Clinical Education Partnership Creates New Roles for Hygienists

Normandale hygiene students
and Ridgeview student
Over half a million public program recipients in Minnesota struggle with getting needed dental care, and one of the biggest reasons for the dental access crisis in Minnesota is a shortage of dentists.

However, at the same time Minnesota’s pool of dentists is drying up, the pool of dental hygienists is growing. And fortunately, recent changes made to the Dental Practices Act in Minnesota allow hygienists to have a greater role in preventive dental care.

In order to create more career options for hygienists, and more dental access options for patients, Dr. Jayne Cernohous, Dental Director of Apple Tree’s Twin Cities Program, and Dr. Colleen Brickle, Program Chair of Dental Hygiene at Normandale Community College, collaborated on an innovative clinical dental education project. This project, which was funded by the Minnesota Department of Health, is called “Expanded Functions through Teledentistry.”

The project began with gathering data. Are hygienists in Minnesota interested in working “outside the box” of the traditional dental office? Would they be interested in serving public program patients in community settings? To find the answers, a survey was sent out in May, 2003 to 4,751 Minnesota Licensed Dental Hygienists. 1,939 surveys were returned for a very high response rate of 40.8%.

The results of the study showed that hygienists were definitely interested in furthering their education in community health. The hygienists surveyed were interested in training in “expanded functions” such as teledentistry. Furthermore, over 70% of respondents indicated that they were interested in working in alternative settings such as schools, public health clinics, hospitals, and nursing homes. The number one reason for wanting to work in alternative settings was to improve access to care.

The next part of the project involved creating a course called “Community Health Topics.” This course was to an introduction to expanded functions, community dentistry, and teledentistry.

In the Spring Semester of 2003, twenty-seven hygiene students signed up and began their special training. Hands-on experiences for the students included providing care for nursing home residents and elementary schools students. The clinical experiences included the application of fluoride varnishes and sealant placements, taking digital x-rays, digital photos and digital intraoral video and still images, and the use of the DIAGNOdent in detection of cavities.

All of these in-the-field clinical experiences included mentoring from Dr. Jayne Cernohous and Apple Tree Hygienist, Heidi Dye. In addition to the on-site experiences, the students participated in teledentistry encounters between Ridgeview Elementary and Apple Tree’s clinic with the technical help of Brenda Marks, Apple Tree’s Director of Information Systems.

The project used Teledenistry to analyze the effectiveness of the DIAGNOdent as a tool for hygienists to detect cavities. Each Ridgeview Elementary student participating in the project was screened by the dental hygiene students using the DIAGNOdent. The correlation findings by the hygiene students was high when compared to those by a dentist either on-site or through teledentistry consultations.

In other words, a hygienist using a DIAGNOdent in consultation with a remote teledentist may be as effective in diagnosing cavities as a dentist using the traditional explorer techniques. Because of the preliminary nature of this study, the short time period, and the small number of patients involved, further study is needed to validate these findings.

 
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