Halitosis, what experiences and methods apply Dutch dental hygienists.

OBJECTIVES: The aim of this research is to gain more insight in the methods and experiences of dental hygienists in the Netherlands regarding the treatment of patients with halitosis. MATERIAL AND METHODS: A total of 92 dental hygienists completed the questionnaire (consisting of 19 questions on personal and professional characteristics, clinical observation and treatment of halitosis, the referral of patients with halitosis, the presence and usefulness of a protocol). The questionnaire was distributed using a social media platform for dental professionals in oral health care from all over the Netherlands. RESULTS: 83.4% of 90 dental hygienists had paid attention to the patient's breath but only 37.8% of dental hygienists always informed the patient. Reasons for not informing patients were the fear of the patient's possible reaction or because other oral health problems were more important. Of the included dental hygienists 67.8% had never referred a patient for treatment of halitosis. 86.7% of the dental hygienists stated there was no protocol for diagnosis and treatment of patients with halitosis. However, 90.0% of the dental hygienists acknowledged a protocol would be useful. CONCLUSIONS: The majority of the dental hygienists in the Netherlands had paid attention to the patient's breath, but only a small group of dental hygienists informed their patients about halitosis. In dental practices halitosis is an underestimated problem. During the coronavirus pandemic people are more aware with the smell of their breath. Dental hygienists indicated scaling and root planning and/or providing information and instruction by patients with a bad breath.

Determinants of intention to improve oral hygiene behavior among students based on the theory of planned behavior: A structural equation modelling analysis.

INTRODUCTION: The prevalence of oral hygiene behaviors (OHB) is very low among school children in Ethiopia. However, the determinants of student's readiness/intention to perform those behaviors have been remained unstudied. OBJECTIVE: This study aimed to identify the determinants of oral hygiene behavioral intention (OHBI) among preparatory school students based on the theory of planned behavior (TPB). METHODS AND MATERIALS: An institution-based cross-sectional study was conducted among 393 students. A 98-item self-administered questionnaire was used to evaluate oral hygiene knowledge (OHK), oral hygiene behavior (OHB), and OHBI based on TPB variables [attitude (ATT), subjective norms (SN) and perceived behavioral control (PBC)]. Descriptive statistics and structural equation modeling analysis (SEM) were employed to confirm relationships and associations among study variables. A p-value of less than 0.05 and a 95% confidence interval were used to declare statistical significance. RESULTS: A total of 393 students were participated with a response rate of 97.5%. The mean age of the participants (54% females) was 18 (± 1.3) with an age range of 16 to 24. The TPB model was well fitted to the data and explained 66% of the variance in intention. ATT (ß = 0.38; 95% CI, (0.21, 0.64)), SN (ß = 0.33; 95% CI, (0.05, 0.83)) and PBC (ß = 0.29; 95% CI, (0.13, 0.64)) were significant predictors of OHBI, where ATT was the strongest predictor of OHBI. CONCLUSION: The TPB model explained a large variance in the intention of students to improve their OHB. All TPB variables were significantly and positively linked to stronger intent, as the theory suggests. Furthermore, these results suggest that the model could provide a framework for oral hygiene promotion interventions in the study area. Indeed, these interventions should focus on changing the attitudes of students towards OHB, creation of positive social pressure, and enabling students to control over OHB barriers.

Practice characteristics and views of dental hygienists in Lithuania.

OBJECTIVES: To evaluate the employment possibilities of Lithuanian dental hygienists. METHODS: The questionnaire asked about the demographics of dental hygienists, characteristics of practice, patient load, career intentions, opinion about dental hygienists workforce and the need of governmental workforce regulation. The study consisted of all licensed dental hygienists in Lithuania in 2018 (N = 1109). RESULTS: The final response rate was 52.1% (n = 578), 64% (n = 370) of respondents lived in the country's five main cities, and 73.5% (n = 425) worked in these population centres, with 94.3% (n = 545) worked in private sector. Over two-thirds of respondents said there was an excess of dental hygienists in Lithuania. Nearly 80% "always" or "sometimes" reported that they had insufficient patients, which may account for the prevalence of supplementary work (48.4%, n = 280), that is work as a dental assistant (67.9%, n = 190). Data obtained show that dental hygienists with less than ten years' experience were likely to work as a dental assistant (P < .05). Notwithstanding, 73.9% (n = 428) of the dental hygienists reported that they only want to practice their profession. Most (83.4%, n = 483) struggled to find dental hygienist work, and 70.5% (n = 408) wanted regulation of number of dental hygienists at a national level. CONCLUSIONS: The respondents suggested there is (a) a lack of dental hygiene patients, (b) available workload for additional preventive dental hygiene services, (c) pressure to search for additional work, usually as a dental assistant. Governmental support to optimally regulate oral health human resources is, according to most dental hygienists, an emphatic wish as a possible solution at national level.

Is there burnout related to work among Dutch dental hygienists?: Combining studies by using the UBOS and the UWES.

OBJECTIVES: To investigate the prevalence of burnout among Dutch young and more experienced dental hygienists and the work experience of young professional dental hygienists. MATERIAL AND METHODS: Two studies were carried out using the Dutch version of the Maslach Burnout Inventory; the Utrecht Burnout Scale (UBOS) and the Utrecht Work Engagement Scale (UWES). In Study I, 400 participants completed an online questionnaire, including the UBOS-general version. In Study II, a questionnaire was distributed via social media to young professionals, including the UBOS-health care version and the UWES-9. RESULTS: 2.5% of 157 dental hygienists (Study I) satisfied the norm of burnout. Dental hygienists' average work experience was 16.6 years, and one-thirds worked 25-32 hours per week. In Study II, 73 young professionals (M = 26.5 years) reported 32.9 weekly working hours. Three-quarters were employed and worked in a dental clinical team practice. UWES-mean scores indicated a moderate to high level of work engagement. Mostly, all aspects of burnout were low compared with the test Manual norms. CONCLUSIONS: Exploratory findings show that generally burnout appears no threat for Dutch dental hygienists, and moderate to high level of work engagement coincides with a low level of burnout-related symptoms.

Periodontal screening during an oral public health promotion campaign: a study among health consumers.

INTRODUCTION: Diseases such as periodontal disease and halitosis have a negative impact on both the economy and the quality of life worldwide; thus, poor oral health has become a public health concern. The aim of this study was to characterise the oral health status of visitors to a public health consumer's exhibition using demographic and social characteristics and consumers' periodontal health condition. METHODS: During this cross-sectional study in 2010-2014, 1,223 visitors completed a questionnaire. The periodontal condition of 760 participants was screened by dental hygienists of the Dutch Dental Hygienists' Association using the Dutch Periodontal Screening Index (DPSI). RESULTS: A total of 1,029 visitors with a mean age of 45.38 years were included. The numerically lowest mean level of DPSI (2.59) occurred in 2014, whereas the numerically highest mean of DPSI (3.67) occurred in 2012. Each year, the DPSI scores were not normally distributed and were significantly higher for men than for women. Significant differences between DPSI score and age and between DPSI score and education were observed. CONCLUSION: Differences in DSPI score related to age and education were found. This means that specific groups of people with poorer oral health, mostly elderly or less-educated people, may need adjusted target interventions to prevent oral diseases. Insights into the benefits of public awareness and the development of optimally targeted interventions are needed for oral health promotion and the prevention of oral diseases.

Determinants of oral hygiene behaviour among patients with moderate and severe chronic periodontitis based on the theory of planned behaviour.

OBJECTIVES: Health interventions based on cognitive theories effectively bring about behaviour change. Therefore, the present study aimed to assess the determinants of oral hygiene behaviour (OHB) based on the theory of planned behaviour (TPB) among patients with moderate and severe periodontitis. METHODS: A cross-sectional study was conducted using a 47-item self-report questionnaire to evaluate oral health knowledge (OHK), expected social outcomes (ESO) and OHB based on the variables of TPB [attitude (ATT), social norms (SN) and perceived behavioural control (PBC)] of patients with moderate and severe periodontitis. Analysis of variance was used for comparison between the parameters. Regression analyses identified the significant determinants of OHB. RESULTS: A total of 543 patients meeting the inclusion criteria were included. ESO (B = 0.04) and OHK (B = 0.14) significantly predicted intention to perform OHB. None of the TPB variables significantly predicted OHB. Apart from ESO and OHK, which were significant predictors for both genders, ATT (ß = 0.22) additionally predicted OHB among men. Also, for university graduates, ESO (ß = 0.13) and OHK (ß = 0.17) significantly predicted OHB. Lastly, OHB showed a significant and positive correlation with all the parameters (P < 0.05). CONCLUSION: The study concludes that the TPB model facilitates the evaluation of psychosocial determinants of OHB among patients with periodontitis. Also, a significant relationship between gender, OHB and variables of TPB further highlights the importance of patient-focused preventive oral health care education.

Diagnosis and treatment of patients with halitosis by dental hygienists and dentists in the Netherlands.

OBJECTIVES: The aims of this study were to ascertain the knowledge level of halitosis in dental hygienists and dentists in the Netherlands and to examine how they deal with patients with halitosis. METHODS: A written survey (comprising 29 questions on personal and professional characteristics, clinical observation and treatment of halitosis, the referral of patients with halitosis and expert knowledge of halitosis) was randomly distributed to a sample of 327 Dutch dentist members of the Royal Dutch Dental Association (Koninklijke Nederlandse Maatschappij tot bevordering der Tandheelkunde; KNMT) and to a sample of 205 members of the Dutch Dental Hygienists' Association (members of the Nederlandse Vereniging van Mondhygiënisten; NVM). A total sample of 168 oral health professionals (92 NVM-dental hygienists and 76 dentists) was included. RESULTS: This sample can be considered as representative of the population of dental hygienists and dentists working in the Netherlands. Knowledge of halitosis in NVM-dental hygienists and dentists was generally the same. In both professions, attention to, and treatment of, halitosis did not take place at every patient contact, even among those who were able to treat patients with halitosis. CONCLUSIONS: This study supports the importance of training programmes aimed at increasing assertiveness, as well as the social and communication skills of dentists and dental hygienists to improve the diagnosis and treatment of patients with halitosis. A guideline on screening, diagnosis and treatment of halitosis may be useful to improve the attitude and behaviour of oral health-care professionals, ultimately aimed at stimulating optimal oral health care.

Work engagement among Dutch dental hygienists.

OBJECTIVES: The aim of this study was to investigate the level of work engagement among Dutch dental hygienists. METHODS: A total of 1,520 questionnaires were randomly distributed to the members of the Dutch Dental Hygienists' Association (Nederlandse Vereniging van Mondhygiënisten). The questionnaire consisted of the short form Utrecht Work Engagement Scale, a hypothesized three-factor structure of work engagement (Vigor, Dedication, and Absorption). Participants ranked statements about how they felt at work on 7-point rating scales (0 = never to 6 = always). RESULTS: From a sample of 490 dental hygienists (32 percent) with a mean age of 38.2 years [standard deviation (SD) = 10.1], the mean level of work engagement was 4.77 (SD = 0.90). The mean score on the dimension of Vigor was 4.74 (SD = 0.74), Dedication was 5.08 (SD = 0.89), and Absorption was 4.48 (SD = 1.12). A significant correlation was found between the dimension Absorption and age (r = -0.11, P < 0.05). CONCLUSIONS: Dutch dental hygienists reported a very high level of work engagement. Many dental hygienists experienced high levels of well-being at work at least once a week, with some reporting high levels of well-being on a daily basis. Only a small percentage of dental hygienists reported experiencing very low levels of well-being at work. Dental hygienists also reported significantly higher scores for work engagement and the three dimensions as compared with the manual norms based on a variety of professions. Finally, dental hygienists had higher scores on these questionnaires compared with Dutch dentists.

Determinants of oral hygiene behavior in the Dominican Republic.

OBJECTIVES: The aim of this study was to identify predictors of oral hygiene behavior based on the theory of planned behavior among dental care seekers in the Dominican Republic. In addition, measures of oral health knowledge and the expected social outcomes of having healthy teeth were examined. METHODS: In this cross-sectional study, 92 participants, who were visited by Dutch dental professionals from the Foundation Bocas Sanas Holanda-Maimón, completed voluntarily a culturally adapted questionnaire. The individuals' clinical oral health status was also assessed. RESULTS: A regression analysis was used to model the prediction, and it accounted for 32.4% of the variance. Only attitude, social norms and perceived behavioral control emerged as significant predictors of the intention to perform adequate oral hygiene behavior. In these multivariate analyses, oral health knowledge and expected social outcomes of having healthy teeth were not related significantly to intention. CONCLUSIONS: This study illustrates how the theory of planned behavior may be used as a basis to design adequate interventions for people in developing and underdeveloped countries. Moreover, it also suggests that oral hygiene-related interventions aimed at improving oral hygiene behavior need to be specifically adjusted to or designed for the target population.

Determinants and promotion of oral hygiene behaviour in the Caribbean and Nepal.

The purpose of this study was to identify predictors of oral hygiene behaviour (OHB) based on the Theory of Planned Behaviour (TPB) among dental care seekers in two cultural different regions: the Caribbean (Aruba/Bonaire) and Nepal. In addition, measures of oral health knowledge (OHK) and the expected social outcomes of having healthy teeth (ESO) were investigated. The main effects of the predictors as well as their interactions with region (Caribbean vs. Nepal) were examined. The interaction term contributed significantly to the amount of explained variance. In the Caribbean, OHB was determined by Attitude and Social Norms, and in Nepal by Perceived Behaviour Control and ESO. On the basis of these findings, quite different oral health care interventions are called for in developing and underdeveloped countries.

Determinants of oral hygiene behavior: a study based on the theory of planned behavior.

OBJECTIVE: The aim of this study was to develop an index for oral hygiene behavior (OHB) and to examine potential predictors of this actual behavior based on the theory of planned behavior (TPB). Measures of oral health knowledge (OHK) and the expected effect of having healthy teeth on social relationships were included too. MATERIAL AND METHODS: Using an Internet questionnaire, 487 participants were asked about actual OHB, attitudes (ATT), social norms (SN), perceived behavioral control (PBC), OHK, and expected social outcomes (ESO). Based on a Delphi method involving oral health professionals, a new index for OHB was developed, including tooth brushing, interdental cleaning, and tongue cleaning. RESULTS: Regression analysis revealed that the TPB variables (ATT, SN, and PBC) and OHK explained 32.3% of the variance in self-reported OHB. CONCLUSION: The present findings indicate that socio-psychological consequences play a role in oral health care.

Oral health related quality of life among imprisoned Dutch forensic psychiatric patients.

Because dental health and oral pathology may affect forensic psychiatric patients' well being, it is important to be able to assess oral health related quality of life (OH-QoL) in these patients. Two studies were conducted among Dutch forensic psychiatric male patients to assess the psychometric properties and some potential predictors of the Oral Health Impact Profile-14 (OHIP-14) as a measure of OH-QoL. Study 1 involved 40 patients who completed the OHIP-14 before receiving professional dental care and were retested 3 months later. The internal consistency was good, the test-retest correlations were fair, and over the 3 months follow-up no significant changes in OH-QoL were observed. Study 2 consisted of 39 patients who completed an improved version of the original OHIP-14, as well as measures to validate of the OHIP. Dental anxiety and unhealthy dentition jointly explained 26.7% of the variance in OH-QoL, and the better patients performed their oral hygiene behavior, the better their OH-QoL. It is concluded that the Dutch OHIP-14 is a useful instrument, and that nurses, especially in forensic nursing, should pay particularly attention to dental anxiety when encouraging patients to visit OH professionals and to perform adequate oral hygiene self-care.

Promoting oral hygiene behavior in recruits in the Dutch Army.

OBJECTIVES: To make practical recommendations for improving oral hygiene behavior (OHB) potential predictors based on the Theory of Planned Behavior (TPB) were assessed. Measurements of oral health knowledge (OHK) and the expected social effect for having healthy teeth were included. METHODS: 216 recruits in the Dutch Army ground forces completed a questionnaire about oral hygiene behavior, attitudes, social norms, perceived behavioral control (PBC), intention to perform optimal OHB, OHK, and expected social outcomes. RESULTS: The multivariate regression analysis revealed that attitude and PBC explained 37.2% of the variance in intention to perform optimal oral hygiene behavior, which is a substantial proportion. Furthermore, actual oral hygiene behavior was only predicted by attitude, explaining 7.1% of the variance. CONCLUSION: The present findings suggest that recruits' oral hygiene behavior may be improved by promoting a more positive attitude and especially by enhancing perceived behavior control.

Evaluación y promoción de la actitud hacia la higiene oral en pacientes de la Facultad de Odontología de la Universidad Católica del Uruguay / Evaluation and promotion of patient's oral hygiene behavior in the Faculty of Odontology of the Catholic University in Uruguay

El primer objetivo de este estudio apuntó a describir la actitud de los pacientes con respecto al cuidado de su salud bucal, lasnormas sociales, las respuestas sociales percibidas de tener dientes sanos, y el comportamiento acerca de la higiene oral. Laevaluación se realizó por medio de la versión en Español del Indice de Comportamiento de Higiene Oral, en un grupo de pacientesde la Facultad de Odontología de la Universidad Católica del Uruguay. El segundo objetivo del estudio fue examinar los predictoresrelevantes de estas conductas de higiene. Ochenta pacientes llenaron el cuestionario durante su atención por los estudiantes depregrado encargados del proyecto en las Clínicas de la Facultad. Generalmente, los pacientes mostraron un nivel adecuado decomportamiento acerca de la higiene oral, una actitud positiva, normas sociales positivas, especialmente en el odontólogo y lafamilia, y un alto valor de las respuestas sociales positivas de tener dientes sanos. El análisis predictivo demostró que la actitudy las normas sociales explicaron un 21.8 por ciento de la varianza en los comportamientos de higiene oral reportados. Estos hallazgossugieren que los pacientes poseen hábitos de higiene oral inadecuados que pueden ser mejorados e indican que los factores psicosocialesjuegan un rol importante en el cuidado de la salud bucal. Más aún, los hallazgos indican que el comportamiento acerca dela higiene oral del paciente puede ser mejorado no solo promoviendo una actitud más positiva hacia esa conducta específica sinotambien especialmente por el apoyo del odontólogo y de la familia del paciente.

The first aim of this study was to describe patients’ attitude with respect to oral self-care practices, social norms, expectedsocial outcomes of having healthy teeth, and oral hygiene behavior, as assessed with the Spanish version of the Oral HygieneBehavior Index (OHB) in dental patients of the Faculty of Odontology of the Catholic University in Montevideo, Uruguay. Thesecond aim of the study was to examine the relevant predictors of this oral hygiene behavior. Eighty participants filled out aquestionnaire during dental care they received from students. Overall, patients exhibited an adequate level of oral hygienebehavior, a positive attitude, positive social norms, especially in the dentist and the family, and positive social outcomes ofhaving healthy teeth. Regression analysis revealed that attitude and social norms explained 21.8 percent of the variance in reported oralhygiene behavior. The present findings suggest that patients’ inadequate oral hygiene habits can be changed in the right directionand indicate that socio-psychological factors play an important role in oral health care. Moreover, the findings indicate thatpatients’ oral hygiene behavior can be improved by not only promoting a more positive attitude toward the performance of thisspecific oral hygiene behavior, but especially, by support of significant others, such as the dentist and patients’ family.