The impact of COVID-19 on the dental hygienists: A cross-sectional study in the Lombardy first-wave outbreak

The impact of COVID-19 on socio-economical activities has changed everyday life. Dental hygienists, who perform aerosol generating procedures, have been strongly affected by changes in routine procedures. This cross-sectional study aimed at carrying out an online survey among dental hygienists in Lombardy. The survey was implemented after the first-wave lockdown focusing on the level of knowledge on COVID-19 and Sars-CoV-2, the virus-related changes in their attitude and working routine, and the socio-economic effects. In this report, we included 313 questionnaires of respondents (259 Females, and 54 Males; age = 33 ± 9 years). A significant percentage of respondents acknowledged the use of “word of mouth” among colleagues (n = 114, 36%) and social networks (n = 113, 36%) to be up to date on COVID-19. About half of respondents correctly identified the main COVID-19 symptoms/signs, just 13% (n = 41) identified the routes of transmission. Three quarters of respondents (n = 234, 75%) were afraid of being infected during the clinical practice, and about half of them would be afraid to treat patients having symptoms attributable to COVID-19. Twenty-one percent (n = 67) of participants also thought about changing job. Air-polishing was identified as the highest risk procedure, and 82% (n = 256) reported that they eliminated its use. Most claimed they never had a swab or a serological test, with two respondents positive to molecular test (0.6%), and 12 positives to serological test (3.8%). More than half of the participants (65%; n = 202) complained the dental hygienist is not protected, despite a loss of earnings due to lockdown between 2,000 and 10,000 euros. This study demonstrated that dental hygienists were emotionally and economically affected by the pandemic, significantly changing their work routine. Anti-epidemic protocols are pivotal to react promptly and to contain the virus in the dental setting.

California's Clinical Dental Team: Evolving Together With an Eye to the Future

California dentists enjoy some of the most well-trained clinical teams in the country. In these changing times, reflecting on our collective history may help inform collaboration and innovation that will serve us well as we create new ways to care for our patients and thrive in our professional lives.

The intersection of education and technology at the century mark

Since the inception of dental hygiene in 1913, we have witnessed the tremendous evolution of the profession. Within the past couple two decades a significant game changer has been technology. The ability to expand access to education through technology has resulted in an increasing number of dental hygienists seeking advanced degrees and gaining new skills and certifications. The evidence shows that dental hygienists are using their advanced education to address lack of access to oral health care services. The profession should remain focused on advocating for the increased education of the dental hygienist, by finding solutions to barriers that presently prevent the realization of this ultimate advancement.

The past and future evolution of the dental workforce team

This article looks at changes in the number and mix of providers in the dental workforce over the past sixty years. First, enrollment trends in dental education programs are investigated. These educational programs feed directly into the dental workforce. Then, the changes in the dental workforce are examined. The focus of this investigation is the composition of the dental workforce and how the components of the workforce have changed over time. The forces that are responsible for these changes in the workforce are explored next. Finally, the possibility for workforce changes in the future is considered.

Looking at the past to see the future: the role of the dental hygienist in collaborating with dentists to expand and improve oral health care

As dental hygiene approaches its 100th anniversary in 2013, it is clear that the profession has evolved far beyond the initial vision of Dr. Alfred Fones. Much of this evolution has been driven by changing oral health needs of the public as well as the way dentists practice, based on innovations in dentistry, to concentrate on more advanced procedures and delegate other duties to the dental hygienist. By and large, these changes have been achieved by dentists, dental hygienists, and other team members working together. We have an opportunity to overcome initial resistance and, based upon evidence of successful outcomes, further extend the reach of the dental team for the benefit of patients, especially the most vulnerable among them.

Predictors of student success in an entry-level baccalaureate dental hygiene program

PURPOSE

The purpose of this study was to measure the utility of various predictors used by the Old Dominion University Gene W. Hirschfeld School of Dental Hygiene baccalaureate degree dental hygiene program in selecting dental hygiene students who are most likely to graduate and be successful in passing the National Board Dental Hygiene Examination (NBDHE). The following factors were examined: grade point average (GPA); science GPA; final grade in various prerequisite courses; final grade in first-year dental hygiene courses; academic setting where prerequisite courses were completed; multiple attempts to achieve a passing course grade; and admissions criteria points (ACP).

METHODS

The sample selected for study consisted of the academic records of dental hygiene students admitted to the program from 1998 to 2002 (n = 235), who would have been eligible to take the NBDHE from 2000 to 2004. Data were analyzed using multiple logistic regression to determine success as measured by graduation (n = 146). With NBDHE as the criterion variable, data were analyzed using the multiple linear regression to determine successful entry into the profession (n = 130); significance was predetermined at the 0.05 level.

RESULTS

Data analysis revealed that final course grade in oral pathology was a significant predictor of successful graduation (P = 0.0008). Variables that predicted NBDHE success were final course grade in oral pathology, final course grade in oral anatomy and histology, and the ACP rating (P < .0001, P < .0001, and P = .0245, respectively). There was no statistically significant relationship for other variables.

CONCLUSION

Final grades in oral pathology and oral anatomy and histology can significantly predict graduation and NBDHE success at this institution, suggesting that educators look to improving student performance after admission to the program to improve the likelihood of success. Additionally, when this institution's admission variables were combined into a cluster of variables (ACP), they proved significant at predicting success.

Dental hygiene education in Japan: present status and future directions

The aim of this report is to provide basic information about the historical development, current status and future needs of education and training of dental hygienists in Japan. The first formal training of dental hygienists in Japan started at Tokyo in 1949. Restructure and modification of the dental hygiene education system has been reiterated over the years in order to satisfy the needs of the constantly changing society. Although previously only vocational training was provided for dental hygienists, higher-level education has been conducted. The present legislation of dental hygiene has gone through a complicated process. The student should take the dental hygienist licensing examination which is held once a year by the National Board organized by the Ministry of Health, Labour and Welfare. Currently there are 136 dental hygiene schools and the total enrolment is about 7000. The duration of dental hygiene education course has been prolonged from 2 to 3 years since 2001. In 2004, the 4-year course started. The 2-year dental hygiene education program is expected to be replaced with the 3- and 4-year courses by 2010. The dental hygiene education system in Japan will be improved in many ways as dental hygienists are expected to participate in health promotion and preventive care, and to gain knowledge of the economics and organization of health care in relation to oral hygiene.

An analysis of present dental professions in Sweden

Dentistry in Sweden is predicted to have a shortage of dentists in the future and the division of labour within dentistry will be a more debated question. In order to forecast the effects of such a shortage the professional status of the involved groups must be made clearer. The objective of this paper is to analyse the emergence and present professional status of clinical dental professions in Sweden. The study was conducted on the basis of theories on professions, and their roles in organizations was analysed. The results were applied on the historical emergence, establishment and consolidation of clinical dental professions in Sweden. The results show that a large sector of salaried dentists has not diminished the professional status of the Swedish dentists. Professional ambitions such as many clinical subspecialties and a strong element of research have not been restrained by the public health ambitions in the Public Dental Health Service (PDHS). Presently, other dental professions are dental hygienists, dental technicians and dental nurses. Of these the only other licensed group, the dental hygienists, are an emerging profession. They have an uphill struggle to obtain a full professional status, mainly because their knowledge domains are neither specific nor exclusive to their group. Development of a common core curriculum on a clearly academic level would enhance their professional status. Dental technicians and nurses are lacking fundamental traits as professions. There appears to be little need for additional groups of clinical professions besides dentists and dental hygienists in Swedish dentistry. In conclusion,this analysis provided better understanding of the present status of the Swedish dental professions, to prepare for future restructuring of the dental care system. Further work will be needed to understand the impact of professional traits on the management of groups of professionals.

International profiles of dental hygiene 1987 to 2001: A 19-nation comparative study

AIM

The purpose of this international longitudinal study is to examine patterns and monitor trends and changes in dental hygiene.

METHOD

Information was collected from national dental hygienists' associations through surveys conducted in 1987, 1992, 1998 and 2001. Sample size increased from 13 countries in 1987 to 22 by 2001--of which 19 were included in the analysis.

RESULTS

Overall, characteristics of the profession were remarkably similar; most noteworthy was the scope of dental hygiene clinical practice. Regarding historical development, educational programmes and professional organisation, the profession was more similar than dissimilar. Greater variation was evident regarding numbers, distribution, regulation, workforce behaviour, predominant work setting, and remuneration. Over the relatively short 14-year period, several observations were of particular interest: marked increase in the supply of dental hygienists, accompanied by a decline in their ratio to populations and to dentists and a high workforce participation rate; increase in baccalaureate dental hygiene programmes, with a gradual shift from the diploma as the entry-level qualification; and increase in scope of practice and professional autonomy, including for Europe and North America in particular, a decline in mandated level of work supervision and a slight but gradual increase in independent practice.

CONCLUSION

By 2001, the profiles reflected the vast majority of the world's population of dental hygienists. Rate of change varied across the countries examined; however, the nature of the change overall was consistent, resulting in a continuing homogeneity in the profession worldwide. Observed trends, changes and persistent issues have implications for service accessibility and technical efficiency and should continue to be monitored.

Providers issue brief: scope of practice and prescriptive authority: year end report-2002

Nonphysician providers continue to achieve enhanced stature, in part by gaining more autonomy in prescribing drugs. There is growing support for the concept that the public health is best served by the broadest access to primary care along with the safe use of pharmaceuticals. The states continue in their efforts to find ways to promote the use of less specialized and less costly providers to help serve the ever-growing population who have access to health care services.

Will there be a shortage of dental auxiliaries in the future?

The number of graduates from dental hygiene programs continues to increase, but retention of dental hygienists in practices is a concern. The numbers of graduates from dental assisting and especially dental laboratory technology programs are decreasing. The impact on dental practice size and practice productivity is considered.

International profiles of dental hygiene 1987 to 1998: a 19-nation comparative study

AIM

Development of an international longitudinal database to examine patterns, trends and changes in dental hygiene.

METHOD

Three surveys of national dental hygienists' associations, mainly members of the International Federation of Dental Hygienists. Data were collected by mail in 1987, 1992 and 1998, using a 40-item questionnaire. Sample size increased over time; results presented are based on responses for 13, 15 and 19 countries respectively. Preliminary tabulations were circulated to respondents for validation.

RESULTS

Overall, characteristics of the profession were remarkably similar; most noteworthy was the scope of dental hygiene clinical practice. Regarding historical development, education and professional organisation, the profession was more similar than dissimilar. Greater variation was evident in terms of numbers, distribution, workforce behaviour, predominant work setting and remuneration. While apparent change over the relatively short period 1987 to 1998 was viewed with caution, several observations were of particular interest: marked increases in the supply of dental hygienists, scope of practice and range of practice settings, accompanied by a decline in mandated level of work supervision. A slight but gradual increase in independent dental hygiene practice also was noted.

CONCLUSION

By 1998 the profiles reflected the vast majority of the world's population of dental hygienists. While rate of change varied across the countries examined, the nature of the change tended to be consistent, resulting in a continuing homogeneity in the profession worldwide. Changes and emerging trends should continue to be monitored in terms of improved access to quality oral health services and technical efficiency in the provision of those services.

Working with a dental hygienist in Ireland

The category of dental hygienist was introduced in Ireland in 1990 in accordance with the scheme made by The Dental Council [An Chomhairle Fiacloireachta] under the provision of Part VII of the Dentists Act 1985. This paper sets out and discusses the instructions of the Dental Council for employing/supervising dentists and registered dental hygienists as they apply at the time of writing. The current status and possible future developments are also considered in relation to the delivery of patient care by the dental team.

[The changing role of the dental hygienist]

This article describes the role of the dental hygienist in the Netherlands from the start of the training of dental hygienists in 1968. With the new Individual Health Care Professionals Bill from 1997 the dental hygienists are entitled to perform more tasks than in the past. This article describes the viewpoint of the professional dental hygienist organization on the future role of the dental hygienist. Cooperation with the other members of the dental team and free entry to the dental hygienist are considered important conditions. The creation of appropriate conditions by government and insurance companies is a matter of major concern.

Dental hygiene practice: international profile and future directions

Results of an international survey on dental hygiene are reported. The survey was conducted in 1988 through the International Dental Hygienists' Federation as part of a project to establish and maintain an international database on the profession. Information was collected by mail from national dental hygienist associations, using a 40-item questionnaire developed for the purpose; preliminary tabulations were validated by the associations. Information is presented for 13 countries-Australia, Canada, Denmark, Italy, Japan, Korea, The Netherlands, Nigeria, Norway, Sweden, Switzerland, the United States and the United Kingdom. Characteristics include historical development, numbers and distribution, education, regulation, scope of practice, employment settings and conditions, professional organisation, and perceived oral health and professional issues. The profiles and issues are examined in the light of broader socio-economic, demographic, epidemiological, technological and policy-related trends and changes. Implications for future health and organisational planning are noted.

Trends in dental hygiene applicant pool size and characteristics of students upon entry over three decades

A survey was conducted to determine trends that have occurred in the dental hygiene applicant pool and characteristics of entering dental hygiene students between 1957 and 1987. A two page, 46-item questionnaire with a cover letter and stamped pre-addressed envelope was mailed to each dental hygiene program director in the United States. A second mailing was sent one month later to directors who had not responded to the first mailing. A total of 106 usable questionnaires were returned, for a 54 percent response rate for 1987 programs. Response rates for programs existing in 1977, 1967, and 1957 were 51 percent, 45 percent, and 45 percent, respectively. For associate degree/certificate and baccalaureate degree programs, results suggest trends toward (1) a dramatic decline in dental hygiene applicants over the past ten years, (2) a decrease in dental hygiene class size, (3) an increase in age of applicants and length of education prior to acceptance into dental hygiene programs, and (4) a slight decrease in applicants' overall grade point average and science grade point average in the past decade. In addition, findings indicate that dental hygiene remains predominantly a Caucasian woman's profession. Implications of these findings for recruitment efforts and the numbers of dental hygienists for the future are discussed.

Dental hygiene's heritage: 1927-1970

Original manuscripts published in the Journal of the American Dental Hygienists' Association (JADHA), (now JDH) from 1927-1970 provide a historical perspective on dental hygiene's professional development. While many of the problems facing hygiene today are not new, there is evidence of progress in addressing them. The problems considered are: (1) hygiene's unique occupational role, (2) independent practice, (3) baccalaureate education, and (4) responsibility for licensure and practice. Support is provided regarding hygiene's unique contribution to society's oral health needs. Further, the article documents progress toward assuming professional responsibility as expressed in hygiene's relationship with dentistry, and in the expansion of hygiene's educational base and research efforts.