Comparison of Corded and Cordless Handpieces on Forearm Muscle Activity, Procedure Time and Ease of Use During Simulated Tooth Polishing

Purpose: Dental professionals suffer from a high prevalence of work-related musculoskeletal disorders (MSD). Dental hygienists in particular have a high prevalence of pain in the forearms and hands. The objective of this study was to compare 1 cordless handpiece to 2 corded handpieces during simulated tooth polishing in terms of the muscle loads (recorded as electromyography (EMG) activity), duration of polishing procedure, and dental hygienist opinion about ease of use. Methods: EMG was used to quantify muscle electrical activity of 4 forearm muscles during simulated dental polishing with 2 corded handpieces (HP-A and HP-B) and 1 cordless handpiece (HP-C). A convenience sample of 30 dental hygienists (23 to 57 years of age) with 1 to 20+ years of clinical practice experience completed the study. Each participant spent approximately 5 minutes polishing 3 predetermined teeth in each of the 4 quadrants. The sequence of the handpieces was randomly assigned. At the end of the study, participants completed a subjective end user evaluation of handpiece preference. Results: Muscle activity levels of 10th, 50th and 90th percentiles did not differ significantly between the 3 handpieces tested (p\u3e0.05). However, total muscle workload (integrated EMG) was lowest for the cordless handpiece (HP-C), but this was only significantly less than HP-A (p\u3c0.05). Polishing using the cordless handpiece (HP-C) (M=257 seconds, SD=112 seconds) took significantly less time than either the HP-A corded (M=290 seconds, SD=137 seconds) or HP-B corded handpiece (M=290 seconds, SD=126 seconds) (p\u3c0.05). Overall, 50% of the study participants preferred the cordless handpiece, 37% preferred HP-A and 13% preferred HP-B (p\u3c0.05). Conclusion: Use of the cordless handpiece reduced the duration of polishing, which in turn led to less total muscle activity, but not muscle intensity. Overall, dental hygienists preferred the cordless handpiece

Fibromyalgia Syndrome: Considerations for Dental Hygienists

PURPOSE: Fibromyalgia syndrome (FMS) is a neurosensory disorder characterized by widespread musculoskeletal pain. Typically persistent fatigue, depression, limb stiffness, non-refreshing sleep and cognitive deficiencies are also experienced. Oral symptoms and pain are common, requiring adaptations in patient management strategies and treatment interventions. Appropriate dental hygiene care of patients suffering with this disorder is contingent upon an understanding of disease epidemiology, pathophysiology, clinical characteristics, oral signs and symptoms, as well as treatment approaches. With this information dental hygienists will be better prepared to provide appropriate and effective treatment to patients with FMS

Oil Pulling: An Ancient Practice for a Modern Time

The practice of oil pulling or oil swishing is a time-honored Indian folk remedy that involves swishing edible oil in the mouth for oral and systemic health benefits. Oil pulling offers a naturalistic approach to oral health care for a growing body of individuals who desire alternative and complementary medicine. The purpose of this paper was to summarize published research on the effectiveness of oil pulling on oral health. Literature was retrieved from 1992-2011 through databases including Cumulative Index to Nursing and Allied Health Literature (CINAHL), Education Resources Information Center (ERIC), Medical Literature Analysis and Retrieval System Online (MEDLINE), and Google Scholar. To date, studies have assessed the effectiveness of oil pulling on plaque, gingivitis, xerostomia, dental caries and malodor. Within the scope of this review, research suggests that oil pulling may hold certain advantages over other commercially available products in reducing various oral conditions, yet there is insufficient scientific evidence to support its effectiveness

A Study of Visible Tattoos in Entry -Level Dental Hygiene Education Programs

Purpose: The purpose of this study was to survey entry-level dental hygiene program directors in the United States (US) to assess their perceptions of dental hygienists with visible tattoos as well as to determine current policies related to dress codes in US dental hygiene programs. Methods: Data was collected with an online survey emailed to 340 dental hygiene program directors from March to April 2016, yielding a 43% (n = 141) response rate. Participants indicated their opinions of visible tattoos on the basis of professionalism and school policy requirements. Results: Eighty percent of respondents reported their program had dress code policies on visible tattoos, with the majority (97%) requiring visible tattoos to be covered. Results revealed that both students (M = 5.57, p Conclusion: Results showed that visible tattoos were not perceived favorably in general, and that the dental hygiene program director\u27s personal perceptions may have influenced existing school dress code polices. These findings provide evidenced based information for hygienists, students, faculty, administrators and hiring managers as they formulate institution policies relating to body art

Dental Hygienists\u27 Perspectives on Four Periodontal Instrument Handle Designs

Problem: Developing new instrument designs to address the ergonomics of instrumentation and to decrease repetitive strain injuries in the dental hygienist is an ongoing area of development. Changing the weight and diameter of instrument handles has been suggested to reduce risk for trauma in the practitioner but minimal research has been conducted to determine design preferences of practicing dental hygienists. Objective: The purpose of this study was to assess dental hygienists opinions on the weight, diameter, balance and maneuverability of four different instrument handles. Methodology: After IRB approval, a convenience sample of 27 practicing dental hygienists from Virginia participated in the study. Four typodonts were set up for each participant with a different instrument randomly assigned for use on each. Subjects scaled first molars coated with artificial calculus using a Columbia 13/14 curet with four commercially available handle designs that varied in weight and diameter: A) 16 grams and 12.7 mm diameter; B) 23 grams and 11.1 mm diameter; C) 21 grams and 7.9 mm diameter and D) 18 grams, and 6.35 mm diameter. Following scaling participants used a 6 item survey to rate their comfort level on a 5-point scale ranging from 1 (very comfortable) to 5 (uncomfortable) with regard to balance, weight, diameter, maneuverability and overall preference. A Friedman test determined significant differences between participants\u27 perceptions. A Wilcoxan signed rank test followed if differences were found. Results: Handle designs had significant effects on dental hygienists\u27 instrument preferences while performing simulated scaling. Results revealed significant differences for participants\u27 preferences concerning diameter (x2(3)=50.584, p=0.000), weight (x2(3)=24.650, p=0.000), balance (x2(3)=69.504, p=0.000) and maneuverability (x2(3)=67.728, p=0.000). When comparing comfort based on diameter grip, results reveal instrument D was least comfortable compared to A, B and C (p=0.000, p=0.000, p=0.000). Instrument A was most comfortable in weight when compared to all other instruments (p=0.008, p=0.000, p=0.000). In regards to balance significant differences were found between instrument A when compared to both C and D (p=0.000, p=0.000), with instrument A having the highest mean score (x=4.7). Finally, instrument A was rated most comfortable for maneuverability (p=0.003, p=0.000, p=0.000). Sixty-three percent of participants preferred instrument A, 26% instrument B, 11% instrument C and none preferred D. Conclusion: When performing simulated scaling, results indicate most participants preferred using a lighter weight, larger diameter instrument handle. Diameter affected preference more than weight. The smallest diameter handle was always ranked the lowest with regards to balance, weight, diameter and maneuverability although it was not the heaviest

The Use of Immersive Visualization for the Control of Dental Anxiety During Oral Debridement

Purpose: The purpose of this study was to evaluate the effects of Immersive Visualization (IV) eyewear on anxious, adult patients during oral debridement. Methods: Thirty adult volunteers (n=23 females n=7 males) were enrolled in the study. Participants were required to be 18 years or older, exhibit at least moderate anxiety (score 9 or higher) on the Corah\u27s Dental Anxiety Scale-Revised (DAS-R), and be generally healthy. Individuals were excluded from participation if they presented with severe dental calculus, periodontal disease, or dental caries, were taking psychotropic drugs, had a history of convulsive disorders, vertigo, or equilibrium disorders, or required antibiotic premedication. Subjects received a full mouth oral prophylaxis (supra- and subgingival scaling and selective polishing) by a single experienced dental hygienist. A split mouth design was utilized whereby each subject served as their own control. Subjects were randomly divided into 2 groups: Group A used IV eyewear during the first one-half of the appointment (right side of the mouth) and Group B used IV eyewear during the second one-half of the appointment (left side of the mouth). At screening, medical and dental histories were obtained, full mouth oral examinations were performed, and DAS-R was scored to determine eligibility. At baseline, the DAS-R was re-scored to validate anxiety levels. The Calmness Scale was scored pre- and post-IV treatment on a Likert scale ranging from 1 (very calm) to 7 (less calm). At the end of the study, subjects completed a Post IV Opinion survey. Data were entered into Microsoft Excel for Mac 2011 (Microsoft Corporation Version 14.3.5) and analyzed using SAS® 9.3 statistical software. Results:Thirty subjects with a mean age of 29.9 years completed the study. Data analysis indicated no statistically significant difference between Group A and B with regard to mean DAS-R anxiety levels at baseline (3.15 and 2.40, respectively), with a p-value of 0.07. Data showed a significant difference when comparing the calmness mean scores within Group A pre- and post-IV treatments (4.66 and 2.93, respectively), with a p-value 0.01. Within Group B the data revealed a statistically significant difference between pre- and post-IV treatments (p Conclusion: Results from this study support the use of IV eyewear as an effective technique to reduce anxiety in adults during oral debridement. The use of the IV eyewear was well received by all subjects. The portable, affordable and easy-to-operate IV system makes this technique an appealing approach of reducing dental anxiety

The Comparative Effects of 0.12% Chlorhexidine and Herbal Oral Rinse on Dental Plaque-Induced Gingivitis

PURPOSE: The purpose of this study was to determine the effects of two oral rinses-one 0.12% chlorhexidine rinse (CHX) and one herbal rinse (HBR)-on gingival health status over time. METHODS: Sixty-three participants were randomly assigned to one of three treatment groups: CHX, HBR, or placebo. For three months, participants rinsed twice daily (morning and evening) with (1/2) ounce of allocated rinse after brushing and flossing. Individuals were given the same type of soft bristle toothbrush and whitening toothpaste. No attempt was made to modify participants\u27 routine oral care, except they were advised to refrain from use of any other oral rinse for the duration of the study. Data were collected at baseline (B), month one (1), two (2), and three (3) utilizing the Gingival Index (GI), Plaque Index (PI), and bleeding on probing (BOP). A full mouth periodontal probing was performed at baseline and at the completion of the study. A soft tissue oral assessment was completed at each visit. CHX, HBR, and placebo data were compared between three time intervals, B-1, B-2, and B-3. Statistical analysis was conducted by means of multiple regression using generalized linear models. Paired comparison tests--ANOVA followed by a post hoc Tukey test--were used to confirm results. RESULTS: CHX was the only oral rinse to demonstrate a statistically significant effect on the reduction of mean GI, BOP, and PI scores when compared to placebo. CHX demonstrated a 31% reduction in the proportion of GI scores between B-2 and a 29% reduction between B-3 (p=.003 and p=.012, respectively). CHX demonstrated a 19% reduction of BOP sites between B-1, 32% reduction between B-2, and 29% reduction between B-3 (p=.028, p=.000, and p=.005, respectively). CHX demonstrated a 20% reduction in PI scores between B-1, and a 28% reduction between B-2 (p=.005 and p=.032, respectively). The effects of HBR on reducing mean GI, BOP, and PI scores were not statistically greater than placebo at any time during the study

The Effect of Magnification Loupes on Dental Hygienists\u27 Posture While Exploring

Purpose: The purpose of this study was to determine the effects of dental magnification loupes on posture during instrumentation. Methods: A convenience sample of 27 right-handed dental hygienists, with no prior history of injuries or disabilities of the head, neck, or trunk region, enrolled in the study. Baseline posture calibration was taken and tri-axial accelerometers were placed on four locations of the head and trunk (occipital region of head; cervical vertebrae C5; thoracic vertebrae T5; lumbar vertebrae L1) to measure acceleration and the orientation of the body to gravity. Participants were randomly assigned to wear self-supplied magnification loupes during either the first or second half of the session. Dental chair mounted typodonts, prepared with artificial calculus, were used to represent a simulated oral environment. Participants were asked to explore all areas of the mouth using an ODU 11/12 explorer. Mean accelerations of the three axes were used to compute average forward/backward (AP) and side to side (ML) tilt of each accelerometer recorded during the instrumentation sessions. An end-user opinion survey was completed by each participant at the conclusion of the session. Results: No statistically significant differences in posture were revealed between the sessions with the participants wearing their loupes and not wearing loupes. However, data from the end-user survey indicate that 74% of all the participants strongly agreed that magnification loupes made exploring easier and 67% strongly agreed that they felt that magnification loupes improved their posture. Conclusion: While the majority of participants perceived that their magnification loupes enhanced their posture and made exploring easier, data from this study provided little evidence to suggest that wearing loupes leads to improved body orientation. Future research needs to examine the declination angle of ergonomic loupes and its relationship to neck and trunk flexion

Sulcular Sulfide Monitoring: An Indicator of Early Dental Plaque-Induced Gingival Disease

Purpose. The purpose of this study was to evaluate the relationship between volatile sulfur compounds (VSC) and gingival health status and to determine if volatile sulfur compounds can detect early dental plaque-induced gingival disease. Methods. A split-mouth design with randomly selected quadrants of the mandibular arch enabled 39 participants to serve as their own controls. At baseline and at three subsequent appointments (days 7, 14, and 21) gingival inflammation (GI), bleeding on probing (BOP), and sulfide levels (SUL) were measured using the Gingival Index and the Diamond Probe/Perio 2000 System. For three weeks, participants refrained from brushing and flossing one randomly selected quadrant of the mandibular arch. The Pearson correlation test was used to determine the relationship between sulfide concentrations and gingival health. The Wilcoxon signed rank test was used to compare the differences in mean GI, BOP, and SUL scores between the hygiene side (H) and the non-hygiene side (NH). Results. Data suggest that SUL correlate positively to GI and BOP on both sides; however, the strength of the correlation was stronger for the NH side. A comparison of mean GI, BOP, and SUL scores revealed a statistically significant difference between sides for all three parameters from baseline to day 21, except for SUL on day 14. Conclusions. Based on study outcomes, the Diamond Probe/Perio 2000 System demonstrated the ability to detect sites with elevated SUL; therefore, SUL may be a useful adjunctive indicator of early plaque-induced gingivitis. In addition, data revealed a moderate correlation between SUL levels and gingival inflammation on the NH sides. Whether sulfur by-product is a contributor to the disease process, or merely a correlate, is inconclusive. [ABSTRACT FROM AUTHOR

The Use of Fluorescence Technology Versus Visual and Tactile Examination in the Detection of Oral Lesions: A Pilot Study

PURPOSE: This study compared the effectiveness of the VELscope(R) Vx versus visual and tactile intraoral examination in detecting oral lesions in an adult, high risk population. METHODS: The pilot study compared the intra oral findings between 2 examination types. The sample was comprised of 30 participants who were addicted to either cigarettes or a dual addiction (cigarettes plus hookah). High risk population was defined as males who were current cigarette smokers or had a dual addiction. Two trained and experienced licensed dental hygienists conducted all examinations. Throughout the study, all visual and tactile intraoral examinations were conducted first by one dental hygienist first, followed by the VELscope(R) Vx fluorescence examinations by the second dental hygienist. All subjects received an inspection of the lips, labial and buccal mucosa, floor of the mouth, dorsal, ventral and lateral sides of the tongue, hard and soft palate, and visual inspection of the oropharynx and uvula. Both evaluations took place in 1 visit in the Dental Hygiene Research Center at Old Dominion University and external sites. All participants received oral cancer screening information, recommendations, referrals for tobacco cessation programs and brochures on the 2 types of examinations conducted. RESULTS: Participants were considered high risk based on demographics (current smokers and mostly males). Neither visual and tactile intraoral examination nor the VELscope(R) Vx examination showed positive lesions. No lesions were detected; therefore, no referrals were made. Data indicated the duration of tobacco use was significantly higher in cigarette smokers (14.1 years) than dual addiction smokers (5 years) (p\u3e0.005). The average numbers of cigarettes smoked per day were 13.5 compared to 14.2 cigarettes for dual addiction smokers. CONCLUSION: Results from this study suggest the visual and tactile intraoral examination produced comparative results to the VELscope(R) Vx examination. Findings from this study support that the VELscope(R) Vx is still considered an adjunct technology and cannot be used exclusively for oral cancer screening