Acknowledgements - UCSF School of Dentistry - University of ...

determination of untreated decay. A 50-item questionnaire included demographics and OH-related behaviors such as oral hygiene
practices and dental care utilization. Chi-squared, one-way ANOVA, and logistic or multivariable regression analyses were
conducted to examine the relationship between sociodemographic and behavioral factors with OH status during pregnancy.
Results: Hispanic ethnicity, lower household income, public dental insurance, and lacking a dental visit in the past year were
significantly associated with poorer outcomes for all 3 OH variables (untreated decay, probing depths, and gingival bleeding) in the
bivariate analyses. After controlling for other variables, insurance status, education, and dental visit were significantly associated
with untreated decay while only lack of dental visit was significantly associated with higher probing depth (pG that replaces Pro with Arg, which would alter the protein structure and its function, as demonstrated by protein
structure modelings.
Conclusion: When patients present with inherited tooth defects, the dentist’s role is to describe the phenotypes and obtain a family
pedigree of the inheritance pattern. Additionally, collecting a patient’s saliva is a simple, painless procedure, which can be used for
DNA purification, mutational analysis, and diagnosis of inherited tooth defects such as AI
Support: UCSF Start-up fund to T.L. and R03 DE019682 to T.L.
#52 Title: Alternative practice dental hygiene in California: past, present, and future
E MERTZ (1), P GLASSMAN (2)
(1) UCSF Department of Preventive and Restorative Dental Sciences, (2) University of the Pacific
Objectives: To improve access to care, policymakers and dental professions often consider workforce redesign and innovation as a
primary strategy to reduce disparities in utilization and oral health outcomes. This study examines one such redesign through the
development of Registered Dental Hygienists in Alternative Practice (RDHAP) in California.
Methods: This comprehensive case study was developed using mixed methods. Archival documents and dental and dental hygiene
association literature inform the historical analysis. This new model of care is documented in two surveys of the dental hygiene
workforce conducted in 2005 and in 2009 at UCSF. A qualitative study of RDHAPs and related stakeholders was also conducted by
the authors in 2007. These data represent a comprehensive set of perspectives on the alternative practice hygienist.
Results: Development of this practice model took 23 years and resulted from a highly politicized and contentious legislative
process. RDHAPs are motivated to autonomously serve underserved patients and communities. Their patients are more likely to be
very young, medically compromised, or developmentally disabled than patients of traditional dental hygienists. RDHAPs work in
high need settings including residential care facilities (63.6%), homebound settings (61.0%), and nursing homes (58.5%). Almost all
provide direct patient care (95.1%). Many provide case management (64.1%) and engage in public health activities (36.98%).
Challenges within their practice include: ergonomics, the referrals process, and payers who don’t recognize them at billable
providers.
Conclusions: The alternative practice of dental hygiene in California is an important innovation in improving access to preventative
dental care services, case management, and referral for a wide range of underserved populations in California. This was made
possible by legal scope of practice changes; however the model’s success requires further dental delivery system and
organizational changes.
Support: Funding provided by National Institute of Dental & Craniofacial Research Awards # P30DE020752 & #U54DE019285.
School of Dentistry Research and Clinical Excellence Day 2011 Program 23