Caries Prevalence and Prevention at population level Flashcards
what is epidemiology
the study of the distribution and determinants of diseases in populations
what are three key factors when looking at caries prevalance
time
place
person
population demographics examples
births, deaths, age structure, gender, migration
what are social aspects of the population to consider when looking at caries
socioeconomic status and degree of poverty, income, wealth, occupation and educational attainment
what is a population pyramid
a visual representation of the age structure of the population
what are counts
the number of people affected by a particular condition at a particular time in a particular area
what is prevalence
the proportion of the population with a disease at any given point or period
what is an incidence
the number of new cases of a disease in a defined population over a defined period of time
what is standardised data
this takes into account population and age structure
how many people estimated to suffer from oral diseases
3.58 billion
what is the DMF index
the number of decayed, missing or filled teeth
what is ICDAS
international caries detection and assessment system
provides restorative status and caries status scores
what is the significant caries index
takes into account skewed distribution of caries in population
what are global surveys for looking at caries prevalence
WHO database
CDC in the US
what are global surveys in the UK
adult dental health surveys
Scottish health survey
child dental health surveys
NDIP surveys
why are the levels of dental decay worldwide likely to rise
growing consumption sugar in the developing world as a result of westernisation
why is there a reduction of caries in industrialised countries despite increased sugar consumption
because of public health measures such as appropriate use of fluoride
what is the main driver of improvement in caries cases
fluoride toothpaste
what are the three strategies for preventing caries in populations
high risk individual approach
targeted population approach
whole population approach
what is the high risk individual approach
clinical risk assessment
what is the targeted population approach
targeting on areas of deprivation in communities
what is the whole population approach
universal founding principle of the NHS
what is the population approach
encourage everyone to change, shifting the entire distribution
what is the risk reduction approach
move high risk individuals into normal range
is the population approach better or worse than the risk reduction approach and why
the population approach is better because shifting the whole population into a lower risk category benefits more individuals than shifting high risk individuals into a lower risk category
why is proportionate targeting beneficial
the social gradient needs to be addressed, by focusing only on the bottom means tackling only one part of the problem. even if the intervention is successful, it will have failed to address inequalities which exist for the other groups on the gradient or the impact will be insufficient to reduce the overall gradient
what are some of the main strategies for delivery of fluoride
toothpaste
water fluoridation
community fluoride schemes
what are strategies for diet improvement in caries control
link with obesity, take action to reduce sugar
local communities and schools should be targeted for education
industrially, sugar substitutes should be used, reformulation and labelling should change
sugar tax
what is included in individual lifestyle factors
smoking
diet
partner issue with alcohol
domestic violence
what is included in social and community networks
isolation
mother support
engaged in wider community
isolated with dominant partner
unemployed
physically isolated in poor area
what is included in the food aspect of social determinants
food desserts
access
affordability
cooking skills
unhealthy options
food banks
what is included in the work environment social determinant
unemployed
partner unemployed
what is included in the housing social determinant
damp, poor quality, poor neighbourhood, lack of safe outside space
what are upstream actions for prevention
socioeconomic and political context, looking at:
- macroeconomic policies
- social and welfare policies
- food policies
- education policies
- health system and policies
what are midstream actions for prevention
community context:
- community assets and workforce
- schools and nurseries
- voluntary sector
- social and physical environment
what are downstream actions for prevention
behaviour and biological factors
- age
- biofil
- behaviours like diet and toothbrushing
- parenting
- psychosocial factors such as stress, perceived control, social support
- health services, quality of care
what are some different health improvement approaches
- theory based approaches
- evidence based
- common risk factor approach
- community engagement
- multi agency working
- proportionate universalism (looking at entire social gradient)
