title: Incorporating oral-systemic evidence into patient care: practice behaviors and barriers of North Carolina dental hygienists.
abstract: OBJECTIVE
  Current research has reported associations between periodontal and systemic health, however, there is little data regarding how dental hygienists are incorporating this evidence into the dental hygiene practice. The purpose of this survey research was to determine what practice behaviors are prevalent among North Carolina dental hygienists regarding the incorporation of oral-systemic evidence into practice as well as perceived barriers to implementation.
  
  
  METHODS
  A questionnaire was developed, pilot tested, revised and mailed to 1,665 licensed dental hygienists in North Carolina. After 3 mailings the response rate was 62%, with 52% (n=859) of respondents meeting inclusion criteria. Survey data was analyzed using descriptive statistics and Chi-square analysis.
  
  
  RESULTS
  Respondents were predominately female (99%) with a 2 year degree (84%). While a minority of dental hygienists (20%) reported measuring blood pressure routinely on all patients, a majority (62%) measure blood pressure in select patients. Oral cancer screenings were performed by 89% of respondents. Eight percent record blood sugar levels, but only 3% record HbA1c values. Fifty percent of dental hygienists are extremely likely to refer patients to a medical provider for follow up assessments. Conditions dental hygienists are likely to discuss with patients include tobacco use (89%), pregnancy (84%) and genetics (79%). Significant barriers to implementing oral-systemic evidence include lack of time (52%), concern over legal risks (44%) and lack of education (27%).
  
  
  CONCLUSIONS
  North Carolina dental hygienists are implementing some aspects of oral-systemic evidence into practice, but could take a more active role if they had more allotted time, education and training.
authors.affiliation: Pacific University, School of Dental Health Science, USA.
authors.forename: Kathryn P
authors.initials: KP
authors.lastname: Bell
authors.forename: Ceib
authors.initials: C
authors.lastname: Phillips
authors.forename: David W
authors.initials: DW
authors.lastname: Paquette
authors.forename: Steven
authors.initials: S
authors.lastname: Offenbacher
authors.forename: Rebecca S
authors.initials: RS
authors.lastname: Wilder
mesh_terms: D001291:Attitude of Health Personnel; D003756:Dental Hygienists / Q000706:statistics & numerical data*; D055094:Evidence-Based Dentistry; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006304:Health Status; D006305:Health Status Indicators; D006801:Humans; D009657:North Carolina; D009909:Oral Health; D010353:Patient Education as Topic / Q000706:statistics & numerical data; D010510:Periodontal Diseases / Q000150:complications* / Q000517:prevention & control; D011364:Professional Practice / Q000706:statistics & numerical data*