Development and evaluation of simulation-based scenario education program for professional oral hygiene care in intubated patient.

PURPOSE: This study was conducted to develop a professional oral hygiene care (POHC) simulation education program for intubated patients and to evaluate the suitability of education by evaluating the performance confidence (PC), critical thinking disposition (CT), and learning satisfaction (LS) of dental hygiene students. METHODS: This study developed a POHC simulation education program (theory, skill training, scenario education, and debriefing) for intubated patients through expert validation and consisted of a single-group pre- and postexperiment design. The subjects were 3rd and 4th year students at the Department of Dental Hygiene in Wonju City, and a total of 30 people were enrolled. The collected data were analyzed using the PASW Statistics version 23.0. The content validity test was measured by the CVI (Content validity index) value, and the PC, CT, and LS of the subjects before and after participating in the program were analyzed using a paired t-test. The significance level (α) was based on .05. RESULTS: After the program, the PC improved from 4.29 ± 0.43 to 4.54 ± 0.44, and there was a significant difference (p = .004). CT improved from 3.73 ± 0.36 to 3.84 ± 0.36, but there was no significant difference (p = .062), and prudence improved from 4.21 ± 0.33 to 4.43 ± 0.27, and there was significant difference. (p = .001). LS increased from 4.66 ± 0.36 to 4.90 ± 0.16 after education, and there was a significant difference (p = .002). CONCLUSION(S): Simulation education program improved dental hygiene students' POHC performance confidence. Various scenarios will need to be developed in the future, and it is necessary to evaluate simulation education within the dental hygiene curriculum and identify areas for improvement.

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 Korean adult inpatients' oral care behaviour in daily life and hospitals.

OBJECTIVES: The objectives of the study were to identify the differences in oral care methods between current and past hospitalizations and to investigate the need for inpatient oral care education for South Korean adults who have been hospitalized for more than 24 h. METHODS: This study employed a cross-sectional design. Between 23 December 2019 and 4 May 2020, a questionnaire was administered to 200 adult inpatients awaiting treatment and their guardians at university hospitals or clinics. Of these, the data of 195 patients were analysed. Frequency analysis, descriptive statistics and chi-square tests were used for data analysis. RESULTS: In daily life, the participants reported brushing their teeth thrice a day (52.3%) for 2 min (60%). A single product was the most used (51.3%). During hospitalization, 40% of the participants brushed their teeth thrice or more a day, 84.1% brushed for <1 min, and 83.6% did not use additional oral care products. CONCLUSIONS: Differences were observed between South Korean adults' oral care behaviours in daily life and those performed in hospitals. Oral hygiene habits, the frequency and duration of tooth brushing, and the use of oral care products decreased during hospitalization. Our findings can be applied to the development of oral care interventions for inpatients, while considering changes in the hospitalization environment and physical activity levels during hospitalization.

Cases of dental clinic visits by COVID-19-confirmed patients.

OBJECTIVES: This study aims to review cases of dental visits by patients who had confirmed COVID-19 infection in Seoul and Gyeonggi-do. It analyses the patterns of infection transmission among dental healthcare professionals and dental clinic visitors. METHODS: This study obtained data from reports on disease trends and press releases published by the Korea Centers for Disease Control and Prevention (KCDC) on its COVID-19 website. RESULTS: After examining cases of patients with a confirmed COVID-19 infection, 24 people (10 in Seoul and 14 in Gyeonggi-do) visited the dental office 1-13 days prior to their case confirmation; however, the spread of the virus in the dental office was not confirmed. CONCLUSION: The WHO and KCDC guidelines must be followed to curb transmission of the SARS-CoV-2 virus among dental patients and professionals.

Learning outcomes of a mobile application for dental infection control education.

PURPOSE/OBJECTIVES: This study aimed to apply and verify the effectiveness of a mobile-based dental infection control education application to enable students majoring in dental hygiene to learning dental infection control education without time and space constraints. METHODS: This study used a nonequivalent control group pretest-posttest design to examine differences in learning outcomes between an experimental group that learned through the mobile application and a control group that learned with handouts. The Infection Prevention and Control Mobile Application (IPC App) and handouts were developed by referring to the Center for Disease Control's (CDC) guidelines for Infection Prevention and Control in Dental Settings. Both the experimental and control groups were guided to perform self-regulated learning, where they independently led and managed their learning for two weeks. The study was conducted at the D university college with 42 students from the second grade in the Department of Dental Hygiene from August to October 2021. Differences in knowledge, self-efficacy, and summative evaluation were analyzed using an independent sample t-test and repeated measures analysis of variance (p < 0.05). RESULTS: The findings confirmed that the experimental group who learned through the IPC mobile application had improved their knowledge and indicated a higher summative evaluation than the control group that learned via learning documents (p < 0.05). CONCLUSIONS: Owing to the high accessibility and repeatability of the learning content, the mobile application recommended in this study may serve as an effective self-directed learning tool for students to gain knowledge on the standard precautions for dental infection control.

Oral health impact of sugar-sweetened beverage consumption among Korean adolescents.

OBJECTIVES: This study aimed to investigate the association between the frequency of SSB consumption and the prevalence of oral symptoms in adolescents. METHODS: We analysed the data collected from the 2017 (13th) Korea Youth Risk Behaviour Web-based Survey (KYRBWS). KYRBS collected beverage consumption data from 64,991 Korean adolescents. Self-reported oral symptoms including sensitivity to food, sharp aches and pains in the teeth, and painful or bleeding gums were also collected. Multivariable logistic regression modelling was used to test the association between the frequency of SSB consumption and oral symptoms groups. RESULTS: It was found that Korean adolescents who consumed SSB at least once a week (94.4%) experienced more subjective oral symptoms (46.5%) even after controlling for confounding variables. In addition, as the frequency of SSB intake in adolescents increased, the subjective oral symptoms increased. CONCLUSIONS: The results of this study clearly revealed that the SSB consumption impacted adolescents' subjective oral symptoms. Compared with those who did not consume SSBs, those who consumed SSBs showed increased for developing subjective oral symptoms.

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.

Measuring workplace violence for clinical dental hygienists.

OBJECTIVE: This study aimed to develop and assess a tool for measuring violence experienced by clinical dental hygienists in the workplace. METHODS: The basic questionnaire used in this study was created by referring to previous studies, the Negative Acts Questionnaire-Revised (NAQ-R) and the Workplace Bullying in Nursing-Type Inventory (WPBN-TI). The content feasibility was verified by ten experts in the field, and irrelevant questions were deleted, based on a content validity index value of 0.8. This study surveyed 205 clinical dental hygienists to test the tool's validity and reliability. Frequency analysis was conducted on items related to general characteristics and workplace violence. RESULTS: The questionnaire set was 31 questions, which, comprised five domains, were finalized through reliability verification. These domains were verbal attacks and alienation (9 questions), inappropriate work experiences (6 questions), physical threats (4 questions), workplace sexual harassment (6 questions) and verbal violence (6 questions) from patients and their family members. Among the study participants, 47.3% said they received rude signals from others, 17.9% said they were subjected to sexual evaluations regarding their appearance, and 29.4% said their abilities were ignored by patients and family members of patients. CONCLUSIONS: Clinical dental hygienists have been exposed to various types of violence in their workplaces, such as sexual and verbal harassment, by patients and their family members. This tool can be used in the dental setting to conduct surveys on workplace violence and establish a monitoring and support system.

Research on dental plaque removal methods for efficient oral prophylaxis: With a focus on air polishing and rubber cup polishing.

OBJECTIVES: This study was conducted to compare the plaque control effectiveness of rubber cup polishing with that of air polishing during oral prophylaxis procedures and to investigate the effect of the order of air-polishing application on the efficiency of oral prophylaxis. METHODS: The study included adult patients (≥20 years of age) who had visited the dental clinic for oral prophylaxis. A total of 173 subjects were divided into three groups (scaling followed by rubber cup polishing, SR; scaling followed by air polishing, SA; and air polishing followed by scaling, AS) based on sex, age, oral health status, oral hygiene status, and indications and contraindications according to the oral prophylaxis method. The analysis of variance (ANOVA) was used to determine the difference in oral prophylaxis time, residual deposits rate, subjects and dental hygienist satisfaction. RESULTS: The total scaling time was shorter in the AS group (15.4 ± 6.9 minutes) than in the SA (18.7 ± 5.5 minutes) and SR groups (19.9 ± 6.2 minutes) (p < 0.05). The rate of residual deposits was significantly higher in the SR group than in the AS or SA groups (p < 0.05). The satisfaction level of dental hygienists was higher in the AS group (8.8 ± 1.0 points) and the SA group (8.4 ± 1.0 points) than in the SR group (6.2 ± 1.3 points). CONCLUSION: During oral prophylaxis, dental plaque removal using air polishing requires a relatively longer time when compared to rubber cup polishing, but it can better eliminate dental plaque. In addition, we found that dental plaque removal using air polishing prior to scaling reduced the total scaling time.

Efficacy of mobile health care in patients undergoing fixed orthodontic treatment: A systematic review.

OBJECTIVES: We performed a systematic review of studies that assessed the efficacy of mobile health care in patients undergoing fixed orthodontic treatment, in an attempt to obtain contemporary evidence on the clinical impact of mobile health care on the patients' oral health and orthodontic treatment outcomes. METHODS: A systematic literature search was conducted using the PRISMA guidelines. We performed a comprehensive search using multiple databases (Cochrane Library, MEDLINE, EMBASE, Scopus, Google Scholar and Web of Science) with no restrictions on the language of publication or publication status up until 23 April 2019 to identify eligible studies. RESULTS: We included 11 unique studies. In this review, 9 of the 11 selected studies showed positive effects of mobile healthcare intervention, which resulted in reduced scores of oral hygiene and periodontal indices and white-spot lesions, as well as decreased duration of treatment, sagittal distance and intensity of self-reported pain. CONCLUSIONS: Mobile health care can be utilized as an adjuvant intervention to improve treatment outcomes in patients undergoing fixed orthodontic treatment. Oral healthcare experts should consider novel interventions using mobile devices in addition to the conventional mode of intervention.

Inter-rater agreement among multiple examiners for the assessment of plaque scores between quantitative light-induced fluorescence-digital and two-tone disclosing solution-stained digital images.

BACKGROUND: To utilize plaque scoring indices as objective measures, a certain standard of intra-rater and inter-rater agreement must be met. Achievement of high consistency among several examiners in the assessment of images from Q-ray cam (for quantitative light-induced fluorescence-digital imaging) and digital single-lens reflex camera of stained tooth surfaces might enable more efficient undertaking of large epidemiological studies and oral tests. METHODS: Second-year dental hygiene students and registered dental hygienists 40 examiners were randomly selected, all of whom provided informed consent. Multiple examiners assessed plaque scoring indices from the two types of images of the same 30 patients. The images were observed on a computer monitor, and the area with dental plaque was assessed using the Patient Hygiene Performance Index. The intra-class correlation coefficient was determined to evaluate the agreement among examiners and test methods for dental plaque Q-ray cam and digital single-lens reflex camera measurements were compared using a Bland-Altman plot. The intra-class correlation coefficient was analyzed using SPSS version 24 software (SPSS Inc., Chicago, IL, USA), and the exploratory graph was analyzed with MedCalc. RESULTS: Agreement among 40 examiners was excellent with an intra-class correlation coefficient of 0.990 when the Q-ray cam was used. The intra-class correlation coefficient for the registered dental hygienists group was 0.987 and that for the dental hygiene students group was 0.980. CONCLUSIONS: The study was high agreement in the assessment of Q-ray cam images and digital single-lens reflex camera images of stained dental plaque by multiple examiners, confirming that the two methods are validated both independently and with high mutual agreement.

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.

Sugar-sweetened beverage consumption frequency in Korean adolescents: based on the 2015 Youth Risk Behavior Web-Based Survey.

INTRODUCTION: The purpose of the present study was to investigate current sugar-sweetened beverage consumption habits in Korean adolescents in conjunction with their demo-socioeconomic characteristics, and to identify variables that affect such behaviours. MATERIALS AND METHODS: The study was conducted via secondary analysis of data from the 2015 Youth Risk Behavior Web-Based Survey (the 11th survey). The dependent variable in the current study was the combined consumption frequency of three types of sugar-sweetened beverages (carbonated beverages, highly-caffeinated beverages, sugary beverages), and demographic (gender, academic grade, residence), sociological (father's education level, mother's education level, having experienced depression within the last 12 months) and economic (subjective economic status, weekly allowance) factors constituted the independent variables. RESULTS: Our results showed that the amount of weekly allowance had the greatest impact on adolescents' beverage consumption of more than seven times a week. Increases in experiencing a depressed mood and allowance were associated with an increased tendency to consume ≥ 7 sugar-sweetened beverages per week. CONCLUSION: The results of the current study suggest that families and society should work collectively to motivate adolescents to consciously choose and buy healthy snacks. Furthermore, society should reach a consensus and invest effort to resolve this issue continuously and gradually, such as by presenting a standard for consumption of sugar-added drinks and implementing regulations to ban sales to adolescents.

A pilot study of occupational exposure to pathogenic microorganisms through lip cosmetics among dental hygienists.

OBJECTIVES: In dental clinics, dental hygienists are exposed to aerosolized pathologic bacteria, which can be transmitted to the oral cavity via lip cosmetics. Accordingly, such contamination poses a consistent health risk among staffs. Our study examined the bacterial contamination of lip cosmetics used by dental hygienists while in a clinic setting. METHODS: Sixteen dental hygienists were surveyed regarding their job assignments and habits associated with lip cosmetic. Subsequently, microorganisms were analyzed in collected samples of the hygienists' lip cosmetics using colony-forming unit (CFU) assays, 16s-rDNA polymerase chain reaction, and DNA sequencing. RESULTS: Notably, 81.3% of the submitted lip cosmetic samples were contaminated, with bacterial CFUs ranging from undetectable to innumerable. Many samples (43.8%) exceeded the microbial limits of cosmetic contamination. Of the lip cosmetic used for more than 6 months, 60% exceeded the microbial limit. When wearing a mask every time, only one of the six samples exceeded the microbial limit. More frequent dental mask changing was associated with a lower likelihood that the cosmetic sample would exceed the microbial limit. No samples from hygienists who changed their masks four times a day exceeded the microbial limit, compared to 33.3% from hygienists who only changed the mask when it became wet. Most isolated bacteria were gram-positive, facultative anaerobic, asporogenic, and opportunistically pathogenic, and the most prevalent species were Staphylococcus aureus, Streptococcus salivarius, and Staphylococcus epidermidis. CONCLUSION: Our findings indicate that dental staff, including dental hygienists, should exercise more careful workplace habits, particularly with regard to infection control and cosmetic use.

Differences in plantar pressure by REBA scores in dental hygienists.

OBJECTIVES: The purpose of the present study was to analyse the effects of working posture, physical balance and work accumulation on shifts in plantar pressure in dental hygienists, by measuring REBA, which evaluates working posture, and plantar pressure, which evaluates physical balance. METHODS: This study was conducted on 24 dental hygienists currently working in dental clinics. The ergonomic assessment method of the Rapid Entire Body Assessment was used to evaluate working posture in the dental hygienists, and a Gait Analyzer was used to measure plantar pressure. RESULTS: The subjects' mean REBA score was 4.96 ± 1.04 points, and 87.5% of the subjects showed poor working posture, with a REBA score of at least four points. Among subjects with a REBA score of four points or more, seven of the eight parts of the sole of the foot showed significant differences in plantar pressure between the right and left feet (P < 0.05). When we examined changes in plantar pressure over a week, pressure increased on the left side, and in particular, for subjects with a REBA score of four points or higher, pressure increased in the left foot and in the anterior right foot. CONCLUSIONS: Most of the dental hygienists in this study showed poor posture during working. Subjects with poor posture at a level requiring intervention showed differences in plantar pressure between the right and left feet. Inappropriate posture can cause musculoskeletal disorders. Therefore, it will be necessary to prepare internal and external measures to maintain proper working posture in dental hygienists, including education, exercise, improvement of the working environment and improvement of ergonomic equipment and devices.

Approach of industrial physical therapy to assessment of the musculoskeletal system and ergonomic risk factors of the dental hygienist.

This study aimed to provide fundamental data to be utilized in preventing and treating musculoskeletal disorders and analyzing working postures commonly used during periodontal treatment. [Subjects] The subjects were three dental hygienists with work experience in dental clinics for more than 10 years. [Methods] For the analysis of working postures, we simulated the work posture of dental hygienists during the scaling procedures and oral radiographic imaging tasks. The subjects were recorded on video to precisely observe them while they were working. The captured working postures were assessed and analyzed using ergonomic assessment methods, the Rapid Entire Body Assessment, Rapid Upper Limb Assessment, and Strain index. [Results] No differences were exhibited in the intensities of manual scaling and ultrasonic scaling. Commonly, the shoulders and waist were found to be the most overburdened. According to the strain index, manual scaling and ultrasonic scaling working postures were identified to be most dangerous. [Conclusion] The work postures of dental hygienists during scaling are postures that are highly likely to generate work-related musculoskeletal disorders. Therefore, the development of therapeutic exercise programs easily performable in the workplace and daily life is thought to be crucial to prevent work-related musculoskeletal disorders.

Validation of a Korean version of the Child Oral Health Impact Profile (COHIP) among 8- to 15-year-old school children.

OBJECTIVES: The purpose of this study was to assess reliability, discriminant validity, and convergent validity of the Oral Health Impact Profile (COHIP) Korean version in a representative community sample of 8- to 15-year-old Korean children. METHODS: A Korean version of COHIP was developed according to the standard procedure of cross-cultural adaptation of self-reported instruments. A representative community sample of 2236 schoolchildren was selected by cluster sampling method. RESULTS: Mean age of the participants was 11.8 years. Mean and median of the overall COHIP score were 103.3 (SD 13.3) and 106, respectively. Internal reliability and retest reliability were excellent with Chronbach's alpha 0.88 and intraclass correlation coefficient 0.88. Face validity was confirmed with 98% of participants reporting the COHIP questionnaire was easy to answer. Nonclinical factors such as self-rated oral health or satisfaction with oral health were significantly related with overall COHIP score and five subscale scores (P < 0.001) in a consistent manner. Children with carious permanent teeth and with orthodontic treatment need had highly significantly lower overall COHIP score (P < 0.01). CONCLUSION: The Korean version of the COHIP was successfully developed. The internal reliability, retest reliability, face validity, discriminant validity, and convergent validity of the COHIP Korean version were confirmed.

Fluoride ingestion is related to fluid consumption patterns.

OBJECTIVES: There have been few reports regarding variations of fluoride intake by fluid consumption patterns. The purpose of this study was to estimate fluoride intake among children in the United States based on their fluid consumption patterns. METHODS: Fluid intakes of children aged 1-10 years from plain water, beverages, and water from foods were assessed in a 24-hour recall diet survey as a part of the third National Health and Nutritional Examination Survey (NHANES III, 1988-1994). The amount of fluoride ingested from fluids in NHANES III was estimated from several assumptions about the concentration of fluoride in drinking water and beverages. Logistic regression analysis was conducted using SAS and SUDAAN. RESULTS: Children at the 75th percentile or higher of F intake from fluids (not including water used in cooking) ingested 0.05 mg F/kg/day or more, and children at the 90th percentile or higher ingested 0.07 mg F/kg/day or more. This finding held across all age groups. There was substantial variation in the estimated amount of fluoride ingestion depending on the children's fluid consumption patterns as well as age, gender, and race/ethnicity. African-American children ingested significantly more fluoride than White children in bivariate analysis. This association remained significant after accounting for fluid consumption pattern and other confounding factors in the model. CONCLUSION: Our results raise concerns that some children are ingesting significantly more fluoride than others depending on sociodemographic factors and fluid consumption patterns. Additional research is warranted to investigate the variation in the amounts of fluoride ingestion by these factors and its impact on fluorosis prevalence in different population groups.