Compassion Fatigue, Compassion Satisfaction, Burnout and Alcohol Use Among Dental Hygienists.

AIMS: The purpose of this study was to investigate the relationship between demographics, compassion fatigue (CF), compassion satisfaction (CS), burnout (BO) and alcohol use among dental hygienists (DHs). METHODS: The web-based survey consisting of two validated instruments [Alcohol Use Disorders Identification Test (AUDIT) and Professional Quality of Life] to measure alcohol use, CF, CS and BO was conducted with a convenience sample of DHs (n = 963). RESULTS: The completion rate was 81.6% (n = 786). Nearly one in five DHs (19.1%) reported having their alcohol consumption influenced by the Coronavirus disease 2019 pandemic at least moderately. The number of hours worked per week (x) and AUDIT scores (y) were fully mediated by BO (m) (P < 0.001); the average number of hours worked per week (x) and AUDIT scores (y) were fully mediated by CF (m) (P < 0.001); the average number of patients seen per day (x) was a predictor of AUDIT scores (y) when partially mediated by BO (m) (P < 0.001); and age (x) was a predictor of AUDIT scores (y), mediated by CS (m). Results showed that one in four DHs could qualify for binge drinking (25.6%, n = 177) and 15.1% experienced blackout drinking episodes within the past year (n = 118). CONCLUSION: Mediating relationships exist between demographics, CF, CS, BO and alcohol use among DHs. More research needs to be conducted on alcohol use and CF among DHs and protective factors that may reduce the risk of BO, CF or alcohol use.

Experiences and characteristics of men working in dental hygiene.

OBJECTIVE/PURPOSE: There is limited research available about men working in the profession of dental hygiene. The purpose of this study was to explore the characteristics and experiences of men in dental hygiene. METHODS: Cross-sectional survey research was conducted with a purposive sample of male dental hygienists (n = 288). Participants were recruited via social media and snowball sampling. The survey was developed based on nursing literature and validated with a panel of experts with a final S-CVI of 98.5%. Descriptive statistics and correlations were used for data analysis. RESULTS: The completion rate was 80.9% (n = 233). Results revealed participants were more likely to be White (59.7%), hold an associate's entry-level dental hygiene degree (60.9%) and work in a private practice dental setting (73.4%). Sixty-one per cent reported full-time employment, and 50% was satisfied or very satisfied with benefits offered by their place of employment. All three sources of gender discrimination (patients, co-workers and employers) were related to experiencing a desire to leave the field. Experiencing gender discrimination from patients indicated a higher likelihood of desire to leave the field (49%) comparatively (33%), χ2  = 5.94, p = 0.02. Half of the respondents reported (56.7%) patients had refused to see them based on their gender. CONCLUSION: This research provides a snapshot of demographics and professional characteristics of male dental hygienists. Gender discrimination from patients emerged as an area that needs to be addressed in practice settings. It will be important to identify ways to make the profession more inviting to encourage men to join the profession.

Postpartum U.S. Women's Oral Health Knowledge, Attitudes, and Practices During Pregnancy.

OBJECTIVE: The purpose of this study was to assess oral health knowledge, attitudes, and practices of women who had given birth in the United States within the past 2 years, and to evaluate factors affecting women's dental service utilization during pregnancy. METHODS: This study used a descriptive, cross-sectional design and employed non-probability sampling methods. The 47-item questionnaire included: oral health behaviors (8), knowledge (5), attitudes (12), and practices during pregnancy (10), and demographic (12) questions. Participants were recruited through multiple postpartum support group forums on Facebook. Logistic regression was used to identify potential predictors of dental utilization during pregnancy. RESULTS: Ninety-one percent of the participants had at least an associate's degree, and 85.6% had dental insurance coverage during pregnancy. Approximately 56% knew the connection between poor oral health and pregnancy complications; however, only 11% obtained this information from their OBGYNs and 10% from their dental offices. Although women aware of the association were more likely to visit the dental office during pregnancy (64%, p < .001), the majority (74%) who experienced tooth or gum related issues during pregnancy reported not receiving any dental or gum treatment. Women, who had positive dental attitudes and awareness of an increased risk of pregnancy complications due to poor oral health, were more likely to receive dental care during pregnancy regardless of dental coverage. CONCLUSION: Medical and dental providers could play an active role in educating women on the importance of having good oral health, potential oral/systemic relationships, and the benefits of receiving dental care during pregnancy.

Work Experiences of Male Dental Hygienists: A qualitative study.

Purpose: The percentage of men entering the dental hygiene profession has increased from less than 1% of the workforce in 1999 to 6.1% in 2020. However, little is known about the experiences of male dental hygienists. The purpose of this study was to explore and better understand the experiences of male dental hygienists.Methods: A qualitative phenomenological research design was used with a purposive sample of male dental hygienists (n=19) recruited via social media groups. Virtual focus groups were conducted and participants were asked open-ended questions to assist in data collection. The data analysis was conducted both manually and with qualitative analysis software. Two investigators independently identified emergent themes and a sub-set of participants participated in member checking of the themes identified.Results: The following major themes were identified: stereotype, "not just because I'm a guy, I'm a dental hygienist," discrimination, reverse discrimination/special treatment, and bringing balance to the work setting. In addition to the major themes, there were also several minor themes identified with the most common being the need for increased male representation in the profession.Conclusion: The findings of this study were consistent with nursing literature regarding the experience of males in female dominated professions. These findings may serve to enhance the positive experiences of being a male in dental hygiene and highlight the need to address the negative experiences such as discrimination to encourage more men to join the profession. Minor themes suggested the need to enhance male representation to make the profession more appealing to men.

Self-Care Practices of Dental Hygiene Students.

Purpose: Little is known about the self-care practices of dental hygiene students. The purpose of this study was to explore the self-care practices among dental hygiene students to examine the relationships between self-care practices, work hours, and caregiver responsibilities.Methods: The validated Health-Promoting Lifestyle Profile [HPLP II] survey was used to assess a convenience sample of dental hygiene students (n=416) in the United States (US) and Canada. The survey instrument consisted of 61 items in six subscales; spiritual growth, nutrition, interpersonal relations, health responsibility, physical activity, and stress management and was distributed to dental hygiene students through program directors and student social media sites. Data was analyzed using correlation, Mann-Whitney U, Kruskal-Wallace and regression to explore relationships between the variables.Results: Eighty-one percent of the target population opened the link and completed the survey (n=337). Mean scores for interpersonal relations (M=3.00) and spirituality (M=3.03) subscales indicated respondents were often engaging in these behaviors. Mean scores for physical activity (M=2.26), stress management (M=2.31), nutrition (M=2.44), and health responsibility (M=2.30) sub-scales suggested respondents sometimes practiced these health promoting behaviors. Respondents working more off-campus hours reported stress management behaviors less frequently (p<0.05). Participants with children living in the home had the median scores of stress management behaviors (Md=2.07, IQR=0.41) across all types of living situations (p=0.002).Conclusion: Outcomes from this study identified the need for improvement in health promoting behaviors related to nutrition, physical activity, and stress management in dental hygiene students. In addition, students with off-campus work and caregiver obligations may need additional assistance with self-care and stress management strategies to support academic success, given the academic and clinical rigors of the dental hygiene program.

Utilization of Periodontal Risk Assessment Tools in the Clinical Setting: Knowledge, attitudes and practice behaviors of dental hygienists.

Purpose: Identifying individuals at risk for developing periodontal disease helps to prevent, treat, and manage this condition. The purpose of this study was to explore the knowledge, attitudes, and practice behaviors of dental hygienists regarding the use of periodontal risk assessment tools.Methods: This cross-sectional survey study used a convenience sample of dental hygienists recruited through social media and snowball sampling. The validated electronic survey included items related to demographics, knowledge, attitude, and practice behaviors regarding the use of periodontal risk assessment tools in the clinical setting. Descriptive statistics were used to analyze the data and outcomes were represented through frequencies and percentiles.Results: Two-hundred eighty-two of the respondents (n=282) (n=530) met the inclusion criteria, for a participation rate of 53%. A majority (88%) "agreed" or "strongly agreed" that periodontal risk assessment tools improve communication and increase educational opportunities with patients and 50% reported completing periodontal risk assessments during a patient's scheduled appointment. Significant relationships existed between "frequently" or "always" reviewing periodontal risk assessment outcomes and the participants age, place of employment and number of continuing education (CE) hours completed (p=0.004). Participants who were members of the American Dental Hygienists' Association (ADHA) were more likely to correctly answer three or more knowledge questions (p=0.01), and more likely to measure and record pocket depths in a periodontal risk assessment tool (p=0.005).Conclusion: Although dental hygienists reported periodontal risk assessment tools were helpful for patient communication and education, only 50% reported regular completion while providing patient care. Continuing education on the value of periodontal risk assessment tools and better understanding of the barriers to routine implementation, could expand their use.

Knowledge, attitudes, and practices of young adults regarding the impact of electronic cigarette use on oral health.

BACKGROUND: The popularity and prevalence of electronic cigarette (EC) usage has continued to surge to 35 million worldwide, with one-half of users younger than 34 years. Despite emerging research suggesting deleterious oral health effects, the perceptions of EC users concerning oral health effects remain unknown. The purpose of this study was to explore knowledge, attitudes, and practices of young adults regarding the impact of EC use on oral health. METHODS: A cross-sectional survey used a validated tool to investigate vaping and oral health knowledge, attitudes, and practices among a convenience sample of EC users (N = 220). Outcomes were analyzed using descriptive and inferential statistics. RESULTS: People 18 through 24 years (N =168) indicated a lack of knowledge (mean [standard deviation {SD}], 2.9 [1.7]) and familiarity with oral health effects of vaping (mean [SD], 2.7 [1.7]). Participants expressed willingness to discuss oral health effects of vaping with dental care professionals (n = 111 [66%]), and most (n = 109 [65%]) would potentially reduce (30%) or quit (24%) if they believed it was harmful to their oral health. Participants 18 through 24 years were more likely to agree they would quit (n = 54 [68%]) than those 25 through 34 years (n = 36 [42%]; χ2 = 11.03; P = .004; φ = 0.26). Those who visit their dental care professional every 6 months (n = 82 [57%]) agreed they would quit vaping versus those who do not (n = 26 [37%]; χ2 = 9.84; P = .007; φ, 0.22). CONCLUSIONS: Respondents reported low knowledge regarding the implications of vaping on oral health but expressed a willingness to discuss vaping with their dental care professionals. PRACTICAL IMPLICATIONS: Most EC users are willing to accept guidance from dental care professionals regarding quitting use.

Oral Health Professionals Knowledge, Attitudes and Practices Toward Patients with Depression.

Purpose: Depression is a rising global health concern manifesting bidirectional relationships between chronic disease conditions such as type 2 diabetes and oral health. The purpose of this study was to explore the knowledge, attitudes, and practices of oral health care professionals towards individuals with depression.Methods: A 24-item, validated Knowledge Attitudes and Practices (KAP) survey was used for this descriptive, cross-sectional study. Non-probability, convenience and snowball sampling was used to recruit oral health care professionals (dentists, dental hygienists and dental assistants) to participate in an electronic survey. Descriptive statistics were used to analyze the data.Results: A total of 288 oral health care professionals (n=288) met the inclusion criteria. Age of the provider was positively correlated with reviewing or assisting in reviewing patient's depression history during routine dental visits (r=.16, p=.007), and referring or assisting in referring a patient to a mental health specialist (r=.30, p<.001). Number of years of practice was positively associated with referring or assisting in the referral of a patient to a mental health specialist (r=.29, p=.001). Oral health care professionals who indicated having had mental health during their education were more likely to indicate reviewing a history of depression with the patient (rho=.17, p=.004).Conclusion: Age, lack of practice experience and education may influence oral health care professionals' attitudes and practices when providing care for patients with depression. Mental health and its relationship to oral and systemic health may be an appropriate addition to dental program curricula. Oral health care providers should consider modifying routine practices to include the special needs of patients with depression.

Faculty perceptions of student incivility in dental hygiene education.

PURPOSE/OBJECTIVE: Conflict and discourtesy between college students and faculty have become increasingly common in higher education. Fallout from uncivil student encounters can have numerous effects on educators' overall health and has been shown to negatively impact learning environments. This research assessed the severity and frequency of student incivility in dental hygiene education and explored the relationship uncivil behavior has on faculty feelings of confidence, career satisfaction, and longevity. METHODS: Cross-sectional survey research was conducted among dental hygiene educators (n = 601) in the United States and Canada using purposive and snowball sampling. The survey (47-item) was developed based on the literature and validated prior to administration. Spearman's correlation coefficient was used to assess the relationship between variables and mean item category scores and thematic analysis was used to identify themes for open-ended questions. RESULTS: Survey completion rate was 78% (n = 469). Behaviors ranked mildly uncivil, such as eating/drinking in class, occurred more frequently, and incivility had less impact on faculty confidence with increased age (r = -.19; P ≤ 0.01). The level of severity of behaviors did not impact educators; however, how often certain behaviors occurred had some effect. Contemptuous behaviors, such as using a disrespectful/sarcastic tone (r = .34, .32, .31; P ≤ 0.01), had the most impact. CONCLUSION: This study determined student incivility exists within dental hygiene education. Day-to-day, minor uncivil behaviors seemingly take a greater emotional toll than occasional, highly uncivil encounter. Understanding how faculty perceive these behaviors may influence development of management strategies, fostering a sense of career satisfaction for educators.

Knowledge, Attitudes and Practices of Dental Hygienists Regarding Diabetes Risk Assessments and Screenings.

Purpose: Untreated and poorly controlled diabetes causes increased levels of blood glucose associated with poor periodontal disease outcomes. Dental hygienists can play a significant role in screening patients for diabetes mellitus, leading to referral and early diagnosis. The purpose of this study was to determine the knowledge, attitudes, practices, and barriers faced by clinical dental hygienists regarding diabetes risk assessment and screenings.Methods: A mixed method design was used with a convenience sample of dental hygienists in clinical practice (n=316). A 32 item, electronic survey was validated at item-level, and participants were recruited through multiple dental hygiene Facebook groups. Descriptive statistics were used to analyze the data. The survey also included two open-ended attitude questions that were interpreted using thematic analysis to pinpoint common patterns within the data.Results: Dental hygienists had high knowledge scores regarding diabetes and oral health, although many were unaware of their states' specific statutes and regulations for screening practices. Nearly all (95.9%), were likely to educate and refer patients (82%), although fewer than half (40.9%), were likely to perform chairside screening for diabetes. Emergent themes for barriers to screening were time, money, patient acceptance/willingness, lack of education, not having the proper tools, and states' rules and regulations.Conclusion: Despite high knowledge scores regarding diabetes and oral health, there is a gap in regards to dental hygienists' willingness to perform diabetes screenings in a clinical setting. Dental hygienists should be capable of integrating chairside diabetes screening practices into the process of care with proper training.

What are the effects of photographic self-assessment on students' risk for musculoskeletal disorders using Rapid Upper Limb Assessment.

PURPOSES/OBJECTIVES: Musculoskeletal disorders (MSD) affect the careers of dental professionals. Research suggests symptoms of MSD begin during educational careers. This sequential explanatory study aimed to determine if dental hygiene students' self-assessment using the Rapid Upper Limb Assessment (RULA) tool reduced the risk of MSD development and explore students' experiences using a risk tool. METHODS: Dental hygiene students (n = 21) in the last 2 of 4 sequential clinical semesters completed self-assessment using the RULA, employing photographs taken during patient care. Initial photographs were taken before students participated in a workshop about ergonomics and application of the RULA tool. Using a within-subjects repeated measures design, student risk scores were calculated for pre- and post-workshop photographs over 4 consecutive weeks. Students (n = 10) participated in a focus group to share their experiences with the risk tool. RESULTS: Repeated measures one-way analysis of variance compared differences in student RULA scores between weeks. There was a statistically significant effect of time on student self-reported RULA scores, F(3, 60) = 7.04, P < .001. Emergent themes from the focus group were practice using RULA, video versus photographs, adjust tool for dental hygiene practice, increased self-awareness, and connect theory to practice. CONCLUSIONS: Results suggested using self-assessment utilizing a risk tool increased self-awareness for ergonomics, thus reducing the risk of developing MSDs for dental hygiene students.

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.

Influence of a Smartphone Application on the Oral Health Practices and Behaviors of Parents of Preschool Children.

Purpose: Numerous oral health promotion programs are directed at reducing the prevalence of early childhood caries. Smartphone applications (app) may be beneficial in oral health promotion. The purpose of this study was to evaluate the effect of a smartphone app, based on the Theory of Planned Behavior (TPB), on the oral health behaviors of the parents of preschoolers.Methods: A two-phase, sequential, embedded mixed methods design explored how the app influenced the attitudes, beliefs, perceived behavioral control, and intentions of parents of preschoolers. Phase 1 was a quasi-experimental, one-group pretest-posttest design. Parents of preschool aged children (n=26) participated in the 4-week intervention. Phase 2 consisted of qualitative interviews with a purposive sample of parents from Phase 1 (n=11).Results: Parents' behavioral intentions or oral health behaviors with their preschoolers did not significantly change from pre- to post-intervention (p>.05). Social norms (SN) and perceived behavioral control (PBC) predicted behavioral intentions pre-intervention and behavioral change post-intervention. Thematic analysis revealed that parents' belief in the importance of establishing oral health habits and brushing reminders and videos delivered via a mobile application supported efforts to form oral health habits.Conclusion: The use of TPB constructs in the development of oral health promotions aimed at parents of preschoolers was partially supported. Intention and behavior were not affected post-intervention, but SN and PBC emerged as significant predictors of intentions and behavior. A dental smartphone app may aid parents to make good oral health habits part of their preschooler's daily routine.

Bridging the Theory-Practice Gap with Dental Hygiene Instrumentation Videos.

Dental educators are challenged to bridge the theory-practice gap to enhance the educational experience and meet the diverse learning needs of students. The aim of this study was to explore dental hygiene students' perceptions of the effectiveness, appeal, and satisfaction regarding instrumentation videos as a resource to improve learning in the clinical environment. All 152 first-year students in a U.S. baccalaureate dental hygiene program at two sites in two consecutive years were invited to participate in the study. Survey questions addressed demographics, effectiveness, appeal, and satisfaction with the instrumentation videos along with open-ended questions to explore students' perceptions of the videos' value and benefits. A total of 143 students completed the survey, for a response rate of 94%. The results showed that 50% to 70% of the respondents agreed or strongly agreed with questions relating to effectiveness, appeal, and satisfaction with the videos. Most participants used the videos while practicing (83%). Students who spoke English as a second language were less likely to feel the videos were effective, found them less appealing, and were less satisfied with them (p<0.05). Participants who practiced while using the videos were more likely to report them as being effective and appealing and were more satisfied with the videos than were participants who did not practice with them (p<0.05). Thematic analysis revealed the following themes in the open comments: helpfulness of the videos in clinical practice to clarify, reinforce, and visualize skills learned. These students reported satisfaction with the instrumentation videos, suggesting these learning aids have potential value in closing the theory-practice gap in clinical dental hygiene education.

Assessing Dental Hygiene Students' Test Anxiety in Examiner-Administered vs. Camera-Supervised OSCEs: A Pilot Study.

The aim of this pilot study was to measure and compare dental hygiene students' level of text anxiety and performance when being tested on an objective structured clinical examination (OSCE) using camera supervision versus direct examiner observation. This randomized, controlled trial, conducted in October 2016, assessed students' anxiety levels and performance using the Zung Self-Rating Anxiety Scale and performance on an OSCE. All 32 first-year students in one U.S. dental hygiene program were invited to participate, and all 32 participated for a 100% response rate. Participants were randomly assigned to the direct observation (N=16) and camera-supervised (N=16) groups. The comparison of pre-OSCE anxiety levels and performance scores evaluated with direct observation (36.4 and 20.4) versus camera-supervised (37.5 and 20.9) found no statistically significant difference between the two groups (p=0.496, p=0.403). The difference in post-OSCE anxiety levels between the direct observation and camera-supervised groups (33.8 and 37.8) approached significance (p=0.051). This study found that student anxiety levels were similar between the two groups except for the post-OSCE direct observation anxiety levels, which were lower. No significant difference was found between the two groups' performance scores. Due to similar performance scores and anxiety levels for the direct examiner and camera-supervised methods, the camera-supervised OSCE warrants further exploration as an alternative approach to direct observation for evaluation of students' performance.

Dental Hygienists' Knowledge, Attitudes and Practice for Patients with Dental Anxiety.

Purpose: The purpose of the study was to assess the knowledge, education, attitudes, confidence, and practice of dental hygienists providing dental care to adult patients with dental anxiety (DA).Methods: A purposive sample of dental hygienists, using a snowball sampling technique, were recruited through social media sites. Inclusion criteria were limited to actively practicing, registered dental hygienists in the United States (U.S.). The validated survey had 29 questions regarding dental hygienists' knowledge, education, attitudes, confidence, and practice in regards to patients with DA. Regression analysis and chi square tests were performed on the data with research outcomes represented through frequency tables and percentiles.Results: A total of 417 participants attempted the survey; 355 participants (n=355) completed the survey yielding a participation rate of 87%. A majority, 73%, of the respondents reported DA as a "somewhat serious" to "extremely serious" issue when treating patients. Forty-eight percent of the respondents indicated that their education had prepared them to address DA but also reported the need for additional education in this area. Dental hygienists indicating higher levels of confidence in addressing DA in their patients also allowed for extra time in their schedules to treat patients with DA.Conclusion: Increased DA education in the undergraduate dental hygiene curriculum as well as post-graduate education opportunities may increase dental hygienists' confidence and capability in the management of DA.

Interest in Dental Hygiene Therapy: a study of dental hygienists in Maine.

Purpose: The purpose of this study was to assess the awareness of registered dental hygienists (RDHs), licensed in the state of Maine, regarding the midlevel dental hygiene therapist (DHT) provider model and to gather data regarding the degree of interest in enrolling in a DHT program.Methods: A quantitative cross-sectional study design with a non-probability purposive sampling of actively practicing RDHs in the state of Maine (n=1,284) was utilized for the web-based survey. Survey questions included awareness in the passage of DHT legislation, level of interest pursuing education and licensure in this midlevel provider model. Data was collected over a three-week period. Descriptive statistics and thematic analysis were used for data analysis.Results: Response rate was 21% (n=268). Sixty-five percent of respondents expressed interest in enrolling in a DHT program and 40% of those respondents stated a willingness to enroll in a DHT program within the coming year. Although willing to travel 25-50 miles, a majority of respondents preferred programs incorporating online components combined with clinical training completed in nearby communities. Themes emerging from the open-ended question regarding DHT program feasibility and appeal included: convenience, flexibility, cost/affordability, and independent or collaborative practice.Conclusion: Study outcomes indicated interest exists among Maine RDHs regarding the DHT provider role and enrollment in a DHT program. Although there are no DHT programs currently being offered in the New England states, results suggest further investigation is warranted regarding the development of a DHT program in the Northeastern United States.

Variations in Periodontal Diagnosis Among Clinicians: dental hygienists' experiences and perceived barriers.

Purpose: Research indicates clinicians face barriers when attempting to utilize evidence-based protocols for periodontal disease and periodontal disease diagnosis often varies between dental providers. The purpose of this study was to identify and better understand dental hygienists' perceived barriers and experiences during the process of diagnosing periodontal disease in clinical practice.Methods: This study used a qualitative design and a purposive sample of dental hygienists (n=20). Utilizing a virtual video-conferencing platform, participants logged into focus group sessions to discuss their experiences with diagnosing periodontal disease in clinical practice. Focus group sessions were recorded and transcribed. Thematic analysis involved the use of inductive coding to draw themes from the data.Results: Dental hygienists reported being responsible for periodontal disease diagnosis, and that they utilized similar classification systems, and agreed with colleagues' periodontal disease diagnoses. However, participants reported the lack of a standardized periodontal classification system was confusing when communicating outside of their dental practice and described both intrinsic and extrinsic barriers to diagnosing disease. A common theme expressed by participants was that patients' lack of acceptance of their periodontal disease status and inability to fund treatment interfered with providing an evidence-based diagnosis and treatment plan. Newly licensed dental hygienists felt somewhat prepared to diagnose periodontal disease upon completion of their education but reported increased confidence in their skills and knowledge with years of practice and continuing education.Conclusion: Study data indicates dental hygienists feel the lack of a standardized periodontal classification system causes confusion and inconsistencies when communicating with other oral health care providers outside of their clinical practice setting, and dental hygienists face barriers when diagnosing periodontal disease. These findings may be instrumental in assisting educators in preparing students for clinical practice.

Development and Testing of a Smartphone Application Prototype for Oral Health Promotion.

Purpose: The purpose of this study was to develop and test a smartphone application (app) prototype, ToothSense, as an oral health promotion tool for the prevention of Early Childhood Caries (ECC) based on the Theory of Planned Behavior (TPB).Methods: A quantitative and qualitative design process based on the TPB was used for the app development in the first phase of the study. A behavioral intervention technologic model was used to document the app features design, accounting for Doshi's intervention strategies for the TPB. Beta-testing of the app was hosted via an online software program. Testers were presented with a series of tasks and prompts followed by a 5-point Likert-scale questionnaire that quantitatively measured perceptions of the app's interactive design based on Jakob Nielsen's principles and behavioral strategies. A Net Promotor Score was calculated to determine the tester's likelihood to recommend the app prototype. Audio and video aspects of the app were qualitatively measured using a template approach.Results: Beta testers agreed the app met the majority of the five usability statements. The Net Promotor Score indicated a likelihood to recommend the app prototype. Thematic analyses revealed the following themes: interface design, navigation, terminology, information, and oral health promotion.Conclusion: Beta testing results from this study provided health promotion project design information for the prevention of ECC using the TPB and highlighted the importance and usability of smartphone app for oral health promotion.

Childhood Obesity: Dental hygienists' beliefs attitudes and barriers to patient education.

Purpose: Increasing childhood obesity rates present a significant threat to public health. The purpose of this study was to explore dental hygienists' (DH) beliefs, attitudes, knowledge, current practices, and barriers for assessing and educating patients about childhood obesity.Methods: A random sample of DHs (n=13,357) was selected and emailed a link to the validated survey. Of the 1046 respondents who accessed the survey, 919 completed the survey for a completion rate of 89%.Results: A majority of the respondents understood the risk of chronic disease and obesity (99%), role sugar-sweetened beverages (SSBs) play as added sugar content in the diet (76%), and the amount of SSBs consumed by youth (91%). Participants felt current research showed an association between obesity and periodontal disease (62%), but were unsure of the association between obesity and dental caries (51%). Most respondents never measure height and weight (91%) or plot BMI (94%). Fifty-one percent always provide nutritional counseling to reduce consumption of SSBs, but only sometimes provide nutritional counseling for healthy eating (61%). Respondents had a slightly positive attitude (mean score=4.15, SD=14.58) about assessing and educating for childhood obesity. Major barriers reported were time constraints (63%), and fear of offending the patient or parent (47%). Regression showed attitudes towards patient's nutrition, exercise, and weight predicted the dental hygienist behavior.Conclusion: DHs have some understanding of the risks of obesity and general/oral health, but lack adequate training, knowledge, and confidence to provide obesity counseling in clinical practice settings. There is a need for further education to address the lack of knowledge about nutritional guidelines and practitioners' beliefs regarding addressing childhood obesity without offending the patient or parent.