Community Health: BOARDS Review

primary prevention

Goal is to delay the onset of disease, reverse its progress or arrest it

primary

What type of prevention is health education & promotion?

tertiary prevention

Replacement of lost tissues through rehabilitation: disease has done damage

secondary prevention

Routine tx to terminate the disease process or restore tissues (aka restorative care)

tertiary

What type of prevention is implants?

0.7ppm

What is optimal fluoride level in drinking water?

xylitol

inhibits bacteria's ability to metabolize sugar

Alternative restorative tx (ART)

sealing a tooth after removing demineralized tooth surface

・Physical

・Intellectual/Mental: (knowledge)

・Emotional: (trust)

・Social

・Spiritual (values, morals)

(PIE… So Scrumptious)

What is the five dimensional health model?

Maslow hierarchy of needs

a method of classifying human needs and motivations into five categories

・Physiological needs (water, food)

・Safety needs (health, employment)

・Love and belonging needs

・Self-esteem needs

・Self-actualization needs (creativity, acceptance, purpose)

(Pumpkin Spice Latte… So Scrumptious)

What are the maslow hierarchy of need in order from lowest to highest?

→ Must meet lower level need before next higher need can be met

・Unawareness

・Awareness

・Self-interest

・Involvement

・Action

・Habit

(Unicorns Are So Incredible And Happy)

What are the steps of the learning ladder (Theory of stages of learning)

・Assessment

・DH diagnosis

・Planning

・Implementation

・Evaluation

・Documentation

(ADPIED)

What are the six steps of participating in a community program?

assessment

- Analyze and understand your target population

- Assess the populations: needs・interests・resources・demographics

- How to conduct needs assessment: direct observation・interview・questionnaire・survey・epidemiology・records

dental hygiene diagnosis

- Identify the needs based on your thorough assessment of the population

- Prioritize needs

planning

Develop a goal and objectives

Goal

broad statement about the expected outcome when project is complete

Objectives

specific and observable actions that the learner can perform

goal, objectives

The ____ for your program is set FIRST... then you develop measurable _____

Implementation

carrying out the lesson plan

Evaluation

Measure whether your goals and objectives were met

qualitative evaluation

how well did we do, quality of program

quantitative evaluation

how much did we do, numerical scale

Formation evaluation

internal evaluation of the program during planning

Summative evaluation

evaluation of program after planning

nonclinical

interviews, surveys, observations

clinical

basic screenings, exams that use dental indices

complete examination

This type of examination uses a mouth mirror, explorer, illuminations, study models, radiographs, (least used in community health)

limited examination

This type of examination uses a mouth mirror, explorer, illuminations, BW radiographs

inspection

This type of examination uses a mouth mirror, explorer, illuminations

Most common in community health

screening

This type of examination uses a tongue depressor, illumination, least valid examination

simple index

presence or absence of condition (plaque or no plaque)

cumulative index

all past and present evidence of condition (dmft)

irreversible index

conditions that will not change (caries)

reversible index

conditions that can be changed (plaque)

patient hygiene performance

reversible, assess performance in removing plaque and debris

plaque index

reversible, assess plaque and thickness

oral hygiene index

reversible, measure oral hygiene status, observe debris and calculus

volpe-manhold index

reversible, test for plaque control and calculus inhibition, measures supragingival calculus

gingival index

reversible, uses probe, based on severity and prevalence of gingivitis

gingival bleeding index

reversible, uses unwaxed floss, bleeding and delayed bleeding-gingivitis

sulcular bleeding index

reversible, uses probe, detect early signs of gingivitis

Eastman interdental bleeding index

reversible, uses wooden interdental cleaner, papillary bleeding, indicates inflammation

periodontal index

irriversible, only clinical exam with radiographs

periodontal disease index

irriversible, ramfjord version of PI scale, measures prevalence and seversity of periodontal disease

periodontal screening and recordings

classifies perio tx quickly, requires special probe

community periodontal index of treatment needs

developed by WHO, determines periodontal needs rather than status, requires special probe

CAMBRA (caries management by risk assessment)

finds cause of disease based on assessment and risk factors, risk factors managed through small steps

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

irreversible, used to measure past and present caries of a population with permanent dentition

deft (decays, need for extraction, filled teeth)

irriversible, measures observable caries experience in primary teeth

root caries index

irreversible, only takes into account areas of root exposure

Dean’s index of fluorosis

irreversible, rates fluorosis within a population

incidence rate

How many new cases are seen in a population

ex: water coming into the bathtub

prevalence rate

total number of cases at a given time

ex: standing water in the bath

question, develop a hypothesis

Research always begins with a...

null hypothesis

stated as a negative outcome

・[there is no statistically significant difference between…]

research hypothesis (alternative)

stated as a positive outcome

・[there is a statistically significant difference between…]

sample

is a representative subset of a population

large

What type of sample is most accurate?

random

every subject selected independently and randomly

systemic

every "nth" subject to participate

convenience

group is already together and convenient

historical

looks at incidence and prevalence of disease in a population over time

descriptive

describe the presence and distribution of a disease or health condition at one point in time

retrospective

investigates possible causes of disease, uses medical records

Experimental

known as “clinical trials”

・ investigates cause and effect, involves multiple variables

control group

what stays constant in the study

independent variable

outcome that is being studied

dependent variable

outcome that is being studied

Quasi-experimental

experimental study that does not have a control group - UNETHICAL

pilot study

a small version of a study (trial run)

IRB - Institutional Review Board

reviews the ethical implications of research study, ensures safety

Qualitative data

shows the quality or nature of variables [can be ranked ordered]

QuaNtitative data

represented by numbers [counts, percentages, means]

categorical, dichotomous

______ variable has no numeric representation

______ variable places subject into only TWO groups

continuous, discrete

______ variable large or infinite number of measurement

______ variable distinct and separate units, whole numbers

nominal scale

organizes data into mutually exclusive groups

- Categories have NO rank order

ordinal scale

organizes data into mutually exclusive categories

- Categories have a rank order

interval scale

all characteristics of ordinal scale, PLUS equal distance between units of measurement

- No absolute zero point (numbers can be negative)

ratio scale

all characteristics of interval scale, PLUS has absolute zero point

Frequency distribution tables

shows the number of times a score/item occurs

ungrouped

data presented in ascending or descending order with frequency of each individual score

grouped

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

cumulative

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

normal distribution (Gaussian Distribution)

bell-shaped curve, mean, median, mode are EQUAL

Skewed distribution

distribution of scores in asymmetrical

mode

median

mean

____ = value that occurs most often

____ = midpoint of the data

____ = average

range

subtract the lowest score from the highest = least helpful measure

Standard deviation

square root of the variance, most common and useful measure of dispersion

Correlation Co-efficient Value (r-value)

Shows the strength of relationship between two variables (are they correlated?)

・ correlation = is there a relationship of association between the variables

Ranges from -1 to +1

closer R is to 1 = stronger

closer R is to 0 = weaker

positive correlation

direct relationship (as x increases, y increases)

negative correlation

inverse relationship (as x increases, y decreases)

Probability value (p-value)

probability that findings are due to chance

・if p is greater than 0.05 = results are not statistically significant

Validity

the instrument measures what it is supposed to measure, does the test really measure what it claims to measure?

internal validity

accuracy of the study's result (affected by: length of study, study size, and accuracy of statistics)

external validity

accuracy of generalizing the results from the sample of the population (affected by: how well the sample represents the population)

Reliability

how consistent is it?

INTRA-examiner reliability

performed by the same investigator

Inter-examiner reliability

performed by different investigators

Calibration

the process of establishing a relationship between a measuring device and the units of measure; increase INTER-examiner reliability