OBJECTIVE: This study evaluates the impact of introducing dental therapists (DTs) into Children\'s Dental Services (CDS), a large non-profit organization in Minnesota. The aim is to assess the effect of DTs in improving access and reducing dental care costs in Minnesota by analyzing the trends in dental care delivery and procedures performed by CDS dentists and therapists.
METHODS: Using 2009 to 2021 data from CDS, the study compares trends in patient volume, types of procedures, salary data and payments by dentists, DTs, and registered dental hygienists (RDH). Return on investment (ROI) trends are calculated using salary and revenues for each provider type.
RESULTS: After introducing DTs at CDS and implementing mobile clinics, the number of patients served and volume increased steadily, demonstrating increased access. DTs provided an increasing proportion of fluorides, sealants, and extractions through 2020. Interestingly 2021, there was a decrease for DTs, possibly due to Covid related workforce shortages. ROI analysis showed that DTs\' ROI dramatically rose, eventually surpassing dentists, while RDHs maintained a constant ROI. Dentists\' ROI also initially increased after adopting DTs in the practice.
CONCLUSIONS: Integrating DTs at CDS improved access by expanding mobile clinics, increasing patient volume, and redistributing procedures, while demonstrating a positive return on investment. Results suggest that adopting the DT model may be a promising practice for other organizations seeking to improve access to dental care, increase operational efficiency, and boost the dental care team\'s ROI.

OBJECTIVE: This randomized, controlled, double-blinded clinical trial aimed to evaluate the efficacy of octenidine hydrochloride and chlorhexidine mouthwashes as adjuncts to instrumentation in stage I-II periodontitis patients.
METHODS: Forty-five patients with mild-to-moderate periodontitis were randomly allocated to three groups: 0.1% octenidine dihydrochloride (OCT), placebo, and 0.12% chlorhexidine (CHX) mouthwashes. Patients were instructed to use the mouthwash after instrumentation for twice a day up to 3 weeks. Periodontal parameters such as probing pocket depth (PPD), clinical attachment loss (CAL), O\'Leary plaque index (PI), Loe and Silness gingival index (GI), Lobene stain index (SI), and oral soft tissue changes were recorded at baseline and once every week for 3 weeks. The visual analogue scale (VAS) was also recorded as a self-administered questionnaire at the end of the study. The one-way ANOVA was used to compare VAS scores between the groups. The repeated measures ANOVA and post hoc Newman-Keuls tests were used to assess the differences in the periodontal parameters between groups at different time intervals. The Kruskal-Wallis test was used to compare the mean SI.
RESULTS: There was a significant reduction in the mean GI of the OCT and CHX groups compared to placebo (p < 0.05). OCT usage resulted in significantly less staining, according to mean SI, when compared to CHX. Furthermore, VAS scores revealed that OCT was significantly the preferred mouthwash (p < 0.01).
CONCLUSIONS: Adjunctive octenidine hydrochloride may be an alternative to chlorhexidine in its ability to control the periodontal parameters in patients with stage I-II periodontitis. Further larger studies are necessary to confirm these findings.

Oral health-related quality of life (OHRQoL) is pivotal in patient care, reflecting oral health through dental patient-reported outcomes (dPROs). This systematic review aims to outline the 4-dimensional (4-D) impact of OHRQoL within patient populations routinely treated by dental hygiene and/or dental therapy providers, as there is limited literature present for these oral health care professionals.
The study extracted and analyzed characteristics and multidimensional impact of OHRQoL, using the Oral Health Impact Profile (OHIP) as the primary dental patient-reported outcome measure (dPROM). The search strategy spanned 7 databases: Medline via the Ovid interface (Ovid MEDLINE(R) ALL), Embase via Ovid, Cinahl, APA PsycINFO via Ovid, Dentistry and Oral Sciences Search, Scopus, and Web of Science (Core Collection). It commenced September 2, 2022, with a refinement search on July 5, 2023. English language criteria yielded 645 articles postduplication removal. A screening procedure involving 3 reviewers encompassed title, abstract, and full-text review.
After application of inclusion and exclusion criteria, 5 articles were subjected to data extraction, capturing domain-specific information including baseline and follow-up OHRQoL data. An additional set of 13 articles containing summarized OHRQoL data underwent separate analysis. The Joanna Briggs Institute (JBI) critical appraisal tools were utilized for risk bias assessment of the included articles. The 4-D impact scores reported for baseline OHRQoL data, ranged from 3.10 to 4.20 for Oral Function, 0.84-2.70 for Orofacial Pain, 1.70-4.50 for Orofacial Appearance, and 0.44-2.50 for Psychosocial Impact. In follow-up OHRQoL data, the range for Oral Function was 1.52-3.60, Orofacial Pain 0.60-2.10, Orofacial Appearance 0.91-2.25, and Psychosocial Impact 0.10-0.60.
This review highlights a critical call for standardization in OHRQoL data collection for dental hygiene and dental therapy patient populations as only 26% of the predetermined distinct populations were found to have studies completed with 4-D impact of OHRQoL. Moreover, the presence of limited research in describing the multi-dimensional impact in patients routinely treated by these providers shows the urgency of substantive research in this area.

Increased awareness of oral health disparities in the United States has highlighted the need to expand the workforce and access to both primary and preventive dental care. Achieving oral health equity will require new dental team members with appropriate clinical skills dedicated to reaching historically marginalized populations through intra and interprofessional practice. Collective efforts by health care advocates in Minnesota led to legislation that created a dental hygiene-based workforce model inspired by the vision and foresight of the American Dental Hygienists\' Association\'s \"Advanced Dental Hygiene Practitioner.\" In July 2023, there were 141 licensed dental therapists and 99 certified advanced dental therapists, with the majority being dual-licensed dental hygienists/dental therapists, providing primary care services in a variety of settings throughout the state. Current data confirm their contributions to increasing access to primary oral health care services for Minnesotans across the lifespan. While surmountable challenges remain, new opportunities are emerging for dental therapists within Minnesota\'s transforming health care system. The purpose of this paper is to describe the implementation of this new workforce model in Minnesota, its challenges and successes to assist other states in developing new models for intraprofessional dental team members.

Interprofessional collaboration between dentistry and pharmacy has great value but is often lacking in didactic and experiential education, particularly in dental hygiene programs.
A case-based interprofessional assignment was implemented into the dental hygiene curriculum. Students reflected on their experiences and completed the International Collaborative Competencies Attainment Survey (ICCAS) to assess changes in self-reported interprofessional competencies following the activity.
Reflections revealed knowledge gain themes, with medication-related oral health concerns most frequent (53), followed by systemic adverse effects of medications (31), impact of systemic health on oral health (21), drug-drug interactions (17), and drug information (2). Additionally, students identified both future plans to collaborate with a pharmacist (25) and application of clinical knowledge gained (25). Scores from the ICCAS increased significantly in most of the domain statements following the interprofessional activity.
This interprofessional education (IPE) activity increased student knowledge of the pharmacy profession and provided an experience with interprofessional communication. Students identified the impact of medications on oral health, as well as the value of interprofessional collaboration and communication.
This IPE activity positively impacted student perceptions of interprofessional collaboration with pharmacists.

Dental patients seeking care expect to receive treatment options that are supported by evidence-based dental research based on dental patient-reported outcomes (dPROs). In dental hygiene and dental therapy, there is little usage of dPROs and dental patient-reported outcome measures (dPROMs) to assess the four-dimensions of oral health-related quality of life (OHRQoL). In order to assess the current evidence for dental hygiene and dental therapy interventions, the determination of distinct patient populations is essential.
To determine patient populations that are clinically distinct groups of dental hygiene and dental therapy patients. To provide a preliminary literature search for a systematic review to identify interventions that provide four-dimensional oral health impact information for these patient populations.
This narrative and methodological manuscript utilizes an allied dental expert panel consisting of two dental hygienists, two dental therapists, and a moderator to generate a list of clinically distinct patient populations within the scopes of dental hygiene and dental therapy. Additionally, a preliminary literature search utilizing PubMed was completed to assess the current research within the scopes of practice of dental hygiene and dental therapy that uses dPROs and dPROMs to assess the four-dimensions of OHRQoL. The patient population list generated by the allied dental expert panel and the patient populations from the articles identified in the preliminary literature search were compared to determine the needed and available evidence for dental hygiene and dental therapy interventions.
There were 19 distinct patient populations derived from the allied dental expert panel. Nine of the distinct patient populations were shared in the dental hygiene and dental therapy scopes of practice, six were specific to the dental hygiene scope of practice, and four were specific to the dental therapy scope of practice. From the preliminary literature search, five distinct patient populations had corresponding research. Of those, three distinct populations were shared between dental hygiene and dental therapy, and two were dental hygiene specific. There  : were no distinct patient populations found from the preliminary search specific to dental therapy.
There is a lack of research in the dental hygiene and dental therapy scopes of practice regarding utilization of dPROs and dPROMs to assess the four-dimensions of OHRQoL. In order to standardize the assessment of OHRQoL, the development of a list of distinct patient populations for dental hygiene and dental therapy interventions is essential. This initiative identifies which populations are lacking evidence and provides a pragmatic approach to conducting a systematic review to assess the four-dimensions of OHRQoL in the field of dental hygiene and dental therapy.

OBJECTIVE: The nature and quality of feedback provided during the training of healthcare students have been found to influence the progress of students throughout their clinical practice. The use of electronic systems for feedback is becoming more prevalent; but there appears to be an absence of research into the use of these systems with Dental Hygiene and Dental Therapy students (DHDT). The aim of this study was to explore the written, narrative feedback provided by tutors to undergraduate DHDT students on a 3-year BSc programme, using Liftupp - an Information Management System that incorporates electronic feedback mechanisms.
METHODS: The data comprised written, narrative feedback to DHDT students (n = 96) on clinical performance in academic Years Two and Three entered into Liftupp by five clinical tutors (n = 5) over 2 academic years. These feedback comments were subjected to a thematic analysis and matrix queries using NVivo.
RESULTS: Ten major themes were identified. Preliminary findings indicated that the constructive \"Descriptive\" theme was prominent across all tutors, while other constructive themes: \"Directive\" and \"Positive\" were linked more to individual tutors. The less constructive themes were infrequent in tutor feedback. In addition, unique feedback profiles for tutors were generated.
CONCLUSIONS: The analysis of narrative feedback from tutors on Liftupp enables the identification of feedback trends that can be reviewed and shared with tutors to improve the quality of their feedback. In addition, this research can be used to inform tutor training to promote the use of meaningful and effective feedback. Potential further research and limitations have been identified.

Oklahoma an ethnically, financially and geographically diverse population has unique oral health care challenges. These challenges include poor overall oral health, inadequate oral health coverage, significant physical access to care barriers and a shortage of oral health care workers. Just as the oral health care barriers are diverse, so are the potential solutions. Potential solutions include efforts at all levels of government, innovations of health care delivery and recognition of the unique needs of Oklahoma American Indian population. Potential strategies address each of these opportunities and recognize both the short and long term needs of Oklahoma oral health.

This study aimed to investigate how different timelines of various dental therapies were related to osteoradionecrosis development under consideration of radiotherapy dosage in patients with oral cancer.
A total of 7,107 oral cancer patients were enrolled, including 88 osteoradionecrosis patients treated with low radiotherapy dosages (<60 Gy) or high radiotherapy dosages (≥60 Gy), from the Longitudinal Health Insurance Database for Catastrophic Illness Patients of Taiwan. Cox proportional hazard regression was used to compare the osteoradionecrosis risk of various dental treatment timelines under different irradiation dosages.
In the oral cancer population with low irradiation dosages (<60 Gy), performing periodontal therapy combined with irradiation significantly raised the risk of osteoradionecrosis by 2.21-fold. Starting radiotherapy within three months after dental surgery greatly increased the risk of developing osteoradionecrosis by 1.87-fold. The oral cancer patients treated with high radiation doses (≥60 Gy) receiving dental surgery within one month prior to radiotherapy had a significantly raised osteoradionecrosis occurrence by 1.60-fold. While the dental surgery was performed during the radiotherapy course, the risk of osteoradionecrosis was greatly increased by 2.21-fold.
For oral cancer patients, performing dental surgery within three months before radiotherapy might significantly induce osteoradionecrosis. Patients that were treated with high irradiation dosages (≥60 Gy) had a higher tendency to develop osteoradionecrosis if they received dental surgery during radiotherapy. Those who were treated with low radiation dosages (<60 Gy) and received periodontal therapy during radiotherapy might have an increased risk in developing osteoradionecrosis.

Purpose: The state of Virginia faces a reported dental health professional shortage affecting approximately half of its residents.The purpose of this study was to assess the opinions and attitudes of dental hygienists in Virginia toward a mid-level dental provider model, dental therapists (DTs), and to determine whether current education level and years of practice affected opinions regarding the education requirements for DTs.Methods: A 22-item questionnaire was distributed online to a convenience sample of Virginia dental hygienists (n=910). Items assessed attitudes of participants toward the DT using a seven-point Likert-type scale ranging from 1 (strongly disagree) to 7 (strongly agree). Participants were asked to provide demographic information and to respond to open-ended questions regarding potential advantages and/or disadvantages to DTs. Independent samples t-tests and chi-square analyses were used to analyze the data.Results: A response rate of 22% was obtained (n=200). Most respondents agreed a DT was needed in Virginia (M=5.78, p<0.001) and supported the concept that dental therapy could be a solution to the problem of access to care issues in Virginia (M=5.97, p<0.001). While most respondents agreed it was important for Virginia to adopt legislation for a dental therapy model (M=5.89, p<0.001), most disagreed that DTs\' practice should be restricted to acknowledged underserved areas in the state (M=3.19, p<0.001). No significant association was found between years of practice and opinions toward education requirements for DTs; however, a significant association was found between current education level and opinions toward education requirements for DTs (Fisher\'s Exact Test=34.17, df=9, p=.000, Cramer\'s V=.28).Conclusion: Results revealed Virginia dental hygienists had overwhelmingly positive attitudes toward DTs. Research with a larger sample could provide more insight into opinions of the Virginia dental hygienist population regarding this mid-level oral health care provider.