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What Are the Necessary Factors for a Successful Dental Hygiene Program, Research Paper Example

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Abstract

The objective of this study is to examine the necessary factors for a successful dental hygiene program. Toward this end, this work will examine the literature in this area of study including literature contained in academic and professional publications. According to the ‘Standards for Clinical Dental Hygiene Practice’, a hallmark of a true profession is its willingness to assume responsibility for the quality of care that its members provide. The purpose of medical and dental science if to enhance the health of individuals as well as populations.” (American Dental Hygienists Association, 2008) Further stated is that dental hygienists “…must realize and establish their professional privileges in accordance with the right s of individuals and groups.” (American Dental Hygienists Association, 2008) According to the ADA the registered dental hygienist (RDH) or licensed dental hygienist (LDH) is prepared educationally for practice after graduation from an accredited dental hygiene program which may be either a certificate, associate or baccalaureate program “…within an institution of higher education and qualified by successful completion of a national written board examination and state or regional clinical examination for licensure.” (American Dental Hygienists Association, 2008)

Objective

Introduction

According to the ‘Standards for Clinical Dental Hygiene Practice’, a hallmark of a true profession is its willingness to assume responsibility for the quality of care that its members provide. The purpose of medical and dental science if to enhance the health of individuals as well as populations.” (American Dental Hygienists Association, 2008) Further stated is that dental hygienists “…must realize and establish their professional privileges in accordance with the right s of individuals and groups.” (American Dental Hygienists Association, 2008) According to the ADA the registered dental hygienist (RDH) or licensed dental hygienist (LDH) is prepared educationally for practice after graduation from an accredited dental hygiene program which may be either a certificate, associate or baccalaureate program “…within an institution of higher education and qualified by successful completion of a national written board examination and state or regional clinical examination for licensure.” (American Dental Hygienists Association, 2008)

Research Question

The research question addressed in this present study is the question that asks ‘What components are required to formulate an effective dental hygienist program?

Method

The research in this study will be conducted through an exhaustive review of literature on the formulation of a successful dental hygienist program. The literature reviewed will be of a professional and academic peer-reviewed nature.

Literature Review

Responsibility and Accountability of the Dental Hygienist

The responsibilities of dental hygienists and the accountability of dental hygienists in their practice, conduct and decision-making is expected to include knowledge in the following areas:

Understand and adhere to the ADHA Code of Ethics.
Maintain a current license to practice including certifications as appropriate.
Demonstrate respect for the knowledge, expertise and contributions of dentists, dental hygienists, dental assistants, dental office staff, and other healthcare professionals.
Articulate the roles and responsibilities of the dental hygienist to the patient, interdisciplinary team members, referring providers, and others.
Apply problem-solving processes in decision-making and evaluate these processes.
Demonstrate a professional image and demeanor.
Maintain compliance with established infection control standards following the most current guidelines to reduce the risks of healthcare-associated infections in patients, and illnesses and injuries in healthcare personnel.
Recognize diversity. Incorporate cultural and religious sensitivity in all professional interactions.
Access and utilize current, valid, and reliable evidence in clinical decision making through analyzing and interpreting the literature and other resources.
Maintain awareness of changing trends in dental hygiene, health and society that impact dental hygiene care.
Support the dental hygiene profession through ADHA membership.
Interact with peers and colleagues to create an environment that supports collegiality and teamwork.
Take action to prevent situations where patient safety and well-being could potentially be compromised.
Contribute to a safe, supportive and professional work environment.
Participate in activities to enhance and maintain continued competence, address professional issues as determined by appropriate self-assessment.
Commit to lifelong learning to maintain competence in an evolving healthcare system. (American Dental Hygienists Association, 2008)

Six Components to the Dental Hygiene Process of Care

The American Dentistry Association reports that there are six components to the dental hygiene process of care as follows:

Assessment;
Dental hygiene diagnosis;
Planning;
Implementation;
Evaluation; and
Documentation. (American Dental Hygienists Association, 2008)

These six components are stated to make provision of a framework for patient care activities.

Professional Roles of the Dental Hygienist

The professional roles of the dental hygienists are stated to include those as follows:

Clinician;
Educator;
Researcher;
Administrator/Manager; and
Advocate. (American Dental Hygienists Association, 2008)

1^st Standard of Practice

The first standard of practice is that of ‘Assessment’ which is defined as “…the systematic collection, analysis and documentation of the oral and general health status and patient needs.” (American Dental Hygienists Association, 2008) The dental hygienist is responsible for conducting an individualized assessment that is thorough in nature. The assessment is an ongoing process involving the collection and interpretation of data of various types requiring the use of “…radiographs, diagnostic tools and instruments”. (American Dental Hygienists Association, 2008) The dental hygienists must understand that they are required to record the personal profile information of the individual which includes “…demographics, values and beliefs, cultural influences, knowledge, skills and attitudes.” (American Dental Hygienists Association, 2008)

2^nd Standard of Practice

The dental hygienists must also be competent in performing a comprehensive clinical evaluation including: (1) A thorough examination of the head and neck and oral cavity including an oral cancer screening, evaluation of trauma and a temporomandibular joint (TMJ) assessment; (2) Evaluation for further diagnostics including radiographs; (3) A comprehensive periodontal evaluation that includes the documentation of: (a) Full mouth periodontal charting; (2) Presence, degree and distribution of plaque and calculus; (3) Gingival health/disease; (4) Bone height/bone loss (5) Mobility and fremitus; (6) Presence, location and extent of furcation involvement (American Dental Hygienists Association, 2008) The dental hygienists is also response for conducting a risk assessment described as a “qualitative and quantitative evaluation gathered from the assessment process to identify any risks to general and oral health.” (American Dental Hygienists Association, 2008)

3rd Standard of Practice

The third standard is that of ‘dental hygiene diagnosis’ which serves to identify an “existing or potential oral health problem that a dental hygienists is educationally qualified and licensed to treat.” (American Dental Hygienists Association, 2008) This assessment makes a requirement that all available assessment data be analyzed and that critical decision-making skills be used in making a conclusion concerning the treatment needs of the patient. (American Dental Hygienists Association, 2008, paraphrased)

4^th Standard of Practice

The fourth standard is that of ‘planning’ described as the “…establishment of goals and outcomes based on patient needs, expectations, values, and current scientific evidence.” (American Dental Hygienists Association, 2008) Standard four or that of ‘Implementation’ is described as the “…delivery of dental hygiene services based on the dental hygiene care plan in a manner minimizing risk and optimizing oral health.” (American Dental Hygienists Association, 2008) This involves the review and implementation in the dental hygiene care plan and modification of the plan as it is demonstrated to be necessary as well as obtaining the proper consent for services and procedures. This also involves the dental hygienists possessing the proper knowledge to “communicate with patient/caregiver appropriate for age, language, culture and learning style.” (American Dental Hygienists Association, 2008)

5^th Standard of Practice

Standard five is stated to be “Confirming the Plan for Continuing Care’ and involves evaluation according to the following stated guidelines: (1) Use measurable assessment criteria to evaluate the outcomes of dental hygiene care (e.g. probing, plaque control, bleeding points, retention of sealants, etc.); (2) Communicate to the patient, dentist and other health/dental care providers the outcomes of dental hygiene care; and (3) Collaborate to determine the need for additional diagnostics, treatment, referral, education and continuing care based on treatment outcomes and self-care behaviors.” (American Dental Hygienists Association, 2008)

6^th Standard of Practice

Standard six is that of “Documentation” described as the “…complete and accurate recording of all collected data, treatment planned and provided, recommendations, and other information relevant to patient care and treatment.” (American Dental Hygienists Association, 2008)

Study on Validity and Reliability of Portfolio Assessment of Competency in a Dental Hygienist Education Program

The work of Gadbury-Amyot, et al (2003) entitled “Validity and reliability of portfolio assessment of competency in a baccalaureate dental hygiene program” reports a study that examined “…the validity and reliability of portfolio assessment using Messick’s unified framework of construct validity.” It is reported that evidence based on theory and empirical research was sought “for six aspects of construct validity. Seven faculty raters evaluated twenty student portfolios using a primary trait analysis-scoring rubric. A significant relationship (r = .81-.95; p < .01) between the seven subscales in the scoring rubric demonstrates measurement of a common construct.” (Gadbury-Amyot, et al, 2003) Findings report as follows: (1) There was a significant relationship between the portfolios and “GPA (r = .70; p < .01) and the NBDHE (r = .60; p < .01). (2) The relationship between portfolios and the Central Regional Dental Testing Service (CRDTS) examination was both weak and nonsignificant (r = .19; p > .05); (3) A fully crossed, two-facet generalizability (G) study design was used to examine reliability. ANOVA demonstrated that the greatest source of variance was the scoring rubric itself, accounting for 78 percent of the total variance; (4) The smallest source of variance was the interaction between portfolio and rubric (1.15 percent); (5) Faculty rater variance accounted for only 1.28 percent of total variance; and (6) A phi coefficient of .86, analogous to a reliability coefficient in classical test theory, was obtained in the decision study by increasing the subscales to fourteen and decreasing faculty raters to three. In conclusion, the pattern of findings from this study suggests that portfolios can serve as a valid and reliable measure for assessing student competency. .” (Gadbury-Amyot, et al, 2003)

Review of Program Requirements as Per The Commission on Dental Accreditation, 2010

The first standard stated for dental hygiene educational programs is that of institutional effectiveness in planning and assessment that is formal and ongoing and systematically documented by:

development of a plan for teaching, patient care, research and service;
implementation of the plan;
assessment of the outcomes, including measuring achievement of students; and
use of the results for improving the program. (Commission on Dental Accreditation, 2010)

Stated to be evidence of demonstrating compliance are the following:

program completion rates;
employment rates;
success of graduates on state licensing examination;
success of graduates on national boards;
surveys of alumni, students, employers, and clinical sites;
other benchmarks or measures of learning used to demonstrate effectiveness;
examples of program effectiveness in meeting its goals;
examples of how the program has been improved as a result of assessment;
ongoing documentation of change implementation;
admission, goals and strategic plan document; and
assessment plan and timeline. (Commission on Dental Accreditation, 2010)

Secondly, the institution is required to have a strategic plan that “…identifies stable financial resources sufficient to support the program’s stated mission, goals and objectives. A financial statement document must be submitted providing revenue and expense data for the dental hygiene program.” (Commission on Dental Accreditation, 2010) Evidence of compliance is demonstrated through:

the program’s mission, goals, objectives and strategic plan;
institutional strategic plan;
revenue and expense statements for the program for the past three years; and
revenue and expense projections for the program for the next three years. (Commission on Dental Accreditation, 2010)

It is the responsibility of the sponsoring institution to “ensure that support from entities outside of the institution does not comprise the teaching, clinical and research components.” (Commission on Dental Accreditation, 2010) Examples of demonstration of compliance include such as written agreements and contracts executed between the institution and its sponsors in regards to “facilities, funding, faculty, and financial support.” (Commission on Dental Accreditation, 2010)

The authority for development and approval of the curriculum rests with the sponsoring institution according to the Commission on Dental Accreditation (2010). The Institutional Accreditation Program must be sponsored by “institutions of higher education that are accredited by an institutional accrediting recognized by the United States Department of Education for offering college-level programs.” (Commission on Dental Accreditation, 2010)

It is required that all arrangements with co-sponsoring or affiliated institutions be formalized in written form that are clear in defining the roles and responsibilities of each institution involved. In addition, there must be an “active liaison mechanism between the program and the dental and allied dental professions in the community.” (Commission on Dental Accreditation, 2010) Demonstration of compliance include:

policies and procedures regarding the liaison mechanism outlining responsibilities, appointments, terms and meetings;
membership list with equitable representation if the group represents more than one discipline;
criteria for the selection of advisory committee members; (4) an ongoing record of committee or group minutes, deliberations and activities. (Commission on Dental Accreditation, 2010)

Summary of Findings

Required factors for a successful dental hygienists education program include the dental hygiene program relating the ADHA Code of Ethics and the importance of maintaining a license to practice. (American Dental Hygienists Association, 2008, paraphrased ) The properly educated dental hygienists is one who demonstrates a respect for the knowledge possessed by dentists and other dental practice staff and is one who has the capability of articulating the roles and responsibilities of the dental hygienists to the patient, team members and referring providers and others in the dental service delivery process. (American Dental Hygienists Association, 2008, paraphrased ) The dental hygienist that is properly educated is able to apply problem-solving processes in decision making as well as competent in conducting evaluation of these processes. (American Dental Hygienists Association, 2008, paraphrased ) The properly educated dental hygienists is one who demonstrates a professional image and maintain compliance in relation to infection control standards that have been established and follows the most current guidelines in reducing the risks of healthcare-associated infections in patients. (American Dental Hygienists Association, 2008, paraphrased ) The properly educated and certified dental hygienists is able to recognize diversity as well as incorporate sensitivity towards cultural and religious differences in individuals in their professional interactions. The properly educated and certified dental hygienists is able to both access and use evidence that is current and reliable in nature in clinical decision-making through use of analysis and interpretation of the ligature and other available resources. (American Dental Hygienists Association, 2008, paraphrased )The properly educated and certified dental hygienists is one who maintains an awareness of the shifting trends in dental hygiene, health and society that affect dental hygiene care. The dental hygienist who has been properly educated and certified is one who participates in activities that enhancing maintain their competence identifying specific areas through self-assessment and that commits to lifelong learning in a healthcare system that is rapidly evolving. (American Dental Hygienists Association, 2008, paraphrased)

The successful dental hygiene education program is one that is effective in planning and assessing its program and that documents this effectiveness through developing a plan for teaching, patient care, research and service and that implements the plan and assesses the outcomes and uses the results to improve the program. In addition, the successful dental hygiene education program is one that has a strategic plan that makes identification of the needed financial resources for supporting the mission, goals and objectives of the program. The successful dental hygiene education program takes the responsibility to make sure that support is ongoing through securing these agreements in written form.

References

Standards for Clinical Dental Hygiene Practice (2008) American Dental Hygienists Association. 8 Mar 2008. Retrieved from: http://www.usetinc.org/Libraries/THPS/Dental_Hygiene_Standards_of_Care.sflb.ashx

CC Gadbury-Amyot, et al (2003) Validity and reliability of portfolio assessment of competency in a baccalaureate dental hygiene program. J Dent Educ. 67(9): 991-1002 2003. Retrieved from: http://www.jdentaled.org/cgi/content/abstract/67/9/991

Accreditation Standards for Dental Hygiene Education Programs (2008) Commission on Dental Accreditation. 1 Jan 2010. Retrieved from: http://www.ada.org/sections/educationAndCareers/pdfs/dh.pdf