Inter-rater reliability of the Mallampati classification for patients in a dental hygiene clinic.

PURPOSE: The purpose of this study was to assess the inter-rater reliability between dental hygiene students and a supervising dentist using the Mallampati classification to evaluate and classify the pharyngeal soft tissues. METHODS: A sample of 234 patients volunteered for the study. Mallampati classifications were performed by 21 dental hygiene students for patients during a 12 month period. During that same time period, the clinic dentist performed an independent assessment on the same patients. Quantitative research methods were used to evaluate the inter-rater reliability between dental hygiene students and the clinical dentist in performing the Mallampati classification. The data was analyzed using adjusted McNemar test for non-independent data, Kappa score and percentage of agreement with 95% bootstrap confidence interval. RESULTS: There was an agreement between the dental hygiene student and the dentist in the majority of the independent assessments with a p-value=0.498 from the adjusted McNemar test. Inter-rater agreement measured by Cohen's Kappa coefficient was 0.54 with a 95% bootstrap confidence interval of 0.42, 0.64. The percentage agreement was around 77% with a 95% confidence interval of 72%, 82%. CONCLUSION: It was concluded that dental hygiene students can evaluate and classify the pharyngeal soft tissues comparable to a supervising dentist in the clinical dental hygiene setting.

The attitudes of Ohio dentists and dental hygienists regarding the use of automated external defibrillators in the dental setting--a follow-up study.

PURPOSE: In 2004, the attitudes toward and use of automated external defibrillators (AEDs) by Ohio dental professionals were examined. While willing to use an AED, most did not have access to one. With new AED-related legislation and increased awareness of the benefits of AEDs since the initial study in 2004, the purpose of this study was to document the prevalence of and attitudes toward AED usage in the dental setting 7 years following the initial study. METHODS: A 2 page survey instrument was mailed to a random sample of 1,629 dentists and 1,801 dental hygienists in Ohio. RESULTS: A 24% overall response rate was achieved (36% dentists and 64% hygienists). Data were analyzed using SPSS. Results indicate 16% of respondents experienced a cardiac emergency in their practice that required contacting emergency personnel. AEDs are available in 48% of dental practices. Comparing the 2004 and 2011 data, statistically significant differences were found between the responses of dentists and dental hygienists. CONCLUSION: While hygienists reported more positive attitudes toward AEDs than dentists, the majority of all respondents feel AEDs should be mandated in the dental setting. These findings suggest an increase in cardiac emergencies in Ohio dental settings, an increase in the prevalence of AEDs in Ohio dental settings and that the perceptions of dental professionals are changing in favor of the use of AEDs in the dental setting since the 2004 study.

Attitudes of Ohio dentists and dental hygienists on the use of automated external defibrillators.

The American Heart Association reports that approximately 220,000 people die each year of sudden cardiac arrest. In ventricular fibrillation (VF), the most common abnormal heart rhythm that causes cardiac arrest, the heart's electrical impulses suddenly become chaotic, often without warning. Death will follow within minutes if the victim is not treated appropriately, and the only known treatment is defibrillation. An automated external defibrillator (AED) can restore a victim's normal heart rhythm by providing defibrillation. The purpose of this study was to gather data from dentists and dental hygienists in Ohio on their use of and attitudes toward using AEDs in dental offices. Six percent of Ohio dentists and dental hygienists were randomly selected to receive a twenty-three question survey related to their use of and attitudes toward their use of AEDs in dental offices. Thirty-three percent (244) of the surveys were returned; 41 percent of the respondents were dentists, and 59 percent were dental hygienists. Six percent said they have had to administer nitroglycerin to a patient during a dental visit; 5 percent have performed CPR on a patient in the dental office; and 78 percent said their last CPR training course included training on an AED. Eleven percent said there was an AED at their dental office. With the increased likelihood of dealing with a cardiac emergency in the dental office setting and the willingness of dental professionals to use an AED, all dental offices should consider obtaining an AED. Dental educators should become familiar with current protocols for handling cardiac medical emergencies in the dental office and prepare dental and dental hygiene students with the skills necessary to manage patients with cardiac emergencies. Graduating dental students entering private practice may want to consider the AED as part of their medical emergency office protocol.