5

Question 1

descriptive epidemiology

Answer 1

Describes the problem

trends / prevalence

• global
• UK / Scotland

Question 2

analytical epidemiology

Answer 2

• Analyses the risk factors

- biomedical -> social determinants

Question 3

epidemiology

Answer 3

is the study of the distribution and determinants of diseases in populations

Question 4

distruibution

Answer 4

burden

widespread

Question 5

determinants

Answer 5

cause or risk factor

Question 6

population

Answer 6

groups of indiviudals geographic/ area/ community of interest

Question 7

what determines population size?

Answer 7

births, deaths, inward and outward migration determines population size

Question 8

what makes up a populations demographics?

Answer 8

• Births
• deaths
• age-structure
• gender
• migration

Question 9

counts

Answer 9

number of people affected by a particular condition (at a particular time, and area)

limited – need denominator
- i.e. how many possibly could be affected

monitor changes over time, between groups and populations

Question 10

prevalence

Answer 10

is the proportion (%) of population with a disease at any given point (point prevalence) or period (period prevalence in time)

diseases quite stable and chronic e.g. caries, diabetes
- not necessarily cancer – there is more new cases which is incidence

Question 11

incidence

Answer 11

is the number of new cases of a disease in a defined population over a defined period of time (rate)

divide count by population to get rate over a time period

Question 12

standardised data

Answer 12

takes into account population age-structure

needed to have a fair comparison

Question 13

how many people are affected by oral diseases worldwide?

Answer 13

estimated 3.58 billion of 7 billion people total

Question 14

what disease is the most prevalent of 328 conditions that were assessed in a study?

Answer 14

caries of the permanent teeth

Question 15

how many people suffer from caries globally?

Answer 15

estimated 2.4 billion suffer caries of the permanent teeth

486 million children suffer caries of primary teeth

Question 16

3 ways to measure and record dental caries

Answer 16

• DMF/dmf index
• ICDAS International Caries Detection and Assessment System
• Significant Caries Index

Question 17

DMF/dmf index

Answer 17

used to measure and record dental caries

number of decayed, missing, filled teeth (or surfaces)

Question 18

ICDAS International Caries Detection and Assessment System

Answer 18

used to measure and record dental caries

restorative status and caries status scores

• enamel level decay and dentine level decay

Question 19

Significant Caries Index

Answer 19

used to measure and record dental caries

takes into account skewed distribution of caries in population

e.g. tenth with the most decay has more than one decayed surface

Question 20

what has been the main driver in improvement in dental caries incidences since the 70s?

Answer 20

fluoride toothpaste use

but complex range of factors (inc. public awareness)

Question 21

3 strategies for preventing cares in populations

Answer 21

• High risk individual approach (clinical risk assessment)
• Targeted population approach (targeting on areas of deprivation / communities)
• Whole population approach (universal ie / eg. a founding principle of the NHS)

Question 22

what is a proportionate-universal approach?

Answer 22

universal Vs targeted

• high deprivation needs more effort to improve than lower deprivation
• shifting the whole population into a lower risk category benefits more individuals than shifting high risk individuals into a lower risk category

e.g. Childsmile levels

Question 23

3 strategies for delivering fluordie

Answer 23

toothpaste

water fluoridation

community fluoride schemes

Question 24

upstream actions to help improve oral health inequalities

Answer 24

socioeconomic and political context (structure and systems)

• macroeconomic policies
• social & welfare policies
• food policies
• education policies
• health system & policies

Question 25

midstream actions to help improve oral health inequalities

Answer 25

community context

• community assets and workforce
• schools and nurseries
• voluntary/NGO sector
• social and physical environment

Question 26

downstream actions to help improve oral health inequalities

Answer 26

behaviour and biological factors

• age, biolfilm, behaviours (diet, toothbrushing, parenting)

Physiological factors

• stress
• perceived control
• social support

health services
- quality of care

Question 27

childsmile health improvement approaches are….

Answer 27

• Theory-based
• Evidence-based
• Common risk factor approach
• Community engagement
• Multi-agency working
• Proportionate universalism

Question 28

when was Childsmile incorproated into NHS primary care payment system?

Answer 28

2011

Question 29

Childsmile oral health improvement advice

Answer 29

• Demonstrate and observe hands-on brushing instruction
• Tailored advice on diet and nutrition
• Action plan

Question 30

Childsmile fluoride varnish (2-5 years)

Answer 30

for children from 2 years apply varnish twice a year

additional 2 times a yer in nursery/primary schools

Question 31

Childsmile - changed dental contract (statement of renumeration)

Answer 31

change in payment for dentists

got prevention items added