The purpose of this study was to determine the awareness and attitudes of dental hygienists in Ohio regarding the Advanced Dental Hygiene Practitioner (ADHP) as an occupation proposed by the American Dental Hygienists’ Association and to determine whether the ADHP could be a viable career option for Ohio dental hygienists. I developed a survey to assess dental hygienists’ awareness, attitudes, and their views regarding the new mid-level dental provider. The study was limited to licensed dental hygienists in Ohio. The study included a simple random sample of 400 of the 4100 dental hygienists in Ohio obtained by a systematic approach, a random start and selection of subjects at a constant interval. The method of data collection was electronic surveys. Fifty-four dental hygienists (13% of the sample) participated in the study. The results show that most of those responding were aware of the ADHP. Also, their attitude regarding the new mid-level dental provider was positive. Attitudes varied more when the respondents provided data on the adoption of legislation for the new provider. There was no consensus among respondents regarding the ADHP as a viable career option. More robust research is needed on the viability of the ADHP in Ohio.

Bibliography: leaves 347-361. Presents results of 2 longitudinal studies investigating the oral health of older adults with dementia, using questionnaires and clinical inspections at baseline and one year. Groups studied were nursing home residents and those living in the community, with moderate to severe dementia or no dementia diagnosis. Caries experience was related to dementias severity and not to specific dementia diagnoses. Coronal and root caries experience was higher in dementia participants with moderate-severe dementia, the socio-economically disadvantaged, more functionally dependent, taking neuroleptic medications with high anticholinergic adverse effects, with eating and swallowing problems, were not attending the dentist, who needed assistance and were behaviourally difficult during oral hygiene care and whose carers were burdened.

Bibliography: leaves 347-361. / 403 leaves ; 30 cm. / Title page, contents and abstract only. The complete thesis in print form is available from the University Library. / Presents results of 2 longitudinal studies investigating the oral health of older adults with dementia, using questionnaires and clinical inspections at baseline and one year. Groups studied were nursing home residents and those living in the community, with moderate to severe dementia or no dementia diagnosis. Caries experience was related to dementias severity and not to specific dementia diagnoses. Coronal and root caries experience was higher in dementia participants with moderate-severe dementia, the socio-economically disadvantaged, more functionally dependent, taking neuroleptic medications with high anticholinergic adverse effects, with eating and swallowing problems, were not attending the dentist, who needed assistance and were behaviourally difficult during oral hygiene care and whose carers were burdened. / Thesis (Ph.D.)--University of Adelaide, Dept. of Dentistry, 2001

The aim of this study is to analyse and compare the delivery of oral health care services based on the prevailing curative paradigm and WHO-treatment norms for the school-going community of Mitchells Palin district in relation to selected alternative methods of dental care delivery. The optimal use of auxiliary personnel, purchasing care from private dental practitioners and intriducing water fluoridation was examined.

The aim of this study is to analyse and compare the delivery of oral health care services based on the prevailing curative paradigm and WHO-treatment norms for the school-going community of Mitchells Palin district in relation to selected alternative methods of dental care delivery. The optimal use of auxiliary personnel, purchasing care from private dental practitioners and intriducing water fluoridation was examined.

The ETSU dental hygiene program is very competitive and rigorous for those admitted. Student dental hygienists may experience higher levels of anxiety and more stressors while completing their course work and clinical hours than they have previously experienced in general education and prerequisite courses. These increased number of stressors and higher levels of anxiety may have negative impacts on students’ academic performance and success in clinical learning environments. A better understanding of the actual need for a stress reduction and anxiety management curriculum will facilitate creating and implementing this type of curriculum. A total of 44 current ETSU dental hygiene students were included in the study, juniors (55%) and (45%) seniors. Nearly all respondents reported their current stress and anxiety levels are affecting their lives (97.5%). Consistently over a third of students who completed surveys from the ETSU dental hygiene program are experiencing physical symptoms of stress and anxiety including headaches, gastrointestinal distress, trouble sleeping, eating too much or too little daily, tense muscles, worry or phobias, anger or hostility, irritability or hostility, and nervousness 2-3 times a week. The average stress level of the 44 ETSU dental hygiene students reported on a 1-10 scale was a 7.65. Nearly half (40%) of all ETSU dental hygiene students currently enrolled reported their stress level as 8 out of 10 with 10 defined as “I can only think of my stress and anxiety”. Further research including an educational intervention to help teach students skills and coping mechanisms to manage and reduce stress and anxiety was recommended.

Many factors influence poor oral health among disadvantaged populations including socioeconomic circumstances, knowledge of disease prevention strategies and ability to implement those strategies, public policies, insurance status, insurance policies, dental providers and other challenges to accessing dental care. Often these issues converge and result in early disadvantages to achieving good oral health (Horton & Barker, 2010). Addressing even some of the factors that contribute to poor oral health may provide ways to change the dental health status of historically underserved populations. The purpose of this research is to explore my role as a practitioner and researcher in the creation of a hygienist-based, community-site located, teledentistry supported system of dental care for underserved populations and the intersection of my experiences with cultural, societal and educational occurrences. This autoethnography examined my own experiences and also explored the experiences of a small sample of others who participated in onsite dental care systems utilizing hygienists as the prevention-focused primary care provider. As Ellis and Bochner (1996) note “Autoethnography stands as a current attempt to, quite literally, come to terms with sustaining questions of self and culture” (p. 193). The findings that emerged from my work included a realization that the dental industry creates and perpetuates the collective neglect of large portions of the US population. Some of this neglect is embedded in traditional power structures in dentistry, gender bias and distrust in professional skills as a result of separate professional education structures. The result for many people is untreated dental disease, a profound lack of health equity, increased shame due to poor oral health as well as missing school. There are ways to address the collective neglect of the dental industry through the reframing of the dental hygienist as the prevention-focused primary care oral health provider in professional education programs then integrating this provider type into community settings like schools.

One of the most important factors in accessing dental care is having dental insurance. For people with low incomes, Medicaid is the main source of health insurance. Medi-Cal is California’s Medicaid program. Adult dental services were mostly eliminated in Medi-Cal in 2009 due to the economic downturn and partially restored in 2014. The objective of this study is to evaluate the effect of change in Medi-Cal dental coverage, specifically the partial restoration of adult dental coverage in 2014, on dental care utilization among Medi-Cal beneficiaries. The partial restoration significantly increased the utilization rates in dental clinics from 2014 to 2017 (22% in 2017 vs. 12% in 2013) for the overall population. However, the magnitude of increase differs in different age groups and ethnic groups. More statistically significant findings show greater utilization rates among beneficiaries of 19-64 than 65-74 and 75+ years old. Also, more significant findings show lower utilization among Black than White, Hispanic or Asian beneficiaries. The partial restoration significantly reduced the dental related ER visits among Medi-Cal beneficiaries from 2015 to 2017. However, the reduction is largely seen in beneficiaries of 19-64 years old in the ethnic groups of White and Black with reductions of 20 and 15 visits per 1,000 enrollees respectively in 2017 comparing to 2013. The dental related ER visits were lower for Hispanics and Asians, and remained very low among those 65 years old and above. In addition, the partial restoration resulted in increases in participation of dental care providers in the Medi-Cal program.

Oral health is strongly correlated to systemic health in the United States. Dental professionals play a significant role in addressing the oral health and prevention of disease for populations in the United States. Because many areas in the United States lack access to dental care, the federal government considers dental hygienists part of the solution. It is now paying attention to restrictive dental hygiene scope of practice rules in each state. State dental boards, comprised mainly of dentists, make these rules based on their perception of dental hygienists' lack of education. This study explored fourth-year dental students' perceptions of the dental hygienist's education and scope of practice. This research found that while dental students felt that the dental hygienist would be a positive addition to their future practices, they did not wholly understand the rigors of dental hygiene education. In addition, dental schools may need to educate on the differences between direct and general supervision.

Quality assurance in healthcare is fundamental in ensuring the achievement of desired outcomes for patients. In 2011 a quality assurance plan was created at the East Tennessee State University (ETSU) dental hygiene program in order to meet accreditation standards. The purpose of this study was to evaluate this plan in order to determine its effectiveness in improving the quality of patient care indicators. One hundred fifty patient charts were selected and audited. Deficiencies were counted in the categories of assessment, treatment, documentation, referral, caries management, perio management, patient education, and follow-up. Research findings were varied; however, external variables with the potential to affect the study’s results were identified. Furthermore, statistical process control procedures indicated that the quality assurance program was effective or had the potential to be effective. Although further research is warranted, this study could be used to improve quality assurance practices at the ETSU dental hygiene program.