An evaluation of a school-based dental sealant programme

OBJECTIVES

To evaluate the effectiveness of Bengal Smiles, a school-based dental sealant programme and assess outcomes related to the U.S. Healthy People 2020 oral health objectives.

METHODS

A needs assessment identified high caries prevalence in Idaho children and supported the need for a school-based dental sealant programme at a local Title 1 school. Children (n=54) ages 6-12 were screened by dental hygiene students for suspected dental caries, sealant placement and need for referral for dental treatment. Sealant retention and sealant caries rates were computed at 12 months (n=32) using descriptive statistics. Caries rates were analysed with a t test for paired samples, while a chi-square test was used to determine a difference in referral treatment rates before and after the intervention of administrative staff who contacted parents of children in need of dental treatment.

RESULTS

Bengal Smiles participants had a 16% decrease in suspected dental caries; however, there was no statistically significant difference in caries rates (P=.21) at baseline and 12 months. Sealant prevalence increased 370%. Sealant retention outcomes were 74% fully retained with 0% caries, 13% partially retained with 25% caries and 13% no retention with 25% caries. At 12 months, 50% of participants referred for dental treatment accessed care. The intervention of contacting parents had no statistically significant effect on increasing dental treatments (P=.75).

CONCLUSIONS

School-based sealant programmes eliminate disparities in accessing oral health care and contribute to attaining U.S. Healthy People 2020 oral health objectives.

A pilot study of an HbA1c chairside screening protocol for diabetes in patients with chronic periodontitis: the dental hygienist's role

OBJECTIVE

To assess effectiveness, convenience and cost of point-of-care diabetes screenings performed by a dental hygienist for patients with periodontitis, using a diabetes risk questionnaire, periodontal findings and a glycosylated haemoglobin (HbA1c) analyser.

METHODS

A purposive sample of 50 participants with periodontitis, never diagnosed with diabetes, reporting ≥one diabetes risk factor, were administered an HbA1c test. Spearman's correlation measured relationships between HbA1c and diabetes risk test scores, numbers of missing teeth, percentage of deep pockets ≥5 mm and percentage of bleeding sites (BOP). Cost and time were assessed. Analyses used 0.05 alpha levels.

RESULTS

Thirty-two per cent (n = 16) of participants presented HbA1c values indicating prediabetes; one HbA1c value indicated type 2 diabetes, totalling 34% (N = 17). No relationships existed between HbA1c values and diabetes risk scores (rs = 0.153; P = 0.144), numbers of missing teeth (r = 0.190; P = 0.093), percentage of deep pockets (rs = -0.048; P = 0.370) or percentage of BOP sites (rs = 0.066, P = 0.324). Direct cost for each HbA1c was $9US, excluding follow-up medical diagnosis. Mean screening time including patient education was 14 min (SD = 6.2). Fifty-three per cent (n = 9 of 17) of participants with elevated HbA1c values contacted their primary healthcare provider within 2 weeks as recommended.

CONCLUSION

Point-of-care HbA1c screenings by dental hygienists were effective and convenient for identifying undiagnosed prediabetes and provide opportunity for interprofessional patient care; cost or lack of dental insurance may inhibit implementation. Identification of patients at risk for diabetes requires further evaluation.

Summary of the International Federation of Dental Hygienists house of delegates workshop

OBJECTIVES

The 2007 International Federation of Dental Hygienists (IFDH) House of Delegates participated in a two day forum to discuss professional topics of interest and to provide a focus for the direction of the profession and the IFDH.

MATERIALS AND METHODS

Delegates were asked to select a work group of interest based on four main topics: promoting evidence-based dental hygiene practice, procedures, and products; disease prevention and health promotion for primary health care; promoting interprofessional collaboration; and, reframing dental hygiene education. Each work group was challenged to address key questions and create a summary statement with recommendations to the IFDH.

RESULTS

Each work group identified numerous areas for professional growth and development and created a list of aspirations for the profession and the association to achieve.

CONCLUSION

The IFDH has made a commitment to the HOD to incorporate proposed recommendations and future aspirations.

Increasing access to quality dental hygiene care. An educational model

Restrictions on the manner in which dental hygienists practice are determined by individual state laws, each state's dental practice act, and how those are interpreted by the state board of dental examiners. Prior to 1986, state laws or regulations did not permit dental hygienists to practice independently of a dentist's supervision in public and private settings. These restrictions on the way hygienists practiced have been a barrier to expanding access to preventive dental hygiene care. Recently, the number of states that have eased the restrictions related to dental hygiene practice has increased. More hygienists have actively pursued legislation that would permit minimal supervision, and one state, Colorado, secured unsupervised practice. In addition to these legislative changes, the ADHA has made a commitment to expand the scope of dental hygiene practice. Given this focus, it is critical that dental hygiene practitioners receive the appropriate education to support their providing care directly to the public-functioning independently as licensed professionals. The purpose of this paper is to propose an educational model which will describe the advanced clinical and practical management skills necessary to practice unsupervised. Implications for how this model will increase access to care will also be addressed.

An educational model for preparing dental hygiene students in the treatment of periodontal diseases

Inflammatory periodontal disease is the leading cause of tooth loss. Experts agree that prevention is crucial, with frequent and through plaque removal being the simplest and most effective method for preventing inflammatory periodontal disease. Since it is often the dental hygienist who plays the major role in providing such care, it is imperative that dental hygiene programs educate students in the prevention and treatment of periodontal diseases and provide necessary breadth and depth in theory and clinical experience in the curriculum. The purpose of this paper is to describe an educational model designed to enhance the treatment phase of the periodontal component of the curriculum for dental hygiene students. Both the didactic and clinical components of the periodontics courses are built upon a program-planning model: students assess, plan, implement, and evaluate the periodontal needs of all patients. Case presentations permit students to assimilate and analyze clinical data while internalizing the importance of comprehensive care and adequate follow-up. In general, the program-planning model in periodontics incorporates the application of theory to practice and enhances clinical decision-making skills needed for graduates to meet the complexity of periodontal health needs.