2011 ADEA Annual Session: Poster Abstracts

Poster session abstracts from the 2011 American Dental Education Association (ADEA) Conference

Muscle Activity Comparisons In Dental Hygiene Students When Using Different Fulcrums While Scaling

The high incidence rate of cumulative trauma disorders in dental hygienists attests to the musculoskeletal problems experienced by dental hygienists. Research is ongoing to investigate ergonomic practices that will minimize muscle trauma when providing scaling and root debridement. The purpose of this study was to determine differences in the activity of four forearm muscles, (extensor carpi radialis longus, flexor carpi ulnaris, biceps brachii and pronator teres) when using five different finger fulcrums while scaling in dental hygiene students. A convenience sample of 29 consenting senior dental hygiene students participated in the study. Using a 4 x 5 counterbalanced research design, participants used a Gracey 11/12 curet to scale artificial calculus from each permanent first molar tooth on a typodont. While scaling, each participant had sEMG sensors attached to each muscle under investigation to measure muscle activity via electromyography. Participants scaled using one of 5 finger fulcrums (opposite arch, standard intra-oral, basic extra-oral, cross arch and finger on finger) on 5 different typodonts resulting in a total of 20 sEMG readings per participant. The highest amount of muscle activity was observed in the pronator teres (X=28.73) and the least in the biceps brachii (X=13.39). Data analysis with two-way ANOVA revealed a statistically significant difference only in the activity of the biceps brachii muscle when a change in fulcrum occurred. (p=0.0002). Using an average of all four muscles ANOVA revealed no statistically significant differences when comparing scaling with different fulcrums and the amount of muscle activity generated (p=0.0776) In this clinical study that measured the activity of four forearm muscles when scaling, only the biceps brachii was affected by a change in fulcrumming technique. Results suggest that similar muscle activity is produced when scaling regardless of the muscles measured and the type of fulcrum used. More research is needed to clarify the role of fulcrums and individual muscle activity in the ergonomic practice of dental hygiene. [ABSTRACT FROM AUTHOR

Effects of Ultrasonic Scaling and Hand-Activated Scaling on Tactile Sensitivity in Dental Hygiene Students

Purpose. This study was conducted to determine if tactile sensitivity varies in dental hygiene students who use the ultrasonic scaler, as compared to those who scale with hand-activated instruments. Methods. A two-group, randomized subjects, pretest-posttest design was carried out mid-semester for five weeks on 40 first-year dental hygiene students who met the inclusion criteria of this study and who agreed to participate. A convenience sample of 40 consenting, first-year dental hygiene students were randomly assigned to one of two groups (experimental or control). After establishing a baseline tactile sensitivity score with the Vibratory Sensory Analyzer (VSA), experimental group subjects used the ultrasonic scaler to remove 4cc\u27s of artificial calculus from a typodont in a controlled, simulated clinical setting for 45 minutes, while each control subject manually scaled 4cc\u27s of artificial calculus on a typodont in a controlled, simulated situation for 45 minutes. Immediately following exposure to either the ultrasonic scaler or hand-activated scaling instruments, tactile sensitivity scores were obtained using the VSA. Analysis of variance with one repeated measures factor was used to determine between group and within group differences on the pretest and posttest tactile sensitivity scores. Results. Results revealed that tactile sensitivity increased after a 45-minute scaling session with the ultrasonic scaler. Pretest to posttest changes in tactile sensitivity for the ultrasonic scaling group exhibited a much larger threshold as compared to those in the hand-activated scaling group, supporting a gain in students\u27 level of sensitivity with stimulus (vibration). Tactile sensitivity decreased in those who used hand-activated scaling instruments. The thumb, index, and middle fingers of students in both groups showed similarities in tactile sensitivity, with the index finger being the most sensitive. Conclusion. Tactile sensitivity decreases with hand-activated scaling and increases with ultrasonic scaling over a 45-minute period. Short-term vibration exposure from the ultrasonic scaler is insufficient to negatively affect tactile sensitivity

Cultural Adaptability of Dental Hygiene Students in the United States: A Pilot Study

Dental hygiene students should prepare to competently provide services to culturally diverse patients; therefore, this study was conducted as a baseline to determine the cross-cultural adaptability of dental hygiene students. The sample consisted of 188 dental hygiene students attending four culturally diverse dental hygiene programs (N=108) and four non-culturally diverse dental hygiene programs (N=80). The culturally diverse programs randomly selected were located in the southwest, southeast and mid-Atlantic regions of the U.S., and the non-diverse programs were located in the northwest, northcentral, central, and southern regions of the U.S. Any dental hygiene program with students representing four of the five ethnic categories (Caucasian, African American, Hispanic/Latino, American Indian/Alaska Native, and Asian/Pacific Islander) with a culturally diverse student enrollment of 40% or greater, was considered a culturally diverse program; any dental hygiene program enrolling students from only one ethnic category was considered a non-culturally diverse program. Participating students completed the Cross-Cultural Adaptability Inventory (CCAI), a 50-item instrument that measures an individual\u27s cultural adaptability and its four research dimensions: emotional resilience, flexibility/openness, perceptual acuity, and personal autonomy. The instrument does not target one particular cultural, rather it is culture general, meaning the inventory is proficient in assessing all cultures. The unpaired t-test revealed a statistically significant difference, at the 0.05 level, in the overall, emotional resilience, flexibility/openness, and perceptual acuity between the two dental hygiene groups. Data analyses revealed the overall score of the dental hygiene students was lower than the CCAI norm group, which consisted of individuals with cross-cultural experience. The culturally diverse group scored higher than the non-diverse group in emotional resilience but scored lower than the non-diverse group in flexibility/openness and perceptual acuity. There was no statistically significant difference between the culturally diverse and non-culturally diverse groups in the dimension of personal autonomy. Results of the study led to the conclusion that dental hygiene students attending culturally diverse and non-culturally diverse programs possess some qualities such as personal autonomy and self-identity needed for cultural adaptability. The overall CCAI scores were lower than the CCAI norm group suggesting students need cross-cultural education and training. For this reason, it is important that dental hygiene curricula incorporate cross-cultural educational strategies and peer and patient cross-cultural encounters to enable students to develop competency in providing cross-cultural health care. [ABSTRACT FROM AUTHOR

Effects of 5 Different Finger Rest Positions on Arm Muscle Activity During Scaling by Dental Hygiene Students

Purpose. This study was conducted to determine the effects of 5 different finger rest positions: opposite arch, standard intraoral, basic extraoral, cross arch, and finger on finger on the muscle activity of 4 forearm muscles (extensor carpi radialis longus, flexor carpi ulnaris, biceps brachii, and pronator teres) during a simulated periodontal scaling experience. Methods. A convenience sample of 32 consenting senior dental hygiene students who met inclusion criteria participated. Using a 4 x 5 counter-balanced research design, each participant used a Gracey 11/12 curet to scale one cc of artificial calculus from first permanent molar typodont teeth (#3,14,19,30). Five different typodonts were set up for each participant with fulcrums randomly assigned for use on each typodont. While scaling, the participant’s muscle activity was measured by surface electromyography. Two-way analysis of variance with repeated measures was used to determine if significant differences existed in the amount of muscle activity generated with each fulcrum. Results. Results revealed no statistically significant interaction effect between area of the mouth scaled, muscle activity, and fulcrum used. Similar muscle activity was produced throughout the mouth regardless of the fulcrum used. The upper right quadrant produced the most muscle activity (p= 0.0101) and the lower left quadrant produced the least (p=\u3c .0001). When comparing the overall muscle activity generated with each fulcrum, only the cross arch fulcrum when compared to the opposite fulcrum produced statistically significant results (p=0.0110). Conclusions. Based on the results, similar muscle activity is produced when using any of the 5 fulcrums in each quadrant of the mouth. Clinicians appear to experience minimal ergonomic advantage in terms of fulcrums used and area of the mouth scaled during a simulated scaling experience

Vital Tooth Whitening Effects on Oral Health-Related Quality of Life in Older Adults

Purpose: The purpose of this study was to determine if vital tooth whitening affects oral health-related quality of life (OHRQOL) in adults age 50 years and older, and if tooth whitening causes increased participation in social activities. Methods: Using a 2 group, single blind, randomized, pre-test, multiple post-test design, 62 participants were enrolled. The experimental group used a whitening product twice daily for 3 weeks. The control group used no whitening products. The Oral Health Impact Profile (OHIP) served as the pre- and post-test measure. The OHIP measures OHRQOL on 7 subscales: functional factors, psychological disabilities, psychological discomforts, physical disabilities, social disabilities, handicaps and physical pain. Additional questions measured the subjects\u27 social activities at baseline, 3 weeks and 3 months. Data from 53 participants, who completed the study, were analyzed using paired t-tests and ANOVA at p=0.05. Results: Statistical significance was observed for the OHIP physical pain subscale (p=0.0029) and the handicap subscale (p=0.05). Pre- to post-test means of the physical pain subscale increased in the experimental group (4.84 to 7.10), suggesting a lower OHRQOL, most likely related to tooth sensitivity experienced by the experimental group. Means from pre- to post-test of the handicap subscale (1.96 to 1.19) reveal that the experimental group reported an improved OHRQOL and felt they were more willing to work. Repeated measures ANOVA and Tukey\u27s post-hoc tests revealed that the experimental group reported significantly less (p=0.04) social activities at the 3 month post-test (3.92 to 3.45). No statistically significant between-group differences were observed in the overall OHIP score for functional factors, psychological disabilities, psychological discomforts, physical disabilities and social disabilities. Conclusion: Results indicate that vital tooth whitening does not improve overall OHRQOL in older adults

Oral Health Promotion: Knowledge, Confidence, and Practices in Preventing Early-Severe Childhood Caries of Virginia WIC Program Personnel

Purpose: This study assessed the oral health knowledge, confidence and practices of Virginia personnel in the Special Supplemental Food Program for Women, Infants and Children (WIC). Methods: In 2009, 257 WIC personnel were electronically emailed via an investigator-designed 22-item Survey Monkey® questionnaire. Descriptive statistics, Chi-square and Fishers Exact tests compared personnel demographics and oral health knowledge, confidence and practices at the p≤0.01 and 0.05 significance level. Results: Response rate was 68%. WIC personnel were knowledgeable about basic oral health concepts. More than half of those reporting were not confident assessing for visual signs of dental decay and do not routinely assess for visual signs of decay. Only 4% of personnel apply fluoride therapy. Conclusion: Findings support the need for health promotion/disease prevention at WIC. This study supports the NDHRA priority area, Health Promotion/Disease Prevention: Validate and test assessment instruments/strategies/mechanisms that increase health promotion and disease prevention among diverse populations

Effects of Occupational Ultrasonic Noise Exposure on Hearing of Dental Hygienists: A Pilot Study

Purpose. The purpose of this case-control study was to determine whether long-term ultrasonic noise exposure via the dental office environment is related to dental hygienists\u27 hearing status. Methods. Registered dental hygienists (N - 698) who live in the Hampon Roads areas of Virginia were mailed a Dental Hygiene Word History Questionnaire to determine who would meet the inclusion criteria and would be willing to participate in the study. Consenting subjects were categorized into one of two groups, according to ultrasonic sealer usage rate, and matched on age. Persons with known hearing loss due to infection, disease, or congenital defect were excluded from the study. The final sample consisted of 20 dental hygienists with a high ultrasonic usage rate and a matched group of 20 dental hygienists who had a low ultrasonic usage rate. Once the groups were formed, a certified audiologist tested subjects\u27 hearing in each ear via the pure-tone audiometer. Audiometric data were analyzed using the analysis of variance for repeated measures procedure to determine if degree of ultrasonic sealer noise exposure in the dental office environment was significantly related to hearing status in these dental hygienists. Results. Results revealed that the right and left ears were not statistically different in the hearing threshold levels, regardless of group status. However, there was a significant difference in the high ultrasonic usage group and the low ultrasonic usage group at the 3000 Hz. No differences were found at the frequencies of 500, 1000, 2000, 4000, 6000, and 8000 Hz. Conclusions. Based on these outcomes, the ultrasonic sealer is not considered to have a negative effect on the hearing of dental hygienists at 500,1000, 2000, 4000, 6000, and 8000 Hz, but may be related to hearing loss at 3000 Hz. Ultrasonic noise may in fact be affecting dental hygienists\u27 hearing at 3000 Hz, but loss of hearing observed at the higher frequencies may be attributed to other unidentified factors present in both groups

A Brief Motivational Intervention for Heavy Alcohol Use in Dental Practice Settings: Rationale and Development

Although brief alcohol interventions have proven effective in a variety of health care settings, the present article describes the development of the first brief intervention for heavy drinkers in dental practice. Elements of motivational interviewing and personalized normative feedback were incorporated in a 3- to 5-minute intervention delivered by dental hygienists. The intervention is guided by a one-page feedback report providing personalized normative feedback regarding the patient\u27s current oral health practices, their drinking in comparison to others, and oral cancer risk associated with current smoking and drinking. Future publications will present data regarding intervention effectiveness from an ongoing randomized trial