Knowledge and Attitudes of Undergraduate Dental, Allied Oral Health and Nursing Students Towards Patients with Alzheimer's Disease.

Purpose Alzheimer's disease (AD) is an age-related illness that is becoming increasingly more prevalent in the United States. The purpose of this pilot study was to assess dental, allied oral health, and nursing students' perceived knowledge, comfort, and attitudes for individuals with AD.Methods A total of 851 students from a university dental and nursing school were invited to participate in this cross-sectional study. A 48-item survey comprising of demographic questions, the Alzheimer's Disease Knowledge Scale (ADKS) and the Dementia Attitudes Scale (DAS) was disseminated via an electronic survey platform. Responses were summarized as means and standard deviations or counts and rates. Comparisons of survey responses by program type and exposure to AD, age group, and prior degree were performed using the chi-square test for association and analysis of variance.Results The response rate was 33.2%. Nursing students demonstrated the highest level of knowledge on AD with mean score of 25.26 (SD 2.87), followed by dental (M=23.4, SD 3.26) and allied oral health students (M=22.10, SD 2.98). Overall, students demonstrated perceived comfort in treating patients with AD and related dementias with mean scores in the "slightly agree" range. Nursing students demonstrated the highest level of perceived comfort (M=5.61, SD 0.71).Conclusions Nursing students demonstrated higher knowledge and more positive attitudes toward AD than dental and allied oral health students. There is a need for improved educational training and an expanded didactic curriculum to enhance knowledge for dental and allied oral health students. This pilot study provides a blueprint for replication on a national level.

Health Topics Emerged From Brief Motivational Interviewing: A randomized clinical trial.

Purpose The goal of this study was to analyze transcription of audio recordings to determine health topics that emerged from brief-motivational interviewing (MI) compared to traditional oral hygiene instructions (OHI).Methods Fifty-eight periodontal maintenance patients were randomized to a brief-MI or traditional OHI group for a longitudinal 1-year clinical trial. Both groups received four patient education sessions per their assigned group. Audio recordings were transcribed and coded. The overarching themes and subthemes emerged were quantified and reported as the number of instances per participant. Global scores and behavioral counts were compared across baseline, 4, 8, and 12-month research visits using mixed-effect models.Results Of the six overarching themes, the brief-MI group evoked more topics toward total health. Oral home care behaviors (15 vs 10.2) and oral diseases/conditions (3.3 vs 1.9) were discussed more in the brief-MI group compared to the traditional OHI group. This positive outcome for the average number of times a health topic was discussed in the brief-MI group compared to the traditional OHI group continued for the remaining major themes: lifestyle behaviors (1.0 vs 0.4), nutrition (2.6 vs 0.8), emotional/mental health (1.8 vs 0.8) and general health (1.2 vs 0.4).Conclusion This study identified that brief-MI was a more successful communication approach to increase discussions of oral home care behaviors, oral diseases/conditions, lifestyle behaviors, nutrition, emotional/mental health and general health compared to traditional OHI in individuals with periodontitis.

Health topics emerged from brief-motivational interviewing: A randomized clinical trial.

OBJECTIVE: The goal of this study was to analyse transcription of audio recordings to determine health topics that emerged from brief-motivational interviewing (MI) compared to traditional oral hygiene instructions (OHI). METHODS: Fifty-eight periodontal maintenance patients were randomized to a brief-MI or traditional OHI group for a longitudinal 1-year clinical trial. Both groups received four patient education sessions per their assigned group. Audio recordings were transcribed and coded. The overarching themes and subthemes emerged were quantified and reported as the number of instances per participant. Global scores and behavioural counts were compared across baseline, 4, 8, and 12-month research visits using mixed-effect models. RESULTS: Of the six overarching themes, the brief-MI group evoked more topics toward total health. Oral home care behaviours (15 vs. 10.2) and oral diseases/conditions (3.3 vs. 1.9) were discussed more in the brief-MI group compared to the traditional OHI group. This positive outcome for the average number of times a health topic was discussed in the brief-MI group compared to the traditional OHI group continued for the remaining major themes: lifestyle behaviours (1.0 vs. 0.4), nutrition (2.6 vs. 0.8), emotional/mental health (1.8 vs. 0.8) and general health (1.2 vs. 0.4). CONCLUSION: This study identified that brief-MI was a more successful communication approach to increase discussions of oral home care behaviours, oral diseases/conditions, lifestyle behaviours, nutrition, emotional/mental health and general health compared to traditional OHI in individuals with periodontitis.

Oral and Systemic Health Implications of Electronic Cigarette Usage as Compared to Conventional Tobacco Cigarettes: A review of the literature.

Purpose The health implications related to electronic cigarettes are not fully understood and has created a public health concern. The purpose of this narrative review was to highlight the oral and systemic health concerns associated with electronic cigarettes and compare these concerns to those associated with conventional tobacco cigarettes.Methods The literature was obtained from PubMed, Ovid Medline, CINAHL, and Scopus databases in June 2021 and updated in February 2023. Sources were chosen based on the following inclusion criteria: date of publication between 2011 and 2023 and written in English. Articles were excluded based on irrelevance to the topic, weak study designs, lack of outcome data, low quality randomized control trials, unavailability of the full text article, and non-empirical research designs. The Cochrane tool, ROBINS-I, was used to assess the risk of bias.Results A total of 78 studies were included in the review. E-cigarette use was associated with significant adverse effects for cardiovascular, respiratory, immunological, and periodontal health as compared to nonusers; however, impacts were worse with conventional smoked cigarettes. Long term health effects remain unknown with e-cigarettes, but associations have been identified with periodontal and peri-implant disease, oral cancer, and mental health disorders. The heterogeneity of e-cigarette use related to vaping behavior, devices, and liquids limits the ability to generalize results. There is a need for the development of a research standard for exposure methods to establish a consensus with e-cigarette use and support the validity of results among researchers.Conclusion According to current research, e-cigarettes may induce less harm than traditional tobacco products, but e-cigarettes do not remove the carcinogenic and toxic risk that has been associated with conventional cigarettes. Further research is needed to make broad conclusions on the safety of e-cigarettes compared to conventional cigarettes and to nonusers.

Students' knowledge, comfort, attitudes, and training on oral health of transgender individuals: A pilot study.

PURPOSE: The purpose of this pilot study was to evaluate students' knowledge, comfort, attitudes, and formal training on oral health of transgender individuals. METHODS: A single-site cross-sectional study of 223 students from four educational programs were invited to participate in this study. A 17-item survey was modified from two previous instruments with permission. The electronic survey was disseminated via Google Forms two times 6 weeks a part. Analyses were conducted using R version 4.1.1. Survey responses were summarized as means and standard deviations. Comparisons of survey responses by program type, age group, prior degree, and gender were performed using the chi-square test for association and analysis of variance. RESULTS: A total of118 completed the survey for a 53% response rate. Students disagreed (26.3%) they had knowledge on hormone treatments or non-hormonal treatment (40.7%) and strongly disagreed (40.7%) they had knowledge on oral manifestations of hormonal or non-hormonal therapies. Students strongly agreed they are comfortable treating transgender patients (63.6%) and believe it is the responsibility of all healthcare providers to care for transgender patients (83.1%). Students disagreed they are prepared to care for transgender patients (40.7%) or that their faculty demonstrate competency caring for transgender patients undergoing hormonal treatment (21.4%). CONCLUSION: Students are comfortable providing oral health care to transgender individuals and feel a responsibility to care for them. Formal training on hormonal and non-hormonal therapy for transgender individuals is needed in dental education programs to enhance students' knowledge and faculty competence.

Functional Oral Health Literacy and Periodontal Health.

Purpose: Growing evidence associates low oral health literacy (OHL) with poor oral health outcomes. While nearly half of United States adults have periodontal disease (PD), there are conflicting results on association between OHL and PD. The purpose of this pilot study was to explore the association between functional OHL and periodontal health as defined by the American Academy of Periodontology (AAP) classification system.Methods: A cross-sectional study was conducted with a convenience sample of dental patients presenting for care at a Midwestern Federally Qualified Health Center. Functional OHL was measured using the Oral Health Literacy Adults Questionnaire (OHL-AQ), and periodontal health was measured clinically and categorized by stage and grade using the recently revised AAP classification system. Additional demographic factors and health history information related to periodontal health were collected. Descriptive analysis reported the median and range for ordered variables, and frequency and percentages for categorical variables. Wilcoxon rank sum test, Kruskal-Wallis test, and Spearman correlation coefficients were used to find association between functional OHL and periodontal health.Results: Among fifty-four participants, statistically significant associations were found between OHL-AQ scores and AAP staging and grading categories. Periodontal disease stage increased with age, and periodontal disease grades progressed among participants with diabetes. No associations were found between periodontal health and sex, race, ethnicity, education, insurance, or country of origin.Conclusion: Functional oral health literacy had a significant inverse relationship with both AAP periodontal disease staging and grading. A larger study is needed to confirm the findings of this pilot study.

Impact of Brief Motivational Interviewing on Periodontal Clinical Outcomes: A randomized clinical trial.

Purpose: Patient education and oral hygiene instruction (OHI) communication play a key role in the dental hygiene process of care. The purpose of this study was to determine whether brief motivational interviewing (BMI) was superior to traditional OHI in improving periodontal health. Chairside time needed to deliver traditional OHI as compared to BMI was also compared.Methods: A convenience sample of 60 participants were randomized into two groups. The control group received traditional OHI and the test group received BMI. Periodontal indicators of disease were collected by a blinded examiner. Interventions for both groups and data collection occurred at four time points over a 12-month period. Periodontal outcome measures were plaque score, bleeding on probing (BOP), and gingival index (GI).Results: Both groups showed significant reductions in plaque score, BOP, and GI over time. The control group had an improvement in plaque score compared to the test group at visit three (p=0.05) and at visit four (p=0.03). The test group had an improvement in GI score compared to the control group at visit four (p=0.03). Chairside time was shorter in the control (OHI) group at each time point (p<0.01).Conclusion: Both traditional OHI and BMI patient education communication methods improved periodontal outcomes measured by plaque score, BOP, and GI. The inclusion of BMI in patient education sessions was demonstrated to be feasible within the time constraints of the dental hygiene recare appointment.

Preliminary evaluation of dental hygiene curriculum: Assessment and management of peri-implant conditions and diseases.

OBJECTIVE: The purpose of this study was to investigate dental hygiene (DH) educational programs' didactic and clinical curriculum in the management of peri-implant diseases and conditions. The specific aims were (1) assess if evidence-based content for peri-implant diseases and conditions are currently included in didactic and clinical DH curriculum and (2) determine if DH education programs are currently preparing students at a level of clinical competency for the assessment and management of peri-implant diseases and conditions. DESIGN: A cross-sectional study of DH faculty member(s) from 331 United States entry-level programs responsible for didactic and clinical curriculum for peri-implant diseases and conditions were surveyed. The survey was disseminated electronically via Qualtricsxm August 2019 for a response rate of 26%. RESULTS: The results showed didactic courses taught DH students the etiology of peri-mucositis and peri-implantitis (98%), clinical characteristics (98%), and risk factors contributing to these implant diseases (96%). Evaluation methods to determine student level of competency in a didactic setting included quizzes/examinations (98%), case-based examinations (63%), and written essays (6%). Eighty-five percent reported DH students are not required in a clinical setting to provide care for patients with peri-implant diseases and conditions. CONCLUSIONS: Study results suggest DH education programs may need to revise didactic and clinical curriculum to ensure students graduate at a level of clinical competency for assessing and managing peri-implant conditions and diseases. DH educational programs should consider requiring clinical patient experiences for the assessment and management of peri-mucositis and peri-implantitis to prepare students for their professional role.

Obstructive Sleep Apnea Knowledge: Attitudes and screening practices of Minnesota dental hygienists.

Purpose: Reported cases of obstructive sleep apnea (OSA) range between 4% to 9%, however between 70% to 90% of adults in the United States remain undiagnosed. The purpose of this study was to determine the current knowledge and attitudes of OSA among Minnesota dental hygienists and inventory OSA screening protocols currently used in dental practices.Methods: The cross sectional study used an adapted Obstructive Sleep Apnea Knowledge and Attitude (OSAKA) survey instrument. Survey items included demographic variables, and measured attitudes, knowledge and perceived knowledge about OSA, routine screening procedures, and use of validated OSA screening protocols. Paper surveys were mailed to a random sample of 750 licensed Minnesota dental hygienists. Analyses included descriptive statistics (counts and frequencies), and analytic tests (one-way ANOVA, Pearson's correlation, and t-tests, Cronbach's alpha), as appropriate.Results: Twenty-six percent of the returned surveys met inclusion criteria (n=197) and were used in the final analyses. Respondent age ranged from 19 to 70 years and mean years in practice experience was 19.9. The majority (93.9%) were in general practice and had completed an associate degree (59.6%). The mean (SD) self-rated OSA knowledge was 3.5 (3.3) on a scale of 0-10, attitude score was 3.2 (0.8) on a 5-point Likert scale, and knowledge score was 9.5 (range 0-17). No significant differences were found by age, degree type, or years in practice and OSA knowledge or attitudes. Routine practices included head and neck exams (89.3%), taking blood pressure (41.6%). Using a validated OSA screening protocol was reported by 9.6% of the respondents.Conclusion: Dental hygienists perceive that assessing patients for OSA is important, however they have moderate knowledge of the disease. Results support incorporating OSA into dental hygiene practice through additions to the dental hygiene education curriculum and ongoing professional development courses with the goal of improving the screening and referral of patients presenting with OSA symptoms.