AIMS: Attitudes of dentists and dental hygienists towards extended scope and independent dental hygiene practice are described in several studies, but the results are heterogenous. The purpose of this systematic review was to compare the attitudes of dentists and dental hygienists towards extended scope and independent dental hygiene practice.METHODS: PubMed, AMED and CINAHL were screened by two independent assessors to identify relevant studies. Only quantitative studies that reported the percentages of dentists' and dental hygienists' attitude towards extended scope and independent dental hygiene practice were included. The random-effects model was used to synthesise possible heterogenous influences.RESULTS: Meta proportions with regard to a positive attitude towards extended scope of practice are 0.54 for dentists and 0.81 for dental hygienists. Meta proportions of a positive attitude towards independent practice are 0.14 for dentists and 0.59 for dental hygienists. A meta analysis with regard to negative attitudes could only be performed on extended scope of practice and did not reveal a difference between the two professions. We obtained homogeneous outcomes of the studies included regarding negative attitudes of dentists . A minority of dentists hold negative attitudes towards extended scope of dental hygiene practice. Study outcomes regarding negative attitudes of dental hygienists were heterogeneous.CONCLUSIONS: Positive attitudes are present among a majority of dentists and dental hygienists with regard to extended scope of dental hygiene practice, while for independent dental hygiene practice this holds for a minority of dentists and a majority of dental hygienists.
BACKGROUND: In the Netherlands, the scope of dental hygiene practice was expanded in 2006. The objective of this study was to explore reasons among dentists and dental hygienists for supporting or opposing an extended scope of practice and to find explanatory factors.METHODS: A questionnaire containing pre-defined reasons and an open-ended question was distributed among 1,674 randomly selected members of two Dutch professional associations (874 dentists, 800 dental hygienists). Data were analyzed with binary logistic regression with Bayesian information criterion (BIC) model selection.RESULTS: Response were obtained from 541 practitioners (32.3%): i.e., 233 dentists (43.1%) and 308 dental hygienists (56.9%). Non-response analysis revealed no differences, and representativeness analysis showed similarities between samples and target populations. Most often, dentists reported flexible collaboration (50.2%) and dental hygienists indicated task variation (71.1%) as supportive reasons. As opposing reasons, dentists generally reported quality of care (41.2%) and dental hygienists' self-competence (22.7%). Reasons were explained by profession, gender, and new-style practitioners.CONCLUSION: Dentists and dental hygienists conveyed different reasons for supporting or opposing an extended scope of dental hygiene practice. Outcomes can be categorized as reasons related to economic, professional status, quality, job satisfaction, and flexible collaboration and are not only explained by profession.
Attitudes of dental students regarding the provision of treatment tend to be dentist-centered; however, facilitating mixed student group formation could change such perceptions. The aim of this study was to investigate the perceived scope of practice of dental and dental hygiene students and whether their perceptions of task distribution between dentists and dental hygienists would change following an educational intervention consisting of feedback, intergroup comparison, and competition between mixed-group teams. The study employed a pretest-posttest single group design. Third-year dental students and second-year dental hygiene students at a university in The Netherlands were randomly assigned to intraprofessional teams (four or five members) and received team-based performance feedback and comparison. The intervention was finalized with an award ceremony for the best intraprofessional team. Before and after the intervention, students completed a questionnaire measuring their perceived distribution of ten tasks between dentists and dental hygienists. A total of 38 dental students and 32 dental hygiene students participated in the intervention-all 70 of those eligible. Questionnaires were completed by a total 88.4% (n=61) of the participants: 34 dental (89.5%) and 27 dental hygiene students (84.4%). Dental and dental hygiene students had similar perceptions regarding teeth cleaning (prophylaxis) (p=0.372, p=0.404) and, after the intervention, preventive tasks (p=0.078). Following the intervention, dental students considered four out of ten tasks as less dentist-centered: radiograph for periodontal diagnosis (p=0.003), local anesthesia (p=0.037), teeth cleaning (p=0.037), and periodontal treatment (p=0.045). Dental hygiene students perceived one task as being less dentist-centered after the intervention: radiograph for cariologic diagnosis (p=0.041). This study found that these dental and dental hygiene students had different opinions regarding the scope of practice for dentistry and dental hygiene. The number of redistributed tasks after the intervention was especially substantial among the dental students, although the amount of change per task was minimal. Half of all tasks were perceived as less dentist-centered as a result of the intervention.
