2011 ADEA Annual Session: Poster Abstracts

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

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

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

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

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

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

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

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

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