East Tennessee State University Digital Commons @ East Tennessee State University Electronic Theses and Dissertations Student Works 5-2014 Dietary Counseling Practices and Perceived Barriers Among Utah Dental Hygienists Natalie F. Carlson East Tennessee State University Follow this and additional works at:https://dc.etsu.edu/etd Part of theDentistry Commons, and theDietetics and Clinical Nutrition Commons Recommended Citation Carlson, Natalie F., "Dietary Counseling Practices and Perceived Barriers Among Utah Dental Hygienists" (2014).Electronic Theses and Dissertations.Paper 2324. https://dc.etsu.edu/etd/2324 This Thesis - Open Access is brought to you for free and open access by the Student Works at Digital Commons @ East Tennessee State University. It has been accepted for inclusion in Electronic Theses and Dissertations by an authorized administrator of Digital Commons @ East Tennessee State University. For more information, please [email protected]. Dietary Counseling Practices and Perceived Barriers Among Utah Dental Hygienists ___________________________________ A thesis presented to the faculty of the Department of Allied Health Sciences East Tennessee State University In partial fulfillment of the requirements for the degree Master of Science in Allied Health _________________________________ by Natalie F. Carlson May 2014 ______________________________________ Dr. Susan Epps, Chair Dr. Debbie Dotson Dr. Constance Sharuga Keywords: nutritional screening, dietary counseling, dental hygienist, preventive care ABSTRACT Dietary Counseling Practices and Perceived Barriers Among Utah Dental Hygienists by Natalie F. Carlson Diet related factors are associated with the 2 most prevalent oral diseases- caries and periodontal disease. Furthermore, there is growing evidence of a synergistic link between nutrition, systemic health, and oral health. Regardless of this evidence and in spite of recommendations by dental associations, researchers have shown the majority of dental professionals are consistently excluding nutritional screenings and dietary counseling in their dental services. The purpose of this study was to examine the nutritional screening and dietary counseling practices of Utah dental hygienists and to evaluate possible associations between various factors influencing the implementation of nutritional services. Surveys were collected from members of the Utah Dental Hygienists’ Association. Mean scores showed low frequency and low confidence levels in performing nutritional services and high perceptions of barriers to care. Little to no difference in mean scores occurred when differentiating between degree achievements, years in dental hygiene practice, or component affiliation. 2 Copyright 2014 by Natalie F Carlson All Rights Reserved 3 DEDICATION I would like to dedicate this thesis to my parents Michael J. Flynn, D.D.S and Linda Flynn, ANP. You instilled in me a passion for learning and accomplishment and have always supported and encouraged my professional and education goals. I could not have dreamed of obtaining this success without your influence and support. Thank you. 4 ACKNOWLEDGEMENTS Special acknowledgment goes to Dr. Susan Epps who served as chair of my thesis committee. I developed a great respect for your wisdom right from the beginning and have come to trust and appreciate your insight. Thank you for always expecting more than I was initially willing to give. You consistently pushed me to be greater and developed in me a strength I didn’t know I had. Your time and dedication to my success is so greatly appreciated. I would also like to thank Dr. Debbie Dotson, a member of my graduate committee. You constantly challenged my thinking and forced me to re-evaluate my perspectives and expand my horizons. I have become a better dental professional because of you, thank you. Thank you to Dr. Constance Sharuga, who was also a member of my graduate committee. Thank you for your patience and encouragement through the process of the project. Your recommendations were instrumental to the outcome of this project. I also want to thank Dr. Randy Byington, professor of my Methods of Allied Health Research course. Although not a member of my committee, you sacrificed your time to evaluate my project. Your guidance in formatting and statistical inferences was invaluable. To Theresa Levy Richards I would like to let you know of my gratitude for your previous work on this important, however, often over looked topic. I hope our combined efforts encourage future researchers to explore the nature of nutrition practices in the dental field. Finally, words cannot express my gratitude to my husband Jeremy and our three children Oakley, Tate, and Sierra. From my dental hygiene degree to my degree completion to now, you have been there and encouraged me every step of the way. You have sacrificed so much to help me reach my goals. Thank you for believing in me. 5 TABLE OF CONTENTS Page ABSTRACT…………………………………………………………………………… 2 DEDICATION………………………………………………………………………… 4 ACKNOWLEDGEMENTS…………………………………………………………… 5 LIST OF TABLES…………………………………………………………………….. 9 Chapter 1. INTRODUCTION…………………………………………………….............. 10 Statement of the Problem………………………………………………… 12 Research Questions……………………………………………………… 13 Significance of the Study…………………………………………………. 14 Delimitations……………………………………………………………… 14 Limitations………………………………………………………………… 14 Assumptions………………………………………………………………. 15 Definition of Terms……………………………………………………….. 15 2. REVIEW OF THE LITERATURE………………………………………..……. 17 Nutrition…………………………………………………………………… 17 Nutrition and Systemic Health…………………………………………….. 18 Systemic Health and Oral Health………………………………………….. 19 Oral Health and Nutrition………………………………………………….. 21 Micronutrients and Oral Health……………………………………………. 24 Sources of Malnutrition……………………………………………………. 27 Dietary Screening and Nutritional Counseling…………………………….. 29 6 Dental Hygienists’ Knowledge of Nutrition………………………………… 30 Dental Hygienist’s Dietary Screening and Nutritional Counseling Practices.. 31 Barriers to Care……………………………………………………………… 32 Summary…………………………………………………………………….. 33 3. METHODS……………………………………………………………………… 38 Overview…………………………………………………………………… 38 Research Design……………………………………………………………. 38 Population…………………………………………………………………… 38 Informed Consent Consideration…………………………………………… 39 Data Collection Procedure…………………………………………………. 39 Research Questions………………………………………………………… 40 Data Analysis Procedure…………………………………………………… 41 4. ANALYSIS OF DATA…………………………………………………………... 42 Overview……………………………………………………………………. 42 Participants………………………………………………………………….. 42 Selection……………………………………………………………….. 42 Demographics………………………………………………………….. 43 Results………………………………………………………………………. 44 Descriptive Statistics…………………………………………………. 44 Analysis of Variance…………………………………………………... 45 Pearson Correlation Coefficient………………………………………. 48 Discussion…………………………………………………………………… 49 5. CONCLUSIONS, DISCUSSION, AND RECOMMENDATIONS……………… 52 7 Research Questions………………………………………………………….. 53 Conclusions………………………………………………………………….. 54 Discussion……………………………………………………………………. 55 Recommendations……………………………………………………………. 59 Recommendations for Practice or Implementation……………………. 59 Recommendations for Improving the Research………………………… 61 Recommendations for Future Research………………………………… 61 REFERENCES…………………………………………………………………. 63 APPENDICES…………………………………………………………………… 72 Appendix A: Research Survey…………………………………………… 72 Appendix B: Permission to use Research Survey…………………………… 75 Appendix C: Invitation and Informed Consent for Participant…………….. 76 Appendix D: Follow Up…………………………………………………… 77 VITA…………………………………………………………………………… 79 8 LIST OF TABLES Table Page 1 Nutrient, Systemic, and Oral Health Interactions…………………………. 34 2 Drug-Nutrient Interactions………………………………………………… 36 3 Descriptive Statistics………………………………………………………. 44 4 Degree and Confidence……………………………………………………. 46 5 Degree and Frequency……………………………………………………… 46 6 Years in Practice and Confidence…………………………………………. 47 7 Years in Practice and Frequency…………………………………………… 47 8 Component and Barriers…………………………………………………… 48 9 Component and Frequency………………………………………………… 48 10 Frequency and Barriers………………………………………………………. 49 11 Frequency and Confidence…………………………………………………… 49 9