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Communtiy Dental Health

79 important questions on Communtiy Dental Health

Purpose of community dental health

improving public access
Reach as many people as possible with the least cost

Professional Roles of the Dental Hygienist

Clinician
Advocate
Administrator/Manager
Educator
Researcher

Differences in Community dental health practices and private practices

Community served                                                        individual served
team approach                                                              Individual practitioner
Setting in community                                                   Setting in private office

Parallel Procedures between community and private practice

Needs Assessment                                                    Health History and Examination
Analysis                                                                      Diagnosis
Program Planning                                                     Treatment Planning
Program Operation or Implementation                  Treatment
Program Funding                                                      Payment for Service
Evaluation/Appraisal                                                 Evaluation

Public Health Problem is what

condition, practice or situation that is widespread and an actual or potential cause of disease or death

Public Health Solution is what

solution to a public health problem that is directed to the community at large

Characteristics of Public Health Solution

Not hazardous to life or function
effectively prevents or reduces the targeted disease
easily and efficiently implemented
potency maintained for a substantial time period
attainable regardless of socioeconomic status
effective immediately upon application
affordable, cost-effective, and within means of community

Core public health functions

Assessment
Policy Development
Assurance

Core public health Policy Development function

development of comprehensive public health guidelines based on scientific evidence

Core public health Assurance function

Activities to guarantee that service are provided to achieve agreed-upon public health goals
      encouraging actions
      requiring action
      directly providing services

International level of community dental health program

programs for underdeveloped nations
treatment needs for international populations with minimal equipment
World Health Organization (WHO)

Federal level of community dental health program

health problems of national significance
developed Healthy People 2020
works in junction with Department of Health and Human Services (DHHS)
Centers for Disease Control and Prevention (CDC) is a funding source
Health Resources and Services Administration (HRSA) source of workforce funding

State level of community dental health program

consultation services to local health departments
Applies for federal funds-block grants, Medicaid funds

Local level of community dental health program

city, county, or regional where treatment takes place
funded by state and federal levels and grants
initiates dental health legislative measures (fluoridation)

Quantitative data is what

information that can be counted or expressed numerically

What is the epidemiologic triangle and what is included

Host, agent, environment and time
they all have a part that interacts with disease outcomes

Order the occurrence of disease from smallest to largest

Endemic, Epidemic and Pandemic

Name the 6 types of epidemiologic studies

Observational, Descriptive survey, cross-sectional, case control, cohort, experimental

Experimental Research Studies (Clinical Trial)

Uses a carefully designed research question and protocol
used to test hypotheses concerning prevention or control and treatment of disease
cause and effect (causation/causality)
use of control group and a treatment group that are randomized
something has to happen
has to involve more than 1 group
Ex: Hypothesis testing of the effect of using a power toothbrush versus a manual toothbrush on brushing frequency and gingivitis

Steps of the research process

Identify the problem
Develop the hypothesis
Design the research plan
Collect Data - Implementation of project
Analyze and interpret data
Draw conclusions

Judgmental or Purposive Sample

researcher or someone else with knowledge of the population selects a sample that is judged to be most representative of the population

Define Double Blind Study

prevents bias by making the participants and the examiner unaware of the group assignment; best way to avoid bias

Steps of Surveys versus Clinical Trials

Natural population                                                    Population at risk
large representative sample                                     Small non-representative sample
cross-sectional                                                          Longitudinal
General methods                                                      Specific, controlled methods
Establish prevalence                                                 Test hypothesis

Four types of Biostatistical Data

Discrete, Continuous, Categorical, Dichotomous

Discrete Biostatistical Data

counted in whole numbers; not fractions

Continuous Biostatistical Data

Has data points along a continuum; can be a fraction
Probe reading, BP

Categorical Biostatistical Data

categories of data with no real numeric meaning
race, sex

Dichotomous Biostatistical Data

categorical data with only two categories
yes/no

Location of mode, mean and median on a skew curve

mode is the highest point
mean is closest to the low flat part of curve
median is between the two

Statistical ANOVA is what

tests the difference between 3 or more mean scores
more letters=more scores

Statistical Chi-square test is what

comparing entire data sets rather than means

P Value significance

value the significance of the difference between the means or distributions being compared
smaller the p value in relation to .05, the greater the significance

Specificity in relation to dental indices

ability of a test to identify the absence of a disease

DMFT/DMFS indices

Decayed, Missing, FIlled Teeth/Surfaces
coronal caries in Permanent teeth
DMFS is more sensitive, more surfaces
Does not include 3rd molars, congenitally missing teeth, unerupted teeth, removed or restored for other reasons then caries

Df, def, dmf indicies

decayed/filled, decayed/need to be extracted/filled, decayed/missing (due to cavities)/filled
coronal caries of Primary teeth
Never combine DMFT and df for mixed dentition. treat separately

Indices used to identify Periodontal Disease

CPITN
PDI
PI

Indices used to identify Oral Hygiene Status

OHI-S
PlI
PHP
VMI

Community Fluorosis Index (CFI) Normal

0
enamel presents the usual translucent structure; surface is smooth, glossy and usually pale creamy white

Community Fluorosis Index (CFI) Questionable

0.5
enamel has few white flecks to occasional white spots

Community Fluorosis Index (CFI) Very Mild

1
small, opaque, paper-white areas scattered irregularly over the tooth but not involving as much as 25% of surface or just the edge of cusps on posteriors

Community Fluorosis Index (CFI) Severe

4
all surfaces affected and show hypoplasia, pitting may appear, brown spots are widespread and teeth may look corroded

Primary prevention for Community program planning

preventing the onset of disease

Secondary prevention for Community program planning

slowing the progression of a disease

Tertiary prevention for Community program planning

softening the impact of an ongoing illness or injury; replacing lost tissues

Order of approach for community programs

Assessment
Planning
Implementation
Evaluation

First step in planning community programs

Assessment or Needs Assessment

Purpose of assessing community needs

understand the target population and a community profile such as
size, geographics, diversity, baseline data, priority problems and availability

National Oral Health Surveillance System's role and meaning of Surveillance

NOHSS
operated by CDC; measures disease and conditions to evaluate progress on Healthy People 2020
ongoing systemic collection, analysis and interpretation of outcome specific health related data needed for planning, implementation and evaluation of public health practice

National Health and Nutrition Examination Survey

NHANES
data provided by the NOHSS

Common Dental trends in the U.S.

Dental caries in children
untreated tooth decay
higher treatment needs
Oral and pharyngeal cancer
Need for medicaid dental coverage
preventative dental visits
dental sealants

Data to analyze in a community needs assessment (the what)

federal poverty level
infrastructure- ability to provide programs
capacity
access to care
utilization
demand
barriers to care
culture of population

Second step in community planning (APIE)

Planning

Object of Planning step

determine goals and objectives
effective interventions- such as sealant programs, fluoride programs
screenings for dental treatments
oral health education

Optimal fluoride level for water and compounds used

0.7 mg/L to matter where
sodium silicofluoride, sodium fluoride, hydrofluorosilicic acid

Block grants for funding resources

grant of federal funds that a state or local government may use at its discretion

Grants for funding resources

grants for specific programs from CDC, HRSA

Title I for funding resources

schools that receive federal subsidies because of low income status of children

Medicaid for funding resources ( Title XIX )

health insurance for low income and other medically disadvantage populations funded by the federal and states and administered by the state

Medicare for funding resources ( Title XVIII )

comprehensive health insurance for older adults regardless of income

CHIP for funding resources ( Title XXI )

Children's Health Insurance Program
state/federal program to provide comprehensive health care coverage to children of low income families who are above the Medicaid income level

Head Start for funding resources

limited dental care for Head Start children from families with low income but dont qualify for Medicaid or CHIP

Dental HPSA for funding resources

having a shortage in dental practitioners, funds to expand dental workforce

Private dental insurance payment for funding resources

usually through a group plan
COBRA- allows past employees to continue health plan if sudden termination

Third step of community Programming (APIE)

Implementation

Purpose of Implementation in community programming

involves a strategy- why?who?where?when?how?
formative evaluation- process evaluation to adjust program as needed
pilot test- conducting a program with a smaller group of people first to test (trialrun)

Fourth step of community Programming ( APIE)

Evaluation

Purpose of Evaluation as part of community programming

provide information of improvement or revisions
analyze whether or not goals and objectives were met
evaluation should be ongoing from the beginning of program

Order of Health Belief Model constructs

1-perceived susceptibility
2-perceived severity
3-perceived benefits
4-perceived barriers
5-cue to action
6-self-efficacy

Stages of Learning Ladder

low to high:
Unawareness
awareness
self-interest
involvement
action
habit
( Ugly Apes Sit In A Hut )

Unawareness stage of learning ladder

learner has incomplete or inaccurate information

Awareness stage of learning ladder

Correct information is obtained but does not have personal meaning for learner

Involvement stage of learning ladder

old ideas are replaced with new ones; learner in motivated to act

Action stage of learning ladder

learner tests new concepts based on perceived needs

Habit stage of learning ladder

learner begins to experience gratification and self-satisfaction; behavior is then modified

Community Organization Theory

applies to large community groups
incorporates empowerment- involving and activating community towards common goal

Assessing a Lesson Plan

pretest quiz to gather baseline data

Learning experiences to use on a Lesson Plan

formal- lecture, discussion
informal- brochures, billboards
interactive
teach as you go
use past forms that have worked

Implementation for a Lesson Plan

Formative evaluation taking place
ask learners if they understand before moving on and observe reactions

Evaluation of a Lesson Plan

Formative- during presentation
Summative- evaluation of outcomes using baseline data

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