Title: Dental hygiene: evidence-based practice
Aim: This study aims at identifying whether new research findings in the dental hygiene field are put into practice and the effects the consequent effects on overall clients’ oral health.
Background
Dental hygiene is part of oral hygiene which is the practice of maintaining the mouth and teeth clean so as to preclude dental problems as well as bad breath. Dental hygiene calls for the increase of the number of intervention studies which key out advances in clients’ oral health upshots. Dental health practitioners are not adequately informed about novel discoveries in dental hygiene. In cases where knowledge is known, the application of the knowledge is lacking. It is pertinent to note that evidence-based practice can only become operational if the knowledge obtained from current research is put into practice.
Oral health specialists, specifically dental hygienists, endeavor to render healthcare services which are targeted to lead to the specialists’ clients’ optimal oral health results. The use of EBP methodology is aimed at contributing to exploiting such results (Cobban, Edgington and Clovis, 2008). Rogers’ Theory of Diffusion of Innovations (Rogers, 2003) which has been applied to examine research application in several other fields may be used in dental hygiene analysis, as well, to offer insights. That is because research use is a significant constituent of EBP, while diffusion of research cognition is a crucial action in enforcing EBP.
Rogers’ Theory of Diffusion of Innovations (Rogers, 2003) hopefully has got some prognosticate for building up a discernment of cognition transfer in dental hygiene, and has so far been applied in studying the information-seeking conducts among dental hygienists (Rogers, 2003). A lot of correlational and descriptive studies have depicted the dissemination of modification as debuts have disseminated within specific populations (Berwick, 2003). A big proportion of these surveys have analyzed relations amongst the innovation’s elements, the channels applied to disseminate the innovation’s cognition, the social system’s features of prospective adopters, as well as the duration for the innovation’s effectuation to take place.
Oral cancer presents the most serious oral condition as it oftentimes leads to death and severe deformity (Clovis, Horowitz & Poel, 2003). However, oral cancer morbidity and mortality can however be reduced greatly through the involvement of dental hygienists. Syme, Dury and Horowitz (2001) for instance analyzed Maryland dental hygienist’s conducts in relation to evaluation of the oral cancer’s danger on patients. These authors noted that most hygienists examined for current tobacco use, a smaller number examined for previous tobacco habit and an even smaller number of hygienists examined for current or previous alcohol usage. The hygienists who conducted more inclusive screenings were more likely to be more convinced of the need to provide tobacco stoppage teaching. According to Horwitz et al (2002), dental hygienists claimed that their employers’ least expected them to carry oral cancer tests in addition to lack of time to carry the tests.
A study by Clovis, Horowitz and Poel (2003) on Canadian dental specialists in British Columbia and Nova Scotia identified gaps between knowledge and enforcement of the knowledge as far as oral cancer checkups are concerned. Many dental specialist and researchers acknowledge that EBP will close the gap amongst dental practitioners in their endeavor to adopt the latest innovations for application. The main challenge however lies in identifying how the new knowledge can be translated from research into practice in a timelier way than presently going (Rogers, 2003). EBP calls for positioning and receiving the most beneficial manifest and incorporating it with dental expertness and patient predilections, which may contribute to modifications and advances in application and dental health consequences.
Research Question
How are dental practitioners applying up-to-date evidence-based knowledge in addressing oral health concerns?
Research Approach (Methodology)
To address the above research question, it will be necessary to assess the views of dental practitioners and hygienists as far as acquisition of novel knowledge in the field of dental hygiene. In addition to carrying out a survey amongst dental hygienists, patients’ records will be assessed and analyzed to identify the oral health outcomes in cases attended by the sampled dental hygienists. In summary, this quantitative research will involve conducting structured interviews among dental hygienists in addition to conducting document analysis of patients’ dental records.
Design of the Study
Subjects for Study or Sample Selection
This study will be conducted among practicing dental hygienists. 10 practicing dental hygienists will be sampled randomly from10 identified dental clinics in Central Auckland. The selection of the dental clinics will be based on prior identification of existing practicing dental hygienists. Random sampling will reduce sampling bias. A total of 10 dental hygienists will be appropriate as this will ease the conduction of study more so considering that the study will be conducted interviews which are time consuming and involving. A total of 200 patients’ dental health records will be sampled from all the 10 dental clinics. The patients must have been attended to in the last 2 years such that the information obtained will be relevant to this study in terms of application of up-to-date dental health knowledge.
Since this study will take place in New Zealand, it will be important to adhere to the Treaty of Waitangi Principle. The Treaty of Waitangi Principles is generally classified into three principles: partnership, protection and participation. Since partnership encompasses the involvement of all persons (Iwi or Maori) in order to achieve oral health benefits, this research will not discriminate participants, whether the dental hygienists or the patients. It is expected that forming partnerships with the department of health will be quite easy as noted by Durie (1998). Durie (1998) identifies that partnership is realized through formation of agreements between government agencies and different tribes in New Zealand.
In as far as protection is concerned; the Treaty of Waitangi recognizes that researchers must defend the people of Maori as well as their interests. This study will therefore adhere to this principle by maintaining the privacy and confidentiality of all the participants involved in the study. The findings of this study as well as any progress in the study will only be released to authorized persons and used for the purposes of this study only. This will certainly enhance the partnership and cooperation required in the successful carrying out of this study.
The principle of participation as outlined in the Treaty of Waitangi entails that Maori people ought to get involved in health care endeavors. In particular, the involvement of the Maori people will be an improvement in reducing oral health inequalities. This study will therefore form a basis for involving the often ignored Maori people as far as oral health is concerned. Additionally, the participation of the Maori dental practitioners will be a boost to the already rising increase in participation of Maori in clinical studies (University of Otago (2002).
Instrument (Measurement)
Several aspects of dental health will be assessed in this study including current dental health knowledge and practice of up-to-date dental research findings. This study will take both a quantitative and qualitative approach. In specific, the identification of dental hygienists’ application of up-to-date knowledge will be accessed quantitatively by collecting interview data. Interview questions will be developed by the researcher and reviewed by a knowledgeable dental health researcher as well as the University of Ottawa Research Ethics Board for approval (A sample of the interview questions is attached in the appendix). The application and outcome of evidence-based dental care practice will be a qualitative analysis of patients’ dental records.
Data Collection Methods
Structured interviews will be conducted among the sampled dental hygienists. The interviews will be conducted at the dental clinics where each practitioner is situated. The interviews will be scheduled to take place in the evening after the normal working hours with the interview taking approximately 40 minutes. This time will be appropriate to the dental hygienists since they will be less occupied with duties in the clinics thus enabling the researcher to gather information without unnecessary interruptions. Structured interview questions will be standard for all the participants thus ensuring uniformity in interviews and reduces probability of bias.
To identify patient outcomes as a result of application or lack of application of evidence-based findings in dental hygiene practice, document analysis will be done. In specific, patients’ records will be analyzed to identify dental patients who were attended by the sampled practitioners. The data will then be classified in terms of outcomes and grouped according to whether the patient was attended by a hygienist who indicated applying current research and those who rarely apply EBP.
Data Analysis
This study will utilize descriptive statistics to identify the general application of new research knowledge among dental hygienists. By comparing the means of successful dental outcomes among patients attended by practitioners who practice research-based dental care against those attended by dental hygienists who rarely apply research-based practice; it will be possible to identify if there is any significant difference between the two modes of practice. A deeper analysis of the data using Pearson correlational analysis will be used to establish relationships that might exist between evidence-based dental health practice and overall oral health outcome.
Ethical issues
Since this study will involve human subjects, the University of Ottawa Research Ethics Board will be contacted to provide approval for the study. The consent of patients in as far as access and use of dental health records is concerned will be sought and confidentiality of use be reassured to the participants. All information obtained about the participants will not be published without prior permission of the participants. In addition, the dental hygienists who will participate in this study will provide a signed consent and all the participants will validate the interview manuscript used.
Expected Outcome
Through this study, it is expected that a snap view of the practicability of new research-based knowledge among dental hygienist will be provided. As such, it will be possible to identify the extent into which dental practitioners are applying novel and up-to-date dental health knowledge in day-to-day practice. This will form a strong background for research into the outcomes of practicing evidence-based dental health care.
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