Development of Nutritional Biochemistry Learning Goals and Core Competencies in the Dental Hygiene Curriculum / 치위생과학회지

Background@#In the dental hygiene curriculum, efforts are being made to introduce an integrated curriculum based on the competency of a dental hygienist. Because there is a connection and overlap in learning contents between Dental Nutrition and Oral Biochemistry, which are basic dental hygiene subjects, it is possible to integrate these two subjects. This study aims to derive Nutritional Biochemistry as an integrated curriculum for Dental Nutrition and Oral Biochemistry, and to develop learning goals and competencies for Dental Nutritional Biochemistry. @*Methods@#The learning contents of the integrated curriculum were composed by referring to the contents of the Dental Nutrition and Oral Biochemistry textbooks, and learning goals were derived from the learning contents. Moreover, competency was developed by analyzing the duties of a dental hygienist that can be performed through the learning goals. The Delphi survey was conducted twice to verify the content validity ratio (CVR) of the competence and the learning goal of the integrated curriculum. @*Results@#In the first Delphi survey, the CVR for two competencies was 0.56 or higher. Moreover, it was revised based on expert’s opinions, and as a result of the second Delphi survey after the revision, the CVR was either increased or maintained. Eighty-five learning goals were derived by referring to the textbook. According to CVR and expert opinions, after the first Delphi survey, the number of learning goals was reduced to 69. After the second Delphi survey, 68 learning goals were finally derived. @*Conclusion@#The development process of the integrated curriculum conducted in this study can be utilized for integration between subjects in basic dental hygiene.

Status and Opinions of Public Health Centers and Industrial Dental Offices on the Oral Health Promotion of Korean Adult Workers / 치위생과학회지

Background@#This study investigated the status of oral health promotion activities for adult workers in public health centers and industrial dental offices and provided basic data for the model development of oral health promotion program for adult workers in Korea. @*Methods@#A questionnaire was developed separately according to the person who in charge of the oral health promotion activities in public health centers nationwide and dental hygienists working in 20 industrial dental offices. This survey was conducted through postal survey and consisted of 29 items and 35 items respectively, including 19 common items for general information, oral health promotion program status and opinion. Statistical analysis was performed using the IBM SPSS ver. 23.0. @*Results@#We analyzed the data of 147 public health centers (57.9%) and 9 industrial dental offices (45.0%). A workforce with a lack of practice was the biggest barrier to oral health promotion activities for adult workers. However, both groups showed high intention for the practice of adult worker’s oral health promotion activities. Also, they showed willingness to work together in an organic partnership to perform their roles (94.4% and 77.8%, respectively). Regarding the scope of cooperation in the implementation of the industrial oral health promotion activity linked to the public health center, dental hygienists of industrial dental offices responded that they could coordinate necessary matters and schedule management. @*Conclusion@#The development of an oral health promotion program aided by the relationship between public health centers and industrial dental offices is essential for the oral health promotion of adult workers. The possibility of cooperation between the abovementioned centers was confirmed through this study. In a long-term perspective, it would be necessary to identify a method to institutionalize industrial dental hygienists for the provision of continuous oral health care in workplaces.

Dental Hygienist-Led Dental Hygiene Process of Care for Self-Support Program Participants in Gangneung / 치위생과학회지

This study aimed to provide basic data for establishing the clinical basis for dental hygienist-led dental hygiene process of care by identifying multiple risk factors for self-support program participants in Gangneung city; we also compared oral health status and behavioral changes through customized oral health care. Four dental hygienists who were evaluated for degree of conformity provided dental hygiene process of care to eight self-support program participants who were selected as having an oral health risk among people in the self-support center. The clinical indicators measured during dental hygiene assessment and evaluation and behavioral changes due to dental hygiene intervention were compared and analyzed. With respect to clinical indicators, at the time of probe, the retention rate of patients with gingival bleeding decreased from 61.4% to 14.7% after intervention (p=0.004). Furthermore, the retention rate of patients with a periodontal pocket >4 mm decreased from 15.6% to 5.8% (p=0.001). The average modified O'Leary index of the patients improved from 23 to 40 (p=0.002). Previously, all eight subjects used the vertical or horizontal method of brushing; after dental hygiene care interventions regarding method and frequency of toothbrushing, use of oral care products, and individual interventions, they started using the rolling or Bass method of toothbrushing. Four of eight subjects reported using interdental toothbrushes after intervention. As a result of applying the change model to the transtheoretical behavior change of the subject, the result of strengthening the health behavior was confirmed. For promotion of oral health by the prevention-centered incremental oral health care system, dental hygienist-led dental hygiene management and maintenance is essential. It is thought that continuous research, such as for feasibility evaluation, cost benefit analysis, and preparation of legal systems, is needed to establish and activate dental hygiene management.

Evaluation of Dental Hygienist Job Validity according to Judgment Standard of Medical Practice in Medical Law / 치위생과학회지

The purpose of this study was to evaluate the validity of dental hygienist job according to judgment standard of medical practice in medical law. In this study, we conducted a self-administered questionnaire survey to evaluate the validity of dental hygienist job for 12 professors of dental college in Gangneung-Wonju National University from November 10 to 20, 2017. We investigated whether the dental hygienist job conforms to the three criteria of medical practice such as disease prevention and treatment, patient care, and health hazard. The response rates were scored and classified into four categories according to the final score. As a result of this study, dental hygienist job are classified into four categories according to judgment standard of medical practice. The higher the level of the category, the higher the degree of difficulty, and the higher the level of expertise and skills required. More than 50% of respondents answered that measuring the gingival pocket, bleeding on probing, professional tooth cleaning, oral health education, counseling after dental treatment are all three criteria for medical treatment. And these were classified into Level 4 group which requires the difficulty and expertise in the final score 4.3. It is necessary to develop and utilize standardized guidelines on the level of knowledge, education, and qualification standards required for dental practice in order to effectively allocate work among the dental personnel while ensuring the health rights of patients in the dental clinic field in Korea. In addition, there is a need to evaluate the various aspects of cost effectiveness, dental health service productivity, and health promotion contribution to dental hygienist jobs, And based on this evidence, it is necessary to continue to expand and adjust the dental hygienist job and to reorganize the dental workforce system.

Factors Affecting Job Satisfaction of Clinical Dental Hygienists / 치위생과학회지

This study attempted to identify factors work environment that affect job satisfaction in dental hygienists. This study was conducted between August 29 and September 28, 2017, as part of an in-depth study of the ‘Survey on the Working Environment of Clinical Dental Hygienists’ of the Korean Dental Hygienists Association. To get the responses, the questionnaire was posted on the website of the Korean Dental Hygienists Association, and of the respondents, 4,663 were selected and analyzed. An independent t-test and one way ANOVA analysis were used to make a comparison of job satisfaction according to the general characteristics, salary, and tasks. Logistic regression analysis was conducted to identify factors affecting job satisfaction. The significance level was 0.05. In regard to salary information, the job satisfaction was found to be high (p < 0.001) in cases where the salary was considered appropriate, when incentives were provided, when rewards or vacation expenses were supported, and when overtime and nightly work allowances were paid. In regard to job information, the job satisfaction was found to be high (p < 0.001) when the volume of work was considered appropriate, when there were sufficient numbers in the workforce, and when the division of labor among the other personnel was clear. As a factor affecting job satisfaction of dental hygienists, the case of thinking that ‘workload is appropriate’ was found to be 2.052 times, showing the highest score. Job satisfaction in dental hygienists affects the turnover and has a significant effect on the performance of the organization. Therefore, it is believed, that it is urgent to improve the working environment such as salary and clear division of duties affecting job satisfaction of dental hygienists.

Suggestion of Learning Objectives in Social Dental Hygiene: Oral Health Administration Area / 치위생과학회지

The purpose of this study is to propose learning objectives in social dental hygiene by analyzing and reviewing learning objectives in oral health administration area of the existing public oral health. This study is a cross-sectional study. The subjects of the study selected with convenience extraction were 15 members of the social dental hygiene subcommittee of the Korean Society of Dental Hygiene Science. Data collection was conducted by self-filling questionnaire. The research tool is from 48 items of A division in the book of learning objectives in the dental hygienist national examination, and this study classified each of them into ‘dental hygiene job relevance’, ‘dental hygiene competency relevance’, ‘timeliness’, and ‘value discrimination of educational goal setting’ to comprise 192 items. Also, to collect expert opinions, this study conducted Delphi survey on 7 academic experts. Statistical analysis was performed using the IBM SPSS Statistics ver. 23.0 program (IBM Co., Armonk, NY, USA). Recoding was performed according to the degree of relevance of each learning objective and frequency analysis was performed. This study removed 18 items from the whole learning objectives in the dental hygienist national examination in the oral health administration area of public oral health. Fifteen revisions were made and 15 existing learning objectives were maintained. Forty-five learning objectives were proposed as new social dental hygiene learning objectives. The topics of learning objectives are divided into social security and medical assistance, oral health care system, oral health administration, and oral health policy. As a result of this study, it was necessary to construct the learning objectives of social dental hygiene in response to changing situation at the time. The contents of education should be revised in order of revision of learning objectives, development of competency, development of learning materials, and national examination.

The Development of Problem-Based Learning Module for Clinical Dentistry in Dental Hygiene / 치위생과학회지

We attempted to develop a problem-based learning (PBL) module for integrated education in dental hygiene with the aim of helping students gain clinical competencies necessary for dental hygienist work. To develop the PBL Module for Clinical Dentistry in Dental Hygiene course, the researchers identified literature related to not only educational technology, but also medical science, nursing, dentistry, and dental hygiene. During the design phase of the PBL module, problem scenarios and a plan for the teaching and learning process were developed. Developing problem scenarios involved describing a problematic situation and three questions related with that situation. To cultivate competencies required in dental clinics, each question was related to the diagnosis of a dental disease, dental treatment, and dental hygiene procedures for care. Teaching-learning process plan included the designs of operating environment, operational strategies, learning resources, facilitation of problem-solving process, and evaluation. It is necessary to evaluate the PBL module for integrated education in dental hygiene to confirm its effectiveness.

The Association between Types of Smoking and Periodontal Disease according to the Survey Year Using the Fourth and Fifth Korea National Health and Nutrition Examination Surveys / 치위생과학회지

There is little evidence on the effects of environmental tobacco smoke (ETS) on prevalence of periodontal disease. The aims of this study were to explore the trends of prevalence of periodontal disease and types of exposure to smoke, including ETS according to the survey year, identify factors affecting periodontal disease, and compare the effect size of periodontal disease between active smokers and secondhand smokers. Data on 11,643 individuals were obtained from the fourth and fifth Korean National Health and Nutritional Examination Surveys. Information on exposure to ETS at home and work was self-reported. Severity of periodontal disease was evaluated using the community periodontal index. A multivariate logistic regression analysis was performed to model periodontal disease using types of smoking and the survey year. Overall, the prevalence of periodontal disease was 26.0% (n=3,029) and about 9% of the study population were secondhand smokers. The prevalence of periodontal disease among smokers was significantly increased according to smoking types by year. Active smokers showed a statistically significant adjusted odds ratio (aOR) for having periodontal disease except in the year 2007, whereas secondhand smokers had significant associations only in 2010 (aOR, 1.68; 95% confidence interval, 1.05 to 2.70) compared to non-smokers. For secondhand smokers, the statistical relationship of predicting periodontal disease was weaker than that of active smokers. However, ETS should separately be considered as an important risk factor for periodontal disease. This study suggested the need for further investigation of the impact of ETS on prevalence of periodontal disease using in-depth research designs and objective measurements for assessing periodontal disease and ETS.

Study of Clinical Practice Standardization in Dental Hygiene / 치위생과학회지

There are 82 dental hygiene departments and clinical training institutes across the country with a very wide range of clinical practice content and evaluation methods, making standardization difficult. Therefore, there is a need to establish a standard protocol outlining clinical practice content and evaluation methods for systematic and efficient operation of clinical practice. Thus, this study attempted to propose such a protocol for standardization of dental hygiene clinical practice in dental clinics and hospitals to examine the contents of clinical practice by reviewing relevant literature, and relating it to professional practice within the dental hygienic curriculum to facilitate enhancement of expertise. Clinical practice content was extracted from 74 cases, and was consisted of classifying mandatory and optional clinical practice, training time, and activity methods for each component. To standardize effective clinical practice, it is necessary to organize the components acquired in the course of clinical dentistry training in line with their arrangement on each university's curriculum, in order to learn all components step by step. To do this, it is necessary to present a standardized clinical practice protocol and a organic cooperation between educational institutions and clinical training institutions.

Evaluation of Project-Based Learning on Community Dental Hygiene Practice Education / 치위생과학회지

The purpose of this study was to evaluate community dental hygiene practice education, by verifying its effect after applying project-based learning in improving the practical and social skills of learners. A 15-week project-based community dental hygiene practice course was held for 27 senior students, who took community dental hygiene practice course in the Department of Dental Hygiene, Gangneung-Wonju National University. Twenty-seven students were composed of 4 teams. Each team selected a target group for four workplaces for adult workers to apply the oral health promotion project. The project was then planned and conducted based on a survey on the health problems confronting each group, and an evaluation was carried out after 4 weeks. From the results obtained in comparing confidence in problem solving ability, project value, teamwork competency, and community dental hygienist competence before and after course, the improvement in project value and teamwork competence scores was not statistically significant, but all four areas showed positive results. After analyzing the project actuality, learning outcomes, and project satisfaction after course results, the actuality of the project was 19.30 points, the learning achievement was 45.19 points, and the satisfaction was 19.19 points, demonstrating that the aim of achieving actual performance competence and a learning performance exceeding expectations was accomplished. After conducting an interview survey with 8 students, it was found that they had learned social skills involving problem-solving abilities and confidence, and teamwork competence such as cooperation, role responsibility, creative thinking ability, and communication skills. Community dental hygienists should be able to acquire learner-level practical skills and social skills in the community dental hygiene and practical courses, according to their competencies and job needs. It is necessary to develop a project-based systematic learning module to enable the community dental hygiene practice to operate as a subject closely related to fields in other dental hygiene departments.

Competencies for Entry into the Profession of Dental Hygiene / 치위생과학회지

This study was conducted to derive core and detailed competencies of dental hygienists to be utilized as educational targets to be reached by graduation as well as basic data that can be reflected in the development and improvement of dental hygiene curricula. This study analyzed publication reports from the Korean Dental Hygienists Association, the International Federation of Dental Hygienists, the Commission on Dental Accreditation, and the American Dental Education Association. Based on the academic classification system for dental hygiene studies, the components of core and detailed competencies of dental hygiene school at the time of graduation were extracted and developed through expert panel discussions. This study defined competencies at the graduation level of dental hygiene school and derived eight core competencies and their 52 detailed competencies to serve as educational objectives from four areas: professionalism, communication, clinical practice, and community and health promotion. In the future, it will be necessary to conduct self-assessments of competencies based on those developed in this study, at time of the graduation from dental hygiene school, as well as to continuously develop competency-based curricula according to entry level, knowledge level, and graduation level. Thus, it is urgently necessary to develop a system that can evaluate the competencies of dental hygienists after graduation and put this system into practical use.

Comparison of Effects according to Type of Oral Exercise Program for Elderly in Gangneung City / 치위생과학회지

This study compared the effects of programs according to management type by preparing a manual for oral muscle exercises that integrates oral movement and oral massage. The program was performed on 14 elderly patients in a seniors' college self-practice program group and 28 elderly patients in a social welfare center expert intervention group. In the self-practice group, an expert demonstrated oral muscle exercises and subsequently encouraged self-practice by selecting an oral muscle exercise leader. In the expert intervention group, an expert demonstrated oral exercises on a one-on-one basis and subsequently gave oral muscle massages. In the self-practice group, there was no difference in saliva secretion (p=0.213) or oral dryness (p=0.206), after the intervention, the expert intervention group showed improvements in saliva secretion (p=0.009) and oral dryness (p=0.007). There was no difference in program satisfaction between groups (p=0.143), and both groups reported high satisfaction. As seniors may have difficulty in maintaining oral health behaviors, a certain amount of expert intervention may be needed. The results suggest that both a self-practice oral exercise program and an expert intervention program can be effective elderly patients.

Oral Health and Occupational Status among Korean Adults / 치위생과학회지

The purpose of this study was to determine the oral health condition and behavioral status of Korean adults according to occupational status. The subjects were 7,676 adults, aged between 19 and 64 years, who completed both oral examination and questionnaire survey, among those who indicated that they were currently participating in economic activities, according to the data from the Fourth Korea National Health and Nutrition Examination Survey. Occupational class and employment status were selected as measures of occupational status. Complex-samples logistic regression models were used to assess the associations among oral health, behavioral, and occupational statuses. We found a significant occupational class-related difference in the oral health and behavioral statuses of both the men and women. In particular, the prevalence odds ratios of untreated dental caries in manual workers were 1.19 and 1.67 times higher than in non-manual workers, for men and women, respectively. As for oral health condition and behavioral status according to employment status, the health risk in temporary employment workers was higher than that in permanent employment workers. As for the prevalence odds ratios of the risk of dental caries, the highest values were observed for tooth brushing fewer than 3 times per day, not undergoing oral examinations, and chewing difficulty complaints. The risk of dental caries for agricultural, forestry, and fishing workers for both men and women was found to be the highest among other workers. Thus, strategies to promote workplace oral health in the microscopic and macroscopic perspectives should be developed to constantly monitor oral health problems, and to identify vulnerable social groups within occupational groups and the related factors that mediate oral health differences.

Evaluation of Oral Health Promotion Program Connected with Hypertension and Diabetes Management Programs: Use of a Logical Model / 치위생과학회지

This study aimed to design and operate a complementary integrated health management program based on the connection between the hypertension and diabetes management programs and the oral health programs at a public health center. It also proposed to suggest the phased evaluation indicators. In this study, 48 adults registered in the hypertension and diabetes management program were selected from the Gangneung public health center. The clinic-specific programs were led by dental hygienists and operated for visitors twice every two weeks. The programs were designed based on the logical model, and indicators for evaluating the structure, process, and outcome were presented and applied to the input, process, output, and outcome. The evaluation indices consisted of quantitative and qualitative indicators, and the planning and operation, goal achievement, and effect of each program were assessed. The process evaluations were assessed by the appropriateness of the managers and the operating fidelity of the programs. Indicators for evaluating the outcomes were gingival bleeding, oral health knowledge, oral health awareness, and the satisfaction of the participant and the manager. The clinic-specific programs resulted in positive changes in the evaluated outcomes. The integrated health management of visitors to the hypertension and diabetes management program is important as the general and oral health has common risk factors. Furthermore, long-term operation and continuous monitoring of oral health programs are necessary to evaluate the common factors in chronic disease management.

Distribution of between socio-economic state of the parents and Child-Oral Impact on Daily Performances (C-OIDP) for children in Gangneung city / 대한구강보건학회지

OBJECTIVES: The study assessed the status of Child-Oral Impact on Daily Performances (C-OIDP) and association between socio-economic status (SES) and C-OIDP in Korean children. METHODS: The study population was the citizens of Gangneung, aged 4-10 year-old, who were registered at a preschool and primary school. Finally, 1,943 among 2,489 finished the question and response (response rate 74.3%). The children completed the C-OIDP by a face-to-face interview or self-response questions evaluation. The ethic approval of the study protocol was approved form GWNUDH-IRB. RESULTS: Twenty-five percent of the participants answered that they had difficulties on their daily performances from oral health. Problem with cleaning of the mouth was the most frequent performance to be reported and the percentage of the children who had this experience was 20.7%. Fifteen percent of the participants answered that they had difficulties on their daily performances from oral health on a daily basis. Among the children who experienced difficulties on daily performances from oral health on a daily basis, 59.3% of the difficulties on daily performances were moderate or severe effect. Lower SES was significantly associated with the rate of their daily performances from oral health. CONCLUSIONS: This study showed the status of C-OIDP in Korean children. It is suggested to establish the oral health strategy to school-based oral health promotion program. Future longitudinal research is required to determine the specific role to the relation between SES and OHRQoL for children.