OBJECTIVE: This study updates Haaland's 1999 dental hygiene mapping study. By identifying core journals and estimating database coverage, it characterizes changes in dental hygiene research and aids librarians in collection development and user education. METHOD: Cited references from a three-year (2015--2017) sample of core dental hygiene journals were collected, categorized into five formats, and analyzed by format and publication year according to Bradford's Law of Scattering. CINAHL Complete, MEDLINE, and EMBASE were surveyed to determine the indexing coverage of cited journals. RESULTS: The number of cited journal titles increased from 389 in 1999 to 1,675 in 2018. Core Zone 1 titles increased from 5 to 11. Journal article citations increased from 69.5% of all citations in 1999 to 78.4% in the present study, whereas book citations decreased from 18.1% to 5.1%. A newly added category, "Internet sources," accounted for 8.4% of citations. Overall, 68.6% of citations were 10 years or younger versus 71.4% in 1999. Most Zone 1 and Zone 2 journals were specific to dentistry or dental hygiene. CONCLUSION: Notable changes since 1999 were an increased volume of literature and a shift from print to online sources, reflecting improved accessibility of the literature and greater Internet use. From 1999 to 2018, citations to journal articles increased, books decreased, websites appeared, and government publications increased slightly. These findings indicate that dental hygiene research is growing and that indexing coverage for this field has improved dramatically in the past two decades.

Dental hygienists should be aware of the concept of service-learning and how it can enhance dental hygiene education. A look at national documents and other relevant historical literature will be reviewed, in addition to more recent books and articles to define service-learning. Although perceived as a new teaching strategy, service-learning has its roots in experiential education. Several definitions of service-learning have emerged, which take into consideration the reciprocal needs of the student and community, bridging academic theory with community service, and instilling civic responsibility through a reflective component. Considering the advantages and disadvantages, service-learning seems to be a good methodology for dental hygiene education. Recommendations include the expansion of the ADA Accreditation Standards to include service-learning, and incorporation of an operational definition of community-based oral health programs, as well as the term service-learning in its Definition of Terms.

OBJECTIVE: This narrative review explores current research to broaden the understanding of dental hygienists' experiences and satisfaction in the workplace while suggesting strategies for the retention of dental hygienists and examining how current staffing shortages may impact the forthcoming Canadian Dental Care Plan. METHODS: An electronic literature search was conducted in the following online databases: PubMed, Google Scholar, CINAHL, and Education Source. Only full-text, peer-reviewed articles written in English were selected for review. RESULTS: The search yielded 18 articles with a wide range of study designs and methodologies. DISCUSSION: Five key themes emerged from the literature: health impacts, psychosocial environment, strategies for retention, contradictory findings, and implications for the Canadian Dental Care Plan. CONCLUSION: Dental hygienists experience many health, environmental, and psychosocial challenges in their day-to-day working life that affect their job satisfaction and overall willingness to remain in the profession. Strategies for retention are essential for maintaining the current dental hygiene workforce and can have a positive impact on the Canadian Dental Care Plan and its success.

Purpose: The purpose of this study was to investigate how dental hygiene educational programs currently incorporate dental hygiene diagnosis (DHDx) into entry-level, dental hygiene curriculum. Methods: An exploratory, quantitative, descriptive cross-sectional study was designed to assess the extent to which DHDx is integrated into entry-level dental hygiene curriculum. A 30-item survey was designed and content validity established using a subset of dental hygiene faculty and researchers as well as participants from the American Dental Hygienists' Association. Data was collected using the Qualtrics® electronic platform; two electronic mailings were sent to all entry-level dental hygiene programs. All surveys included a consent form and confidentiality was maintained. Descriptive statistics were used to analyze data. Results: Of the 334 surveys e-mailed, 198 responses (n=198) were received for a 59% response rate. Of the program respondents, 98% (n=191) reported that the dental hygiene process of care and concepts specifically relating to the DHDx were being taught. In addition, 79% (n=153) of respondents confirmed that they "always" require students to write a DHDx statement for the patients. Of the respondents, 80% (n=150) recognized that formulating a DHDx should result in improved patient outcomes and 76% (n=143) indicated that formulating a DHDx increases the dental hygienist's accountability in patient care. Conclusion: This exploratory study assessed the extent to which the DHDx is taught in entry-level dental hygiene programs. Findings confirmed that the DHDx is an integral component of dental hygiene education, but there is a need for standardization and faculty calibration for DHDx concepts and terminology. These results support adding DHDx into the Commission on Dental Accreditation (CODA) standards.

This review of the current literature is aimed at examining musculoskeletal disorders in dental hygienists, and investigates the complex nature of this significant occupational health issue. Musculoskeletal disorders (MSD) have been identified as a significant issue for the profession of dental hygiene. The purpose of this review is to examine and assemble the best evidence on the epidemiology, diagnosis, treatment, interventions, prevention, impact and consequences of MSD among the dental hygiene profession. The prevalence of MSD is alarming, with up to 96% reporting pain, and a number of occupational risk factors have been identified by the literature. Studies investigating interventions are generally limited in their study design, which is concerning given the huge impact MSD can have on the practising dental hygienist. Overall, it is evident from the literature that MSD is a complex and multifactorial problem. However, a complete understanding of the progression of musculoskeletal disorders is still far from being realised, due to the lack of longitudinal studies and standardised research techniques. Future research should implement triangulation methods in longitudinal studies, a strategy which will go a long way in the understanding of this complex occupational health issue.

This paper reports an evaluation of a residential care practice, which was part of a 'Dysphagia Management' course introduced into a 3-year dental hygiene curriculum in Japan. The clinical practice was performed at a care facility for the elderly people. Dental hygiene interventions, which consisted mainly of professional oral care, were implemented on a client who was bed-bound after suffering from a stroke. As the client had severe tension in muscles around oral cavity, it was difficult for the facility care workers to provide daily oral hygiene care. The goals of the dental hygiene care plan included decreasing tension of oral muscles and reducing periodontal inflammation and halitosis. The dental hygiene interventions were given once a month for 5 months. Evaluation in the fifth month demonstrated relaxation of oral muscles, decrease in plaque accumulation, and improvements in levels of gingival inflammation, indicating the partial achievements of the initial goals. Possibilities for revision of the care plan could call for more active involvement of the facility care workers and client-centered goal setting. This learning experience provided an opportunity for continuing intervention and evaluation of dental hygiene care for the same client. The positive results of our limited interventions further confirmed the importance of professional oral care in organic and functional improvements in oral health for the elderly people.

UNLABELLED: The changing health care environment and societal imperatives indicate the need for transformative change within the dental hygiene profession to serve the emerging needs of the public. The American Dental Hygienists' Association is leading the way toward meaningful change. BACKGROUND AND PURPOSE: The American Dental Hygienists' Association (ADHA) has as its vision the integration of dental hygienists into the health care delivery system as essential primary care providers to expand access to oral health care. This article provides data on current dental hygiene education programs and those in development. Also included is a discussion regarding how the dental hygiene profession can better serve the health and wellness needs of society by transforming the way graduates are prepared for the future. METHOD: ADHA's dental hygiene survey center data, policies and a futuristic analysis plus a review of the professional literature describe the current state of dental hygiene education and the profession. A discussion of societal, health care and educational trends that creates the imperative for transformation of the dental hygiene profession is provided. CONCLUSIONS: Ultimately, the purpose of advancing education in dental hygiene is to achieve better oral and overall health for more people. The profession's responsibility to the public includes evaluating its own ability to provide care and taking the steps necessary to ensure its maximum effectiveness. ADHA is leading this process for dental hygienists in diverse ways. It is imperative that the dental hygiene profession understands and embraces the changing health care environment. Through open dialog and the sharing of evidence the professional path will be determined along with forward movement for the benefit of society and the dental hygiene profession.

Purpose: To conduct a national survey of dental hygiene program directors to gain their opinions of alternative assessments of clinical competency, as qualifications for initial dental hygiene licensure. Methods: A 22 question survey, comprised of statements eliciting Likert-scale responses, was developed and distributed electronically to 341 U.S. dental hygiene program directors. Responses were tabulated and analyzed using University of California, San Francisco Qualtrics® computer software. Data were summarized as frequencies of responses to each item on the survey. Results: The response rate was 42% (n=143). The majority of respondents (65%) agreed that graduating from a Commission on Dental Accreditation (CODA)-approved dental hygiene program and passing the national board examination was the best measure to assure competence for initial licensure. The addition of “successfully completing all program's competency evaluations” to the above core qualifications yielded a similar percentage of agreement. Most (73%) agreed that “the variability of live patients as test subjects is a barrier to standardizing the state and regional examinations,” while only 29% agreed that the “use of live patients as test subjects is essential to assure competence for initial licensure.” The statement that the one-time state and regional examinations have “low validity in reflecting the complex responsibilities of the dental hygienist in practice” had a high (77%) level of agreement. Conclusion: Most dental hygiene program directors agree that graduating from a CODA-approved dental hygiene program and passing the national board examination would ensure that a graduate has achieved clinical competence and readiness to provide comprehensive patient-centered care as a licensed dental hygienist.

Purpose: To conduct a national survey of dental hygiene program directors to gain their opinions of alternative assessments of clinical competency, as qualifications for initial dental hygiene licensure. Methods: A 22 question survey, comprised of statements eliciting Likert-scale responses, was developed and distributed electronically to 341 U.S. dental hygiene program directors. Responses were tabulated and analyzed using University of California, San Francisco Qualtrics® computer software. Data were summarized as frequencies of responses to each item on the survey. Results: The response rate was 42% (n=143). The majority of respondents (65%) agreed that graduating from a Commission on Dental Accreditation (CODA)-approved dental hygiene program and passing the national board examination was the best measure to assure competence for initial licensure. The addition of “successfully completing all program's competency evaluations” to the above core qualifications yielded a similar percentage of agreement. Most (73%) agreed that “the variability of live patients as test subjects is a barrier to standardizing the state and regional examinations,” while only 29% agreed that the “use of live patients as test subjects is essential to assure competence for initial licensure.” The statement that the one-time state and regional examinations have “low validity in reflecting the complex responsibilities of the dental hygienist in practice” had a high (77%) level of agreement. Conclusion: Most dental hygiene program directors agree that graduating from a CODA-approved dental hygiene program and passing the national board examination would ensure that a graduate has achieved clinical competence and readiness to provide comprehensive patient-centered care as a licensed dental hygienist.

Purpose: The Patient Protection and Affordable Care Act changed the paradigm of health care delivery by addressing interprofessional education (IPE) and care (IPC). These considerations, combined with evolving dental hygiene (DH) workforce models, challenge DH educators and clinicians alike to embrace IPE and IPC. The objectives of this study were to determine DH program directors' perceptions of the importance of IPE, to assess current and planned activities related to Commission on Dental Accreditation (CODA) standards that imply competency in IPE, and assessment of outcomes. Methods: Email addresses of the 322 entry-level, DH program directors in the United States were obtained from the American Dental Hygienists' Association and a web-based survey was developed based on the American Dental Education Association Team Study Group on Interprofessional Education. Descriptive statistics were computed for the responses to the closed ended questions and answers to open-ended questions were transcribed and thematically coded. Results: A response rate of 30% (N = 102) was obtained from the DH program directors. While the respondents indicated that they personally considered IPE to be important, one-third reported that IPE was not a priority for their academic institution. The majority of current IPE activities related to the 2014 CODA Standards 2-17, 2-26 and 2-19 were clinic-based (Standards 2-17 and 2-19: N=49; Standard 2-19: N=64). Fewer classroom-based activities were reported (N=12 vs. N=25). The respondents planned 27 clinic-based, 9 classroom-based and 51 other future IPE-related activities. Competency assessment was mostly determined with clinic-based activities (N=43) and other activities such as rubrics (N=16) and the development of IPE assessment tools (N=10). Thirty-three respondents named positive aspects of IPE and 13 saw IPE as relevant for the dental hygiene profession. Conclusion: Accountable accreditation standards have been identified as the driver of change for incorporating IPE, making an explicit IPE standard for dental hygiene education an important agenda item for the profession.