Education for foreign-trained dentists in the United States: currently available findings and need for further research.

Foreign-trained dentists interested in seeking employment in the United States face numerous challenges, starting with the fact that their degrees are often not valid for U.S. practice because of international differences in the style of education and clinical practice. A small number of North American dental schools have offered modified predoctoral programs for graduates of foreign dental schools since the 1970s, and currently, numerous U.S. dental schools offer such educational programs. The purpose of this literature review was to investigate what has been reported about barriers encountered by foreign-trained dentists in seeking professional opportunities in the United States, focusing especially on factors affecting the admissions process into predoctoral and residency programs, the learning process, and employment of foreign-trained dentists in the United States. This study concludes that published findings do not support the generalization that all foreign-trained dentists seeking employment in the United States have had the same barriers, and the authors conclude that there is a need for further research on this topic. Supplemental information can improve the transition of foreign-trained dentists into a culturally diverse environment. In addition, with greater availability of data, the need for the establishment of assistance programs for this population can be assessed.

Penetration of fluids into periodontal pockets using a powered toothbrush/irrigator device.

UNLABELLED: This study was a single-blind, randomized, controlled clinical trial. The researchers evaluated a powered brush/irrigating device (HydraBrush Oral Health System; OHS) for its safety and ability to deliver a solution to the bottom of 5-6 mm pockets, compared to rinsing alone with a solution following brushing with a powered toothbrush (Sonicare Elite 7800; SE). An evaluation technique to measure the quantity and quality of solution able to enter the pocket was also introduced in this project. METHODS: Subjects were randomized in one of two-groups: brush plus simultaneous irrigation (OHS) versus brush plus rinsing (SE). Subjects used their devices at home for two weeks. At the measurement visit, subjects used the OHS to irrigate and brush simultaneously for 1 minute (30 seconds per each side of the mouth) with a 0.01% erythrosine disclosing solution in 10 oz of distilled water. Control subjects brushed for 2 minutes with a SE followed by a 1 minute rinse with an identical disclosing solution. A blinded evaluator collected six samples of approximately of 1 microL of sucular fluid from six 5-6 mm evaluation sites. This was accomplished by inserting a microcapillary tip with a 20 microL micropipette in the sulcus. Two-group repeated measures ANOVA was used to examine differences in two measures of the disclosing solution between OHS and SE subjects; the spectrometer reading of the disclosing solutions, and by visual inspection of the samples (positive/negative) to determine the presence or absence of solution in the samples. Subjects' diaries were collected. Bleeding and discomfort during the evaluation period was reported. RESULTS: Visually, OHS had a significantly greater proportion of solution taken from the base of 5-6 mm sites than the SE (p=0.0001). However, there was no statistical difference between the two groups (p=.1359) in the spectrophotometer readings. CONCLUSION: The experimental device is more efficient in delivering a solution to the base of 5-6 mm pockets than rinsing following use of a control powered toothbrush. Both devices have demonstrated they are safe and well accepted by patients. The technique developed provides a useful method for quantitative and qualitative studies of solutions from the base of periodontal pockets.

Blood pressure assessment practices of dental hygienists.

An estimated 50 million Americans have high blood pressure (HBP), with 30% of them unaware of their condition. Both the American Dental Association (ADA) and the American Dental Hygienists' Association (ADHA) have advocated including recording blood pressure during the dental appointment. Recording blood pressure is also a standard procedure in patient care. This study surveyed 236 dental hygienists attending a continuing education program to document their blood pressure assessment practices. The majority (55%) of participants indicated they rarely or never record blood pressure. The primary reason cited by 51% of the participants was a lack of time in the appointment. Based on these findings, a recommendation was made for dental offices to modify their patient check-in procedures to include recording blood pressure.

Blood pressure screening practices of a group of dental hygienists: a pilot study.

PURPOSE: Recent research suggests that one in five Americans has hypertension, according to the American Heart Association. When hypertension is undiagnosed or uncontrolled, it places patients at risk for other cardiovascular diseases, contributing to an increase in mortality. Dental hygienists are in an ideal setting to screen for this silent disease. This study was designed to determine how frequently a group of practicing dental hygienists performs screenings for hypertension on their patients, and to determine the barriers that prevent this screening from occurring. METHODS: One hundred one dental hygienists were questioned with a written survey about their blood pressure screening practices and their reasons for not taking blood pressure readings, if applicable. RESULTS: Sixty-seven dental hygienists completed the survey. Survey results revealed that the majority of dental hygienists were not recording blood pressure readings, even though their dental hygiene school curriculum had emphasized doing so for all patients. The most frequently cited reasons for not performing a routine blood pressure screening were insufficient time in the appointment and the minimal value given to the procedure by their employers. CONCLUSION: To work against obstacles that prevent the provision of this service, dental and dental hygiene faculty must increase their efforts to inculcate in their students the value of blood pressure screening. Further studies are needed to determine if the findings of this study are indicative of only one segment of dental hygiene practitioners, or if they represent the norm in the profession.

Treating patients with drug-induced gingival overgrowth.

The purpose of this paper is to review the causes and describe the appearance of drug-induced gingival overgrowth, so that dental hygienists are better prepared to manage such patients. Gingival overgrowth is caused by three categories of drugs: anticonvulsants, immunosuppressants, and calcium channel blockers. Some authors suggest that the prevalence of gingival overgrowth induced by chronic medication with calcium channel blockers is uncertain. The clinical manifestation of gingival overgrowth can range in severity from minor variations to complete coverage of the teeth, creating subsequent functional and aesthetic problems for the patient. A clear understanding of the etiology and pathogenesis of drug-induced gingival overgrowth has not been confirmed, but scientists consider that factors such as age, gender, genetics, concomitant drugs, and periodontal variables might contribute to the expression of drug-induced gingival overgrowth. When treating patients with gingival overgrowth, dental hygienists need to be prepared to offer maintenance and preventive therapy, emphasizing periodontal maintenance and patient education. The affected gingiva presents a bulbous and irregular appearance and requires special modifications in the delivery of dental hygiene care. Dental hygienists play a vital role in the prevention and control of this condition because of the significant correlation between plaque/gingivitis and gingival overgrowth.