Community Health Board Review Textbook

Community Health

Aspect of health concerned with the health of ALL not just individuals, in which the goal is to protect and promote the heath of the public.

Prevention

the FOCUS of community health

primary

Secondary

tertiary

what are the three types of prevention?

Primary Prevention

Prevention in which the goal is to delay the onset of disease, reverse it, or arrest it. (EX: routine dh care, mouth guards, sealants, fluoride, health education and promotion)

Secondary Prevention

Prevention in which routine treatment is performed with the goal of terminating the disease process or restoring tissue to as normal as possible. (EX: fluoride, sealants, periodontal debridement, night guards, restorations)

Tertiary Prevention

Method of prevention in which there is replacement of lost tissue through rehabilitation due to damage caused by disease. (Crowns, partials, dentures, implants)

DH treatment

community water fluoridation

Fluoride Preventative strategies

Dental Sealants

ART

Xylitol Products

nutritional counceling

Oral cancer exam and tobacco cessation

Athletic mouthguard

mass education and promotion

Dental Health Prevention Methods include

Community Water fluoridation

dental health prevention method that has systemic and topical effects through addition of fluoride into community water. (OPTIMAL FLUORIDE LEVEL IN DRINKING WATER: .7 ppm)

.7 ppm

OPTIMAL FLUORIDE LEVEL IN DRINKING WATER

Dental Sealants

Prevent pit and fissure caries, and should be placed as soon as possible after eruption.

Alternative Restorative Treatment (ART)

prevention method in which a tooth is sealed after removing demineralized tooth surfaces manually.

Xylitol Products

Prevention method in which this product can be used, as it inhibits bacteria's ability to metabolize sugar

Barriers to Dental Care

Anything that limits an individual's ability to receive dental services.

Age

Language

Culture

Finances

Education

Fear

Transportation

Values

Denial

Unavailability of dental providers

barriers to dental care include

Five-Dimensional Health Model

Model of dental education and promotion that analyzes the five systems of physical, intellectual/mental, emotional, social, and spiritual input for maximum wellness.

Physical – tooth brushing/flossing

Intellectual – dental knowledge

Emotional – trust

Social – interaction with others

Spiritual – values/morals

Maslow Hierarchy of Needs

Model of dental education and promotion in which there is a list of needs from lowest to highest, and the individual must meet the lower level need before the next higher need can be met.

From lowest to highest

Psychological needs (food, water, clothing, shelter)

Safety needs (health, employment, property)

Love and belonging needs (friendship, family, connection)

Self esteem needs (confidence, achievement, respect)

Self-actualization needs (creativity, acceptance, purpose)

Theory of Stages of learning

Theory of dental health education and promotion that focuses on:

Habit

Action

Involvement

Self-interest

Awareness

Unawareness

Unicorns are so incredible and happy

ADPIED

Stands for assessment, DH diagnosis, planning, implementation, evaluation and documentation. Order of treatment

assessment

aspect of ADPIED in which you Analyze and understand your target population (the population you will be serving) by assessing needs, interests, resources, demographics, and funding need through:

Direct observation

Interview

Questionnaire

Survey

Epidemiological surveys

Records, documentation, charts

Screenings

Dental Hygiene Diagnosis

aspect of ADPIED in which you identify the needs based on your thorough assessment of population, and prioritize those needs.

Planning

aspect of ADPIED in which you develop a lesson plan/blueprint, and then develop goal and objectives.

Goal

Broad statement about the expected outcome when project is complete

Objectives

Specific and observable actions that the learner can perform, steps to achieve the goal of the program

GOAL

which comes first, goal or objectives?

Implementation

aspect of ADPIED in which you carry out the lesson plan.

Evaluation

Aspect of ADPIED in which you evaluate the outcomes to provide information for program revisions in the future, by measuring if objectives and goals have been met.

Can be accomplished by:

Pre-test/post test

Questions

Games

Activities

Qualitative evaluation

evaluation type in which we measure how well we did, quality of a program

Quantitative evaluation

evaluation type in which we measure how much we did, numerical scale

Formative Evaluation

Internal evaluation of the program DURING planning

Summative Evaluation

Evaluation of a program AFTER implementation.

Nonclinical Evaluation

Evaluation type that consists of interviews, surveys, document analysis, and observation.

Clinical evaluation

Evaluation type in that consists of basic screenings and exams that use dental indices.

Type 1

Complete dental exam, in which mouth mirror, explorer, illumination, radiographs, study models, and other tests are needed. (Least used in community health)

Type 2

Limited examination dental exam, in which mouth mirror, explorer, illumination, posterior bitewing radiographs, and select periapicals are used.

Type 3

Inspection dental exam, in which mouth mirror, explorer, and illumination are used. (most common exam in public health)

Type 4

screening dental exam, in which only tongue depressor and illumination are used. (least used exam due to number of errors)

Type 4

IF EXAM USES A TONGUE DEPRESSOR IT IS

Type 1 or 2

dental examinations that must be performed if treatment is planned

Simple Index

index that describes Presence or absence of a condition (ex: plaque or no plaque)

Cumulative Index

index that describes All past and present evidence of condition (ex: dmft)

Irreversible index

index that describes Conditions that will not change (ex: Caries)

Reversible Index

index that describes Conditions that can be changed (ex: presence of plaque)

Ramfjord Teeth

modified dental indices used commonly in community health settings to make it quicker to perform exams, in which only teeth 3, 9, 12, 19, and 25 are examined. Serve as representation of full dentition.

PHP (patient hygiene performance)

reversible oral hygiene index, used to assess performance in removing plaque and debris after toothbrushing

PI I (plaque index)

reversible oral hygiene index in which the probe is used to assess amount of plaque, and thickness of plaque at gingival margin

OHI (Oral Hygiene Index)

Reversible oral hygiene index used to measure oral hygiene status by observing debris and calculus.

VMI (Volpe-Manhold Index)

Reversible Oral hygiene index that is used to test for plaque control and calculus inhibition by measuring supragingival calculus formation AFTER prophylaxis.

GI (Gingival Index)

reversible gingivitis index, in which the probe is used to examine severity and location of inflammation, to determine prevalence and severity of gingivitis.

GBI (Gingival Bleeding Index)

Reversible gingivitis index, in which unwaxed floss is used to check for bleeding and delayed bleeding due to gingival inflammation.

SBI (Sulcular Bleeding Index)

Reversible gingivitis index, in which the probe is used to detect early signs of gingivitis.

Eastman Interdental Bleeding Index

Reversible gingivitis index, in which a wooden interdental cleaner is used to assess papillary bleeding, indicating inflammation

PI (Periodontal Index)

perio irreversible index, in which clinical exam alone or with radiographs is utilized, and each tooth is scored based on condition of surrounding tissue. (question of validity due to fact it does not measure loss of attachment)

PDI (periodontal disease index)

irreversible modified PI index, in which Ramfjords teeth is used to measure the prevalence and severity of periodontal disease by measuring both reversible (gingival) and irreversible (attachment loss) periodontal disease.

PSR (periodontal screening and recording)

perio index that classifies periodontal treatment needs quickly and efficiently by determining the need for a full mouth periodontal assessment - requires use of a special probe

CPITN (community periodontal index of treatment needs)

Perio index developed by WHO that determines periodontal needs rather than periodontal status through use of a special probe.

CAMBRA (caries management by risk assessment)

Dental caries index that is a method of identifying the cause of disease through assessment of risk factors of individual patients. Risk factors must be individually managed through behavior, chemical, or minimally invasive procedures.

DMFT/DMFS (decayed, missing, filled teeth / decayed, missing, filled surfaces

Irreversible dental caries index used to measure past and present caries of a population with permanent dentition.

Deft (decayed, need for extraction, filled teeth)

irreversible dental caries index used to measure observable caries experience in primary teeth - does not take into consideration teeth that have been extracted or exfoliated due to past caries experience.

RCI (root caries index)

irreversible dental caries index used to assess extent of root caries experience - only takes into account areas of root exposure.

Dean's Index of Fluorosis

Irreversible dental fluorosis index that rates fluorosis within a population

Incidence Rate

How many new cases are seen in a population

Prevalence Rate

Total number of existing cases at a given time

Hypothesis

educated guess

Null Hypothesis

type of hypothesis stated as a negative outcome - rejected if research finds a significant difference (EX: there is no statistically significant differences between...)

Research Hypothesis

type of hypothesis stated as a positive outcome EX: there is statistically significant differences between...)

Sample

representative subset of the population - the larger the more accurate

Random

Type of sample in which every subject is selected independently and randomly to reduce chance of bias.

Stratified

Type of sample in which subject choosing in based on certain subgroups - such as age, gender, income

Systematic

Type of sample in which every "nth" subject is chosen to participate

Judgmental

Type of sample in which subjects are selected by personal judgment of who would be a typical participant

Convenience

Type of sample in which group is already together and convenient - creates bias.

Primary Studies

Includes case control studies, cohort studies, and randomized controlled trials

Secondary/Pre-appraised/Filtered Studies

Includes meta analysis, systemic review, and clinical practice guidelines

Historical

Research design that looks at indices and prevalence of disease in a population over time - review of records and literature

Descriptive

Research design that describes teh presence and distribution of a disease or oral health condition at one point in time - uses the survey method

Retrospective

Research design that investigates possible causes of disease by using medical records

Longitudinal

Research design in which a group is observed over a long period of time.

Experimental

Most familiar research design, known as clinical trials that investigates the cause and effect through variables of control group, independent variable, and dependent variable.

Control Group

What stays constant in the experimental study. (often receives placebo)

Independent Variable

Variable in experimental study that is being manipulated.

Dependent Variable

Variable in experimental study that is the outcome that is being studied.

Double Blind Study

Neither the subject or the researcher knows who is in the control group, and who is in the group receiving the treatment (independent variable)

Quasi-Experimental

Experimental study that DOES NOT have control group - considered unethical

Pilot Study

A small version of a study, commonly a trial run to test it for a long term study.

IRB (Institutional Board Review)

Reviews the ethical implications of research study to ensure safety.

Insufficient number of subjects

Too short of a duration

Incorrect measurement instruments

Incorrect procedures utilized

Incorrect statistical tests are used to analyze data

Causes of Invalid Research include

Qualitative Data

Shows the quality or nature of variables -potentially rank ordered.

Categorical Variable

qualitative data that has no numeric representation (ex: color)

Dichotomous Variable

qualitative data that places subject into only two groups (ex: male/female)

Quantitative Data

Data represented by numbers, expressed as counts, percentages, and means. (ex: pocket depths, number of sealed teeth)

Continuous Variable

Quantitative data that has large or infinite number of measures - can be fractions. (ex: height, weight)

Discrete Variable

Quantitative data that is distinct and separate units expressed in whole numbers (ex: number of children, DMFT)

Nominal Scale

scale of measurement that Organizes data into mutually exclusive categories in which categories have NO RANK ORDER (ex: hair color)

Ordinal Scale

scale of measurement that organizes data into mutually exclusive categories WITH RANK ORDER but difference in rank order is not equal in value and has no numerical meaning. (ex: difficulty of DH patients)

Intervale Scale

scale of measurement that organizes data into mutually exclusive categories WITH RANK ORDER but difference in rank order is not equal in value and has no numerical meaning PLUS equal distance between units of measurement. - has no absolute zero point, numbers can be negative. (ex: temp in F)

Ratio Scale

scale of measurement that organizes data into mutually exclusive categories WITH RANK ORDER but difference in rank order is not equal in value and has no numerical meaning PLUS equal distance between units of measurement. - HAS AN ABSOLUTE ZERO POINT. (ex: money, height, weight, number of teeth)

Frequency Distribution Tables

Tables that show the number of times each score/item occurs.

Ungrouped Distribution

Data presenting in ascending or descending order with the frequency of each individual score.

Grouped Distribution

Data presented in a range of scores with the frequency of scores that fell within the range

Cumulative Distribution

Frequency of occurrence of scores up to and including any given value in the data set.