Caries Prevalence and Prevention at population level

Question 1

what is epidemiology

Answer 1

the study of the distribution and determinants of diseases in populations

Question 2

what are three key factors when looking at caries prevalance

Answer 2

time
place
person

Question 3

population demographics examples

Answer 3

births, deaths, age structure, gender, migration

Question 4

what are social aspects of the population to consider when looking at caries

Answer 4

socioeconomic status and degree of poverty, income, wealth, occupation and educational attainment

Question 5

what is a population pyramid

Answer 5

a visual representation of the age structure of the population

Question 6

what are counts

Answer 6

the number of people affected by a particular condition at a particular time in a particular area

Question 7

what is prevalence

Answer 7

the proportion of the population with a disease at any given point or period

Question 8

what is an incidence

Answer 8

the number of new cases of a disease in a defined population over a defined period of time

Question 9

what is standardised data

Answer 9

this takes into account population and age structure

Question 10

how many people estimated to suffer from oral diseases

Answer 10

3.58 billion

Question 11

what is the DMF index

Answer 11

the number of decayed, missing or filled teeth

Question 12

what is ICDAS

Answer 12

international caries detection and assessment system
provides restorative status and caries status scores

Question 13

what is the significant caries index

Answer 13

takes into account skewed distribution of caries in population

Question 14

what are global surveys for looking at caries prevalence

Answer 14

WHO database
CDC in the US

Question 15

what are global surveys in the UK

Answer 15

adult dental health surveys
Scottish health survey
child dental health surveys
NDIP surveys

Question 16

why are the levels of dental decay worldwide likely to rise

Answer 16

growing consumption sugar in the developing world as a result of westernisation

Question 17

why is there a reduction of caries in industrialised countries despite increased sugar consumption

Answer 17

because of public health measures such as appropriate use of fluoride

Question 18

what is the main driver of improvement in caries cases

Answer 18

fluoride toothpaste

Question 19

what are the three strategies for preventing caries in populations

Answer 19

high risk individual approach
targeted population approach
whole population approach

Question 20

what is the high risk individual approach

Answer 20

clinical risk assessment

Question 21

what is the targeted population approach

Answer 21

targeting on areas of deprivation in communities

Question 22

what is the whole population approach

Answer 22

universal founding principle of the NHS

Question 23

what is the population approach

Answer 23

encourage everyone to change, shifting the entire distribution

Question 24

what is the risk reduction approach

Answer 24

move high risk individuals into normal range

Question 25

is the population approach better or worse than the risk reduction approach and why

Answer 25

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

Question 26

why is proportionate targeting beneficial

Answer 26

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

Question 27

what are some of the main strategies for delivery of fluoride

Answer 27

toothpaste
water fluoridation
community fluoride schemes

Question 28

what are strategies for diet improvement in caries control

Answer 28

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

Question 29

what is included in individual lifestyle factors

Answer 29

smoking
diet
partner issue with alcohol
domestic violence

Question 30

what is included in social and community networks

Answer 30

isolation
mother support
engaged in wider community
isolated with dominant partner
unemployed
physically isolated in poor area

Question 31

what is included in the food aspect of social determinants

Answer 31

food desserts
access
affordability
cooking skills
unhealthy options
food banks

Question 32

what is included in the work environment social determinant

Answer 32

unemployed
partner unemployed

Question 33

what is included in the housing social determinant

Answer 33

damp, poor quality, poor neighbourhood, lack of safe outside space

Question 34

what are upstream actions for prevention

Answer 34

socioeconomic and political context, looking at:
- macroeconomic policies
- social and welfare policies
- food policies
- education policies
- health system and policies

Question 35

what are midstream actions for prevention

Answer 35

community context:
- community assets and workforce
- schools and nurseries
- voluntary sector
- social and physical environment

Question 36

what are downstream actions for prevention

Answer 36

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

Question 37

what are some different health improvement approaches

Answer 37

• theory based approaches
• evidence based
• common risk factor approach
• community engagement
• multi agency working
• proportionate universalism (looking at entire social gradient)