Investigation into the enablers and barriers of career satisfaction among Australian oral health therapists.

OBJECTIVES: This qualitative study explored the enablers and barriers of career satisfaction among Australian oral health therapists (OHTs) and the reasons behind career changes. METHODS: Participants were recruited in 2 ways: 1) recruitment posts were made on the Facebook pages of two professional groups; and 2) an email was sent to the Doctor of Dental Medicine students of the University of Sydney School of Dentistry, inviting those with OHT qualifications to participate. Each participant completed a semi-structured interview which was guided by open-ended questions. The average interview length was 45 min. All interviews were recorded, transcribed verbatim and manually coded. Thematic analysis of the qualitative data was completed using an inductive approach. RESULTS: Twenty-one OHTs participated in this study. The enablers of OHT career satisfaction include clinical practice, job variety, career flexibility, being in a supportive team environment and the opportunity for constant learning and growth. The barriers to career satisfaction include musculoskeletal problems, restrictions on the scope of practice use, psychological stress and lack of recognition from others. OHTs remain in the profession due to stable income and employment opportunities. The main reasons for retirement were burnout and pursuing dentistry. OHTs pursue dentistry to expand their scope of practice. CONCLUSION: This study revealed the enablers and barriers of OHT career satisfaction in an Australian context. OHTs are an important component of modern dental workforces, and reasons for attrition within the workforce are essential for maintaining responsiveness to community oral health needs.

What informs oral health and chronic disease policy development in Australia: a citation analysis.

Improvement of health services and patient outcomes depends on the translation of health research into health policy. Oral health research can inform policies to manage chronic diseases and improve quality of life of affected individuals. To determine if translation of this research into policy is occurring, we identify where policymakers obtain evidence to inform the development of Australian health policy. We conducted a citation analysis of oral health, cardiovascular disease, diabetes and cognitive impairment National policies to determine if current oral health research has informed oral health and chronic disease policy. We analysed five National policies with 268 individual references to policy or organizational documents (n = 179), peer-reviewed research (n = 74), grey literature (n = 12), or unidentifiable (n = 3). Although we found oral health references listed in the National policies (92), we did not find this information to have been translated into the oral health and chronic disease policies we analysed.

Dental and oral health students' perceptions of loupes.

Objectives. The dental industry has embraced the usage of loupes, with recent literature identifying numerous clinical and ergonomic benefits. Despite the growing usage of loupes among Australian dental professionals and dental students, few data regarding the perceived benefits and limitations of their use in clinical practice are available. The aim of this study was to examine the experiences and opinions of loupe usage among Australian dental and oral health students. Methods. A self-reporting questionnaire was distributed to all dental and oral health students across Australia during 2016. Results. A total of 223 students responded to the questionnaire. Of these responses, 45.7% reported they wear loupes during their clinical training, with the majority (32%) purchasing them due to recommendation by a demonstrator. Primary benefits reported included ergonomics/posture (89%), restoration evaluation/detection (72%) and quality of care/improved patient care (63%). Primary limitations reported included infection control (53%), decreased awareness of patients' non-verbal communications (44%) and vision dependency (30%). Conclusions. Overall, the students in this study identified both benefits and limitations to wearing loupes in clinical practice. Despite this, an overwhelming majority (96%) of those who used loupes would recommend them to other dental and/or oral health students.

Australian dental practitioner perspectives on academic careers.

OBJECTIVES: Due to forecasted faculty shortages and increasing student enrollments in dental education, there is a need to attract talented clinicians into academia. To address this growing concern, we need to explore dental practitioners' perspectives on the academic career pathway, including enablers and barriers to entering the academic workforce. METHODS: A mixed-methods electronic survey was disseminated through professional associations and dental groups on social media in 2018. Qualitative responses were examined using an inductive thematic analysis. RESULTS: Participants (n = 85) considered an academic career highly regarded (80%) but indicated there was not a clear pathway (79%) and could not recall it being discussed during their dental studies (85%). It was perceived that experience, further study, and networks all played a significant role in forging an academic career. Perceived benefits to an academic career included professional development opportunities, good employment conditions, and making a meaningful contribution. Barriers included the geographical location of universities, losing clinical skills and the lack of a clear career pathway. CONCLUSION: Despite being a highly regarded career, clinicians admit the career pathway to academia is not clear. Improving awareness of academic career paths might be achieved by educating dental students and providing accessible resources to the wider profession.

How do we teach simulation-based dental education? Time for an evidence-based, best-practice framework.

Historically, simulation-based dental education was taught using practical skills and the action of doing. An increased awareness of the importance of patient safety in healthcare education and delivery has seen considerable advances in the application of simulation-based education across several healthcare disciplines including medicine, nursing and anaesthetics. Dental simulation-based education requires improved standards of best-practice, and evidence-based, curriculum design that is based on theoretical frameworks, conceptual frameworks and educational theories. In this commentary, we explore the educational theory and the development of healthcare simulation, including internationally recognised standards of best practice and the simulation-based activity cycle. Given simulation-based education should be fit-for purpose, the components of these standards are examined within the specific context of dental education. We propose an evidence-based, best-practice framework that can be applied in the design and delivery of contemporary simulation-based dental curriculum.

Leadership and career development curriculum in Australian dental and oral health programmes.

INTRODUCTION: There is very little evidence of dental schools offering leadership or career development training for students. Given that tertiary students come from diverse backgrounds with differing experiences, it is important that all students learn skills that improve their employability by preparing them for a range of career paths and equipping them with the confidence to lead their profession into the future. This study mapped current leadership and career development training in dental education programmes throughout Australia, focusing on the capacity, barriers and enablers. METHODS: In 2018, an electronic survey was sent to the Program Convenors of all nineteen dental programmes in Australia. Survey questions were sourced from existing literature and the current regulatory competencies. RESULTS: Whilst the majority of respondents (n = 17, 89% response rate) indicated that their programmes included both leadership training (72%) and career development activities (88%), it is clear that the content focus, hours allocated and assessment items vary widely across the country. Further, curriculum appeared to focus almost exclusively on clinical work, which does not provide an avenue for students to explore alternative, non-clinical career options or pathways or develop their skills beyond treating individual patients. Time constraints and ideological differences were reported as the biggest barriers to implementing leadership and career development curricula. CONCLUSION: Despite an inconsistent approach nationally, it appears there is an opportunity for faculty across institutions to collaborate, potentially to develop a set of leadership and career development competencies and best practice teaching and learning activities.

Ergonomic interventions for preventing musculoskeletal disorders in dental care practitioners.

BACKGROUND: Dentistry is a profession with a high prevalence of work-related musculoskeletal disorders (WMSD) among practitioners, with symptoms often starting as early in the career as the student phase. Ergonomic interventions in physical, cognitive, and organisational domains have been suggested to prevent their occurrence, but evidence of their effects remains unclear. OBJECTIVES: To assess the effect of ergonomic interventions for the prevention of work-related musculoskeletal disorders among dental care practitioners. SEARCH METHODS: We searched CENTRAL, MEDLINE PubMed, Embase, PsycINFO ProQuest, NIOSHTIC, NIOSHTIC-2, HSELINE, CISDOC (OSH-UPDATE), ClinicalTrials.gov, and the World Health Organization International Clinical Trials Registry Platform (ICTRP) Search Portal to August 2018, without language or date restrictions. SELECTION CRITERIA: We included randomised controlled trials (RCTs), quasi-RCTs, and cluster RCTs, in which participants were adults, aged 18 and older, who were engaged in the practice of dentistry. At least 75% of them had to be free from musculoskeletal pain at baseline. We only included studies that measured at least one of our primary outcomes; i.e. physician diagnosed WMSD, self-reported pain, or work functioning. DATA COLLECTION AND ANALYSIS: Three authors independently screened and selected 20 potentially eligible references from 946 relevant references identified from the search results. Based on the full-text screening, we included two studies, excluded 16 studies, and two are awaiting classification. Four review authors independently extracted data, and two authors assessed the risk of bias. We calculated the mean difference (MD) with 95% confidence intervals (CI) for continuous outcomes and risk ratios (RR) with 95% confidence intervals for dichotomous outcomes. We assessed the quality of the evidence for each outcome using the GRADE approach. MAIN RESULTS: We included two RCTs (212 participants), one of which was a cluster-randomised trial. Adjusting for the design effect from clustering, reduced the total sample size to 210. Both studies were carried out in dental clinics and assessed ergonomic interventions in the physical domain, one by evaluating a multi-faceted ergonomic intervention, which consisted of imparting knowledge and training about ergonomics, work station modification, training and surveying ergonomics at the work station, and a regular exercise program; the other by studying the effectiveness of two different types of instrument used for scaling in preventing WMSDs. We were unable to combine the results from the two studies because of the diversity of interventions and outcomes.Physical ergonomic interventions. Based on one study, there is very low-quality evidence that a multi-faceted intervention has no clear effect on dentists' risk of WMSD in the thighs (RR 0.57, 95% CI 0.23 to 1.42; 102 participants), or feet (RR 0.64, 95% CI 0.29 to 1.41; 102 participants) when compared to no intervention over a six-month period. Based on one study, there is low-quality evidence of no clear difference in elbow pain (MD -0.14, 95% CI -0.39 to 0.11; 110 participants), or shoulder pain (MD -0.32, 95% CI -0.75 to 0.11; 110 participants) in participants who used light weight curettes with wider handles or heavier curettes with narrow handles for scaling over a 16-week period.Cognitive ergonomic interventions. We found no studies evaluating the effectiveness of cognitive ergonomic interventions.Organisational ergonomic interventions. We found no studies evaluating the effectiveness of organisational ergonomic interventions. AUTHORS' CONCLUSIONS: There is very low-quality evidence from one study showing that a multi-faceted intervention has no clear effect on dentists' risk of WMSD in the thighs or feet when compared to no intervention over a six-month period. This was a poorly conducted study with several shortcomings and errors in statistical analysis of data. There is low-quality evidence from one study showing no clear difference in elbow pain or shoulder pain in participants using light weight, wider handled curettes or heavier and narrow handled curettes for scaling over a 16-week period.We did not find any studies evaluating the effectiveness of cognitive ergonomic interventions or organisational ergonomic interventions.Our ability to draw definitive conclusions is restricted by the paucity of suitable studies available to us, and the high risk of bias of the studies that are available. This review highlights the need for well-designed, conducted, and reported RCTs, with long-term follow-up that assess prevention strategies for WMSDs among dental care practitioners.

The Effect of Stainless Steel and Silicone Instruments on Hand Comfort and Strength: A pilot study.

Purpose: Many dental hygienists experience musculoskeletal pain during the course of their careers, often as a result of the sustained grips on instruments and repetitive movements employed during clinical practice. Current research suggests that lighter instruments with a larger diameter reduce force and load on the hand during scaling procedures; therefore, the texture and weight of silicone handles is designed to decrease the strain placed on the hand and fingers. The purpose of this research is to investigate and compare the effect of silicone instrument handles and traditional stainless steel instrument handles on hand comfort and strength.Methods: This pilot study used a comparative cross-sectional study design. A convenience sample of dental hygiene students (n= 23) participated in two simulated scaling sessions for 30 minutes, one week apart. During the first session, students were required to use traditional stainless steel instruments (10mm diameter and 21-26g weight), while during the second session students used instruments with silicone handles. Students were required to complete a Hand Health Profile and perform hand strength tests following each session. Paired t-tests were used to determine significant differences between the grip strength, pinch strength and hand health profiles scores after using stainless steel and silicone instrument handles.Results: The data analyses revealed a statistically significant improvement in grip strength (p<0.02), key pinch strength (p<0.05) and overall hand comfort (p<0.001).Conclusions: This study suggests that the use of silicone instrument handles may improve hand comfort and reduce hand fatigue. These findings should prompt further investigation on ergonomic instrument design.

Cultural Competency Education in Academic Dental Institutions in Australia and New Zealand: A Survey Study.

The aim of this study was to assess the status of cultural competency education in Australian and New Zealand dental, dental hygiene, and oral health therapy programs. The study sought to explore the extent to which cultural competence is included in these programs' curricula, building on similar studies conducted in the United States and thus contributing to the international body of knowledge on this topic. A 12-item instrument was designed with questions in four areas (demographics, content of cultural competency education, organization of overall program curriculum, and educational methods used to teach cultural competence) and was sent to all Australian and New Zealand dental, dental hygiene, and oral health therapy educational programs. Of the total 24 programs, 15 responded for a response rate of 62.5%. The results showed that lectures were the most frequent teaching method used in cultural competency education; however, the variation in responses indicated inconsistencies across study participants, as discussions and self-directed learning also featured prominently in the responses. The majority of respondents reported that cultural competence was not taught as a specific course but rather integrated into their programs' existing curricula. The variations in methods may indicate the need for a standardized framework for cultural competency education in these countries. In addition, the notion of cultural competency education in academic dental institutions demands additional evaluation, and further research is required to develop a solid evidence base on which to develop cultural competency education, specifically regarding content, most effective pedagogies, and assessment of student preparedness.

Musculoskeletal Disorders and Working Posture among Dental and Oral Health Students.

The prevalence of musculoskeletal disorders (MSD) in the dental professions has been well established, and can have detrimental effects on the industry, including lower productivity and early retirement. There is increasing evidence that these problems commence during undergraduate training; however, there are still very few studies that investigate the prevalence of MSD or postural risk in these student groups. Thus, the aim of this study was to determine the prevalence of MSD and conduct postural assessments of students studying oral health and dentistry. A previously validated self-reporting questionnaire measuring MSD prevalence, derived from the Standardised Nordic Questionnaire, was distributed to students. Posture assessments were also conducted using a validated Posture Assessment Instrument. MSD was highly prevalent in all student groups, with 85% reporting MSD in at least one body region. The neck and lower back were the most commonly reported. The final year dental students had the highest percentage with poor posture (68%), while the majority of students from other cohorts had acceptable posture. This study supports the increasing evidence that MSD could be developing in students, before the beginning of a professional career. The prevalence of poor posture further highlights the need to place further emphasis on ergonomic education.

The effect of loupes on neck pain and disability among dental hygienists.

BACKGROUND: Musculoskeletal disorders represent a significant occupational health issue in dental hygiene, with high prevalence rates documented. Despite this fact, there have been few advancements in the application of ergonomic principles in the dental hygiene profession. While the use of loupes is often promoted as an ergonomic solution, there is little published research to support this claim. OBJECTIVES: The aim of the present study, therefore, was to investigate the effect of the use of loupes on neck pain and disability in dental hygienists. METHODS: The study was conducted using an exploratory pre-test post-test design, comparing musculoskeletal measures in dental hygienists wearing loupes with final year dental hygiene students who do not wear loupes. Pre- and post-test measures included the Neck Pain and Disability Scale and a standardised physical assessment using previously validated measures. Statistical analysis was conducted as a series of mixed ANOVAs with time and treatment as the independent variables. RESULTS: While the analyses revealed no significant interactions between time and treatment (p <  0.05), there were general trends of improvement or deterioration for outcome measures. Improvements over time were noted in the treatment group for cervical range of motion and deep neck muscle endurance; however deteriorations were noted for forward head posture and cervical kinaesthetic sense. CONCLUSIONS: Overall, despite no statistically significant differences being detected, this study suggests that wearing loupes appears to have both positive and negative outcomes with regards to physical well-being. As such, further studies are required to more precisely determine the effects of loupes on MSD among dental hygienists, particularly long-term. Dental hygienists with existing neck pain exploring ergonomic equipment may reflect on the findings and consider the potential benefits and risks of wearing loupes.

The Frequency of Dietary Advice Provision in a Dental Hygiene Clinic: A Retrospective Cross-Sectional Study.

PURPOSE: The aim of this retrospective, cross-sectional study was to assess the frequency of dietary advice provision by dental hygiene students. METHODS: Data was obtained from clinical records of third-year Bachelor of Oral Health students at the University of Newcastle. Frequency of dietary advice was recorded by students over a 12-month period. The study investigated associations between demographics, treatment provided and frequency of dietary advice. RESULTS: The results indicated dietary advice was provided infrequently by dental hygiene students, with only 6.48% of all patients seen during the 12-month period receiving dietary advice. A statistically significant correlation was observed between dietary advice and age, with children under the age of 18 being 2.5 times more likely than adults to receive dietary advice. Additionally, patients who received oral hygiene instruction were 2.5 times as likely to receive dietary advice. Strong correlations were also observed between topical and concentrated fluoride application and dietary advice. CONCLUSION: The findings indicate dietary advice is provided infrequently by dental hygiene students. Further research is required to strengthen the findings and to investigate barriers to dietary advice provision, as well as perceptions of dental practitioners regarding dietary advice.

Musculoskeletal disorders in a 3 year longitudinal cohort of dental hygiene students.

PURPOSE: Musculoskeletal disorders (MSDs) are a significant occupational health issue for the dental hygiene profession. There is increasing evidence that these problems commence during undergraduate training; however, there is a surprising lack of studies investigating how MSD develops in student groups over the course of their study. The aim of this study was to determine the longitudinal MSD trends among a cohort of undergraduate dental hygiene students at an Australian university. METHODS: A previously validated self-reporting questionnaire was distributed to dental hygiene students in 3 consecutive years from 2008 to 2010. RESULTS: MSDs were most commonly reported in the neck (ranging from 66 to 68%) and lower back (ranging from 61 to 68%), with a marked increase in reported lower back pain by the final year of study. CONCLUSION: This study not only supports mounting evidence that MSDs are a common problem for dental hygiene students, but further demonstrates the magnitude of this occupational health issue across the training program. These findings are concerning for a group yet to embark on their professional careers, given that it raises some serious questions about career longevity and the efficacy of preventive measures.

Tobacco use among Australian dental hygiene students is declining, but more still needs to be done.

While health care professionals have a responsibility to prevent and control the use of tobacco for improved health outcomes, it appears that some dental hygiene students continue to smoke. A survey of Australian dental hygiene students found that up to 16.3% smoke, although this prevalence rate decreased with each year of study. As future role models, it is essential that smoking cessation counselling is embedded in the dental curriculum to not only discourage their own habits, but so that they may promote the importance of being tobacco free to the wider population.

Musculoskeletal disorders and symptom severity among Australian dental hygienists.

BACKGROUND: Recent literature has identified that musculoskeletal disorders (MSD) are a significant occupational health issue for both dentists and dental hygienists. Research on the occupational health of dental hygienists is lacking in Australia, which is of particular concern given that it is a rapidly growing field in this country. The aims of this research are to investigate the prevalence of MSD and correlating regions of pain among Australian dental hygienists. A self-reporting questionnaire was distributed to all registered dental hygienists in Australia. The questionnaire was a modified version of a validated tool, used previously among health practitioners and students. RESULTS: A total of 624 dental hygienists responded to the questionnaire, achieving a response rate of 42%. MSD were frequently reported by dental hygienists in the neck (85%), shoulder (70%), and lower back (68%). Of those reporting pain, over two thirds reported that the pain lasted for longer than two days, for all body regions. Logistic regression analysis revealed that there is a correlation between reports of MSD in the neck, shoulder and lower back regions. CONCLUSIONS: Overall, this study suggests that MSD are a reasonably common problem for Australian dental hygienists, and that they often need to seek medical treatment for these problems. It is concerning that there is a correlation between reports of MSD in the neck, shoulder and lower back regions; further studies are needed to establish the epidemiological patterns of MSD in this profession.

Dental hygiene student experiences in external placements in Australia.

While placements in external locations are being increasingly used in dental education globally, few studies have explored the student learning experience at such placements. The purpose of this study was to investigate student experiences while on external placement in a baccalaureate dental hygiene program. A self-reporting questionnaire was distributed to final-year dental hygiene students (n=77) at the University of Newcastle, Australia, in 2010. The questionnaire included questions regarding the type of placement, experiences offered, supervision, resources available, and lasting impressions. Responding students were generally positive about their external placement experience and indicated that the majority of facilities provided them with the opportunity to provide direct patient care and perform clinical tasks typical of a practicing hygienist. However, there was a statistically significant difference in their opinions about discipline-focused and community placements. Students indicated that their external placement experience provided opportunities to learn more about time and patient management, including hands-on experience with specific clinical tasks. Ongoing evaluations are necessary to ensure that external placements meet both student needs and intended learning outcomes within dental hygiene programs.

An international review of musculoskeletal disorders in the dental hygiene profession.

This review of the current literature is aimed at examining musculoskeletal disorders in dental hygienists, and investigates the complex nature of this significant occupational health issue. Musculoskeletal disorders (MSD) have been identified as a significant issue for the profession of dental hygiene. The purpose of this review is to examine and assemble the best evidence on the epidemiology, diagnosis, treatment, interventions, prevention, impact and consequences of MSD among the dental hygiene profession. The prevalence of MSD is alarming, with up to 96% reporting pain, and a number of occupational risk factors have been identified by the literature. Studies investigating interventions are generally limited in their study design, which is concerning given the huge impact MSD can have on the practising dental hygienist. Overall, it is evident from the literature that MSD is a complex and multifactorial problem. However, a complete understanding of the progression of musculoskeletal disorders is still far from being realised, due to the lack of longitudinal studies and standardised research techniques. Future research should implement triangulation methods in longitudinal studies, a strategy which will go a long way in the understanding of this complex occupational health issue.