ± 9 years). A significant percentage of respondents acknowledged the use of "word of mouth" among colleagues (n = 114, 36%) and social networks (n = 113, 36%) to be up to date on COVID-19. About half of respondents correctly identified the main COVID-19 symptoms/signs, just 13% (n = 41) identified the routes of transmission. Three quarters of respondents (n = 234, 75%) were afraid of being infected during the clinical practice, and about half of them would be afraid to treat patients having symptoms attributable to COVID-19. Twenty-one percent (n = 67) of participants also thought about changing job. Air-polishing was identified as the highest risk procedure, and 82% (n = 256) reported that they eliminated its use. Most claimed they never had a swab or a serological test, with two respondents positive to molecular test (0.6%), and 12 positives to serological test (3.8%). More than half of the participants (65%; n = 202) complained the dental hygienist is not protected, despite a loss of earnings due to lockdown between 2,000 and 10,000 euros. This study demonstrated that dental hygienists were emotionally and economically affected by the pandemic, significantly changing their work routine. Anti-epidemic protocols are pivotal to react promptly and to contain the virus in the dental setting.

Dental hygienists' biopsychosocial beliefs and giving autonomy support in treatment of patients: A self-determination theory perspective.

OBJECTIVES: Self-determination theory posits that managers' autonomy-supportive behaviour and employees' autonomy causality orientation are motivation constructs to explain internalization of values, functioning and wellness at work. Hypothesis 1 tested whether profiles comprising perceived dental clinic managers' autonomy-supportive, as opposed to their controlling interpersonal style, and dental hygienists' autonomy, as opposed to their control and impersonal, causality orientations at baseline, would be positively related to dental hygienists' biopsychosocial (BPS) beliefs and giving autonomy support in treatment of patients after 18 months. Hypothesis 2 tested whether dental hygienists' BPS beliefs in treatment of patients will be positively associated with their autonomy-supportive behaviour given to patients after 18 months. MATERIAL AND METHODS: A prospective cohort design with 299 (Mage  = 42.71; SDage  = 12.62) dental hygienists completed an online survey at baseline and after 18 months. RESULTS: Latent profile and correlational analyses supported the hypotheses. Effect sizes were moderate to large. CONCLUSIONS: Both perceived managerial styles and dental hygienists' causality orientations are important for dental hygienists' BPS beliefs and autonomy-supportive behaviours when working with dental patients.

Quality of life in dental hygienists using complementary alternative medicine approaches for work-related musculoskeletal disorders.

OBJECTIVES: The use of conventional treatment for work-related musculoskeletal disorders (WRMSDs) reduces the prevalence of pain, but with popularity of complementary alternative medicine (CAM) therapies for treatment, it is important to explore their use and impact on dental hygienists (DHs) quality of life (QoL). METHODS: A cross-sectional survey research design was used with a non-probability sample of dental hygienists (n = 85) with WRMSDs who used CAM therapies. The WHOQOL-BREF was used to assess quality of life and compared with CAM use and frequency. Analysis included descriptive, t-tests, correlation and chi-square tests of independence. RESULTS: The most commonly used CAM types were massage (81%) and chiropractic manipulation (67%) with 66% of respondents using two or more CAM therapies. Participants using five or less different CAMs (n = 46), compared with those using more than five CAM types (n = 35, M = 2.3, SD = 1.5), t (79) = 2.7, p = 0.01, had a higher average number of years before they noticed their WRMSD (M = 3.3, SD = 1.9). Participants reporting use of a higher number of CAM types also had lower QoL physical health domain scores (rho = -0.2, p = 0.03). CONCLUSIONS: Dental hygienists used a variety of CAM approaches to manage WRMSDs and had a lower QoL across all domains (physical health, psychological health, social relationships and environment) than the normative mean. More research is needed to explore the use of CAM approaches, such as yoga, for prevention and management of WRMSDs to improve QoL.

Relationship Between Job Satisfaction and Health of Hygienists in Lithuania.

OBJECTIVES: This study aimed to determine the perceived musculoskeletal and psychological symptoms and job satisfaction of Lithuanian dental hygienists. Second, the study aimed to examine the relationships between job satisfaction and musculoskeletal and psychological symptoms amongst dental hygienists in Lithuania. METHODS: A 41-item survey was sent by email to all members of the Lithuanian Dental Hygienists Association (N = 328) up to 3 times. The questionnaire comprised 5-point Likert scale structured questions, which were developed according to 3 existing questionnaires. RESULTS: The final response rate was 52.4% (N = 172). The level of overall work-related physical health was 3.76 ± 0.65, and the most common physical health symptom was upper back pain; the level of overall work-related psychological health was 3.84 ± 0.64, and the most common symptom was stress. The level of overall job satisfaction was 3.87 ± 0.62, and the most satisfying areas were their relationships with colleagues, relationships with dentists, and working conditions (equipment, work environment); the least satisfying practice areas were income, work-related physical and psychological health, and social security. CONCLUSIONS: According to the results of this study, Lithuanian dental hygienists were quite satisfied with their job but sometimes experienced work-related musculoskeletal and psychological disorders. Their physical health score and the total psychological health score were significantly correlated with all job satisfaction criteria. The better the self-evaluation of physical and psychological health, the higher the job satisfaction reported.

Job Attractiveness and Job Satisfaction of Dental Hygienists: From Japanese Dental Hygienists' Survey 2019.

Job attractiveness and job satisfaction are important factors in the continuity of employment among healthcare professionals. The aim of this study was to assess job satisfaction and job attractiveness among dental hygienists in Japan. The Japan Dental Hygienists Association conducted a survey of the employment status of Japanese dental hygienists in 2019. Questionnaires were distributed to all 16,722 members, and 8932 were returned (Collection rate: 53.4%). Data from 7869 currently working dental hygienists were analysed in this study. We analysed seven items of job attractiveness, 14 items of job satisfaction, and 13 items of request for improving the working environment. Item response theory and structural equation modelling (SEM) were utilized for the analysis. For attractiveness of dental hygienists' work, respondents placed greater emphasis on the fact that dental hygienists needed national qualifications rather than on income stability. SEM showed that job satisfaction consisted of two factors, 'Value for work' and 'Working environment', as did job attractiveness, with 'Contribution' and 'Assured income'. Value for work affects the contribution to people, and, employment environment affects assured income. Improving job satisfaction and work environments could help to improve the employment rate of dental hygienists, which could positively influence patient care.

Fear control and danger control amid COVID-19 dental crisis: Application of the Extended Parallel Process Model.

OBJECTIVES: There is high risk of contamination with COVID-19 virus during routine dental procedures and infection control is crucial. The aim of this study was to determine the factors associated with Covid-19 preventive behaviors among oral health care providers using an extended parallel process model (EPPM). METHODS: In a cross-sectional study, short text message invite surveys were sent to 870 oral health care providers in west part of Iran. Data were collected through validated self-report EPPM questionnaires. Descriptive statistics, Chi-square and Fishers exact tests were used for data analysis. RESULTS: In total, 300 completed questionnaires were received and the mean age of respondents was 29.89 ± 11.17 years (range: 20-75 years). Among the study population, 284 (94.67%) perceived the threat of infection highly. Washing hands frequently with water and soap and use of hand sanitizer was reported by 93.33%, of participants. Age (P = 0.010), sex (P = 0.002) and occupation field (P = 0.010) were significantly associated with danger control responses. Data identified that those oral health care providers that were on the danger control response adopted preventive behaviors more strictly than those on fear control response. CONCLUSION: The results of this study showed how degrees of perceived threat and perceived efficacy influenced oral health providers' willingness to perform recommended health behaviors. These findings can assist public health agencies in developing educational programs specifically designed for promoting preventive behaviors among oral health providers in pandemic situations.

COVID-19 Factors and Psychological Factors Associated with Elevated Psychological Distress among Dentists and Dental Hygienists in Israel.

The aim of this study was to evaluate the association of COVID-19 factors and psychological factors with psychological distress among dental staff during the COVID-19 pandemic outbreak. A cross-sectional survey was conducted among 338 Israeli dentists and dental hygienists, who provided their demographic data; answered questions about COVID-19-related factors; and were assessed by subjective overload, self-efficacy, and psychological distress scales. Data were analyzed using a multivariate logistic regression. Results revealed that elevated psychological distress was found among those who have background illness, fear of contracting COVID-19 from patient, and a higher subjective overload. Lower psychological distress was associated with being in a committed relationship and having higher scores for self-efficacy. Given these results, gathered during times of an infectious disease outbreak, exploring psychological distress among dental staff is warranted as the effects may be long-term.

Occupational stressors of dental hygienists in the United States.

BACKGROUND: Demand of the work environment can cause stress. Stress can cause anxiety, depression, reduced productivity, job dissatisfaction, and health issues. Unfortunately, little attention has been placed on the stressors of dental hygienists. OBJECTIVE: The purpose of this study was to examine occupational stressors related to personal, environmental, and physical stressors and their relationship to job satisfaction and burnout of dental hygienists. METHODS: Survey research was conducted with a convenience sample of practicing dental hygienists (n = 763). The survey instrument consisted of 10 scales from the New Brief Job Stress Questionnaire and four questions related to burnout. RESULTS: Job satisfaction was affected by work overload, anxiety, depression, and emotional demands. Leaving clinical dental hygiene in the next year was affected by physical stress (p < 0.05), and burnout was related to the emotional demands (p < 0.05). CONCLUSIONS: Dental hygiene has a significant emotional component to the profession and these emotional demands were more likely to lead to burnout and affect job satisfaction. Physical demands were related to dental hygienists leaving clinical dental hygiene. Attention needs to be paid to these stressors to enhance retention and job satisfaction of dental hygienists.

Knowledge of human papillomavirus among dental providers: A mixed methods study.

Dental professionals are encouraged by the American Dental Association (ADA) to recommend the HPV vaccine to eligible patients. To better understand their comfort level in following this recommendation, we conducted a mixed methods study of dentists and dental hygienists. A total of 173 providers were surveyed and 8 interviewed. The majority felt they had an important role in preventing HPV-related OPC and that they should educate their patients and encourage HPV vaccination. However, most providers had low knowledge about HPV and expressed a need to obtain more information on the topic. In particular, they desired information about the HPV vaccine, its connection to cancer and where to refer patients for vaccination. They also wanted access to visual aids to help them bring up the topic. This study demonstrates the need to develop and disseminate educational programs for dental providers so they can assist with efforts to raise HPV vaccination rates.

Teaching and Learning in an Active Learning Classroom: A Mixed-Methods Empirical Cohort Study of Dental Hygiene Students.

The aim of this study was to discover how an active learning classroom (ALC) influenced the teaching and learning of dental radiology with dental hygiene students through a mixed-methods approach. A year-long observation of a dental hygiene professor who was teaching two consecutive courses in an ALC was conducted in 2015-16. Nineteen classes were recorded and transcribed, and observational notes on classroom activities were taken. Towards the end of the academic year, the professor was interviewed with use of a 13-question guide, and the students were surveyed with a 25-question survey. Moreover, five-year grades in the same two courses, including four-year historical grades earned in the traditional classrooms (TCs) and one year from the ALC, were collected along with demographic and prior academic performance data. Thirty-two of the 38 students responded to the survey, for a response rate of 84%. The results showed that 63% of the students preferred to take classes in the ALC rather than TC. They especially enjoyed the ALC's spaciousness, mobility, unobstructed views, and ease of information-sharing and engagement in class. However, the ALC presented both the faculty and students with sensory and technique challenges. The analysis of students' grades suggested that GPA was one of the strongest predictors for both courses' final grades in the TCs but had weaker predicting significance in the ALC setting. Overall, the majority of students enjoyed taking classes in the ALC due to its physical charm and dynamic collaboration. Sensory and technique challenges coexisted with benefits.

Attitudes towards people with dementia: a cross-sectional study comparing dental hygiene students with registered dental hygienists.

OBJECTIVE: In order to adequately care for patients with dementia, it is necessary for dental hygienists to develop unprejudiced attitudes towards and obtain sufficient knowledge of dementia. The aim of this study was to assess attitudes towards and knowledge of dementia among Japanese dental hygiene students and identify related factors to the attitude and the knowledge. We compared the attitude and the knowledge between dental hygiene students and practising dental hygienists. BACKGROUND: Dental hygienists are required to care for patients with dementia by developing appropriate attitudes towards dementia and gaining knowledge of dementia. MATERIAL AND METHODS: Between May 2016 and July 2016, 191 third-grade dental hygiene students and 64 registered dental hygienists were surveyed. We modified questionnaires to assess attitudes towards and knowledge of dementia. Ageism was assessed using the Fraboni Ageism scale. To determine potential dementia awareness factors, information regarding participants' experiences with dementia was collected. RESULTS: Factor analysis revealed four factors in the attitude scale (Cronbach's α, 0.652-0.820). All item-total correlation coefficients for the knowledge scale were above 0.3, and Cronbach's α was 0.827. All awareness factors for dementia were significantly different between students and registered dental hygienists. Total scores of attitude and knowledge were higher among registered dental hygienists, indicating better attitude and knowledge, but total scores of ageism were lower among registered dental hygienists, indicating worse ageism. Multiple regression analysis revealed that the attitudes towards dementia correlated with years of experience, ageism, interest in dementia and desire to work with patients with dementia. CONCLUSION: Registered dental hygienists had more positive and more knowledge compared to dental hygiene students. Attitudes towards dementia, but not knowledge of dementia, were significantly positively correlated with ageism.

Relationship Between Resilience and Self-Rated Health in Dental Hygiene Students and Registered Dental Hygienists.

The aim of this study was to investigate whether two aspects of resilience-acquired and innate resilience-were related to self-rated health status in registered dental hygienists and students. In May through July 2017, 405 students at three dental hygiene programs and 85 registered dental hygienists, all in Fukuoka prefecture in Japan, were invited to participate in a survey including three scales: the Bidimensional Resilience Scale (BRS) to assess innate and acquired resilience, the Stress Response Scale-18 (SRS-18) to assess daily stress responses, and the Sense of Coherence 13-item scale (SOC-13) to assess the sense of coherence. Information about self-rated health status and number of years of clinical experience was also collected. Respondents were 398 students (98.2% response rate) and all 85 dental hygienists (100% response rate). The cohort with a self-rated "healthy" status scored higher on total scale and each domain of the BRS, SRS-18, and SOC-13 scales than the cohort with other self-rated health statuses. These three scales and self-rated health status were significantly correlated with each other. When innate resilience increased by one point, average self-rated health was 1.14-fold higher. In contrast, when the depression/anxiety domain score of SRS-18 increased by one point, self-rated health was 0.84-fold lower. The number of years of clinical experience was also negatively correlated with self-rated health. For these participants, innate resilience was a significant predictor of better self-rated health. To maintain the health of dental hygienists and students, it is important to understand their innate resilience as well as stress responses related to depression/anxiety factors and length of clinical experience.

Reasons That Dutch Dentists and Dental Hygienists Oppose or Support an Extended Scope of Practice for Dental Hygienists.

BACKGROUND: In the Netherlands, the scope of dental hygiene practice was expanded in 2006. The objective of this study was to explore reasons among dentists and dental hygienists for supporting or opposing an extended scope of practice and to find explanatory factors. METHODS: A questionnaire containing pre-defined reasons and an open-ended question was distributed among 1,674 randomly selected members of two Dutch professional associations (874 dentists, 800 dental hygienists). Data were analyzed with binary logistic regression with Bayesian information criterion (BIC) model selection. RESULTS: Response were obtained from 541 practitioners (32.3%): i.e., 233 dentists (43.1%) and 308 dental hygienists (56.9%). Non-response analysis revealed no differences, and representativeness analysis showed similarities between samples and target populations. Most often, dentists reported flexible collaboration (50.2%) and dental hygienists indicated task variation (71.1%) as supportive reasons. As opposing reasons, dentists generally reported quality of care (41.2%) and dental hygienists' self-competence (22.7%). Reasons were explained by profession, gender, and new-style practitioners. CONCLUSION: Dentists and dental hygienists conveyed different reasons for supporting or opposing an extended scope of dental hygiene practice. Outcomes can be categorized as reasons related to economic, professional status, quality, job satisfaction, and flexible collaboration and are not only explained by profession.