Assessment of psychological changes in young children during dental treatment: Analysis of the autonomic nervous activity and electroencephalogram.

BACKGROUND: Understanding the emotional changes in children during dental treatment is necessary for providing stress-free care. AIM: To objectively assess the stress associated with dental treatment in children, based on the autonomic nervous activity and the electroencephalogram (EEG). DESIGN: Twenty-two children aged 4-9 years were recruited from outpatients of a paediatric clinic. Electrocardiogram and EEG were recorded throughout the treatment to analyze the autonomic nervous activities and the powers of brain waves, respectively. Changes in these measurements during each treatment process were evaluated in two age groups: 4-6 years and 6-9 years. RESULTS: Elevations in sympathetic activities accompanied by decreased parasympathetic activities induced by stress were observed during rubber dam setting (RD) in the age group of 4-6 years and during infiltration anesthesia (IA), RD, and cavity preparation with a dental turbine (CP-T) in the age group of 6-9 years. Stress-related beta wave increments in EEG were observed during IA and CP-T in the age group of 6-9 years but not in the age group of 4-6 years. CONCLUSION: Monitoring the autonomic nervous activities during treatments is useful in assessing stresses in a wide age of young children, whereas EEG monitoring is applicable only to children older than 6 years.

A survey of oral health status, subjective oral symptoms and oral health behaviors among first-year dental students at a Japanese university.

PURPOSE: The rapid deterioration of oral health in young adults is an alarming problem in Japan. The aim of the present study is to investigate the oral health status, subjective oral symptoms and oral health behaviors of dental students. METHODS: Participants were 108 first-year students attending dental school in 2018-2019. Oral examinations were performed to assess dental caries indices, oral hygiene status, gingival bleeding on probing (BOP) and pocket depth. A self-administered questionnaire was used to assess subjective oral symptoms and oral health behaviors. RESULTS: The prevalence of decayed teeth (DT) and gingivitis (BOP ≥ 10%) were 43.5% and 50.0%, respectively. Having DT and gingivitis were significantly associated with poorer oral hygiene. No association was observed between DT and subjective symptoms. Having gingivitis was significantly associated with xerostomia, mouth-breathing and less use of interdental cleaning tools. Multiple logistic regression analysis for gingivitis yielded an odds ratio of 1.41 (95% confidence interval: 1.19-1.67) for plaque score, and 2.75 (1.27-5.98) for xerostomia. CONCLUSION: Since a relatively high ratio of students had DT and gingivitis without clear subjective symptoms, they require regular dental visits for early treatment and oral hygiene maintenance from the start of their time at university.

Improvement of Workplace Environment That Affects Motivation of Japanese Dental Hygienists.

Dental hygienists are in high demand due to insufficient workforce and a lack of an effective reinstatement support system. We investigated the reasons for willingness to work by analyzing the survey results of the employment status of Japanese dental hygienists conducted by Japan Dental Hygienists' Association. In total, we mailed 16,113 questionnaires to all members of the association (response rate 53.4%). We carried out statistical analysis to determine the specific items to improve the hygienists' working environment. Fourteen factors of working conditions that they wish to improve were determined. Structural equation modeling showed that a path, "Reduction of work volume", "Reduction of working hours" and "Increased number of holidays" were higher than other items. A decision analysis demonstrated that most of the respondents answered "Yes" to "Improvement in working conditions including higher salary" out of those who answered, "Strongly disagree" for "Do you feel that dental hygienist work is rewarding?". Improving workplace environment is integral to keeping high levels of work motivation and a low turnover rate. Most of the hygienists wish for a salary raise among all the conditions. The transition from conventional work styles to non-conventional flexible working patterns is needed.

Prioritization of the Skills to Be Mastered for the Daily Jobs of Japanese Dental Hygienists.

Dental hygienists require proficiency in a wide variety of job skills. Dental hygienists should master their job skills step by step, and the prioritization of these steps is important. In this study, we investigated the frequency at which Japanese dental hygienists performed daily jobs and attempted to classify the jobs according to the proficiency levels. The aim of this study was to surmise the order in which skills should be mastered in terms of priority and to investigate the relationship between daily jobs and the motivation for completing jobs. The Japan Dental Hygienists' Association conducts a survey on the employment status of dental hygienists in Japan every five years. The questionnaire is distributed to all members of the Japan Dental Hygienists' Association. In this study, the responses of 3,807 dental hygienists who worked at dental clinics were analyzed. We analyzed 77 kinds of daily jobs and the items regarding the motivation to work. For the analysis, item response theory (IRT), structural equation modeling (SEM), and logistic regression analysis were applied. According to the item response curve, the jobs were classified into 11 clusters. The jobs classified into Cluster 1 were the jobs that most of the average-proficiency Japanese dental hygienists performed. Scaling and root planing were the representative jobs in Cluster 1. Performing the jobs classified into Cluster 5 clearly discriminated whether the dental hygienists were performing multiple jobs. Jobs concerning care for elderly or disabled patients were classified into Cluster 5. Jobs concerning gerodontology, implants, management of staff, and consultations were significantly associated with the motivation to perform jobs. Polishing and adjustment of orthodontic apparatuses was negatively associated with the motivation to perform jobs. Understanding the features of each daily job of dental hygienists is important for planning dental hygienists' lifelong educational programs and evaluating their skill levels and proficiency levels. The results presented in this study may help to reveal the characteristics of dental hygienists' daily jobs.

Development of an oral health-related self-efficacy scale for use with older adults.

AIM: Self-efficacy is considered to be an important factor influencing behavior change; however, there are no existing tools to measure self-efficacy in the context of oral health among older adults. The purpose of the present study was to develop the Geriatric Self-Efficacy Scale for Oral Health (GSEOH) for use with older adults, and to evaluate its reliability and validity. METHODS: The self-administered questionnaire was completed by 646 Japanese older people. The draft version of the scale consisted of 35 items that were generated to measure the three dimensions of personal beliefs in tooth brushing, observing own oral health status and oral function. We carried out a principal components factor analysis with promax rotation, and investigated the scale's internal consistency and construct validity. RESULTS: The final version of the scale consisted of three dimensions measured with 20 items. Cronbach's alpha of the GSEOH total scale was 0.924. There were significant differences (P < 0.05) in total scores on the GSEOH for the change process of oral health behavior, and in relation to self-rated oral health. CONCLUSIONS: We developed the GSEOH, with three factors and 20 items, and confirmed its reliability and validity. More studies are necessary to investigate the cross-cultural validity and reliability with larger samples from other countries. Geriatr Gerontol Int 2017; 17: 1406-1411.

[Career history and perceptions of dental hygiene education programs--questionnaire mail-in survey of alumni of the School of Dental Hygiene in Tokyo Medical and Dental University].

This study was conducted to investigate the career history and perceptions about dental hygiene education programs among the alumni (1952-1999 graduates) of the School of Dental Hygiene in Tokyo Medical and Dental University. A questionnaire containing demographic, practice characteristics and views on the programs was mailed to 997 alumni in 1999, and 576 alumni (57.8%) responded. Three hundred and forty-one respondents worked as dental hygienists. The majority who responded were in clinical practice. One hundred and thirty-one of the respondents worked in private clinics, 76 in public health centers, and 72 in clinics in companies. The rate of them who worked in public health centers was much higher than the national average cited in the Statistical Report on Public Health Administration and Services. Two hundred and ninety-one respondents reported inadequate programs. The rate of them who reported inadequate programs was significantly higher in alumni who were working than in alumni who were not. The items cited as insufficiently taught at the school were clinical practice, instrumentation, foreign language, psychology, counseling, and nursing related subjects. Thus, many alumni suggested the need for better programs and continuing education. From these results, it was suggested that dental hygienists need to change their education programs in order to meet the present and future needs of more diversified society. This view was particularly prevalent among alumni who were working. The result showed that dental hygiene educators and dental hygienists urgently need to reconsider the professionalism of their field.

Effectiveness of an oral health educational program on community-dwelling older people with xerostomia.

AIM: The purpose of the present study was to evaluate the changes in oral health and function through an oral health educational program for the independent older people with xerostomia. METHODS: Community-dwelling older people with xerostomia aged over 65 years who participated in a preliminary comprehensive health survey in 2011 were recruited for the educational program. A total of 47 participants were randomly assigned into two groups, the intervention group (n = 26) and the control group (n = 21). The intervention group attended a 90-min oral health education program every 2 weeks for 3 months. The program consisted of oral hygiene instruction, facial and tongue muscle exercise, and salivary gland massage. The control group was provided only general information about oral health. The assessments of oral function, such as oral diadochokinesis of articulation, swallowing, taste threshold and salivary flow rate, were carried out before and after 3 months with or without intervention. RESULTS: A total of 38 participants (21 of intervention group and 17 of control group) completed the study protocol. In the intervention group, resting salivation significantly improved after the program. The second and third cumulated Repetitive Saliva Swallowing Test times significantly improved in the intervention group. The threshold for bitterness significantly lowered in the intervention group, whereas the sour threshold significantly heightened in the control group after 3 months (P < 0.05). CONCLUSIONS: The present study suggests that the educational program targeting oral function improvement is effective among the independent older population.

Influence of patients perception on their acceptance and understanding of dental care within an education system.

This study examined the effects of conditions (that is, the fee structure and the easy of obtaining a dental appointment) on patient understanding and cooperation in clinical practice for dental hygiene and dental students. A questionnaire was given sequentially to 1483 patients attending the Tokyo Medical and Dental University dental hospital on "clinical education and patient satisfaction". Direct participants consisted of 650 patients, of which 213 (32.8%) were male and 422 (64.9%) female. The remaining 15 (2.3%) did not specify their gender. Patients who were satisfied with care received by dentists tended to be older compared to patients who were dissatisfied with dentists. The difference was significant (p < 0.001). Acceptable conditions for patients such as fees and appointments at the clinical session had an effected on patient acceptance of clinical training. The findings of this study suggest that patient satisfaction should be considered as part of the reasons for patients accepting dental care by students in their clinical education programs. Fees and appointment schedules strongly affect patient acceptance of clinical education.

[The relationship among eating habits, lifestyles, and oral health status of students].

A questionnaire survey and oral health examination were conducted in 2000. The subjects were students of dental and dental hygiene schools at Tokyo Medical and Dental University. Subjects totaled 101 (48 males, 53 females), and the average age was 22.0 +/- 3.3. The relationship among eating habits, lifestyles, and oral health status of the students was analyzed. The following results were obtained. 1. Almost half of the students did not eat one of the three main meals; that is, breakfast, lunch, or supper. Most of them skipped breakfast. 2. The students who ate rice (traditional Japanese-style food) for breakfast had less DMFT compared with those who ate other foods, such as bread or noodles, or who did not eat breakfast. 3. The amount of stimulated saliva of the students who ate rice for breakfast was greater than that of others. 4. The oral health behavior and nutrition balance of the students who ate rice for breakfast was better than that of others. 5. The students' eating habits were related to their living styles, such as living alone or with the family. From these results, it was suggested that educational emphasis on nutrition balance and eating habits is needed for dental students and dental hygiene students, because in the future they must advise patients on good oral health and general health through good eating habits, as dental professionals.