Comparison of calculus detection among dental hygienists using an explorer and ultrasonic insert.

INTRODUCTION: Periodontal therapy disrupts the biofilm harbouring calculus that triggers inflammation. The explorer is primarily used for calculus detection, and the ultrasonic instrument is primarily used for calculus removal. The efficiency in dental hygiene care may improve if the ultrasonic instrument could be used in both calculus detection and removal. PURPOSE: The purpose of this study was to validate the effectiveness of calculus detection between the Thinsert® ultrasonic insert and the 11/12 explorer. METHODS: Upon IRB approval, this validation study involved three dental hygiene faculty from the Ohio State University Dental Hygiene Program and 30 patient participants from the Ohio State University community. Using both instruments, calculus was evaluated on Ramfjord index teeth and on four possible surfaces per tooth. Data were analysed to evaluate for interrater reliability, intrarater reliability, sensitivity, and specificity. RESULTS: For interrater reliability, the average measure of intraclass coefficient (ICC) value was 0.782 with a 95% confidence interval (CI) of 0.749-0.810 (F(1439, 2878)  = 4.852, P < 0.01). For intrarater reliability, mean Kappa averages were in the full agreement range (κ = 0.726, n = 2160, P < 0.01). When using the Thinsert® for calculus detection, the sensitivity was 75%, specificity was 97%, PPV was 81%, and NPV was 94%. CONCLUSION: Since calculus evaluation was comparable when using the ODU 11/12 explorer and the Thinsert®, efforts can be focused on developing the tactile sensitivity when using the Thinsert® ultrasonic instrument in the assessment, treatment, and maintenance of periodontal disease and the support of oral health. The efficiency in dental hygiene care may improve by using the Thinsert® ultrasonic instrument in both the detection and removal of calculus.

Comparison of the Efficacy of Calculus Detection Between Ultrasonic Inserts and an Explorer.

Purpose: The purpose of this study was to evaluate the efficacy of calculus detection between a thin and curved ultrasonic inserts (UI) as compared to the Old Dominion University (ODU) 11/12 explorer.Methods: Three clinical dental hygiene faculty members were recruited to participate as calibrated raters for the presence of calculus in a group of 60 patient volunteers. Inclusion criteria were: adults aged >18 in good health, and no history of a professional prophylaxis within the past six months. Raters used an ODU 11/12 explorer, thin and curved UIs to evaluate 4 surfaces on Ramfjord index teeth for the presence of subgingival calculus. Data were analyzed for intra- and intrerrater reliability, sensitivity, and specificity.Results: Interrater reliability for calculus detection with an ODU 11/12 explorer and a thin UI was demonstrated with an Intraclass Coefficient (ICC) of .782, confidence interval (CI) 95%. An ICC of .714, CI 95% was demonstrated with the ODU 11/12 explorer and curved UIs. Intra-rater reliability was shown with mean Kappa averages in the full agreement range (Kappa=.726, n=2,160, p<0.01) for use of the ODU 11/12 explorer versus the thin UI as well as versus curved UIs (Kappa=.680, n=2160, p<0.01). Sensitivity was 75%, specificity 97%, PPV 81%, and NPV 94% when the thin UI was used and sensitivity measured 65%, specificity 98%, PPV 81%, and NPV 95% when curved UIs were used.Conclusion: Calculus detection was comparable when using the ODU 11/12 explorer, a thin UI and curved UIs on patients with limited amounts of calculus among the three clinicians. Efforts may be focused on developing tactile sensitivity for calculus detection in addition to calculus removal when using thin and curved ultrasonic instruments. Future studies should investigate calculus evaluation utilizing a variety of ultrasonic insert designs, varying amounts of calculus, and levels of clinical experience.

A Comparison of Attrition Rates in Dental Hygiene Programs Using Selective and Nonselective Admissions.

Purpose: The purpose of this study was to determine if there is a difference between attrition rates for dental hygiene programs that use selective admissions and nonselective admissions. Admissions to dental hygiene programs is based on a predetermined class size; therefore, applicants must meet the criteria to be considered for selection. Dental hygiene programs want to retain their enrolled students and maximize their student successes; therefore, it is imperative to validate current admissions practices that help reduce attrition rates.Methods: An online survey consisting of forced choice and open-ended questions was sent to the directors of accredited dental hygiene programs in the United States. Surveys were analyzed using descriptive statistics and frequency distributions. Open-ended questions were analyzed using the constant comparative method to identify recurring themes.Results: Ninety-nine surveys were returned for a 30% response rate. There was no statistical difference in attrition rates when selective or nonselective admissions criteria was used in dental hygiene programs (year 2011 p=.435 and year 2012 p=.784). Results of this study also showed baccalaureate degree dental hygiene programs have significantly higher completion rates than associate degree dental hygiene programs (2011 p=.002 and 2012 p=.005).Conclusion: Evidence from this study suggests there is no difference between attrition rates for dental hygiene programs that use selective admissions versus nonselective admissions. Additionally, this study determined that baccalaureate degree dental hygiene programs have less attrition compared to associate degree dental hygiene programs.

Efficacy of an automated flossing device in different regions of the mouth.

BACKGROUND: Manual floss is often difficult to use, particularly in hard to reach posterior teeth. Many prefer automated flossers because of their ease of use. The aim of the present study was to compare the effectiveness of an automated flosser to manual floss for anterior, premolar, and molar teeth using the plaque index (PI) and gingival (GI) index. METHODS: A 10-week, two-treatment period, crossover design was used. The subjects were randomly assigned to control (C), manual (M), or automated (A) groups. The PI and GI were measured interdentally at baseline and days 15 and 30. Treatment subjects were assigned to the opposite group at the second baseline visit after a 2-week washout period. Subjects brushed twice a day. Treatment subjects used their respective floss once per day. Subjects refrained from oral hygiene 24 hours before study visits. The PI was measured pre- and postintervention on days 15 and 30. Mixed-effect analysis of covariance crossover models were used to test group effects at days 15 and 30 from both periods with the corresponding mean preintervention and baseline score as covariates for PI and GI, respectively. Within-subject treatment comparisons were made, and carryover effects were evaluated. RESULTS: The majority of subjects (N = 102) were students (mean age, 23.3 +/- 5.0 [SD] years) with minimal gingivitis at baseline. At days 15 and 30, the M group had more plaque than the A group for all regions (P < or = 0.008), and the C group had more plaque than the A (P <0.001) and M groups (P < or = 0.021) for all regions. No regional treatment effect was observed for the GI. Within-subject analyses were more favorable for the A group than the M group. No significant carryover effect was observed. CONCLUSIONS: The automated flossing device removed significantly more interproximal plaque in molar, premolar, and anterior teeth compared to manual floss at days 15 and 30. There was no significant difference in interdental inflammation between groups.

Evaluation of the safety and efficacy of an automated flossing device: a randomized controlled trial.

OBJECTIVE: To evaluate the safety and efficacy of a newly developed automated flossing device (AF). METHODOLOGY: Subjects were recruited from a university campus via announcements, and were randomly assigned to a control (C), manual (M), or automated (A) group. Subjects brushed twice a day and treatment groups used their respective floss daily. The safety assessment (SA), plaque index (PI), and gingival index (GI) were measured at days one, 15, and 30. A pre- and post-intervention PI was measured at days 15 and 30. RESULTS: The majority of subjects (n=76) were students, mean age +/- SD of 23.3 +/- 5.2 years. Based on one-way analysis of covariance, C had a higher mean PI score than A at days 15 (p = 0.019) and 30 (p < 0.001), and M had a higher mean PI score than A at day 30 (p = 0.022). The C had a higher mean GI score than A at day 30 (p = 0.034). The SA included trauma associated with improper use of the AF for two subjects. CONCLUSION: At four weeks, the AF removed more interproximal plaque than M, and there was less interdental inflammation compared to brushing alone. The AF is safe and effective when used properly, and demonstrates great promise as an alternative to manual floss.

Predicting academic and National Board Dental Hygiene Examination performance based on Academic Factors.

PURPOSE: Numerous studies have explored reliable variables that predict student success in dental hygiene programs and on the National Board Dental Hygiene Examination (NBDHE). However, no studies were found using data collected since the NBDHE format changed in 1998 to investigate if traditional predictors hold true. The objective of this study was to examine the relationship between pre-admission requirements, basic college science requirements, site of academic preparation, cumulative dental hygiene grade point average (CDHYGPA) and the NBDHE score. METHODS: Data from the academic records of 173 graduates of the dental hygiene program at The Ohio State University from 1998 through 2002 were entered into an Excel spreadsheet using identification numbers. Demographic information for the description of the subjects, course transfer data, course grades in program prerequisites and basic science requirements, CDHYGPA, and NBDHE scores were entered. Data were analyzed using the Statistical Package for the Social sciences (SPSS-version 10), Pearson's r correlations, regression analysis, and ANOVA with a predetermined level of significance at .05. RESULTS: Of the 173 records entered, 132 had complete data (76.3%). Results indicate the existing prerequisites for the dental hygiene program remain strong predictors for success. A strong correlation was noted between human nutrition courses and the CDHYGPA. Other core science courses completed while in the program-anatomy, physiology and microbiology--also rendered a moderately strong correlation to the CDHYGPA. The greatest predictors for success on the NBDHE were the student's CDHYGPA and the prerequisite three science GPA. Consistency in site of science preparation also revealed a positive correlation to the CDHYGPA. CONCLUSIONS: This study confirmed the continued use of the three science GPA pre-requisite and entering GPA for predicting success in this dental hygiene program and on the NBDHE even after the format changed to include case-based items. Other predictors for success that were identified in the study may aide dental hygiene program admission committees in their selection process. These committees may also consider the site of science preparation noting that institution consistency played a role in academic performance.

Preference and compliance of waterless hand-hygiene products versus soap and water.

PURPOSE: To compare handwashing using traditional antimicrobial soap and water with two antimicrobial waterless hand-hygiene products for personal preference and compliance. METHODS: Fifty dental and dental hygiene students were randomly chosen to participate in the study. All subjects were anonymously observed prior to the introduction of the waterless products for handwashing compliance using soap and water for 1 week. All subjects were then instructed on the use of a waterless gel and foam for handwashing. Both waterless products were used for a period of 1 week and students again were anonymously observed. A questionnaire was distributed at the conclusion of the study to determine product preference. RESULTS: During handwashing with soap and water, the average time the soap was in contact with the hands was 7.0 seconds. The average contact time with the gel and foam was 15.3 seconds and 20.0 seconds, respectfully. Questionnaire results indicated that the foam was significantly preferred over the gel and soap and water (54%, 28% and 16%, respectively). The foam was also significantly preferred when evaluating fragrance (52%), kindness to the skin (66%), convenience (64%) and fastest drying time (54%). Results from this study indicate that the waterless foam product was significantly preferred over the waterless gel and traditional soap and water for handwashing procedures. Since handwashing guidelines, regardless of which product used, recommend a minimum of 15 seconds to minimize the number of transient microorganisms on the hands, compliance was found only with the foam and the gel.

The effect of air polishing on contemporary esthetic restorative materials.

Air polishing devices are designed primarily to remove soft deposits and stains from tooth surfaces. While improved strength and durability of esthetic restorative materials have resulted in increased usage, the effect of air polishing on these improved materials has not been determined. The purpose of this study was to examine the effect of air polishing on contemporary esthetic restorative materials. Four materials were tested: ceramic, hybrid composite resin, microfilled composite resin, and glass ionomer cement. Ceramics and hybrid composites exhibited the least change in surface roughness, followed by microfilled composites. Glass ionomers showed the greatest change in surface roughness. Results from this study suggest the surface roughness of all of the materials tested increased after exposure to air polishing instrumentation. Practitioners utilizing air polishing devices for prophylaxis procedures should exercise caution in the area of esthetic restorations.

A comparison of perceived injection pain with and without anesthetic between elderly and young female subjects.

Several reports have indicated that the perception toward pain declines with age. However, since pain thresholds have been reported to be lower in females than in males, studies to detect pain perception may be more sensitive in females. In dental care, the injection of local anesthetics with a needle is used to abrogate subsequent pain from treatment. However, the anomaly of using one potentially painful procedure to prevent subsequent pain often hinders patients from seeking dental care. The purpose of this study was to evaluate the perception of pain from needle-sticks with and without anesthetic between young and elderly female subjects. We compared the perception of pain stimulated by needle-sticks without (NS) and with (NS-I) 0.3 mL of local anesthetic injected into the oral mucosal tissues of a group of 20 young females (aged 19-24 yrs) and a group of 18 elderly females (aged 70-75 yrs). A Verbal Pain Scale (VPS; descriptors assigned, 0-4) and a Visual Analogue Scale (VAS; 0-10 cm) were used to measure pain intensity. Statistical analyses by ANOVA and Fisher's Exact Test were used where appropriate. The VPS and VAS scores for perception of pain in elderly females were lower than the scores from the younger subjects. No differences between Ns and Ns-I in either age group were found. Study limitations included potential periodic hormonal imbalances in both groups of females as well as untested diminished cognitive function in elderly subjects. However, we conclude, with the noted cautions, that pain perception between the two groups was not significantly different.