Background: To compare fatigue, comfort, and muscle work associated with the use of two periodontal curettes during scaling: one with a novel adaptive design, the other with a conventional non-adaptive design. Methods: Twelve hygienists scaled a typodont using two Universal Barnhart 5/6 curettes: (1) a prototype featuring an adaptive silicone-covered handle (Curette A), and (2) a stainless-steel curette (Curette B). Surface Electromyography (sEMG) traced muscle work. Hand positions, fatigue, comfort, pinch, and grasp strength were recorded. Paired t-tests and a repeated measures ANOVA with covariates were tested for differences. The significance level was set at p < 0.05. Results: Curette A performed significantly better in all categories. Pinch and grasp strength and fatigue were significantly reduced post-instrumentation for Curette B. Curette A required significantly less (i) total muscle work and (ii) work in individual muscles. Comfort, correct grasp, and blade adaptation were significantly better using Curette A. Conclusions: A curette featuring a novel adaptive handle design demonstrated significantly improved ergonomic performance. Additional clinical studies are needed to solidify our understanding of the potential short- and long-term benefits of the novel curette handle design. Practical Implications: A novel adaptive curette handle design that enables the clinician to adapt the instrument across the index finger may reduce musculoskeletal burden and fatigue, as well as improve comfort during periodontal instrumentation.

Oral non-neoplastic and neoplastic lesions have similar clinical manifestations, increasing the risk of inaccurate screening decisions that adversely affect oral cancer (OC) outcomes. Tobacco-use-related changes in the oral soft tissues may affect the accuracy of “smart” oral screening modalities. Because smoking is such a strong predictor of OC risk, it may overwhelm the impact of other variables on algorithm performance. The objective was to evaluate the screening accuracy in tobacco users vs. non-users of a previously developed prototype smartphone and machine-learning algorithm-based oral health screening modality. 318 subjects with healthy mucosa or oral lesions were allocated into either a “tobacco smoker” group or a “tobacco non-smoker” group. Next, intraoral autofluorescence (AFI) and polarized white light images (pWLI), risk factors as well as clinical signs and symptoms were recorded using the prototype screening platform. OC risk status as determined by the algorithm was compared with OC risk evaluation by an oral medicine specialist (gold standard). The screening platform achieved 80.0% sensitivity, 87.5% specificity, 83.67% agreement with specialist screening outcome in tobacco smokers, and 62.1% sensitivity, 82.9% specificity, 73.1% agreement with specialist screening outcome in non-smokers. Tobacco use should be carefully weighted as a variable in the architecture of any imaging-based screening algorithm for OC risk.

(1) Background: Musculoskeletal disorders (MSDs), discomfort, fatigue, pain, and other acute and chronic work-related injuries are common among dental clinicians. Hand instruments constitute a primary risk factor for these conditions. The overall goal of this study was to compare in dental hygienists with healthy hands, and in those with MSDs, the effect of three different handle designs on instrumentation-related muscle work, comfort, fatigue, and quality of tactile feedback. (2) Methods: Clinicians tested three periodontal curettes: one with a novel adaptive silicone handle, another with a rigid resin handle, and the third with a rigid silicone handle. Ten hygienists—five with MSDs and five without—each scaled three typodonts using the three different curettes. Statistical analysis was performed using a General Linear Model (GLIM) and Tukey’s post hoc test, and a significance level of p < 0.05 was implemented. (3) Results: On average, mean comfort and fatigue across all instruments were significantly worse in testers with MSDs, who also expended significantly more work to complete the same task. In all testers, a novel adaptive handle design was associated with significantly reduced total muscle work and post-instrumentation fatigue, as well as better comfort than conventional rigid handle designs. (4) Conclusions: An adaptive curette handle design demonstrated significantly better ergonomic outcomes than conventional rigid curette handle designs. Hygienists with MSDs expend significantly more muscle work during dental instrumentation.

(1) Background: Periodontal instrumentation with dental curettes is associated with discomfort, fatigue, and musculoskeletal diseases. The goal of this study was to compare comfort, fatigue, and muscle work using three different curettes. (2) Methods: Eight hygienists each scaled three typodonts using the three different curettes. Curette A was a prototype with a novel adaptive design, Curette B had a conventional stainless-steel design, and Curette C featured a conventional silicon-covered handle. Time-based work in four muscles, comfort, fatigue, tactile feedback, grip and blade position, and pinch and grasp strength were recorded. Statistical analysis was performed using a General Linear Model (GLIM) and Tukey’s post hoc test. The level of significance was set at p < 0.05. (3) Results: Comfort, correct grasp, fingertip placement, and blade-to-tooth adaptation were significantly better with Curette A (p < 0.05). While pinch and grasp strength were significantly reduced post-instrumentation for Curettes B and C (p < 0.05), they remained unchanged for Curette A. Curette A required significantly less total muscle work and work in individual muscles, resulting in significantly less post-instrumentation fatigue than for Curettes B and C, but similar levels of tactile feedback (p < 0.05). (4) Conclusions: The ergonomic performance of a prototype adaptive periodontal curette was significantly better than that of two conventional instruments with rigid handle designs.

Background: Dental instrumentation with hand-held devices is associated with discomfort, fatigue and musculoskeletal diseases or repetitive stress injuries. The goal of this in vivo study was to determine the effect of an ergonomic handle sheath on muscle work, comfort and fatigue associated with (a) piezoelectric scaling by hygienists with and without musculoskeletal disorders (MSDs), and (b) dental cavity preparation by healthy dentists using a dental micromotor. Materials and Methods: Two groups of ten hygienists each tested the piezoelectric scaler. Hygienists in Group 1 had no MSDs, while those in Group 2 had been diagnosed with MSDs. Additionally, ten dentists with no MSDs used a dental micromotor to prepare four standardized cavities. Time-based work in four muscles, comfort and fatigue were recorded in the presence and absence of an add-on soft, insulating handle sheath. Data were analyzed using a repeated measures analysis of variance model with Tukey’s post-hoc test. Results: Comfort, fatigue and muscle work were significantly better for both devices when the sheath was used. While hygienists with MSDs used more muscle work to complete the set scaling task, and the sheath-related reduction in work was somewhat greater, these MSD-related differences did not quite reach significance. Conclusions: The results of this pilot study show that the ergonomic performance of an ultrasonic scaler and a dental micromotor may be improved by the use of an ergonomic handle sheath.

The low-resource, minority and underserved populations (LRMU) that carry the highest risk of oral cancer (OC) experience many barriers to early detection and treatment, resulting in disproportionately poor out-comes. One major barrier to better outcomes is poor compliance with specialist referral for diagnosis and treatment. The goal of this study was to compare specialist referral compliance for Telehealth vs. in-person visits in LRMU individuals screening positive for increased OC risk. Forty subjects who had screened posi-tive for oral potentially malignant lesions (OPMLs) were recruited from community clinics. The subjects indi-cated whether they would prefer an in-person or Telehealth specialist visit. They were offered assistance with all aspects of the visit, and then tracked over 3 months for referral compliance. A novel, very low-cost, simple Telehealth platform located within the community clinic was used for the remote specialist visit. In the Telehealth group, 16/24 subjects attended the first scheduled remote specialist visit; 4/24 attended resched-uled visits within 3 months, and 4/24 did not comply at all. All attendees and specialists were able to com-plete the remote visit in full. Of the 7/16 subjects who completed the in person visit, 3/16 attended the first scheduled visit, 4/16 complied within 3 months. 9/16 did not comply at all with specialist referral. Significantly more individuals complied with telehealth specialist referral at 1 month (p=0.0006) and after 3 months (p=0.0154). A novel Telehealth platform may improve compliance with specialist referral in low-resource in-dividuals with OPMLs.