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.

Introducing and Evaluating Intraprofessional Team-Based Care Delivery in a Dental School Clinic: A Pilot Study.

There is growing interest in developing more efficient, patient-centered, and cost-effective models of dental care delivery using teams of professionals. The aims of this small pilot study were to assess the number of patient visits, type and number of procedures performed, and clinic revenues generated by an intraprofessional team of dental, dental hygiene, and dental therapy students and to determine the students' and patients' perceptions of this model of care. Sixteen senior students from three student cohorts (dental, dental hygiene, and dental therapy) at the University of Minnesota piloted a team-based dental delivery model from January to April 2015. The group was named the Team Care Clinic (TCC), and the team for each clinical session consisted of one dental student, three dental hygiene students, and one dental therapy student. Data were collected from the school's database to determine the number of patient visits, type and number of procedures performed, and clinic revenue generated by the TCC. Focus groups were used to assess student perceptions of the experience, and patient satisfaction surveys were administered to assess the patients' experience. The TCC students were given twice as many patients as non-TCC students, and they managed them effectively. Working as a team, the TCC student providers completed twice as many procedures per patient encounter as non-TCC students. Patients and students said their experiences in the TCC were positive, and students expressed a preference for team-based care delivery. The results of the study suggest the team-based dental care delivery model is promising. Team-based care delivery may allow providers to accomplish more during a patient appointment and increase provider satisfaction.

Dental Therapists as New Oral Health Practitioners: Increasing Access for Underserved Populations.

The development of dental therapy in the U.S. grew from a desire to find a workforce solution for increasing access to oral health care. Worldwide, the research that supports the value of dental therapy is considerable. Introduction of educational programs in the U.S. drew on the experiences of programs in New Zealand, Australia, Canada, and the United Kingdom, with Alaska tribal communities introducing dental health aide therapists in 2003 and Minnesota authorizing dental therapy in 2009. Currently, two additional states have authorized dental therapy, and two additional tribal communities are pursuing the use of dental therapists. In all cases, the care provided by dental therapists is focused on communities and populations who experience oral health care disparities and have historically had difficulties in accessing care. This article examines the development and implementation of the dental therapy profession in the U.S. An in-depth look at dental therapy programs in Minnesota and the practice of dental therapy in Minnesota provides insight into the early implementation of this emerging profession. Initial results indicate that the addition of dental therapists to the oral health care team is increasing access to quality oral health care for underserved populations. As evidence of dental therapy's success continues to grow, mid-level dental workforce legislation is likely to be introduced by oral health advocates in other states. This article was written as part of the project "Advancing Dental Education in the 21st Century."

Dental School Faculty Attitudes Toward Dental Therapy: A Four-Year Follow-Up.

This study is a follow-up to a 2010 study at one U.S. dental school that found faculty attitudes toward the dental therapy model were mixed and there was a clear divide in attitudes between faculty members who were full-time educators and part-timers who also practiced outside the educational institution. The aim of this study was to determine faculty attitudes toward and perceptions of the dental therapy model at the same school four years after implementation of the dental therapy program. The identical questionnaire used in 2010 was used in this survey conducted from November 2013 to January 2014. All 254 full-time and part-time faculty members were invited to participate; responses were received from 75 faculty members, for a 30% response rate. Four years after the initial survey, the respondents showed greater acceptance of dental therapists and of dental therapy as a mechanism for addressing access to care problems. A majority of the respondents reported feeling a personal responsibility to ensuring the dental therapy model succeeded (52%); indicated being comfortable having a dental therapist provide care for their patients (60%); and agreed that the ability to delegate work to a dental therapist would make a dentist's job more satisfying (54%). Faculty members who also worked in a private practice viewed the role of dental therapists in private practice more favorably in 2014 than in 2010. This study provides insight into how attitudes of educators toward a new profession evolve over time. The faculty appeared to be undergoing a reorientation on the topic of dental therapy. This transition in point of view may have been facilitated by factors such as continued exposure to the new professionals, information sharing, and time.

Dental school faculty perceptions of and attitudes toward the new dental therapy model.

The University of Minnesota School of Dentistry launched its new dental therapy program in September 2009 after the Minnesota state legislature had authorized the training and practice of a dental therapist in May of the same year. The creation of this mid-level dental provider is seen as a workforce solution to help address the problem of access to dental care experienced by some members of our society. However, there is a lack of consensus and even controversy in organized dentistry about dental therapy, one of the mid-level provider models. This study explored the attitudes and perceptions of dental school faculty members who have been tasked to prepare these new dental therapists to do their work. Focus groups were conducted with a randomly selected group of faculty members, the results of which were used to develop a survey of faculty members in all departments of the school. A total of 151 faculty members responded to the survey: 68 percent of these respondents were fifty-one years of age or older; 79 percent were male; and 39 percent were full-time and 61 percent part-time. Fifty-four percent were clinical faculty members, and the rest taught in the preclinical courses and basic sciences. The study found that these dental faculty members believe dentists have a personal responsibility in the care of the underserved but do not agree that the dental therapists are part of the solution to improve access. There was a clear divide between the part-time faculty members, who practice outside the institution, and the full-time educators with regard to the role of dental therapists. However, there was an overall consensus that dental faculty members have a commitment and responsibility to educate future dental therapists regardless of their personal position. This is encouraging to dental therapy students, who can be assured that they will receive the education they need to prepare them to practice.