Dissertations / Theses on the topic 'Dental hygiene practice'

Thesis (M.S.)--University of North Carolina at Chapel Hill, 2006.
Title from electronic title page (viewed Oct. 10, 2007). "... in partial fulfillment of the requirements for the degree of Master of Science in Dental Hygiene Education in the Department of Dental Ecology, School of Dentistry." Discipline: Dental Ecology; Dental Hygiene Education; Department/School: Dentistry.

The proposed dually licensed advanced dental therapy program, a graduate level curriculum created by the American Dental Hygienists’ Association (ADHA) encompassing both dental hygiene and basic restorative procedures, creates an innovative career path in dental hygiene and increases the standing of the dental hygienist from an auxiliary role to an independent midlevel dental practitioner. Data were gathered via an online anonymous survey tool from Massachusetts registered dental hygienists to assess support of this proposed curriculum by practicing hygienists. Eighty-seven percent of survey respondents are in agreement that the scope of dental hygiene responsibilities should increase with level of education, and that the inclusion of limited restorative procedures should generate independent midlevel dental practitioner status.

This qualitative case study explored faculty perceptions regarding best practices and uses of assessment in a dental hygiene program at a small northwestern college. It was discovered that faculty in the program were assessing students in their clinical courses using widely varied methods, designs, and scoring tools. Faculty neither calibrated processes nor communicated about this problem. In addition, a review of the assessments in this local setting indicated a significant gap in the current guidelines for best practices in clinical assessment procedures. Knowles' adult learning theory served as the foundation for this study. Research questions were designed to obtain clinical faculty's perceptions of their knowledge of best practices in assessment, assessment design, methods including scoring tools, and how faculty could work collaboratively to implement clearly and consistently designed best-practice assessments in their clinical courses. Interviews and reviews of assessment documents were conducted with a purposeful sample of 8 faculty participants. Data were coded and analyzed for common themes. Results indicated that instructors did not collaborate and had little knowledge of assessment criteria based on best practices, administration, and scoring procedures. At the request of the dean, a position paper was created as a project. The paper outlined strategies for designing clinical skills assessments with criteria that is consistent, clear, and based on best practices. Also included were procedures for ongoing faculty professional development and collaboration, insuring that faculty are calibrated and that assessments are valid and reliable. The results of this study can promote positive social change as faculty in this program will be increasingly confident in assessment practices, and graduates will consistently provide greater quality patient and community care.

Dental practice requires unique working conditions such as prolonged working hours, strained body postures and laborious, high finesse dental techniques. However, it can be more efficiently performed by the application of ergonomics, rather than physically forcing the worker's body to fit the job. Posture is highly influenced by factors such as inadequate working level, incorrect patient positioning, and poor visual comfort. In order to eliminate musculoskeletal disorders it is necessary to control these and other factors, and design the human work environment to be more ergonomic. The aim of this study was to assess ergonomics within Indian dental practice and elucidate factors that prevented application of ergonomics. An observational study was conducted among 58 Indian dentists, both from a private dental hospital and clinics. A questionnaire that consisted of 37 open-ended and closed-ended questions was used as a research tool for the study. Information on background characteristics, work environment, equipment, work administration, and ergonomic awareness was collected using the questionnaire. Sampling consisted of observing 37 male and 21 female dentists. A total of 58 individuals, 62 % ( 36), worked for a private dental hospital, and 38% (22) for dental clinics. A majority, 84.5% (49), of the dentists reported that they did not receive ergonomic training from their work administration. Most dentists, 96% (56), reported that there was no system of recordkeeping for workplace accidents. Lack of proper ergonomic training and no system of recordkeeping for workplace accidents were found to be the primary factors for not applying ergonomics by Indian dentists. Ergonomic training programs are needed in India to help educate dentists on workplace safety and health, and thus aid in reducing musculoskeletal pain. Finally, a system is needed in Indian dental practice to promote workplace safety and health by identifying workplace hazards that result in injuries.

Background: Childsmile, the national oral health improvement programme for children in Scotland, aims to reduce oral health inequalities and improve access to dental services. Childsmile is delivered, in part, by a new category of lay or community-based worker known as a Dental Health Support Worker (DHSW) who supports families to improve oral health behaviours and attend a dental practice. Findings from Childsmile’s national process evaluation indicated there was widespread variation in delivery of the DHSW role and additional research was required to further understand and develop programme theory for the DHSW role; and clarify areas of variation which were adaptive and which were a risk to the programme meeting its desired objectives. Aims: The overarching aim was to gain further understanding of which factors and variants (contextual and those associated with programme delivery) impact on effectiveness of the DHSW role within Childsmile Practice. This research is a component study of the national Childsmile evaluation strategy. Findings will be fed back to the Childsmile programme to optimise delivery of the role and to enable future evaluation of the role’s impact. Methods: Learning and evidence generation was triangulated from two phases of research, comprising three component studies. Phase 1 comprised the sensitising study and comparative case studies: both provided learning from within Childsmile. The sensitising study was designed as a scoping exercise using qualitative data collection methods. The aim was to establish existing programme theory and explicate delivery of the DHSW role, while uncovering deviation (from programme theory) and variation within and between NHS boards. Findings were used to design three comparative case studies, comprising one DHSW and key stakeholders involved in delivery of the role from three NHS boards. The comparative case studies employed qualitative data collection methods; and were designed to address the overarching aim, and explore the casual links between context, delivery, and outcomes in delivery of the role using Realist-inspired analysis. Phase 2 comprised a Realist Review to provide learning from out with Childsmile. The aim was to gain an understanding of which components of child health interventions, delivered by lay health workers to parents, could influence ‘child health parenting behaviours’. Findings and Conclusions: Findings indicated that in terms of motivational readiness to engage with positive oral health parenting behaviours (POHPBs) there were three types of families referred to the DHSW for support: low, moderate, and high-risk. It was established that to address programme aims DHSWs ought to support moderate-high risk families, yet DHSWs only had capacity to support low-moderate risk families. Findings demonstrated that the Public Health Nurses/Health Visitors were best placed to triage families according to their needs and motivational readiness. The peer-ness of the DHSW role was found to positively influence parental engagement with the programme and facilitate person-centred support. However, an embedded ‘sweetie culture’ and health damaging environments were found to negatively impact on parents’ self-efficacy and perceived locus of control to engage with POHPBs. Learning indicated that: delivery over a prolonged period of time; incorporation of the programme into the Early Years Pathway and GIRFEC policy; and recent changes to the Children and Young Person (Scotland) Act (2014), served to embed Childsmile within the NHS boards and facilitated stakeholder buy-in, which positively impacted on delivery of the role. From the learning derived within and out with Childsmile the recommendations for the DHSW role included: (1) DHSW support should move away from a primarily information provision and facilitation of families into dental practice role, and incorporate socio-emotional and person-centred support; (2) The DHSW role should be redefined to support moderate-high risk families; and interpretation and application of referral criteria should be addressed to ensure continuity with who is referred for support; and (3) Programme theory for the DHSW role should be refined and future evaluative effort should concentrate on assessing impact.

Nurse Practitioners (NPs) comprise a significant portion of the U.S. primary care workforce and play an essential role in patients' health awareness, prevention strategies, disease management, and in providing appropriate provider referrals. Nurse Practitioners receive education on the oral-systemic connection, yet there have been limited studies on the clinical practice of NPs assessing the oral cavity to evaluate the condition of the teeth and the oral tissues. The purpose of this study was to explore the nurse practitioners’ knowledge and practice habits of assessing the oral cavity for diseases or abnormalities in the mouth that can, in turn, affect overall health. A total of 66 NPs were included in the study, primarily female (91%) with master’s degrees (77%). While knowledge and education were not significantly associated, this research found significant associations between confidence and assessments, less than one-third (30.3%) were confident in their knowledge and ability to evaluate oral abnormalities.

Thesis (M.S.)--West Virginia University, 2002.
Title from document title page. Document formatted into pages; contains ix, 83 p. : ill. (some col.). Vita. Includes abstract. Includes bibliographical references (p. 64-66).

The incidence of oral cancer continues to rise in the UK and in Scotland, with a steady increase in oral cavity cancer rates and a rapid increase in oropharyngeal cancer rates in the last decade. These rates are projected to increase further over the next decade, so there is a pressing need to optimise oral cancer prevention strategies. Tobacco and alcohol use are recognised as the major modifiable risk factors for developing oral cancer (both oral cavity and oropharyngeal). In addition, there is a significant increased risk for oral cancer among lower socioeconomic groups, males, and older age groups. Recently there has been recognition of the role of human papillomavirus in the aetiology of oropharyngeal cancers. The major behavioural risk factors (tobacco and alcohol) implicated in oral cancer risk are also associated with a wide range of diseases affecting oral and general health and are thus termed 'common risk factors', increasing the public health benefit should they be tackled. Given the pivotal role in oral cancer and wider disease prevention of reducing tobacco and alcohol use, there is a clear need to optimise the role of primary care dental professionals in delivering behavioural interventions. However, there are uncertainties about the best evidence for particular strategies and approaches to assess risk factors, advise and/or refer in the dental practice setting, with a particular lack of clarity in terms of the specific form and content of such interventions (for example: duration, tailoring to need, who delivers). In addition, the barriers and facilitators to implementation in primary care dental practice - from both the dental professional and patient perspectives - is relatively under-explored. This thesis describes studies undertaken to address these gaps in the knowledge and evidence-base. First a systematic overview was undertaken of systematic reviews and published (international) clinical guidelines. This aimed to identify the evidence on the best practice for the assessment of the major behavioural risk factors associated with oral cancer and for delivering effective behaviour change preventive interventions (in relation to, for example: advice, counselling, signposting/referral to preventive services) by dental professionals in primary care dental practice setting. This evidence was then explored via a study in primary care dental practices in Scotland utilising qualitative in-depth interviews with dental professionals, to identify barriers and facilitators to implementation, and to gather suggestions to inform the development of interventions to support dental professionals in delivering prevention. Finally, a small qualitative survey of patients attending primary care dental practice was conducted to explore barriers, facilitators, and acceptability of risk factor assessment and preventive interventions from the patients' perspective. The overview shows a lack of direct evidence from the dental practice setting (one high-quality systematic review relating to tobacco prevention and none relating to alcohol). However, relatively strong evidence and recommendations from other primary care (medical/pharmacy) settings were identified and synthesised, which could potentially be adapted and adopted by dental professionals. Overall the findings show that robust risk factor assessment is an important first step in any prevention intervention. There is a clear indication of the effectiveness of a "brief", in-person, motivational intervention for sustained tobacco abstinence and reduced alcohol consumption. The lack of detail particularly in relation to duration made it difficult to make a conclusion regarding precise specification of the duration of element of the "brief" interventions. For tobacco users, though longer (10-20 minutes) and intensive (more than 20 minutes, with follow-up visits) interventions have shown to be effective in increasing quit rates compared to no intervention, very brief (less than 5 minutes) interventions in a single session also showed comparable effectiveness to the longer brief or intensive interventions. While, for alcohol users, 10-15 minutes multi-contact interventions were most effective, compared to no intervention or very brief intervention or intensive intervention; brief interventions of 5 minutes duration were also reported to be equally effective. Thus, very brief or brief advice of up to 5 minutes, should be trialled for tobacco and alcohol respectively in a dental practice setting, tailored to patient motivational status. Exploring use of the dental team is supported, as effectiveness was generally independent of primary care provider (i.e. general practice physician or nurse). The qualitative studies on feasibility showed time and resources to be the major barriers from the dental professional perspective. Dental professionals also reported social barriers for a) using cancer as a term to frame preventive consultations and b) in delivering alcohol advice which may not be welcome by patients. Professionals were willing to receive training to overcome confidence issues in approaching behavioural aspects of both main risk factors. Patients however generally supported explicit conversations on oral cancer, and were amenable to alcohol as well as smoking advice, provided their stage-of-change (motivational readiness) was incorporated. The use of formal risk assessment tools to frame discussions was broadly supported by patients and professionals alike. Recommendations are made for testing a model of preventive consultation that draws from this best available evidence and addresses barriers for professionals and patients alike to help shape practice and support this important area of public health going forward.

Although tobacco cessation is an uphill battle for almost everyone who attempts to quit, it is important that dental hygienists do not assume that patients are not interested. Dental hygienists are in an ideal position to offer cessation help to their tobacco using patients. The purpose of this study was to gain a better understanding of the tobacco cessation practices among central Texas dental hygienists. Specifically, dental hygienists were asked about beliefs, motivation, and confidence with regard to their tobacco cessation practice. A positive significant, moderate, relationship was found between beliefs and confidence (r=0.647), beliefs and practices (r=0.704), knowledge and capability (r=0.579), motivation and capability (r=0.529), motivation and practice (r=0.605), and years of practice and capability (r=0.699). The mean confidence scores for hygienists with more than 20 years of experience differed from those with 1-5 years of experience (p=.003) and 6-10 years of experience (p=.025).

Interprofessional education is recommended as a necessary step to prepare a collaborative, practice-ready workforce to engage in effective teamwork and team-based care. Professional identity and the perceptions of stereotypes that professionals hold of other professions have been identified as key factors in either enhancing or inhibiting effective teamwork. Information about interprofessional collaboration and education, competencies, and related variables is limited, particularly within the profession of dental hygiene. The purpose of this study was to investigate the relationship of interprofessional competencies to professional identity and stereotypes among U.S. dental hygiene students and practicing dental hygienists. The study used a correlational design with a cross-sectional survey utilizing the Student Stereotype Rating Questionnaire, Interprofessional Education Collaborative. Revised Survey, and Macleod Clark Professional Identity Survey-9 instruments. A total of 423 participants were recruited: 222 dental hygienists and 201 dental hygiene students. The survey data were analyzed using descriptive statistics, correlational analysis, independent and paired t tests, and multiple regression. Dental hygiene students had a significantly higher interprofessional competency aggregated mean score than registered dental hygienists (t = -4.837). Dental hygiene students’ interprofessional education experience correlated positively with the Interprofessional Competency Revised Scale score (r = 0.290, n = 201, p < .01). There was a modest relationship between interprofessional practice experience and the Interprofessional Competency score (r =. 255, n = 222, p < .01). The stereotypes dental hygienists and dental hygiene students have of themselves (auto-stereotypes) were rated the highest (M = 40.46, SD = 4.45) compared to stereotypes they have about dentists (hetero-stereotypes) (M = 37.57, SD = 6.03). The results of the multiple regression analysis, F (4, 418) = 16.805 p < .001, R2 = 0.14, showed that the variables of professional identity, interprofessional education activity experience, auto-stereotypes, and being a dental hygiene student were predictors of interprofessional competency. This study contributes to a unique understanding of the relationship between interprofessional competencies to stereotypes and professional identity among practicing dental hygienists and dental hygiene students. With these findings, educators and policymakers can identify issues and address modifications to curricula, professional development, and organizational changes.