Evidence-based dentistry can effectively be taught to dental care professional students - A mixed methods study

BACKGROUND

Little research exists in the teaching of evidence-based dentistry (EBD) to students in the fields of dental hygiene, dental nursing and orthodontic therapy. This study aims to analyse the effect of a 1-day EBD programme on knowledge and confidence whilst also gaining insight into students' experience of the intervention.

METHOD

A mixed methods study was utilised with explanatory sequential design. The population consisted of dental hygiene (DH), dental nursing (DN) and orthodontic therapy (OT) students (N = 44). The intervention consisted of a 1-day active learning EBD programme, delivered via group projects and lectures. In the initial quantitative phase, a standardised questionnaire pre- and post -intervention measured changes in confidence for all participants, whilst change in knowledge was measured for DH and OT students only. Following this, focus groups were scheduled for all members of each discipline 3 months post-intervention for DN and 2 months post-intervention for DH and OT students. Semi-structured focus group schedules were drawn up, and groups organised according to the outcomes of quantitative data analysis. Qualitative results were analysed using a deductive adaptation of Burnard's thematic content analysis.

RESULTS

Forty-two students took part (94.45%) in this study. Median knowledge scores increased from zero to two of five (P < .001), whilst median confidence score doubled from four to eight of eight (P < .001). Results of thematic content analysis were coincident with quantitative results; however, it also provided constructive feedback regarding design and content of the course.

CONCLUSIONS

A 1-day bespoke programme in EBD increased students' confidence and knowledge in EBD skills. However, the findings further suggest that two successive half-day training sessions instead of one full-day training, tied in with coursework that requires the application of the acquired skills, may increase the learning experience further.

Patient safety culture perceptions in the college of dentistry

A positive safety culture is essential to patient safety because it improves quality of care. The aim of this study was to assess staff and student perceptions of the patient safety culture in the clinics of the College of Dentistry at King Saud University in Saudi Arabia.A cross-sectional study was conducted in the College of Dentistry at King Saud University in Saudi Arabia. It included 4th and 5th year students, interns, general practitioners, and dental assistants. The data were collected by using paper-based questionnaire of modified version of the Agency for Healthcare Research and Quality Hospital Survey on Patient Safety Culture. Data were entered into SPSS Version 20. Score on a particular safety culture dimension was calculated.The overall response rate was 72.8% (390/536). Team work dimension had the highest average percent positive dimension score (72.3%) while staffing had the lowest score (10%). Dental assistant had high agreement in Teamwork dimension (87.8%); Supervisor/Manager Expectations and Actions Promoting Patient Safety dimension (66.9%); Organizational Learning-Continuous Improvement dimension (79.1%); Management Support for Patient Safety dimension (84.5%); Feedback and Communication About Error dimension (58.3%); Frequency of Events Reported dimension (54.0%); Teamwork Across Units dimension (73.2%). Most of areas perceived that there is no event reported (76.1-85.3%) in the past 12 months.Overall patient safety grade is more than moderate in the clinic. Teamwork within Units and Organizational Learning-Continuous Improvement dimension had the highest score while staffing had the lowest score. Dental assistants perceived positive score in most dimensions while students perceived slight negative score in most dimensions.

Attitudes toward and beliefs about the use of a dental diagnostic terminology: A survey of dental care providers in a dental practice

BACKGROUND

Attitudes and views are critical to the adoption of innovation. Although there have been broadening calls for a standardized dental diagnostic terminology, little is known about the views of private practice dental team members regarding the adoption of such a terminology.

METHODS

The authors developed a survey by using validated questions identified through literature review. Domain experts' input allowed for further modifications. The authors administered the final survey electronically to 814 team members at a multioffice practice based in the US Pacific Northwest.

RESULTS

Response proportion was 92%. The survey had excellent reliability (Cronbach α coefficient = 0.87). Results suggested that participants showed, in general, positive attitudes and beliefs about using a standardized diagnostic terminology in their practices. Additional written comments by participants highlighted the potential for improved communication with use of the terminology.

CONCLUSIONS

Dental care providers and staff in 1 multioffice practice showed positive attitudes about the use of a diagnostic terminology; specifically, they believed it would improve communication between the dentist and patient, as well as among providers, while expressing some concerns about whether using standardized dental diagnostic terms helps clinicians to deliver better dental care.

PRACTICAL IMPLICATIONS

As the dental profession is advancing toward the use of standardized diagnostic terminology, successful implementation will require that dental team leaders prepare their teams by gauging their attitude about the use of such a terminology.

Evaluating different measures of sickness absence with respect to work characteristics

AIMS

Four different measures of sickness absence were related to psychosocial and physical work characteristics in workplaces with high, intermediate, and low sickness absence. The relationships between work characteristics and sickness absence were hypothesized to differ depending the sickness absence measure used.

METHODS

Questionnaire data on physical work environment, physical load, support, influence at work, and worry were collected from 1,726 employees at 48 dental clinics in Stockholm, Sweden and were related to registry-based sickness absence obtained at the workplace level. The sickness absence measures included: (1) frequency, (2) one-day absence, (3) overall duration, and (4) duration between 2 and 21 days.

RESULTS

For frequency, significant differences were found for all work characteristics, with poor work characteristics being associated with a high frequency of sickness absence. Considering duration between 2 and 21 days, there were significant differences in support, influence at work and physical work environment; for one-day absence, support, influence at work and physical load differed significantly. Conversely, there were no significant differences for the overall duration measure.

CONCLUSIONS

The results show that frequency of sickness absence is most consistently related to work characteristics, that short-time sickness absences have more inconsistent relationships and that relationship with overall duration is lacking. This highlights the need for further differentiation between different sickness absence measures, the behavioral patterns associated with different types of absences and the implication of such processes for prevention and intervention.

Factors affecting job satisfaction and their correlation with educational standards among dental assistants

A disparity exists in the educational qualifications of dental assistants working in various public and private institutions in Riyadh, Saudi Arabia. The aim of this study was to assess the influence of professional and personal characteristics on job satisfaction among dental assistants. A cross-sectional survey was performed among dental assistants using a 24-item self-administered questionnaire. Multinomial logistic regression was used to assess the relationship between overall job satisfaction and other variables. The overall response rate was 72.1%. Factor analysis suggested that five underlying factors were related to job satisfaction. The mean score for overall job satisfaction was 3.86 (satisfied) out of 5. Among the work environment factors, the highest mean score, 4.26 (satisfied), was obtained for quality of service, and the lowest mean score, 2.78 (neutral), was obtained for the perception of income. The income and general prospects of the profession was significantly associated with overall job satisfaction. This study suggests that for dental assistants, professional and personal life, quality of service, perception of income and prestige and self-respect are important factors for job satisfaction. Despite differences in professional formation standards, in general, the study participants were considerably satisfied with their jobs.

The management of dental caries in primary teeth - involving service providers and users in the design of a trial

BACKGROUND

There is a lack of evidence for the effective management of dental caries in children's primary teeth. The trial entitled 'Filling Children's Teeth: Indicated Or Not?' (FiCTION) was designed to examine the clinical and cost effectiveness, in primary dental care, of three different approaches to the management of caries in primary teeth. However, before the FiCTION main trial commenced, a pilot trial was designed. Service provider (dentists and other members of the team including dental nurses and practice managers) and participant (child participants and their parents) involvement was incorporated into the pilot trial. The aim of this study is to describe service providers' and users' perspectives on the pilot trial to identify improvements to the conduct and design of the FiCTION main trial.

METHODS

Qualitative interviews (individual and group) were held with dentists, dental team members, children and parents involved in the FiCTION pilot trial. Individual interviews were held with four dentists and a group interview was held with 17 dental team members. Face-to-face interviews were held with four parents and children (four- to eight-years old) representing the three arms of the trial and five telephone interviews were conducted with parents. All interviews were transcribed verbatim. Framework analysis was used.

RESULTS

Overall, service providers, children and parents found the pilot trial to be well conducted and an interesting experience. Service providers highlighted the challenges of adhering to research protocols, especially managing the documentation and undertaking new clinical techniques. They indicated that the time and financial commitments were greater than they had anticipated. Particular difficulties were found recruiting suitable patients within the timeframe. For parents recruitment was apparently more related to trusting their dentist than the content of information packs. While some of the older children understood what a study was, others did not understand or were not aware they were enrolled.

CONCLUSIONS

The findings provided valuable recommendations to improve the method of recruitment of dental practices and patients, the timing and content of the training, the type of support dentists would value and ways to further engage children and parents in the FiCTION main trial.

TRIAL REGISTRATION

ISRCTN77044005.

Dental nurses as trainers and assessors: vocational dental trainer attitudes

AIM

To explore the attitudes of vocational dental trainers (VDTs) working in general dental practice to the role of dental nurses as trainers and assessors of trainee dental nurses (tDNs), vocational dental practitioners (VDPs) and vocational dental hygienist/therapists (VDHTs).

METHOD

This research was conducted within the context of the development of a training and assessment qualification for dental nurses. A survey was sent to all 148 VDTs in Scotland. The survey assessed VDT attitudes as to the appropriateness of dental nurses to train and assess tDNs, VDPs, VDHTs with regard to their clinical, communication-based and administrative duties. The three sets of attitudes for tDNS, VDPS and VDHTs were assessed on a five-point Likert scale ranging from 1 (strongly disagree) to 5 (strongly agree). The data were subjected to one way and repeated measures of ANOVA.

RESULTS

A total of 126 VDTs responded giving an 85% response rate. For clinical, communication-based and administrative activities, VDTs had significantly greater mean scores for the appropriateness of DNs to train [F(1,57) = 45.69, P < 0.001] and assess [F(1,57) = 76.94, P < 0.001] tDNs compared with VDPs and VDHTs.

CONCLUSION

Vocational dental trainers felt it was more appropriate for DNs to train and assess tDNs' clinical, communication-based and administrative activities compared with VDPs and VDHTs. Over 80% of dental trainers, however, indicated there would be benefit to their practice in having a dental nurse educated in the principles and application of training and assessment.

Factors related to performance effectiveness of dental nurse in primary care unit in the northeastern part of Thailand

OBJECTIVE

To investigate the relationships between job characteristics, motivation, role stress and performance effectiveness of dental nurses in primary care units in the northeastern part of Thailand.

MATERIAL AND METHOD

A explanatory cross-sectional study was conducted in 326 dental nurses who were working in 310 PCUs of 19 provinces, 220 amphurs in the northeastern part of Thailand were taken as the study samples. Data were collected by using questionnaires. Pearson's Product Moment Correlation was applied to test between job characteristic model, motivation, role stress and performance effectiveness.

RESULTS

The analysis showed that there was no relationship between job characteristics model and performance effectiveness as performing dental task needed 'dealing with others' and 'task significance'. There was a positive relationship between motivation and performance effectiveness at a low level. Role stress was not related to performance effectiveness; however, when the dental nurse had more stress caused by role conflict internal standard, several roles and their performance effectiveness was reduced.

CONCLUSION

From the research result, it is necessary to help construct networks of dental tasks and other public health tasks in obvious forms, for some feedback from agents. Work allocation should be precisely arranged and professional skill should be determined responsibility. Lastly, recruiting dental nurses with proper characteristics in primary care units in the northeastern part of Thailand is crucial as well.

Dental nursing education and the introduction of technology-assisted learning

The aim of this paper is to explore the profile of dental nursing students in the National Dental Nurse Training Programme of Ireland and their adjustment to a technology-assisted learning environment. Evaluation by students of the course and their reactions to the course were analysed. Dental nurses must possess the skills and knowledge to proficiently function in the modern day dental surgery. The implementation of a dental nurse programme that is heavily reliant on technology has started to create a group of dental nurses equipped with basic skills to access and retrieve information over a lifetime. However, the transition to a technology-assisted learning environment including online learning activities requires adaptation and expertise by educators and students alike. Careful evaluation and stakeholder feedback is imperative in the creation and maintaining of a quality programme. In conclusion, the students in this study responded well to the transition to a technology-based learning environment. Furthermore, the findings of this study suggest that the use of an online environment is an effective and stimulating learning environment for the students of a dental nurse programme; however, familiarity skills and knowledge of information technology is a prerequisite for success.

Attitudes of Irish dental, dental hygiene and dental nursing students and newly qualified practitioners to tobacco use cessation: a national survey

BACKGROUND

Ireland has some of the strictest smoking regulations in the world. Little is known of the attitudes of student Irish dental healthcare workers towards tobacco control and tobacco use cessation. This study aimed at determining the knowledge and attitudes of these students towards the deleterious effects of tobacco in the mouth and towards tobacco use cessation in dental practice.

METHOD

A questionnaire survey was distributed to 654 students (including newly qualified) on dentistry, dental hygiene and dental nursing programmes in Irish dental schools. Information sought included college, course, year of study, sex, age, nationality, smoking status, knowledge of effects of tobacco in the mouth and attitudes towards tobacco use cessation in dental practice and towards the Irish smoking bans.

MAIN FINDINGS

There was a 90% response rate. In all, 12% of dental students, 25% of dental hygiene students and 31% of dental nursing students were current smokers. Newly qualified dental hygienists were as knowledgeable about tobacco effects in the mouth as newly qualified dentists. Overall, the majority in each student category believed that all three groups could be effective tobacco counsellors and should provide tobacco use cessation counselling to patients, although less than half of evening course dental nursing students felt that dental nurses could be effective counsellors or should provide counselling. There was overwhelming support for the Irish smoking ban. Only a minority of dental students and dental nursing students had received instruction in tobacco use cessation counselling.

CONCLUSIONS

There are strong positive attitudes to tobacco use cessation counselling in dental practice among these young dental healthcare students. This is true even amongst those who have not received specific instruction in tobacco use cessation counselling.

Work environment factors affecting quality work in Swedish oral and maxillofacial surgery

The aim of this study was to investigate how work environment influenced attitudes to and knowledge of quality among employees of Oral and Maxillofacial Surgery (OMFS) clinics in Sweden. Data were collected with a questionnaire of 67 questions, related to quality management at the clinic, working situation, content of "good work", physical environment and health. 22 clinics with 297 employees responded, 65% of the clinics and 86% of the employees. A multiple regression analysis with the dependent variable "Attitude towards quality work" showed that only "work environment" (p = 0.010) revealed a significant association (p < 0.05). The personnel will have a more favourable attitude to quality work if they regard work environment to be important. Dental nurses and assistant nurses had more than four times more knowledge of the used quality management system than had the maxillo-facial surgeons. Women had nearly four times more knowledge of quality management than men. Clinic size was important, with better knowledge of quality management in bigger clinics. Soft demands were defined as demands for "flexibility, creativity, quality, service, engagement/commitment and ability to work together, and competence". Hard demands included economy as important, and emphasis on efficiency and productivity. There was a weak association with knowledge of quality management systems if soft demands increased, but negative if hard demands increased. In conclusion, mainly work environment was of significance for the attitude towards quality work among the employees of OMFS clinics in Sweden. Profession, gender, clinic size, and the hard demands were significantly associated with knowledge of the quality management system used.

Perceptions, attitudes and opinions of general dental practitioners and dental nurses to the provision of lifelong learning for the dental team

This paper reports on a survey of the attitudes of general dental practitioners (GDPs) and dental nurses to continuing education. This has become the subject of increased policy attention in recent years. The Adult Dental Health Survey of 1998 indicated that in order to meet the increase in requirements for the provision of Dental Health Services in the UK the Professions Complementary to Dentistry (PCDs) would be required to play a greater role in the delivery of dental services. In 2001, the Government undertook a review of the dental workforce, with a remit to look at ways to modernise the education and training system for dentists and the other members of the dental team.

Allied restorative functions training in Minnesota: a case study

In 2003, the Minnesota Dental Practice Act was modified to allow dental hygienists and assistants to place amalgam, composite, glass ionomer, and stainless steel crowns. The concept of utilizing allied professionals to perform expanded functions has been suggested as a way to increase access to care and productivity. A continuing education course was offered to provide required certification for interested dental practitioners (N=12). The objectives of this study were to examine confidence levels and effectiveness of the continuing education program. Pre- and post-course restorative content knowledge, along with confidence levels in knowledge, technical skills, and the ability to implement skills were measured. A matched pairs t-test found a significant increase in participants' restorative content knowledge (p<.001). Wilcoxen signed rank tests revealed an increase in confidence in all content knowledge (p<.01) and technical skill (p<.05) categories. Participants did not significantly increase in confidence to implement restorative functions skills into practice (p<.7). Interview data revealed that participants remain unclear about ways to incorporate restorative functions into the schedule. Findings in this case study suggest that content knowledge and confidence levels increase following completion of a restorative functions course. To improve education and training, research is needed to identify why participants' confidence in implementation did not increase.

Dental students interacting with dental nurses: an investigation of the role of gender and ethnicity in inter-professional communication and working styles

AIM

To examine the influence of dental students' gender and ethnicity on their perceptions of dental nurses' duties and upon their communication and working styles when interacting with dental nurses (DNs).

METHOD

A survey of clinical dental students attending Queen's University Belfast and University of Leeds. Students were invited to complete the 34 item Communication and Working Styles Questionnaire. The questionnaire assessed the students' perceptions of the duties of a DN and the students' communication and working styles. Factor analysis revealed two communication and working styles which were friendly and difficult styles, respectively.

RESULTS

Two hundred and forty-eight students participated giving a response rate of 88%: 58% were female and 30% of students from Leeds were from various ethnic minority groups. The students' perceptions as to the duties of a DN were affected by university attended and ethnicity. The majority of students used friendly communication styles. The type of style used was determined by university attended, gender and ethnicity. Male students had higher mean scores for friendly working styles whereas students from minority ethnic groups had higher mean scores for gender-related communication style. Female students and students from minority ethnic groups had higher mean scores for items relating to teamwork.

CONCLUSIONS

This survey illustrates the different communication and working styles used by male and female and dental students from different ethnic backgrounds when interacting and working with DNs.

Cultural and communicational traits of oral health care: results of a Finnish case study

PURPOSE

This paper aims to describe the cultural and communicational traits of Finnish oral health care. First, employees' views and experiences regarding their organization and their position within it are investigated and, second, relations between different individual and organizational factors are analyzed. Finally, a conceptual framework of organizational coherence is constructed.

DESIGN/METHODOLOGY/APPROACH

The paper shows that data collection (n = 58, 84 percent response rate) was carried out in 2002 at a Finnish dental clinic by using a semi-structured questionnaire. The data were analyzed statistically by using, among other things, non-parametric tests and a structural equation model (LISREL) and qualitatively by using content analysis.

FINDINGS

The paper finds that the organization was described as role-dependent and task-centered. Unidirectional chain of communication and responsibility for interaction were observed as the descriptive traits of communication, regardless of satisfaction or dissatisfaction with the communication. Developmental challenges involved opportunities to exert influence in the organization as well as giving and receiving feedback in leadership relations. It was found that a good sense of one's position in the organization was positively associated with several essential experiences (e.g. confidence, openness and equality), regarding organizational factors.

ORIGINALITY/VALUE

It appears in this paper likely that, by adopting the perspective of organizational coherence, it will be possible to approach the reality of an oral health care organization. As such a new and informative perspective is added.

Dental nurses on perceived gender differences in their dentist's communication and interaction style

OBJECTIVES

To investigate if dental nurses perceive gender differences in the communication and interaction style used by their dentist in general practice.

METHODS

Data were collected from 64 Northern Irish dental nurses (70% response), and from 549 Dutch nurses (41% response). Respondents completed the Communication and Working Styles Questionnaire (CWSQ), a self-report questionnaire with 20 items on staff communication and working styles. Using principal component analysis, six distinguishable factors could be extracted: [1] gender-related (four items, Cronbach's alpha = 0.78), [2] friendly relation (four items, alpha = 0.66), [3] teamwork (four items, alpha = 0.44), [4] playfulness (two items, alpha = 0.69), [5] personal attention (three items, alpha = 0.60), and [6] business-like (two items, alpha = 0.32). Factors [3] and [6] were additionally analysed at item level given their low internal consistencies.

RESULTS

MANOVA indicated a main effect for dentist's gender [F(6,541) = 4.649, p < 0.001], and for country [F(6,541) = 37.601, p < 0.001] on the communication style scales. No interaction effect of gender with country was found. Nurses working with a male dentist had higher scores for the 'gender-related' communications styles, whereas those working with a female dentist had higher scores for 'friendly-relation' and 'personal attention' communication styles. Dutch nurses had higher scores on 'playfulness', whereas Northern Irish nurses had higher scores on 'friendly relation' and 'personal attention' communication styles. Some additional differences were found at item level. The age of the dental nurse explained some differences in communication and working styles [F(6,541) = 2.341, p = 0.031); younger dental nurses scored significantly higher for 'gender- related' communication and working style.

CONCLUSION

Gender of the dentist does influence dental nurses' perceptions of the communication styles used in the primary dental care setting. Dental nurses working with female dentists report a style predominantly characterized by 'friendly-relation' and 'personal attention', whereas those working with a male dentist report 'gender-related' communication and working styles. Given the steadily growing percentage of females entering the dental profession, it is recommended to raise both dentists' and nurses' awareness on gender influences in professional communication by introducing these topics in their respective education.

Work Characteristics and Upper Extremity Disorders in Female Dental Health Workers

Many dental health workers suffer from musculoskeletal disorders in the upper extremities. In addition to ergonomic factors, psychosocial work characteristics have been linked to musculoskeletal disorders. The present cross-sectional study aimed at investigating how musculoskeletal disorders in the upper extremities (UED) and occupational position are related to work characteristics and general health problems in female dental health workers. Questionnaire data from dentists, dental hygienists and dental nurses (N=945) showed that 81% reported UED. Multivariate analysis of variance showed that dentists reported the highest levels of physical load and fatigue whereas dental nurses reported the lowest levels of influence at work. Irrespective of position, those with UED considered their physical and psychosocial work environment and their own health to be significantly poorer than did those without UED. A hierarchical multiple regression showed that the physical load of dentistry was most strongly related to UED. Despite improvements to the ergonomics and physical work environment of dentistry, it is concluded that female dental health workers are still at high risk of developing UED.

Infection control knowledge and practices among dentists and dental nurses at a Jordanian University Teaching Center

BACKGROUND

Information regarding compliance with infection control precautions in the dental settings in the Middle East is scant.

OBJECTIVE

To examine the knowledge and practices in infection control among dental staff and dental nurses at a university teaching dental center.

METHODS

A self-administered, confidential questionnaire concerning various aspects of infection control knowledge and practices was distributed to 48 dental staff and 28 dental nurses working at the Jordan University of Science and Technology Dental Teaching Center.

RESULTS

Responses came from 37 (77%) dental teaching staff members and 23 (82%) dental nurses. Of the dental staff participants, 95% received hepatitis B immunization in comparison with 87% of the dental nurses. Dental nurses were more prone to percutaneous dental injuries (P < .05). In both groups, 100% reported routine wearing of gloves. Although the dental staff reported a statistically higher frequency of washing hands before gloving (46%), dental nurses reported a higher frequency of washing hands after removing the gloves (100%). Dental staff reported statistically higher frequency of routine mask use (43%) than dental nurses (30%).

CONCLUSION

Compliance with recommended guidelines for control of cross infection varied among the 2 tested groups. A need exists for proper practice of infection control by both dental staff and dental nurses.

Ways of understanding the encounter with head and neck cancer patients in the hospital dental team—a phenomenographic study

INTRODUCTION

Head and neck cancer is the sixth most common malignancy in the world. Fifty percent of the patients can be cured by surgery, radiotherapy or a combination approach. Head and neck cancer is life-threatening, and treatment may leave the patient with visible facial disfigurements and impairment of functions such as speech and eating. This affects not only the patient, but may arouse difficult feelings in the treatment staff. Dental personnel are involved in all facets of treatment, yet they have no specific training in cancer care.

BACKGROUND

The aim of this study was to describe the variation in ways dental personnel understand and experience the encounter with head and neck cancer patients, as the way of understanding a certain phenomenon is judged to be fundamental to the way we act and form our beliefs.

METHODS

Twenty members of hospital dental teams were interviewed. The interviews focused on experiences of the encounter with head and neck cancer patients. A qualitative research approach, phenomenography, was used in analysing the interviews. The encounter was perceived in three qualitatively different ways: as an act of caring, as a serious and responsible task and as an overwhelming emotional situation. The results indicate that hospital dental personnel are not able to lean on education and professional training in finding ways of dealing with situations with strong emotional impact. This has implications for the treatment of patients with head and neck cancer, as well as education of dental personnel.

A comparison of career satisfaction amongst dental healthcare professionals across three health care systems: comparison of data from the United Kingdom, New Zealand and Trinidad & Tobago

BACKGROUND

The aim of this study was to compare the expressed levels of career satisfaction of three groups of comparable dental healthcare professionals, working in Trinidad, the United Kingdom and New Zealand.

METHODS

Three questionnaire surveys were carried out of comparable dental healthcare professionals. Dental nurses in Trinidad and dental therapists in the UK and New Zealand. Questionnaires were sent to all registered dental nurses or dental therapists.

RESULTS

Career satisfaction was lowest amongst Dental Therapists working in Trinidad and Tobago. Approximately 59% of the Therapists working in New Zealand reported stated that they felt they were not a valued member of the dental team, the corresponding proportion in the United Kingdom was 32%, and for Trinidad 39%.

CONCLUSION

Dental therapists working in different healthcare systems report different levels of satisfaction with their career.

Dental therapy in Western Australia: profile and perceptions of the workforce

BACKGROUND

In 2002, the Centre for Rural and Remote Oral Health (CRROH) completed a rural oral health workforce survey which indicated that a high number of therapists, although registered, were not working as therapists. The aim of the present study was to develop a profile of the dental therapy workforce and analyse the perceptions of therapists.

METHODS

In 2004, a postal questionnaire survey was undertaken amongst all registered dental and school dental therapists for 1999, 2000, 2001, 2002 and 2003.

RESULTS

Valid information was obtained from 253 therapists (55 per cent response rate). The therapy workforce are almost exclusively female, have an average age of 40 years, are working in urban areas, obtained their qualification on average 20 years ago, work for the School Dental Service and qualified in Western Australia. More than a quarter no longer worked as therapists. Perceptions regarding the advantages and disadvantages of dental therapy as a career were identified.

CONCLUSIONS

When trying to promote dental therapy and school dental therapy as a career, retain therapists and recruit new graduates, the opportunities identified in this survey should be embraced. A clear focus on the issues will be required to facilitate meeting the workforce objectives as outlined in Australia's National Oral Health Plan.

Access to care and the allied oral health care workforce in Kansas: perceptions of Kansas dental hygienists and scaling dental assistants

Access to oral health care continues to be a problem in the United States. Research has called for innovative approaches to improve access to oral health care and reduce oral health care disparities. Successful alternate approaches have been reported. In 1998 the Kansas Legislature passed a proposal to enhance access to care and manpower needs by allowing dental assistants to provide supragingival scaling, a service traditionally assigned to dental hygienists. In 2000, Mitchell et al. investigated the perceptions of Kansas dental hygienists and scaling dental assistants in relation to House Bill 2724 (HB 2724), which allows dental assistants to perform coronal scaling. The intent of the study was to collect baseline data in relation to HB 2724. The purpose of the present study was to follow up on the impact of HB 2724 six years after legislation. Both groups report satisfaction with their professions: scaling dental assistants believe the delivery of care in Kansas has changed, and areas of Kansas previously noted as dental health professional shortage areas are now served by either a registered dental hygienist or scaling dental assistant.

Impact of the Konstanz method of dilemma discussion on moral judgment in allied health students: a randomized controlled study

The objective of the study was to determine the effect of the Konstanz method of moral dilemma discussion (KMDD) on moral judgment in allied health students. The study employed the Moral Judgment Test, translated from English into Thai and validated in 247 students, as an moral judgment instrument. The scale satisfied four validity criteria: preference hierarchy, quasi-simplex structure of stage preference, affective-cognitive parallelism, and positive correlation between education and moral competence score (C-index). Test-retest reliability at a 1-month interval was 0.90. To investigate the impact of the KMDD, 83 pharmacy technician and dental nursing students were asked to participate in the study. The subjects were randomly assigned into control (n = 41) or experimental (n = 42) groups. The experimental group participated in a 90-min KMDD once a week for 6 consecutive weeks. Students in the control group also met once a week for 6 weeks to discuss the topics not related to ethics. All subjects completed the Moral Judgment Test before and after the intervention and again 6 months later. Split-plot ANOVA of the C-indexes at the beginning revealed that the experimental and control groups were not different (20.57 +/- 13.45 and 24.98 +/- 16.12). However, the experimental group scored significantly higher than the control group did after the intervention (35.18 +/- 10.96 and 24.20 +/- 14.70) and 6 months later (33.00 +/- 11.02 and 23.67 +/- 14.35). The KMDD appears to be a practical and effective intervention for developing moral judgment in allied health students. The effect on moral judgment remains at least 6 months after the intervention.

Dentist-assistant communication style: perceived gender differences in The Netherlands and Northern Ireland

OBJECTIVES

To assess communication style differences with the (female) dental assistant, as perceived by male and female dentists.

METHODS

Data were collected from 216 Dutch (male: 99; female: 117) and 261 Northern Irish (male: 135; female: 126) dentists (overall response rate: 60%). Respondents filled in a self-report questionnaire (one follow-up mailing), with 22 items on staff communication style. Using principal component analysis, four distinguishable factors could be extracted: businesslike leadership style (seven items, Cronbach's alpha = 0.87), friendly leadership style (seven items, alpha = 0.87), professional interacting style (four items, alpha = 0.83) and gender interacting style (four items, alpha = 0.83).

RESULTS

manova indicated a main effect for gender [F(8,946) = 10.905, P < 0.001] and for country [F(4,474) =4.197, P = 0.002] on the communication style scales. Male dentists, compared with female colleagues, showed higher mean scores on businesslike leadership style and gender interacting style, whereas female dentists showed higher mean scores on friendly leadership style and professional interacting style. Dutch dentists showed higher mean scores on friendly leadership style and professional interacting style than their Northern Irish colleagues. No interaction effect between gender and country was found. Dentist's age and length of assistant's employment (in years) partly explained differences in means.

CONCLUSION

Male and female dentists perceive their communication with the assistant differently; male dentists tend to be influenced by the gender differences, female dentists by striving for friendliness. Some country differences were found. Increasing influx of young female dentists underlines the relevance of this topic in dental education and for future research.

Dentists interacting and working with female dental nurses: a qualitative investigation of gender differences in primary dental care

OBJECTIVES

To investigate if women compared with men dentists experience deferential treatment from their female nurses, what workplace strategies women use to manage chair-side assistance and to examine if these were country related.

METHOD

A convenience sample of 22 male and female dentists of different ages working in general dental practice in The Netherlands and Northern Ireland participated. The sample framework was determined by saturation of the concepts. All informants were interviewed in a clinical setting. The data was subjected to rigorous line by line coding in order to identify clusters of codes, themes and concepts.

RESULTS

Three themes were identified. These were: experiencing deferential nursing assistance; adopting 'friendly-like' working strategies and adopting business-like, hierarchical working strategies. Gender differences were shown for each of the themes. Women rather than men made friends with their nurses and attempted to reduce status inequalities. This led to workplace strategy inconsistencies. This suggested that it was not the type of strategy adopted but the inconsistency with which it was implemented that caused difficulties between younger women dentists and their nurses.

CONCLUSIONS

Training dental students and young graduates how to interact appropriately in the clinical situation and to appreciate the nurses' work status will assist in improving working relationships.

The impact of Kansas House Bill 2724: perceptions of Kansas dental hygienists and dental assistants

PURPOSE

Kansas House Bill 2724 (HB 2724), which allows dental assistants to perform coronal scaling, was passed by the Kansas legislature in the spring of 1998. This bill was the legislature's way of addressing access to care and manpower issues, in relation to oral health care in Kansas. The intent of this study was to collect baseline data related to HB 2724. Specific purposes of this study were to, 1) compare overall perceptions of dental hygienists and scaling assistants related to HB 2724, 2) compare perceptions of dental hygienists and scaling assistants on how HD 2724 has addressed access to care and manpower issues, and 3) examine the impact of HB 2724 on the delivery of preventive care in underserved areas in Kansas.

METHODS

This study employed a nonexperimental descriptive survey research design. Two survey instruments were developed consisting of Likert scale questions, demographic information, and closed and opened-ended questions. All registered Kansas dental hygienists, and dental assistants who had completed the training course approved by the Kansas Dental Board to perform coronal scaling of teeth, were chosen to participate.

RESULTS

A total response rate of 38% for dental hygienists, and 42% for scaling assistants was achieved. Analyses were conducted to ensure validity and reliability of the two survey instruments, including factor analysis and internal reliability measures. In relation to overall satisfaction with career choices, both dental hygienists and scaling assistants reported being happy in their professions and respected by their dentist employers. The majority of dental hygiene respondents (79%) did not see HB 2724 addressing either access to care or manpower issues in the state, while in contrast a majority (89%) of scaling assistants believed that this was the best answer for Kansas in relation to access to care and manpower. In examining the impact of HB 2724 on delivery of preventive care in underserved areas of Kansas, this study found that the majority of scaling assistants reported practicing in metropolitan areas, as opposed to identified oral health care shortage areas in the state.

CONCLUSIONS

While both dental hygienists and scaling assistants are satisfied with their career choices, this legislation does not appear to be addressing its main objectives-access to care and increased manpower in dentally underserved areas in Kansas.

2002 British and Irish Dental Associations' Annual Conference

This year's annual conference held at Belfast's Waterfront Hall proved a resounding success. The three-day conference focused on 'Quality Partnership'--the importance of the dentist/team partnership, keeping-up-to-date and ensuring patients are well informed.

The role of the dental nurse in general practice

Dental nurses have reported dissatisfaction with their work which is associated with feelings of lack of control and being undervalued. This paper examines some of the possible reasons behind job dissatisfaction with illustrations from a pilot study conducted in general dental practice.

Factors affecting dental surgery assistants' job satisfaction in general dental practice

Reported studies suggested that job satisfaction, was low among non-operating dental auxiliaries. Clearly this might affect the quality of their work. The study reported in the present article evaluated dental surgery assistant (DSA) job satisfaction in general dental practices in the northwestern region of England. An initial qualitative study determined the factors that DSAs thought affected their job satisfaction and these were evaluated in a quantitative study. Although the majority of DSAs found their work satisfying and enjoyable, a number found some aspects unsatisfactory and changes are proposed which may improve the quality of their working lives.

Exposure to mercury vapor and impact on health in the dental profession in Sweden

Possible adverse effects of mercury exposure in dentistry have been discussed in several studies. The objective of the present study was to carry out detailed measurements of mercury exposure in the dental profession in Sweden, and to search for adverse health effects from such exposure. We examined 22 dentists and 22 dental nurses, working in teams, at six Swedish dental clinics. Measurements of air mercury, performed with personal, active air samplers, showed a median air Hg of 1.8 micrograms/m3 for the dentists, and 2.1 micrograms/m3 for the dental nurses. Spot measurements with a direct reading instrument displayed temporarily elevated air Hg, especially during the preparation and application of amalgam. The average concentration of mercury in whole blood (B-Hg) was 18 nmol/L, in plasma (P-Hg) 5.1 nmol/L, and in urine (U-Hg) 3.0 nmol/mmol creatinine. Possible effects on the central nervous system (CNS) were registered with three questionnaires: Q16, Eysenck Personality Inventory (EPI), and the Profile of Mood Scales (POMS). In the Q16, the number of symptoms was statistically significantly higher in the dentistry group compared with an age- and gender-matched control group (n = 44). The urinary excretion of albumin and urinary activity of the tubular enzyme N-acetyl-beta-glucose-aminidase (NAG) did not differ between the two groups. The results confirm that exposure to mercury in the dental profession in Sweden is low. The air Hg levels were mainly influenced by the method of amalgam preparation and inserting, and by the method of air evacuation during drilling and polishing.

Comfort and frictional properties of dental gloves

OBJECTIVES

A survey of general dental practitioners and dental surgery assistants was carried out to ascertain their preferences and opinions on powder-free hydrogel-coated gloves compared with starch-powdered gloves. The aim was to relate the survey findings to laboratory measurements of the frictional characteristics of glove inner surfaces and their water absorptive capability.

METHODS

The survey was carried out using a questionnaire given to local dental practitioners. Glove friction and water absorption measurements were made using specially designed equipment.

RESULTS

The survey showed that a selected group of dentist and dental surgery assistants preferred hydrogel-coated gloves, particularly for damp donning, durability and long-term wear comfort. Laboratory measurements showed that the hydrogel coating gave a low friction coefficient against damp skin. The coating was durable, and absorbed water more readily than other treatments.

CONCLUSION

A survey of dental practitioners and dental surgery assistants and laboratory measurements indicates that hydrogel-coated gloves have superior properties, and are preferred to other non-sterile glove types.

Cross-infection control: the role of "in-training" dental nurses

OBJECTIVES

This paper reports the findings of a study on the roles of dental nurses in cross-infection control in general dental practices and who were undergoing training for their initial certificate. The research aimed to find out what factors in their vocation gave them satisfaction, what caused stress and the bearing of these factors on cross-infection control. The study complemented previous research on the same matters carried out face-to-face in dental practices and aimed to test the validity of this previous research.

METHODS

The study was made anonymously by means of self-administered questionnaires completed by respondents attending evening classes.

RESULTS

Sixty per cent of respondents reported suffering anxiety in their work, the list of causes being headed by lack of experience, language barriers and taking part in general anaesthetic sessions. A third thought their workload was too great and a third quoted lack of time as the reason for not always completing cross-infection control procedures. Half were worried about cross-infection control. Clinical work was the most, and adequate pay the least important of five factors that gave respondents satisfaction in their work. Respondents always welcomed a word of thanks from their dentists and relied on them for information about their tasks.

CONCLUSIONS

In order to carry out their work thoroughly, uncertificated dental nurses need sufficient time. They benefit from support and encouragement from their dentist. These are important factors in cross-infection control so that stress is prevented and job satisfaction enhanced. Our two studies validate each other.

Work stress, job satisfaction and emotional well-being among Canadian dental assistants

Although dentistry is considered to be a stressful occupation, few data exist on work stress among dental assistants. In a previous paper, the extent and nature of work stress among this group was described and linked to a behavioural outcome; namely, intentions to change jobs or seek work outside of dentistry. In this paper the psychological outcomes of work stress, in the form of job satisfaction and emotional well-being, are examined. Using data collected by a mail survey, it was revealed that the main sources of dissatisfaction for dental assistants were low incomes, lack of opportunity to develop professionally and lack of recognition. Almost one-in-five had scores on a standard measure of emotional distress, which indicated a cause for concern. Work stress proved to be a significant predictor of job satisfaction, and work stress and job satisfaction emerged as significant predictors of emotional well-being. Social support while at work showed direct and interactive effects on job satisfaction but not emotional well-being. Role ambiguity, under-utilization of skills and low self-esteem emerged as important issues. These results are of interest theoretically and have important implications for the way dental practice and dentistry are organized.

Staff meetings as perceived by dental assistants

CDAs generally prefer meetings with these characteristics: organization; written agendas; longer, frequent, and regularly scheduled; compensated attendance; follow-up on progress toward goals/objectives; avoidance of personal and individual-compensation issues; input from staff members, and open discussion; and encouragement and praise. These results should help dentists and staff members to make staff meetings more efficient and effective.

A survey of job stress and job satisfaction among DSAs in the north-west of England

This study was a survey of job stress and job satisfaction among DSAs in general practice in the north-west of England during 1993. The results suggest that severe overall job stress and dissatisfaction were not prevalent but do present an important problem for a minority. The chief sources of stress are ranked. Those which caused moderate to severe stress were: running behind time, feeling under-valued by the dentist and handling difficult patients. Those experiencing greater stress outside work were more likely to report stress within it. Having a regular staff meeting, an annual salary review and a clear job description were associated with significantly less job stress.

Use of the SADP for measurement of attitudes of Chinese dental students and dental surgery assistants toward disabled persons

The purpose of this study was to determine the attitudes of Chinese dental students and dental surgery assistants toward disabled persons using the Scale to Determine Attitudes Toward Disabled Persons, the SADP. A group of 99 Hong Kong University psychology students, 50 male and 49 female, was used as the control and to determine the internal consistency and reliability of the Chinese version of the scale. A group of 4th year (n = 25) and a group of 3rd year (n = 46) dental students and a group of in-house dental surgery assistants (n = 86) at the Prince Philip Dental Hospital, Hong Kong, were asked to complete a Chinese translation of the SADP. Results showed that there was no significant difference between attitude scores of 3rd and 4th year dental students (p = 0.06). There was a significant difference in attitude scores between dental students and the dental surgery assistants (p < 0.001), with those of dental students being lower. In the control group, there was no significant difference between female control and dental surgery assistant scores (p = 0.289). There was a significant difference between dental students and male control scores (p < 10(-6)). Not only did the dental students score lower than the dental surgery assistants, but they also scored significantly lower than a group of non-dental students of the same University.

Response of dental professionals in Saudi Arabia towards hepatitis B vaccine and glove wearing

Dental specialists, dental general practitioners, dental assistants and hygienists at the medical province of Riyadh (95, 111, 141 and 14 respectively), were surveyed to ascertain their uptake of vaccination against the hepatitis B virus. Only 25.3% of dental specialists, 14.4% of dental practitioners, 25.5% of dental assistants and 42.9% of hygienists have been vaccinated. Side effects of vaccination were always minimal. Some of those respondents who have not been vaccinated were aware of the necessity of the vaccine but unable to get anyone to do it for them and the other part were aware of the desirability of the vaccine but had not yet taken positive steps to seek vaccination. Despite the risks and possible sequelae of contracting hepatitis B infection, a few of the respondents still consider vaccination unnecessary. Surprisingly, a quarter of the non-vaccinated group were not aware of the availability of the vaccine. Unfounded ideas of contracting AIDS from the vaccine accounted for 5% of the total participants in this survey. Only a quarter of the vaccinated groups have had antibody titre tests after vaccination. Wearing rubber/latex gloves when treating all patients is a further simple preventive and protective measure. However, 5% of the surveyed group never wear gloves.