Oral health statuses of individuals diagnosed with gastroparesis: A Cross-Section study

BACKGROUND

Gastroparesis (GP) is a debilitating gastric motility disorder associated with digestive dysfunction, reduced quality of life (QoL), and increased mortality rates. There is no known cure for GP and treatment options are limited. The oral cavity is responsible for initiating digestion, yet the impact of GP symptom frequency on oral health status and oral healthcare utilization is not well understood.

METHODS

A 21-item electronic survey was developed and disseminated to a private GP social media forum. Survey questions explored GP symptom frequency, oral health status, dental care utilization, and oral health education post GP diagnosis. Descriptive and inferential statistics analysed data.

KEY RESULTS

There were 434 study participants. An overwhelming 83% reported GP negatively influenced their oral health and oral function. Significance was observed between GP symptom frequency and oral health status (p = <0.0001). The majority (81%) reported receiving dental care post GP diagnosis, yet (63%) reported current untreated dental concerns. Interestingly, (74%) of participants reported that they have never been educated about oral health risks associated with GP by any healthcare professionals.

CONCLUSIONS

GP negatively affects oral health. Study participants reported a need for extensive dental treatments and high levels of untreated dental concerns. Results strongly support that preventive oral healthcare and education must be provided for individuals with a GP diagnosis. As leading oral disease prevention specialists, dental hygienists must be aware of the effects of GP on the oral cavity to help provide person-centred evidence-based care, improve digestive processes, and increase QoL for GP sufferers.

Artificial intelligence (A.I.) in dental curricula: Ethics and responsible integration

The use of artificial intelligence (AI) is deeply embedded in all aspects of our daily lives, promoting efficiency and safety in routine tasks at home and work. Likewise, dentistry is rapidly exploring new uses of AI for image analysis, electronic health records, and clinical decision-making. The accelerating advancement of AI and its application in dentistry demands dental education conscientiously integrate AI into curricula and equip graduates to use it ethically and responsibly in practice. The approach must be threefold: instill knowledge of the basic algorithms and appropriate application of AI, discuss its limitations/biases, and examine current and potential ethical challenges in practice. Furthermore, dental education must protect the public from intentional and unintentional harm introduced by AI. Therefore, the purpose of this perspective paper is to discuss various considerations for integrating AI into the dental curriculum, prioritizing patient safety by ensuring knowledgeable, safe, and ethical application by future providers.

Oral Health Recovery: A Peer Support Specialist-Led Health Education Program for People With Serious Mental Illness

Oral health affects whole health and quality of life. This is especially true for people with serious mental illness, a population with heightened risks for oral disease and needs for oral treatment. Studies have previously shown the effectiveness of peer support specialist (PSS)-led wellness interventions. Oral health educational materials and a health education approach were collaboratively developed by a multidisciplinary team and then implemented at one community mental health center and three PSS-run drop-in centers. PSSs provided health education and linked consumers to dental care. Program evaluation (N=41 respondents) indicated the approach's acceptability, feasibility, and sustainability.

Dental hygiene educators' knowledge and implementation of objective structured clinical examination in United States dental hygiene programs

PURPOSE

In 2021, the American Dental Association (ADA) announced the intention to develop a standardized dental hygiene licensure objective structured clinical examination (DHLOSCE). The purpose of this study was to measure the United States (US) dental hygiene (DH) educators' foundational knowledge of OSCE development and delivery in light of the impending development of the DHLOSCE by the ADA's Testing Services.

METHODS

The study was determined to be exempt from Institutional Review Board oversight. A 21-question survey was developed, pilot tested, and electronically disseminated through Qualtrics. The survey recruitment was emailed to the directors of all entry-level DH education programs in the US (n = 328), asking them to participate in the survey and to forward it to the clinical faculty in their institutions. Descriptive and inferential statistics were utilized to analyze the data.

RESULTS

There were 143 study participants, for a completion rate of 45%. Over two-thirds of respondents (64%) were unaware of the plans to develop the DHLOSCE, while 13% reported utilizing OSCEs to meet accreditation standards. Only 3% reported receiving a formal education in OSCE development compared to 29% who learned through a colleague or peer. Nearly half reported a lack of faculty experience as a barrier to OSCE implementation. Over three-quarters, 76% reported a lack of OCSE development committees within their program and only 14% had experience developing an OSCE station.

CONCLUSION

The study results suggest an urgent need for the development of OSCE training resources specific to DH education, as programs across the US prepare for the impending DHLOSCE.

Experiential Interprofessional Education Rooted in the Social Determinants of Health and Ecological Model Fosters Interprofessional Socialization

OBJECTIVE

Experiential interprofessional education (IPE) fostering socialization to interprofessional teams is essential to clinical practice. Inclusion of authentic patient voices cultivates an understanding of social factors that patients face. We qualitatively assessed how experiential IPE framed around social determinants of health (SDH) and socioecological model (SEM) influenced early health profession students' development of interprofessional socialization while working with patients. Secondarily, we explored how students shifted their mindsets for future interactions.

METHODS

Fifty-one health profession students participated in the Longitudinal Interprofessional Family-based Experience (LIFE), a virtual, 13-week experiential IPE opportunity during which students interacted with patients living with chronic illnesses through two interviews. Prompts representing aspects of working on an interprofessional team while interacting with a patient framed around social factors affecting healthcare were coded using the constant comparative method of analysis. Themes were derived and tallied for frequencies.

RESULTS

Themes from prompt related to working with an interprofessional team included: 1) perspectives, 2) informative, and 3) collaboration. Themes related to patients as a team member included: 1) active listening, 2) patients of similar/dissimilar back¬grounds, 3) person-centered care, and 4) awareness. Themes derived from prompt about future collaborations included: 1) collaboration, 2) awareness, and 3) person-centered care.

CONCLUSIONS

This SDH-focused experiential IPE advanced the understanding among early learners of how social factors that patients experience are barriers to how care is delivered and interprofessional teams must collaborate to consider factors to support patients.

Periodontal Staging and Grading: An International Dental Hygiene Education Survey

OBJECTIVES

The 2017 World Workshop on the Classification of Periodontal and Peri-Implant Diseases and Conditions ushered in a new paradigm for assessing and classifying periodontal diseases. This has significant implications for dental hygiene (DH) education programs' curricula. The purpose of this international survey was to assess: if and how accredited DH education programs were integrating the new staging and grading system into their curricula, and program directors' perceptions of the barriers and benefits to integration and teaching it.

METHODS

This study was deemed exempt from IRB oversight. A total of 339 undergraduate DH program directors from the US, Canada, and Australia that had similar accreditation standards were recruited for the survey. An electronic survey was developed and disseminated via Qualtrics^XM . Survey design included demographics and other questions to assess program directors' knowledge, understanding, integration of and barriers to implementing the new staging and grading system into their curricula.

RESULTS

A total of 140 surveys were completed, for a response rate of 42%. Results showed that (91%) of DH education programs had integrated the new staging and grading system into their curricula. DH didactic/theory courses (99%) and clinical courses (94%) were the curricular areas hosting the content. There was a statistically significant difference in the confidence of teaching the staging and grading system across institutional settings (p=0.02). The three main benefits identified were consideration of expected disease progression (3.25±2.06), individual risk factors (3.45±1.73), and personalized treatment (4.04±2.20). The most frequently reported barrier was lack of faculty support (26%).

CONCLUSION

DH educators have implemented the new staging and grading system into their clinical and didactic curricula. DH educators valued the individual, patient-specific components of the new system. While educators were confident in integrating the new system, those at community and technical colleges were less confident in teaching the system.

Examining the Influence of Academic Degree Level on Health Care Providers' Perceptions of Interprofessional Collaboration: A pilot study

Purpose: Health care provider perceptions of interprofessional collaboration (IPC) have been well documented, however barriers to provider participation persist. The purpose of this pilot study was to examine differences in health care providers' perceptions of IPC based on the academic degree level.Methods: Licensed health care providers with faculty appointments at a four-year university-based setting were invited to participate in an electronic survey. Attitudinal questions in the survey instrument were based on the Theory of Planned Behavior and the Social Cognitive Theory and assessed perceptions, attitudes, norms, and self-efficacy toward IPC. Descriptive statistics were used to analyze the data.Results: Respondents (n=179) included faculty in medicine (29%), dentistry (23%), nursing (13%), dental hygiene (11%), physical therapy (8%), and pharmacy (7%). Ninety percent of respondents agreed or strongly agreed that IPC is important for improving patient health outcomes. Respondents across all degree levels were significantly more comfortable taking recommendations on patient treatment from another health care provider with a doctoral degree as compared to a health care provider with an associate degree, with mean scores declining from 5.58 to 4.58 (p=0.000).Conclusion: While all respondents valued IPC in improving patient outcomes, their perceptions of other health care providers' level of academic degree may play a role in their willingness to truly collaborate with them. Despite an institution's positive culture of IPC, bias and stereotypes regarding the level of academic degree need to be addressed. Results indicate that while health care providers with lower academic degrees may be valuable contributors to the IPC team, their academic degree could be a barrier to their meaningful inclusion.

Impact of Covid-19 on dental hygiene educators: A national survey

PURPOSE

The purpose of this study was to assess the impact of the Covid-19 pandemic on dental hygiene (DH) educators' perception of personal and professional burnout and efficacy in the online/hybrid learning environment.

METHODS

A cross-sectional study of DH faculty members from 327 United States entry level DH programs was invited to participate in this study. A 36 item survey was disseminated in Qualtricsxm March 2021. The Copenhagen Burnout Inventory was used to measure personal, work-related, and burnout related to working with students. The Michigan Nurse Educators Sense of Efficacy for Online Teaching instrument was used to measure efficacy in online/hybrid learning.

RESULTS

The survey had an institutional response rate of 46%. Personal burnout scores had a significantly higher mean as compared to work-related and burnout working with students' scores. A majority (66%) of respondents reported often feeling tired. Only personal burnout scores had a significant negative correlation with teaching efficacy scores. Administrators/program directors and full-time faculty had significantly higher mean personal and work-related burnout scores as compared to part-time/adjunct clinical faculty. There were no significant differences in teaching efficacy scores by faculty position and institutional setting.

CONCLUSION

COVID-19 had significant impact on full-time DH educators' personal and professional burnout levels. Full-time administrators/program directors/DH educators reported higher levels of personal burnout. It seems that personal burnout has a negative relationship with teaching efficacy. Faculty position rather than institution impacted personal burnout. Despite personal and professional burnout, DH faculty reported low-levels of burnout related to working with students.

A qualitative assessment of dental hygiene educators' COVID-19 related burnout

Purpose

The purpose of this study was to elicit ideas or concerns influencing dental hygiene educators’ experiences of personal and professional burnout, burnout working with students, and teaching efficacy in an online/hybrid environment as a result of the COVID‐19 pandemic.

Methods

A qualitative, content‐analysis study included a convenience sample of dental hygiene educators emails. An invitation to participate in an August 2021 or October 2021 focus group was sent via Qualtrics^xm with informed consent, and focus groups were held over Zoom. Conversations were audio recorded, transcribed, and de‐identified. Consensus on a codebook by two coders achieved an 88% agreement.

Results

Fifty‐three were invited to the August 2021 focus groups for a 26% (n = 14) response rate, and 116 were invited to the October 2021 focus groups for an 11% (n = 13) response rate. Contributing factors to experiences of burnout expressed were: (1) work–life balance (n = 59), including (a) overwork, (b) pressure to be available, and (c) lack of boundaries; (2) change (n = 34) involving (a) developing new protocols, (b) constant uncertainty, (c) COVID‐19 requirements, and (d) new platforms; and (3) negative interactions (n = 32) with (a) students and (b) faculty.

Conclusion

A lack of work–life balance from overwork, pressure to be available at all times, no boundaries with students, and an absence of a sense of connection for workplace vitality were contributors to burnout. Work‐from‐home flexibility, a work environment that supported wellness and mental well‐being, and the ability to leave the workplace for periods of time were reported as helpful solutions to combatting burnout.

Utilization of Objective Structured Clinical Examinations (OSCE) as an Assessment for Clinical Competency and Licensure: A survey of dental hygiene director's knowledge and attitudes

Purpose: Objective Structured Clinical Examinations (OSCEs) have been established as a gold standard assessment for determining clinical competence. The Coalition for Dental Licensure Reform called for the acceptance of the Dental Licensure Objective Structured Clinical Examination (DLOSCE) to replace the live-patient examinations (LPE) for dental licensure, which are often viewed as biased, unreliable, and in some cases unethical. The purpose of this study was to assess dental hygiene program directors' awareness of and attitudes toward the DLOSCE, whether their curricula included OSCEs, and perceived barriers to implementing OSCEs.Methods: A nine-question electronic survey was developed, and pilot tested by five-dental hygiene program directors across three-dental hygiene institutions. The survey was emailed to the directors of all dental hygiene program directors in the United States (n=332). Descriptive statistics were used to analyze the data.Results: A response rate of 36% (n=121) was achieved. Nearly 30% of respondents were unaware of the developing DLOSCE, however, the majority (80%) were in favor of the acceptance of the examination. Nearly three-quarters of the respondents considered OSCEs as valid assessments of clinical competence, however, over half of the respondents reported not currently utilizing OSCEs in their curricula. Barriers reported were time (22%), perceived lack of best practices (21%), and lack of resources (18%). Respondents who currently employed OSCEs were more likely to agree they were both valid and reliable assessments (p=0.05).Conclusion: The majority of dental hygiene program directors were in favor of eliminating the single-encounter LPE in favor of an OSCE for licensure. However, more than half do not currently utilize OSCEs for clinical assessments. Further studies are needed to explore implementation of OSCEs in dental hygiene education, and how a potential dental hygiene licensure OSCE might impact the current curricula and licensure of dental hygienists in the United States.

Clinical trial of moxidectin oral gel in horses

A clinical trial carried out over 98 days was done to evaluate treatment of horses with moxidectin gel for efficacy as measured by (1) reduction in the production of parasite ova post treatment, (2) a comparison of the posttreatment parasite egg count suppression of moxidectin to ivermectin, and (3) assessment of the field safety, animal acceptance of the moxidectin formulation, and the utility of the moxidectin delivery device. One hundred and fifty Standardbred horses with naturally acquired parasite infections were used in the study. Moxidectin had more prolonged and greater suppressive influence than did ivermectin on reappearance and magnitude of strongyle egg counts post treatment. Differences were not observed between the capability of ivermectin or moxidectin to reduce and suppress low Parascaris equorum egg counts. Adverse reactions to treatments were not observed, and the utility of the moxidectin delivery syringe and animal acceptance of moxidectin treatment were satisfactory.