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

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

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

Bactericidal Effects of Cold Plasma Technology on Geobacillus Stearothermophilus and Bacillus Cereus Microorganisms

Cold plasma is a state of matter that contains a large number of particles that are electrically charged. Plasmas generate chemically reactive species and ultraviolet radiation making them useful in decontamination applications (Kong & Laroussi, 2003). Research regarding the inactivation of gram-positive bacteria by cold plasma has been studied by Laroussi et al (2003); however, there is limited research regarding the germicidal effectiveness of cold plasma on Geobacillus stearothermophilus and Bacillus cereus microorganisms. The purpose of this study was to determine if cold plasma technology inactivates Geobacillus stearothermophilus and Bacillus cereus vegetative cells and spores. This study consisted of 981 samples; 762 experimental samples exposed to cold plasma at various times and 291 controls. Experimental samples were inoculated and exposed either directly or indirectly/remotely to cold plasma. After exposure the samples were incubated for 12 to 16 hours and colony forming units (CFU) were quantified. The percentage kill and log concentration reductions were calculated from the CFU counts. Data was analyzed using one-way ANOVA, Kruskal Wallis and Tukey\u27s tests at the .05 level. There was a statistically significant difference in the inactivation of Geobacillus stearothermophilus vegetative cells for indirect exposure (p=.0001), direct exposure (p=.0013), as well as for Bacillus cereus vegetative cells and spores (p=.0001). Exposure of Geobacillus stearothermophilus spores to cold plasma demonstrated no statistically significant differences in inactivation for indirect exposure (p=.7208) and direct exposure (p=.0835). Results indicate that cold plasma exposure significantly inactivated Geobacillus stearothermophilus (vegetative) and Bacillus cereus; however, Geobacillus stearothermophilus spores were not significantly inactivated. Funding for this project was provided by ADHA IOH

Cold Plasma Technology: Bactericidal Effects on Geobacillus Stearothermophilus and Bacillus Cereus Microorganisms

Introduction: Cold plasma, also known as Low Temperature Atmospheric Pressure Plasma (LTAPP) is a novel technology consisting of neutral and charged particles, including free radicals, which can be used to destroy or inactivate microorganisms. Research has been conducted regarding the effect of cold plasma on gram-positive bacteria; however, there is limited research regarding its ability to inactivate the spore-formers Geobacillus stearothermophilus and Bacillus cereus. Purpose: The purpose of this study was to determine if cold plasma inactivates G. stearothermophilus and B. cereus vegetative cells and spores. Methods: Nine hundred eighty-one samples were included in this study (762 experimental and 219 controls). Experimental samples were exposed indirectly or directly to cold plasma, before plating and incubating for 16 hours. Control samples were not exposed to cold plasma. The percentage-kill and cell number reductions were calculated from Colony Forming Units (CFU). Data were statistically analyzed at the .05 level using one-way ANOVA, Kruskal Wallis and Tukey\u27s tests. Results: There was a statistically significant difference in the inactivation of G. stearothermophilus vegetative cells receiving indirect and direct exposure (p=0.0001 and p=0.0013, respectively), as well as for B. cereus vegetative cells and spores (p=0.0001 for direct and indirect). There was no statistically significant difference in the inactivation of G. stearothermophilus spores receiving indirect exposure (p=0.7208) or direct exposure (p=0.0835). Conclusion: Results demonstrate that cold plasma exposure effectively kills G. stearothermophilus vegetative cells and B. cereus vegetative cells and spores; however, G. stearothermophilus spores were not significantly inactivated

Dental Hygienists\u27 Contributions to Improving the Nation\u27s Oral Health Through School-Based Initiatives from 1970 Through 1999: A Historical Review

PURPOSE: The purpose of this literature review is to document the contributions dental hygienists have made over the past 3 decades to improve the nation\u27s oral health. This historical review encompasses selected literature that acknowledged dental Hygienists\u27 direct involvement in U.S. school-based or school-linked oral health programs from 1970-1999. METHODS: Five researchers independently searched MEDLINE, PubMed, and other electronic databases to identify relevant literature for the years 1970-1999. The search aimed to locate articles authored by or that documented dental Hygienists\u27 involvement as service provider in U.S. school-based oral health programs. For the purpose of this review, service provider was defined as educator, administrator, clinician, examiner, or any other unspecified service performed by a dental hygienist. RESULTS: Fifty-seven articles were retrieved, of which 36 (63%) directly linked dental hygienists to U.S. school-based activities. Twenty-seven articles specifically identified dental hygienists as service providers. Dental hygienists were listed as either primary or contributing author on 19 of these articles. CONCLUSION: The decade of the 1970s revealed very little literature documenting dental Hygienists\u27 involvement in U.S. school-based oral health programs. The 1970s, however, were instrumental in laying the foundation for service in the years that followed. As public health initiatives expanded in the 1980s, dental hygienists were identified in the largest number of papers as key personnel in the areas of education, management, service provider, and author. The decade of the 1990s yielded less literature than the 1980s, yet recognized dental Hygienists\u27 involvement in all aspects of oral health care delivery, program development and management, and authorship. The authors of this review theorize that dental hygienists were engaged in more school-based programs than reported and were involved in the authorship process more frequently than documented. Due to lack of credentials, or the omission of the words dental hygienist, RDH, or LDH, in favor of health care provider, auxiliary, or trained health care educator, it is unknown what portion of contributions made by dental hygienists remain undocumented

Workplace Bullying: A Survey of Virginia Dental Hygienists

Purpose: Workplace bullying in health care has been identified as a problem that negatively affects career satisfaction, career longevity and patient outcomes. The purpose of this pilot study was to determine the prevalence of workplace bullying in a convenience sample of dental hygienists in the state of Virginia. Methods: Two hundred and forty Virginia dental hygienists attending a continuing education seminar were invited to participate. Using the Negative Acts Questionnaire-Revised (NAQ-R), respondents were asked to indicate how often they had experienced 22 negative acts or behaviors according to rate of occurrence (never, now and then or monthly, weekly or daily). Bullying was defined as experiencing two or more of the specified negative behaviors over the past 6 months. The negative behaviors were categorized into three subgroups: work-related bullying, personal bullying and physical intimidation. Results: The response rate was 64%. Data revealed almost one fourth (24%) of respondents experienced workplace bullying. The most frequent behaviors experienced by those being bullied were having their opinions and views ignored (73%), experiencing unmanageable workloads (68%) and having their work excessively monitored (68%), on a weekly or daily basis. Conclusions: Results from this study suggest approximately 1 out of 4 Virginia dental hygienists responding to this survey experience workplace bullying. Education and support to ensure identification of bullying may be helpful in promoting proactive awareness, prevention strategies and a healthier work environment leading to greater job satisfaction. This manuscript supports the NDHRA priority area: Professional development: Occupational health (career satisfaction and longevity