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.

The Effect of Metabolic Syndrome on Periodontal Disease in Korean Adults: Based on the Data from the 6th Korea National Health and Nutrition Examination Survey (2013∼2015) / 치위생과학회지

Background@#The purpose of this study was to evaluate the association between metabolic syndrome and periodontal disease in Korean adults. @*Methods@#This study analyzed the screening data of 12,686 adults aged ≥19 years, including demographic characteristics, lifestyle habits, and each component of metabolic syndrome, obtained from the sixth Korea National Health and Nutrition Examination Survey database. Periodontal health status was measured by the community periodontal index. Subjects with three or more risk factors were considered as having metabolic syndrome. The Rao–Scott chi-square test was performed to assess the relationships between demographic characteristics, lifestyle habits, components of metabolic syndrome, and periodontal disease. Logistic regression analysis was performed based on the complex sample to evaluate the relationship between metabolic syndrome and periodontal disease. @*Results@#The prevalence of periodontal disease was higher among the subjects with advancing age, lower average household income and education level, those working in production, residents of eup-myeon areas, in past or current smoker, those with excessive alcohol consumption habit in a week, and reduced brushing frequency and the use of oral care products (p＜0.001).Each component of metabolic syndrome was associated with higher prevalence of periodontitis in the subjects with abnormal than in those with normal levels (p＜0.001). The prevalence of periodontal disease in subjects with metabolic syndrome was approximately 1.443 times higher than that in normal subjects (odds ratio,1.443; p＜0.001). @*Conclusion@#This study confirmed the association between metabolic syndrome and periodontitis in Korean adults, and further studies will be needed to determine the causal relationship between the two conditions.

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.

The Dentists’ View of Dental Hygienist Duties in Korea / 치위생과학회지

Background@#The number and curriculum of dental hygienists in Korea have dramatically increased. Controversies have since resulted from insufficient job descriptions of the work performed by a dental hygienist. A dentist's perception was examined to legally reflect the actual work of dental hygienists. @*Methods@#Four hundred and nineteen dentists were surveyed about the duties of a dental hygienist. Their views on the career and availability of each job were examined. The duties of the dental hygienist include 13 items in dental treatment preparation, 14 items of radiography, 21 items of preventive dentistry, 6 items of periodontal treatment, 12 items of oral medicine, 12 items of conservative dentistry, 8 items of prosthetics, 10 items of orthodontics, 7 items of oral and maxillofacial surgery, 6 items of implantation, 6 items of impression taking and model fabrication, 5 items of anesthesia and injection, 11 items of management and administrative, and 3 items of self-development. @*Results@#Most of the duties were doable by a dental hygienist. Many dentists reported that managing implants, oral hygiene of special patients, some duties in oral medicine, teeth brightening, making temporary crowns, making individual trays, selecting shades, ligaturing, and precision impressions need ≥3 years of experience. Duties perceived by dentists not to be performed by dental hygienists were reading radiographs (55.4%), suture and stitch out (48.0%), intramuscular injection (36.0%), root planning (27.2%), cementation and removal of prostheses (23.2%), and examining pulp vitality (22.0%). @*Conclusion@#Current laws are to be revised to include, the care provided by dental hygienists and under a physician’s supervision. Flexibility is also needed to cope with rapidly changing dental technology.

Clinical Dental Hygienists’ Experience of the Prevention Based Incremental Oral Health Care: Applying Focus Group Interviews / 치위생과학회지

Background@#In this study, we tried to comprehensively explore clinical dental hygienist’s experience of a prevention-based incremental oral health care program, which was pilot-operated by dental clinics, define prevention-based incremental oral health care as experienced in the field, and identify factors to be considered. @*Methods@#This study conducted a focus group interview with five dental hygienists who participated in an ongoing oral management pilot project in 2016. The interview was conducted by a researcher, and the co-research team attended as progress assistants and recorded characteristics of the participants, main dictations, and non-verbal characteristics. All interviews were recorded and underwent thematic analysis to examine the questions of the study as the main axis. @*Results@#As a result of the study, 65 meaningful statements were extracted by code, integrated into 24 sub-categories, and structured into 11 categories. Finally, four keywords were drawn: characteristics, facilitating factors, conflicting factors, and improvement measures for prevention-based incremental oral health care. Regarding prevention-based incremental oral health care in dental clinics, dental hygienists were highly aware of the physical and mental burdens of personalized treatment and education for each individual. They were responsible for the patient and for facilitating changes in the behavior of the client, leading to professional satisfaction. The dental team’s cooperation and supportive attitude were found essential to continue oral health care in the dental clinic. @*Conclusion@#Through dental team-based treatment philosophy sharing and collaboration, it is possible to provide prevention-based incremental oral health care in dental clinics. In future, it is necessary to develop a system for establishing a sustainable preventative management system for public health promotion.

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.

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.

Study on Current Curriculum Analysis of Clinical Dental Hygiene for Dental Hygiene Students in Korea / 치위생과학회지

The purpose of this study was to provide basic data to standardize the clinical dental hygiene curriculum, based on analysis of current clinical dental hygiene curricula in Korea. We emailed questionnaires to 12 schools to investigate clinical dental hygiene curricula, from February to March, 2017. We analyzed the clinical dental hygiene curricula in 5 schools with a 3-year program and in 7 schools with a 4-year program. The questionnaire comprised nine items on topics relating to clinical dental hygiene, and four items relating to the dental hygiene process and oral prophylaxis. The questionnaire included details regarding the subject name, the grade/semester/credit system, course content and class hours, the number of senior professors, and the number of patients available for dental hygiene clinical training purposes. In total, there were 96 topics listed in the curricula relating to clinical dental hygiene training, and topics varied between the schools. There was an average of 20.4 topic credits, and more credits and hours were allocated to the 4-year program than to the 3-year program. On average, the ratio of students to professors was 21.4:1. Course content included infection control, concepts for dental hygiene processes, dental hygiene assessment, intervention and evaluation, case studies, and periodontal instrumentation. An average of 2 hours per patient was spent on dental hygiene practice, with an average of 1.9 visits. On average, student clinical training involved 19 patients and 26.6 patients in the 3-year and 4-year programs, respectively. The average participation time per student per topic was 38.0 hours and 53.1 hours, in the 3-year and 4-year programs, respectively. Standardizing the clinical dental hygiene curricula in Korea will require consensus guidelines on topics, the number of classes required to achieve core competencies as a dental hygienist, and theory and practice time.

A Case Study on the Validity of Dental Communication Curriculum of a Dental Hygiene Department / 치위생과학회지

The purpose of this study was to examine the validity of the content of an educational curriculum by understanding the opinions of experts in the development of weekly educational content for dental communication or communication-related subjects. It was composed of educational content on how to communicate with patients by cultivating a professional attitude through basic contents and a self-understanding of communication. Three experts were asked to evaluate the feasibility of educational contents and their appropriateness in order to evaluate the criteria for certification as a dental hygienist. The validity of the weekly educational contents and the period of education were awarded 4 points out of a maximum of 5 points; overall, the curriculum was evaluated to be valid and to be acceptable for use as criteria for certification evaluation. On the other hand, it was confirmed that not only should the contents be made appropriate for the grade level, but it should be complemented so that theoretical and practical learning can be achieved in a gradual and interrelated manner rather than as a one-time curriculum. Therefore, the result of this study can be considered for use as background data for curriculum development, and for standardization of the communication course in the dental hygiene department.

A Qualitative Study on Reducing Dental Anxiety through Cognitive Behavioral Therapy / 치위생과학회지

Many people in Korea suffer from a fear of dental treatments; however, only a few studies have focused on this population. This study assessed the effectiveness of cognitive behavioral therapy (CBT) and its interventions in reducing dental anxiety, especially when administered by trained dental staff. Using case studies, the authors analyzed the content of each session and examined the process of reducing dental anxiety. First, the authors observed that the results of both dental fear scale and subjective unit of disturbance decreased significantly with changes in cognitive distortions related to dental anxiety and that rapid improvements were noted after two therapy sessions. Second, the study reported that practicing relaxation (deep-breathing) and muscle relaxation techniques; using hand signals to indicate anxiety or discomfort; establishing an empathic relationship with the therapist; making an anxiety list; and graded insensitive and exposure along with rehearsal, were effective in coping with dental anxiety and in changing negative thoughts towards the dentist. Third, a simple cognitive behavioral intervention can be effective in reducing dental anxiety. In summary, a short-term, five-session psychological intervention with CBT produced a sustained decrease in the symptoms of dental anxiety, allowing the patients to receive the required procedures. The authors discussed the study limitations and the implication of their results on future research.

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.

Study on Clinical Dental Hygiene in Korea Based on Analysis of Clinical Dental Hygiene Curriculum of Fones School in the United States / 치위생과학회지

The aim of this study was to analyze in depth the standardized Clinical dental hygiene curriculum of the Fones School in the United States. We investigated the clinical dental hygiene curriculum in 2015~2016 including title, credit, hours, contents, goals, competencies, and evaluation. We obtained the course syllabus and data related to each subject, for each grade, from the professors and students at the university. The goals and competencies, of the clinical dental hygiene program, which were based on the goals of the Fones School and the mission of the University of Bridgeport, were developed in accordance with the dental hygienist practice standards proposed by the American Dental Hygienists Association. The curriculum consisted of theory to teach proper dental hygiene care procedures and incorporated practical exercises that modeled an actual clinical setting. The students had to document the procedures performed for each client/patient and improve their clinical competency through discussion with the professors. Dental hygiene care should be provided for children, adolescents, adults, elderly, and patients, which includes patients with moderate or severe periodontal status. Students were evaluated by a paper test or case study presentation and their clinical evaluation was based on their clinical competency. In particular, professors evaluated students on a rotational basis, so they could evaluate the level of achievement of clinical competency of all students and find ways to improve any weaknesses. Therefore, the current study suggested that clinical dental hygiene program in Korea could be improved if based on the curriculum of Fones School in the United States.

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.

Distribution of the Korean Dental Hygiene Research Agenda Suggested by the Korean Dental Hygienists Association and Affiliated Groups / 치위생과학회지

The objective of this study was to realize research demands by gathering the research agenda from the Korean Dental Hygienists Association and affiliated groups through a Delphi survey. The study subjects were the heads of eight groups. The Delphi survey was conducted by e-mail after a researcher explained the objective of the study to the heads. The research agenda was classified according to the Korean dental hygiene academic classification and the National Dental Hygiene Research Agenda classification. To compare the number of research agendas according to classification among the groups, we conducted a chi-squared test by using IBM SPSS 20.0. In total, 316 agendas were submitted. According to the Korean dental hygiene academic classification, there was a significant difference among the groups, and the agendas associated with clinical dental hygiene (36.7%) were the best. According to the National Dental Hygiene Research Agenda classification, there was no significant difference and the agendas associated with health promotion and disease prevention (27.8%) were the best. In conclusion, the Korean Dental Hygienists Association and affiliated groups demanded similar research agendas, corresponding to the purpose of each establishment. However, the groups did not seem to show unique characteristics according to the purpose of each establishment. In other words, the groups should corroborate such characteristics and suggest a corresponding agenda to establish specific areas of research in dental hygiene. Also, dental hygiene researchers should mark the academic classification of the studies they want to submit.

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.