The standard of care for dental hygiene prophylaxis 20 years ago consisted of coronal polishing each tooth with a rubber cup and abrasive paste.Shortly thereafter, research discovered that polishing removed valuable enamel (an estimated 4 micrometers [µm] per tooth) (Wilkins, 2004).With a baseline of 1,000 to 1,500 µm of enamel, it was deduced that 4 µm per prophylaxis was too much to loose (Rozycki, 1998).As a result, the recommended standard of care shifted toward polishing selective teeth.
In our current curriculum we are taught to selectively polish the dentition in an effort to preserve enamel.However, it is commonly known that after graduation we will be expected by our employing dentist and by paying patients to polish every tooth surface every time.This dichotomy in practice between what we learn and what we will be expected to practice is the impetus for our research study.
The purpose of this research is to determine if the enamel removed after a professional coronal polishing with a prophylaxis angle and paste, is “clinically” significant enough to warrant the practice of selective polishing.The seminal research deemed that clinically significant.The guiding research questions are: 1) Is the amount of enamel removed significant enough to warrant selective polishing? 2) What are the perceptions of coronal polishing among dental professionals? 3) What are the perceptions of coronal polishing among the general population?
Proposed Methodology:
Extracted teeth will be collected from various dental offices within the state.The teeth will then be mounted into dental stone and one surface of each tooth will be polished with a predetermined prophylactic paste and length of time.The University of Utah has agreed to perform an electron microscopy evaluation.They will scan the untreated side of each tooth for a baseline and then the treated side of the same tooth to evaluate the removal of enamel.We will also conduct a survey consisting only of opinions of dental professionals.The survey will contain two questions:1. What polishing technique is used in your office? 2. What do you consider to be a significant loss of enamel?Another survey would be directed toward the opinion of dental patients.It would consist of one question: 1. If your teeth were not polished during dental hygiene treatment, would you think that your treatment was complete?We will take the results of the surveys and determine the perceptions of the professional and public communities.
All researchers are WSU dental hygiene students, who are extensively trained on all aspects of various dentitions.We have been assessed on several performance evaluations and have been assured that we have adequate knowledge and training to successfully accomplish the purpose of this research.
Expected Outcomes:
After analysis of the enamel, we will determine the amount of enamel removed.We know that statistically there will be some enamel loss, however with this research we will be able to determine if the amount of loss is clinically significant.Each of us will report our finding in the form of a baccalaureate thesis regarding the results of our study.We will also be presenting at the annual WSU Undergraduate Research Symposium.
References:
Rozycki, William (1998). Early Detection of Dental Caries: Quantitative Laser Fluorescence.Research & CreativeActivityIndianaUniversity, XXI(2).
Wilkins, Esther M. (2005). Clinical Practice of the Dental Hygienist 9th ed. pp. 726-741.
Budget Narrative:
The supplies we would need consist of dental stone.We would need approximately 2 pounds of dental stone to cement 200 teeth at approximately $1.00 a pound (total of $2.00).We would also need approximately 8 prophylaxis angles considering that we will use one angle per 30 teeth.The cost of 8 prophylaxis angles are approximately $0.40 each (total of $3.20).Prophylaxis paste is estimated at $0.26 each.We would need 16 units, using one unit per 15 teeth (total $4.20).The charge required to use the University of Utah’s electron microscopy lab is $59.96 an hour for an estimated 6 hours (total $359.76).We would then need $43.52 at $0.32 a mile for a total of 136 miles to transport the teeth to the lab and pick them up.Printing of the surveys would be approximately $15.00 at $0.10 a page for a total of 150 pages.
Timeframe:
It is expected that we will have acquired all of the teeth that we need for our study by January 2006.At this time, we will conduct the polishing of those teeth according to the proposed methodology in January and deliver them for evaluation at the University of Utah by February 2006.We will analyze and write up results in March 2006.
We will be conducting opinion surveys as noted in the methodology during the month of February and will analyze and write up the results in March 2006.An IRB proposal was submitted on November 7, 2005, approval is pending.
2005-06 WSU Undergraduate Research Budget Worksheet
BUDGET ITEM
Department or College Funds
Outside Agency Funds
Personal Funds
Undergrad. Research Funds
GRAND
TOTAL
Materials *
$24.40
$24.40
Equipment *
$359.76
$359.76
Travel to gather data
$43.52
$43.52
Travel to present results (must have proof of acceptance)
$0.00
Stipend:
Hrs @ $10/hr
Benefits @ 8.5%
Total
$0.00
GRAND TOTAL
$427.68
$427.68
NOTE –Equipment and left-over materials purchased with this grant will remain the property of WSU
2005-06 WSU Undergraduate Research Faculty Mentor Recommendation Form
Student Name (last, first): Brittany Nelson, Melissa Rees, and Heidi Wilson
& MaryAnn Jones
Project Title: Selective Polishing: An Analysis of Enamel Removal During Professional Coronal Polishing Procedures
Mentor Directions:After carefully reviewing the proposal and assessing both the viability of this project and the qualifications of the student requesting funding, answer the questions found below.If the project involves the use of human subjects or protected animals, be sure the student secures IRB or ACUC approval.If the project receives funding, it is your responsibility to work closely with the student, monitor the ongoing progress of the project and budget, and evaluate the project’s results.Failure to do so will jeopardize funding for this project and any future projects.
1.How long and in what capacity have you known this student?
I have known MaryAnn, Brittany, Melissa and Heidi for the last year and a half as dental hygiene students in the WSU program.During this time they have all demonstrated the capacity for self-motivation and efficiency.
2.Briefly describe the proposed project.Is this part of a larger research project? Is this part of a course?If so, how is the project apart from the nature and scope of activities normally taken for the course?
These students are conducting this research project for two reasons: 1) a project of this nature is required for the partial completion of the requirements toward their baccalaureate degree and 2) they have always been curios about the fact that we teach selective polishing in school but they (having been previous dental assistants) have never seen selective polishing actually practiced.In our conversations they decided to reinvestigate the idea and rationale behind selective polishing and see if they can have an impact on the way the dental profession view coronal polishing.
3.Give an assessment of the project’s significance to the student’s discipline and of the project’s educational and/or professional benefit to the student.
This project will be of great value to the students as it will serve as their final baccalaureate thesis project.In addition, I think that it is a valuable study to reinvestigate selective polishing because current research is not available on the topic.This project has the potential to change the way that dental preventative procedures are practiced.
4.Comment on the qualifications of the student to successfully complete this project, both in terms of the project’s scope and its time frame.
I am fully confident that these students will complete this project in the timeframe they have allotted.I will work with them to analyze their data and interpret their results, but other than that they are fully qualified to conduct the experimental phase of their research.
5.Comment on the justification and appropriateness of the project budget.
I think that the budget section is pretty straightforward and appropriate for the project.
6.Describe your role in the project.
I serve as a mentor for this project and will assist the students in the data analysis stage of the interpretation and write-up of the results.
7.Include anything else that you think will be helpful to the committee in evaluating this application.
This project __X___ DOES ____ DOES NOT require review by the WSU Institutional Review Board for Human Subjects or the WSU Animal Care and Use Committee.
* IRB approval has been submitted 11/07/05, approval pending.