The purposes of this pilot study were as follows: 1) to determine the percentage and frequency of dental hygiene graduates who were providing tobacco cessation counseling (TCC) activities, after receiving TCC training during their formative years of education; 2) to identify the graduates' stages of change using the transtheoretical model regarding TCC; and 3) to identify factors influencing the delivery of TCC. A convenience sample of fifty-one Minnesota State University, Mankato (MSU) dental hygiene graduates were surveyed in this study. Wilcoxen signed rank tests were used to analyze the relationship between counseling actions and dental hygienists' stage of change in four TCC activities: asking, advising, assisting, and arranging follow-up. Pros and cons affecting the delivery of TCC were also examined. Findings indicate that dental hygienists who received TCC education during their training do not provide cessation counseling to a high percentage of their patients even though they believe in the value of such activity. However, dental hygienists are more likely to provide TCC to patients with periodontal disease than other dental patients. Conclusions: 1) addressing the potential frustration of the dental hygienist and coping methods when providing TCC during training may alleviate one of the barriers to TCC; 2) ready access to tobacco education materials may alleviate one of the barriers to TCC; and 3) emphasis during TCC training on providing education for all patients as part of health promotion, rather than just periodontal patients, may increase the overall counseling provided.

In 2003, the Minnesota Dental Practice Act was modified to allow dental hygienists and assistants to place amalgam, composite, glass ionomer, and stainless steel crowns. A restorative functions course was added to the curriculum of a dental hygiene program at a state university in Minnesota to teach these skills. Student requirements for the course included clinical experiences on a minimum of twelve patients, as outlined by the Minnesota Board of Dentistry. The objectives of this study were to describe the characteristics and satisfaction levels of patients receiving care in the restorative functions dental hygiene clinic. An online survey was offered to eighty-two adult patients receiving restorative treatment in the clinic, with sixty-four patients agreeing to participate for a response rate of 78 percent. The average patient was thirty-one to forty years old, Caucasian, worked full-time, did not have dental insurance, had a family income of between $20,000 and $40,000, and chose this clinic due to low cost. Ninety-eight percent of responding patients were satisfied or very satisfied with their overall clinic experience, and 98 percent also thought the quality of care at this clinic was the same, better, or much better than previous dental care they had received. Most patients would return to this clinic for future restorative work (97 percent), in addition to recommending this clinic to others seeking restorative work (98 percent). Wilcoxen signed rank tests revealed the patients were significantly more satisfied (p<.001) with the fees of this clinic, as well as the communication, caring, organization, and preparedness of the dental hygiene student as compared to their last restorative visit to a private dentist. Group differences were examined using the non-parametric test, Mann-Whitney, which is similar to the two-sample t-test for parametric data. No significant group differences in the overall satisfaction with this clinic were found according to income level, dental insurance, or ability to pay for an unexpected dental bill. Findings in this study suggest the majority of patients were satisfied with the overall experience of restorations placed by a dental hygienist. Further research is indicated to determine if these results are typical of other dental hygiene restorative functions clinics in the United States.

In 2003, the Minnesota Dental Practice Act was modified to allow dental hygienists and assistants to place amalgam, composite, glass ionomer, and stainless steel crowns. The concept of utilizing allied professionals to perform expanded functions has been suggested as a way to increase access to care and productivity. A continuing education course was offered to provide required certification for interested dental practitioners (N=12). The objectives of this study were to examine confidence levels and effectiveness of the continuing education program. Pre-and post-course restorative content knowledge, along with confidence levels in knowledge, technical skills, and the ability to implement skills were measured. A matched pairs t-test found a significant increase in participants' restorative content knowledge (p<.001). Wilcoxen signed rank tests revealed an increase in confidence in all content knowledge (p<.01) and technical skill (p<.05) categories. Participants did not significantly increase in confidence to implement restorative functions skills into practice (p<.7). Interview data revealed that participants remain unclear about ways to incorporate restorative functions into the schedule. Findings in this case study suggest that content knowledge and confidence levels increase following completion of a restorative functions course.

The authors explored the use, demographics, knowledge, and the impact of a statewide smoking ban on smokeless tobacco use among college students. Participants and Methods: During spring of 2008, 417 students enrolled at a Midwestern state university completed a 12-item survey. Results: Twenty-two percent of males in this sample have recently used smokeless tobacco. Participants had a mean knowledge score of 7.8, constructed from nine items on the survey. Non-users scored higher (p<.001) than users and females scored higher (p<.001) than males. Users (N=34) did not demonstrate a significant difference (p=.71) in use after the implementation of a statewide smoking ban. Conclusions:Knowledge does not appear to be the only factor influencing the use of smokeless tobacco. Additional research is needed to investigate other factors including the impact of a statewide smoking ban on smokeless tobacco use.

Assisting patients to quit smoking continues to be critical for all health care providers as the Surgeon General’s report in 2004 reported a significant increase in the number of diseases caused by smoking. Awareness of the extreme addictiveness of nicotine may help health care providers increase empathy for patients attempting to quit. Health care providers can identify the patient’s stage of change, according to the Transtheoretical Model, and incorporate appropriate pharmacological and educational methods to aid in the quit attempt.