Occupational hazards among dental hygienists: Risk level assessment of scaling work.

OBJECTIVES: This study aimed to classify occupational hazards of ultrasonic scaling by factor and to identify the distribution of occupational risk levels of the study participants according to occupational hazards. In addition, the relationship between the general characteristics of dental hygienists and the occupational risk level of scaling was investigated. METHODS: This study was conducted on 237 dental hygienists. Exposure frequency and the degree of work loss were investigated on a five-point scale for each of the 15 occupational hazards of scaling. RESULTS: Among occupational hazards, the proportion of high-risk individuals for biological hazards (32.9%) was the highest. Dental clinics (33.6%) were found to have a higher proportion of high-risk individuals than dental hospitals (16.5%) (p < 0.05). The proportion of high-risk individuals was higher in the absence of an infection control coordinator (33.9%) (p < 0.05) and infection control education in the preceding 2 years (28.6%) (p < 0.05). CONCLUSION: To create a safe dental work environment, appropriate measures according to the risk level and measurement of occupational risk should be discussed.

Differences in Determinants Influencing Self-Rated Oral Health in Korean and American Adults.

This study aims to identify the differences in the determinants that influence self-rated oral health (SROH) among Korean and American adults aged 20 years or older and the differences in objective oral health status between Korea and the United States. It included 13,068 Koreans and 5569 Americans who participated in the seventh Korea National Health and Nutrition Examination Survey and the 2017-2018 National Health and Nutrition Examination Survey. All analyses were conducted using the SPSS 25 program. The 39% of Koreans and 27.7% of Americans rated their oral health as "poor". The mean SROH score was lower in Korea (2.66) than in the US (3.15). Conversely, objective oral health was better among Koreans. Further, an analysis of the differences in the predictors of SROH between the two countries confirmed that there were significant differences in age, household income, education level, insurance type (none), type of smoking, self-rated health, and decayed teeth index. Government-led projects or policy-based changes that can improve objective oral health status are needed to boost SROH in Korea, and subsequent studies should examine other objective oral health indices (e.g., periodontal disease) as well as differences in sociocultural backgrounds between countries.

Development of a competency for professional oral hygiene care of endotracheally-intubated patients in the intensive care unit: development and validity evidence.

BACKGROUND: Professional oral care in the intensive care unit may reduce the incidence of Ventilator Associated Pneumonia, which increases the patient's mortality rate. This study aimed to develop a competency for professional oral hygiene care of endotracheally-intubated intensive-care patients. METHODS: First, we developed a competency draft by reviewing the literature on oral hygiene care of patients in the intensive care unit. Next, we developed expert validity test questionnaires using this draft and conducted expert validity tests twice on 18 experts. We determined competency as a content validity index of 0.8 or more and received expert additive opinions about competency through an open-questionnaire expert validity test paper in this methodology study. RESULTS: The content validity index ranged from 0.8 ~ 1.0 for all items. The competency of 'professionalism' comprised 2 sub-competencies with 7 behavioral indicators. 'POHC preparation' comprised 3 sub-competencies with 10 behavioral indicators. 'POHC implementation' comprised 3 sub-competencies with 6 behavioral indicators. 'POHC evaluation' comprised 2 sub-competencies with 8 behavioral indicators. Lastly 'Cooperation among experts' comprised 3 sub-competencies with 7 behavioral indicatiors. CONCLUSIONS: To provide patients with high quality oral hygiene care, these competencies should be implemented, and oral hygiene care professionals and related medical personnel should form a cooperative system.

Oral health care provided by nurses for hospitalized patients in Korea.

OBJECTIVES: To investigate registered nurses' awareness and implementation of oral health care in patients who are hospitalized in general wards or intensive care units (ICUs) in South Korea. METHODS: This research was performed as a descriptive survey of 149 nurses working in nine general hospitals with at least 100 beds in major Korean cities. RESULTS: Approximately half (40.9%) of the survey respondents reported providing oral health care for hospitalized patients but that relevant protocols were not available at most hospitals or wards (89.5%). Nurses working in an ICU were significantly more likely to provide oral health care than those working in general wards (83.9% vs 15.1%; P < .001). Most respondents (83.2%) were aware of the importance of providing oral health care for hospitalized patients; however, the proportion considering that such care should be provided by dental hygienists was greater than that considering it should be provided by nurses (36.4% vs 26.0%; P < .001). Agreement that oral health care should be provided for hospitalized patients by dental hygienists was highest in nurses working in ICUs (53.3%; P < .001). CONCLUSIONS: According to this survey, oral healthcare provision is generally low in hospitalized patients and differs between ICUs and general wards. Most respondents considered that dental hygienists should provide oral health care for hospitalized patients. There is an opportunity for nurses and dental hygienists to work collaboratively towards development of an evidence-based protocol for oral health care in hospitalized patients.

Relationships between dental hygienists' work environment and patient safety culture.

BACKGROUND: Patient safety culture is a core factor in increasing patient safety, is related to the quality of medical service, and can lower the risk of patient safety accidents. However, in dentistry, research has previously focused mostly on reporting of patient safety accidents. Dental professionals' patient safety culture must therefore first be assessed, and related factors analyzed to improve patient safety. METHODS: This cross-sectional study completed a survey on 377 dental hygienists working in dental settings. To assess patient safety culture, we used a survey with proven validity and reliability by translating the Hospital Survey on Patient Safety Culture (HSOPS) developed by Agency for Healthcare Research and Quality (AHRQ) into Korean. Response options on all of the items were on 5-point Likert-type scales. SPSS v21 was used for statistical analysis. The relationships between workplace factors and patient safety culture were examined using t-tests and one-way analysis of variance (ANOVA) tests(p < 0.05). RESULTS: The work environment of dental hygienists has a close relationship with patient safety. Dental hygienists working ≥40 h/week in Korea had a significantly lower for patient safety grade than those working < 40 h/week. When the number of patients per day was less than 8, the safety level of patients was significantly higher. And significant differences were found depending on institution type, institution size. CONCLUSIONS: In order to establish high-quality care and patient safety system practical policies must be enacted. In particular, assurance in the quality of work environment such as sufficient staffing, appropriate work hours, and enough rest must first be realized before patient safety culture can easily be formed.

Association of Emotional Labor, Self-efficacy, and Type A Personality with Burnout in Korean Dental Hygienists.

The purpose of this study was to examine the relationship between emotional labor and burnout, and whether the levels of self-efficacy and type A personality characteristics increase the risk of burnout in a sample of Korean female dental hygienists. Participants were 807 female dental hygienists with experience in performing customer service for one year or more in dental clinics, dental hospitals, or general hospitals in Korea. Data were collected using a structured self-administered questionnaire. A hierarchical multiple linear regression analysis was used to examine the effects of emotional labor on burnout, and to elucidate the additive effects of self-efficacy and type A personality on burnout. The results showed that "overload and conflict in customer service," "emotional disharmony and hurt," and "lack of a supportive and protective system in the organization" were positively associated with burnout. With reference to the relationship between personality traits and burnout, we found that personal traits such as self-efficacy and type A personality were significantly related to burnout, which confirmed the additive effects of self-efficacy and type A personality on burnout. These results indicate that engaging in excessive and prolonged emotional work in customer service roles is more likely to increase burnout. Additionally, an insufficient organizational supportive and protective system toward the negative consequences of emotional labor was found to accelerate burnout. The present findings also revealed that personality traits such as self-efficacy and type A personality are also important in understanding the relationship between emotional labor and burnout.

Comparison of push-out bond strength of fiber-reinforced composite resin posts according to cement thickness.

STATEMENT OF PROBLEM: Post space size and cement thickness can differ because of variations in root canal morphology, such as an oval shape, and because the entire canal space cannot be included in the post space preparation. As a result, increased cement thickness around the post may affect the bond strength between the post and the dentin. PURPOSE: The purpose of this in vitro study was to evaluate the push-out bond strength of fiber-reinforced composite resin posts to root dentin with cement layers of varying thickness. MATERIAL AND METHODS: Thirty human premolars were endodontically treated and restored with fiber-reinforced composite resin posts. Post space was prepared using a drill with a 1.5-mm diameter and diameters of 1.25 mm (small [S] group), 1.375 mm (medium [M] group), and 1.5 mm (large [L] group) were cemented. The specimens were sectioned horizontally into 1-mm-thick slices, and the push-out bond strengths of the apical and coronal fragments were evaluated. Bond strength was compared using analysis of variance and 2-sample t tests (α=.05). RESULTS: No significant differences were found in the debonding force and push-out bond strength among fiber-reinforced composite posts of different sizes (P>.05). The mean debonding force and standard deviation of the posts were 25.05 ±9.52 N for the S group, 28.17 ±11.38 N for the M group, and 33.78 ±12.47 N for the L group. The corresponding push-out bond strength values were 3.11 ±1.54 MPa, 3.39 ±1.4 MPa, and 4.15 ±1.75 MPa. The differences in debonding force between the apical (26.43 ±10.72 N) and coronal (31.57 ±12.03 N) areas were not significant (P>.05). However, the differences in push-out bond strength between the apical (4.27 ±1.73 MPa) and coronal areas (2.83 ±1.08 MPa) were significant (P<.05). CONCLUSIONS: The widening of post spaces and, consequently, the increased cement thickness do not significantly affect the bond strength of fiber-reinforced composite resin posts to root dentin.

Secretory leukocyte protease inhibitor promotes differentiation and mineralization of MC3T3-E1 preosteoblasts on a titanium surface.

Mineralized bone matrix constituted with collagenous and non-collagenous proteins was synthesized by osteoblasts differentiated from mesenchymal stem cells. Secretory leukocyte protease inhibitor (SLPI), a serine protease inhibitor, promotes cell migration and proliferation, and suppresses the inflammatory response. Recent studies reported that SLPI regulates the formation of dentin and mineralization by odontoblasts and increases the adhesion and viability of preosteoblasts on a titanium (Ti) surface. Ti and its alloys are widely used implant materials in artificial joints and dental implants owing to their biocompatibility with bone. Therefore, this study aimed to examine whether SLPI can be an effective molecule in promoting differentiation and mineralization of osteoblasts on a Ti surface. In order to investigate the effects of SLPI on osteoblasts, an MTT assay, PCR, western blotting and Alizarin Red S staining were performed. The results demonstrated that SLPI increased the viability of osteoblasts during differentiation on Ti discs compared with that of the control. The expression levels of SLPI mRNA and protein were higher than that of the control after treatment of osteoblasts with SLPI on Ti discs during differentiation. SLPI increased the formation of mineralized nodules and mRNA expression of alkaline phosphatase, dentin sialophosphoprotein, dentin matrix protein 1, bone sialoprotein, and collagen I in osteoblasts on Ti discs compared with that of the control. In conclusion, SLPI increases the viability and promotes the differentiation and mineralization of osteoblasts on Ti surfaces, suggesting that SLPI is an effective molecule for achieving successful osseointegration between osteoblasts and a Ti surface.

Effect of (-)-epigallocatechin-3-gallate on maintaining the periodontal ligament cell viability of avulsed teeth: a preliminary study.

PURPOSE: Avulsed tooth can be completely recovered, if sound periodontal ligament (PDL) of tooth is maintained. Although a lot of storage solutions have been explored for the better storage of avulsed tooth, there is a shortcoming that the preservation time is much short. On the other hand, there has been studies that (-)-epigallocatechin-3-gallate (EGCG), the most abundant polyphenol in green tea, which is related to the anti inflammatory, antioxygenic, and antibacterial effects, allows the successful preservations of tissues and cells. This study evaluated the effect of EGCG on avulsed-teeth preservation of Beagle dogs for a period of time. METHODS: The atraumatically extracted teeth of Beagle dogs were washed and preserved with 0/10/100 µM of EGCG at the time of immediate, period 1 (4 days in EGCG-contained media and additional 1 day in EGCG-free media), period 2 (8 days in EGCG-contained media and additional 2 days in EGCG-free media) and period 3 (12 days in EGCG-contained media and additional 2 days in EGCG-free media). Then, the cell viabilities of preserved teeth was calculated by dividing optical density (OD) of 3-(4,5-Dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) assay with OD of eosin assay to eliminate the measurement errors caused by the different tissue volumes. RESULTS: From the results, the immediately analyzed group presented the highest cell viability, and the rate of living cells on teeth surface decreased dependent on the preservation period. However, the 100 µM of EGCG-treated group showed statistically significant positive cell activity than EGCG-free groups throughout preservation periods. CONCLUSIONS: Our findings showed that 100 µM EGCG could maintain PDL cell viability of extracted tooth. These results suggest that although EGCG could not be a perfect additive for tooth preservation, it is able to postpone the period of tooth storage. However, further in-depth studies are required for more plausible use of EGCG.

Effect of chlorophyllin on normothermic storage of human periodontal ligament cells.

The purpose of the present study was to evaluate whether chlorophyllin could serve as an effective constituent of a storage medium to enhance the human periodontal ligament (PDL) cell viability. Freshly isolated PDL cells from premolars extracted from healthy people were stored at 37 degrees C for 6 h in various solutions: F-medium and Hank's balanced salt solution (HBSS), supplemented with chlorophyllin. From MTT viability assays, the highest cell viability was found in the PDL cells stored in HBSS supplemented with 500 nM chlorophyllin, and the chlorophyllin-treated cells showed a dose-dependent response to concentration. Additionally, the results from flow cytometry showed that 77 to 80% of the PDL cells were in the G0/G1 phases of the cell cycle, which suggested that most were in a stable stage. These result showed that HBSS, supplemented with chlorophyllin, may be a useful solution for preserving the viability of PDL cells.