Pinch Force Generation During Scaling by Dental Professionals: A Systematic Review

Objective The objective of this review was to examine the impact of instrument designs on pinch force generation during scaling by dental professionals. Methods Three databases were utilized from September 2019 to November 2021 in addition to hand-searching specific journals and reference lists. Research articles that examined pinch force generation in dental professionals during scaling with manual instruments only were included. Bias was assessed in the individual articles. Results Six research articles were included with sample populations that varied from 12 to 24 participants. Four articles evaluated instrument designs in relation to pinch force generation during scaling by dental professionals. Two articles evaluated the clinicians\u27 experience levels and the impact on pinch force generation. Results of three articles revealed instruments with large diameters and low weights produced the least amount of pinch force (p \u3c 0.05). Additionally, two articles found instruments with a round, tapered shape produced less pinch force and instrument handles made of silicone produced higher pinch strength post-scaling (p \u3c 0.05). One study indicated instrument designs associated with modified scaling techniques may reduce thumb and index finger pinch force (p \u3c 0.05). Conclusion The findings from this review indicate weak evidence for instrument choices to reduce pinch force during scaling. Dental professionals should consider lightweight and large diameter instruments for manual scaling. Clinicians may also want to consider round, tapered handles and instrument designs with modified scaling techniques. This systematic review further identified the need for clinical research studies with rigorous research designs that examine the ergonomic impacts of instrument designs

The Prevalence of Burnout Among Entry-Level Dental Hygiene Program Directors

Purpose: Workplace burnout in academia is a problem that affects career satisfaction and longevity. The purpose of this study was to determine the prevalence of burnout among entry-level dental hygiene program directors. Methods: The Copenhagen Burnout Inventory (CBI) survey was used to determine prevalence of burnout in 325 dental hygiene program directors from across the United States. The survey was disseminated electronically. The CBI contains 19 questions that measure overall, personal, work-related, and client/student-related burnout on a five-point Likert type scale. The survey also included nine demographic and three open-ended questions related to burnout. Descriptive statistics, one sample t-tests, and one-way ANOVA tests were used to analyze the data. Results: One hundred twenty-seven dental hygiene program directors completed the survey for a 39.1% response rate. Most participants (62.2%, n=79) indicated moderate to high burnout on the personal burnout subscale, approximately one half (51.2%, n=65) on the work-related burnout subscale, and one third (33.1%, n=42) on the client/student-related burnout subscale. No statistically significant differences were found when comparing mean scores between directors of two-year and four-year program or between participants under age 50 and those 50 years of age and older (p-values\u3e0.05). Program directors with teaching workloads of 51-60% had significantly lower burnout on the work-related burnout subscale when compared to participants with teaching workloads of 31-40% (p=0.045). Participants with the lowest workload allocations for administrative duties had higher overall mean burnout scores. Conclusion: Results from this study suggest one out of two dental hygiene program directors have symptoms of some type of burnout with the highest prevalence rate in the personal burnout subscale. Findings underscore the need for further research to identify stressors that lead to burnout as well as identify prevention strategies that promote a healthier work climate for dental hygiene program administrators

Color-Blind Racial Attitudes in Practicing Dental Hygienists

Purpose: Individuals who subscribe to a color-blind racial ideology may not be aware of differences or differential treatment based on race which may be related to racial inequality in the delivery of oral health care. The purpose of this study was to determine color-blind racial attitudes in a convenience sample of clinical dental hygienists. Methods: A convenience sample of practicing dental hygienists recruited through social media via snowball sampling was invited to participate in this cross-sectional survey study. The Color-Blind Racial Attitudes Scale (CoBRAS), a valid and reliable measuring instrument, was used to determine unawareness of racial attitudes and stereotyping. Three subscales (Racial Privilege, Institutional Discrimination, and Blatant Racial Issues) were measured by the survey. Descriptive statistics and separate one-way between-subjects ANOVA were used to analyze the data. Results: Two-hundred and thirty-three (n = 233) dental hygienists in clinical practice completed the survey. ANOVA revealed statistically significant differences in overall CoBRAS scores when comparing age groups and ethnicities. Participants aged 18-29 had significantly lower overall CoBRAS scores compared to participants aged 60 and over (x = 49.41, x = 59.17, respectively; p = .019). African American participants scored significantly lower on overall CoBRAS scores compared only to those in the Other ethnicity category (x = 42.27, x = 62.08, respectively; p = .029). Conclusion: Participants possessed moderate levels of color-blindness, suggesting unawareness of racism and a need to understand the implications of racism as a means of promoting equity and improve oral health care delivery. Findings emphasize a need for more research examining color-blind ideology and how it affects oral health care delivery to diverse patient populations

Color-Blind Racial Attitudes in Dental Hygiene Students: A Pilot Study

Purpose: Color-blind racial attitudes and biases have been linked to racial prejudice which may potentially affect dental hygiene care to diverse patients. The purpose of this pilot study was to determine the color-blind racial attitudes of dental hygiene students. Methods: A 20-item, Color-Blind Racial Attitudes Scale (CoBRAS) electronic survey was sent to a convenience sample of 41 first-year and 30 second-year dental hygiene students (n=71) in a dental hygiene program in Virginia. The CoBRAS instrument measures contemporary racial attitudes and stereotyping in three subcategories: Unawareness of Racial Privilege, Institutional Discrimination, and Blatant Racial Issues. CoBRAS scores range from 20-120, with higher scores indicating elevated levels of denial of racism. Descriptive statistics were used to analyze the data. Results: Of the 71 students invited to participate, 70 completed the survey (n=70) for a 98.6% response rate. The majority of respondents were White females (70%, 98% respectively), aged 18-29 (90%). Results indicated an overall average CoBRAS score of 64.89. No statistically significant findings were identified between the two groups in regards to overall scores (p\u3e0.05). Conclusion: A majority of the participants in this pilot study possessed moderate levels of color-blind racial attitudes, suggesting rejection of the concept of racism. Color-blind racial attitudes and biases have been linked to a lack of awareness of White privilege. Further education in this area may foster improved interactions with diverse patient populations

The Additive Effects of Cell Phone Use and Dental Hygiene Practice on Finger Muscle Strength: A Pilot Study

Purpose: The purpose of this study was to determine strength of muscles involved with instrumentation (scaling) by dental hygienists and the additive effects of cellular (mobile) phone usage, as indicated by measurements of muscular force generation. Methods: A convenience sample of licensed dental hygienists currently in clinical practice (n=16) and an equal number of individuals not currently using devices/tools repetitively for work (n=16), agreed to participate in this pilot study. All participants completed a modified cell phone usage questionnaire to determine their use pattern and frequency. Upon completion of the questionnaire, participants\u27 force production in six muscle groups was measured using a hand-held dynamometer. Descriptive statistics were used to analyze the data. Results: A total of 16 licensed dental hygienists (n=16) and 16 participants with no history of using tools/devices repetitively for work (n=16), comprised the experimental and control groups, repectively. The control group generated greater muscle force than the experimental group for the abductor pollicis longus (p=0.045). Significant differences were identified when comparing the low mobile phone users in the experimental group to the control group for the flexor pollicis brevis (p=0.031), abductor pollicis longus (p=0.031), and flexor digitorum (p=0.006), with the control group demonstrating higher muscle force. Years in clinical practice and mobile phone use was shown to have a significant effect on muscular force generation for the flexor pollicis brevis (F=3.645, df=3, p=0.020) and flexor digitorum (F=3.560, df=3, p=0.022); subjects who practiced dental hygiene the longest produced the least amount of muscle force. Conclusion: Results from this pilot study indicate there are no significant additive effects of cell phone use and dental hygiene practice on finger muscles used for instrumentation. However, results indicate that dental hygiene practice demonstrated significant effects on muscular strength as compared to individuals who do not use tools/devices repetitively for work. The small sample size may have impacted results and the study should be repeated with a larger sample

The Effects of Dental Hygiene Instrument Handles on Muscle Activity Production

Purpose The objective of this study was to compare the effects of ten commercially available instrument handle designs’ mass and diameter on forearm muscle activity during a simulated periodontal scaling experience. Methods A convenience sample of 25 registered dental hygienists were recruited for this IRB-approved study. Ten commercially available instruments were categorized into four groups based on their masses and diameters: large diameter/light mass, small diameter/light mass, large diameter/heavy mass, and small diameter/heavy mass. Participants were randomized to four instruments with one from each group. Participants scaled with each instrument in a simulated oral environment while muscle activity was collected using surface electromyography. Muscle activity was compared among the four instrument group types. Results Muscle activity of the flexor digitorum superficialis was not significantly influenced by instrument mass (p=0.60) or diameter (p=0.15). Flexor pollicis longus muscle activity was not significantly influenced by instrument mass (p=0.81); diameter had a significant effect (p=0.001) with smaller diameter instruments producing more muscle activity. For the extensor digitorum communis and extensor carpi radialis brevis, instrument mass did not significantly affect muscle activity (p=0.64, p=0.43), while diameter narrowly failed to reach significance for both muscles (p=0.08, p=0.08); muscle activity for both muscles increased with smaller diameter instruments. Conclusion Results from this study indicate instrument diameter is more influential than mass on muscle activity generation; small diameter instruments increased muscle activity generation when compared to large diameter instruments. Future research in real-world settings is needed to determine the clinical impact of these findings

Attitudes of Virginia Dental Hygienists Towards Dental Therapists

Purpose: The state of Virginia faces a reported dental health professional shortage affecting approximately half of its residents.The purpose of this study was to assess the opinions and attitudes of dental hygienists in Virginia toward a mid-level dental provider model, dental therapists (DTs), and to determine whether current education level and years of practice affected opinions regarding the education requirements for DTs. Methods: A 22-item questionnaire was distributed online to a convenience sample of Virginia dental hygienists (n=910). Items assessed attitudes of participants toward the DT using a seven-point Likert-type scale ranging from 1 (strongly disagree) to 7 (strongly agree). Participants were asked to provide demographic information and to respond to open-ended questions regarding potential advantages and/or disadvantages to DTs. Independent samples t-tests and chi-square analyses were used to analyze the data. Results: A response rate of 22% was obtained (n=200). Most respondents agreed a DT was needed in Virginia (M=5.78, p\u3c0.001) and supported the concept that dental therapy could be a solution to the problem of access to care issues in Virginia (M=5.97, p\u3c0.001). While most respondents agreed it was important for Virginia to adopt legislation for a dental therapy model (M=5.89, p\u3c0.001), most disagreed that DTs’ practice should be restricted to acknowledged underserved areas in the state (M=3.19, p\u3c0.001). No significant association was found between years of practice and opinions toward education requirements for DTs; however, a significant association was found between current education level and opinions toward education requirements for DTs (Fisher’s Exact Test=34.17, df=9, p=.000, Cramer’s V=.28). Conclusion: Results revealed Virginia dental hygienists had overwhelmingly positive attitudes toward DTs. Research with a larger sample could provide more insight into opinions of the Virginia dental hygienist population regarding this mid-level oral health care provider

Attitudes of Virginia Dentists Toward Dental Therapists: A Pilot Study

Purpose: The purpose of this pilot study was to determine perceptions of Virginia (VA) dentists toward mid-level dental providers, specifically dental therapists (DT), and determine whether membership in the American Dental Association (ADA) membership affected attitudes. Methods: A convenience sample of 1208 dentists in the state of VA were invited to participate in an electronic survey. The instrument consisted of 11 Likert type scale questions assessing attitudes toward DTs. Additional items included the appropriate level of education and supervision of a DT, and five demographic questions. Descriptive statistics were used to analyze the data. A one-sample t-test was used to determine statistical significance for the Likert scale items. Results:An overall response rate of 12% was obtained (n=145). Most respondents were male (73%), members of the ADA (84%), and over the age of 40 (65%). Results suggest that most participants did not perceive (M=1.90, p Conclusions: Virginia dentists surveyed did not perceive a need for DTs and generally reported unfavorable attitudes towards this mid-level provider. Findings support the need for more research with a larger, more diverse sample population

The Shrinking Space for Civil Society : Philanthropic Perspectives From Across the Globe

The shrinking space for civil society and reported violations to fundamental and democratic rights are a global phenomenon. Foundations and other philanthropic organisations have reported problematic laws in Algeria, China, Columbia, Egypt, Ethiopia, India, Russia, Syria and Zimbabwe, just to name a few. And EU countries are hardly immune. Of serious concern have been ongoing challenges to civic rights in Hungary, UK surveillance programmes, anti-protest laws in Spain, counterterrorism measures in France, and attacks in Poland on the freedom of public media and the independence of the judiciary. In this publication, a group of European Foundation Centre members working across the globe share their thoughts on and experience of the shrinking space for civil society. This publication signals the EFC's ambition to scan the landscape on developments important to its members in an effort to contribute intelligence and capture the experience of foundations to make sense of the increasingly complex and interconnected world in which we all live. The insights from foundations and other philanthropic organisations on this issue are particularly valuable as these organisations, due to their funding practice and policy work, are often ahead of the curve in terms of what's happening on the ground

ManyDogs Project: A Big Team Science Approach to Investigating Canine Behavior and Cognition

Dogs have a special place in human history as the first domesticated species and play important roles in many cultures around the world. However, their role in scientific studies has been relatively recent. With a few notable exceptions (e.g., Darwin, Pavlov, Scott, and Fuller), domestic dogs were not commonly the subject of rigorous scientific investigation of behavior until the late 1990s. Although the number of canine science studies has increased dramatically over the last 20 years, most research groups are limited in the inferences they can draw because of the relatively small sample sizes used, along with the exceptional diversity observed in dogs (e.g., breed, geographic location, experience). To this end, we introduce the ManyDogs Project, an international consortium of researchers interested in taking a big team science approach to understanding canine behavioral science. We begin by discussing why studying dogs provides valuable insights into behavior and cognition, evolutionary processes, human health, and applications for animal welfare. We then highlight other big team science projects that have previously been conducted in canine science and emphasize the benefits of our approach. Finally, we introduce the ManyDogs Project and our mission: (a) replicating important findings, (b) investigating moderators that need a large sample size such as breed differences, (c) reaching methodological consensus, (d) investigating cross-cultural differences, and (e) setting a standard for replication studies in general. In doing so, we hope to address previous limitations in individual lab studies and previous big team science frameworks to deepen our understanding of canine behavior and cognition