caries symposium 5 - population level Flashcards

1
Q

what is epidemiology

A

study of the distribution and determinants of diseases in populations

  • distribution = burden
  • determinants = cause or risk factors
  • population = groups of individuals geographic/area/community
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2
Q

what is descriptive epidemiology

A
  • describes the problem

- trends/ prevalence

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3
Q

analytical epidemiology

A
  • analyses the problem
  • risk factors
  • social determinants
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4
Q

what are the 3 factors that cause caries

A
  • time = years, seasonal, time of day, generation
  • place = regional, global, communities
  • person = age, gender, medical history
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5
Q

how do you describe disease in a populations

A
  • counts = number of people affected by a particular condition at particular time and area
  • prevalence = proportion of population with a disease an any given point (point prevalence) or period (period prevalence)
  • incidence = number of new cases of a disease in a defined population over a defined period of time (rate)
  • standardised data = number of new cases of a disease in a defined population over a defined period of time
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6
Q

what is point prevalence

A

proportion (%) of population with a disease at any given point

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7
Q

what is period prevalence

A

proportion of population with a disease at any given period

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8
Q

what is descriptive epidemiology of the oral health

A
  • it is estimated that 3.5 billion people worldwide have oral diseases
  • caries of the permanent teeth is the most prevalent
  • globally, 2.4 billion adults suffer from caries and 486 million children in primary teeth
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9
Q

how do you measure/record caries

A
  • DMFT/dmft = upper case for permanent teeth, lower case of primary
  • ICDAS = international caries detection and assessment system, restorative and caries status scores, looks at enamel and dentine level of decay
  • significant caries index = take into account skewed distribution of caries in population
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10
Q

what percentage of 5 year olds in Scotland have a score of 7 dmft

A

10th of population

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11
Q

what are the caries detection stages

A
  • extensive decay
  • moderate decay
  • initial decay
  • very early decay
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12
Q

what is extensive decay

A

lesions into the pulp (D3)

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13
Q

what is moderate decay

A
  • clinically detectable lesions in dentine

- clinically detachable cavities limited to enamel

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14
Q

what is initial decay

A

clinically detectable enamel lesions with intact surfaces

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15
Q

what is very early decay

A
  • small lesions detectable only with additional diagnostic aids
  • sub-clinical initial lésions in a dynamic state of progression/regression (a lot of decay is this)
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16
Q

what are some global surveys used

A
  • WHO database

- US has CDC

17
Q

what are some UK surveys used

A
  • adult dental health survey
  • child dental health surveys
  • BASCD surveys
  • NDIP surveys
18
Q

why is the amount of caries in developing countries increasing

A

due to a growing consumption of sugar

- opposite happens in developed countries as they have effective public health measures

19
Q

what is the main thing that has driven improvements in oral health

A

fluoride toothpaste

20
Q

what four things make up the traditional biomedical model of caries

A
  • plaque microorganisms
  • substrate
  • time
  • tooth
    (if only two or three of these occur don’t get caries, only get caries if all 4 occur)
21
Q

what are the strategies for preventing caries in a population

A
  • high risk individual approach (clinical risk assessment)
  • targeted population approach (targeting on areas of deprivation/communities)
  • whole population approach (universal e.g. NHS)
22
Q

what are the strategies for delivering fluoride

A
  • toothpaste
  • water fluoridation
  • community fluoride schemes
23
Q

what are the main risk factors of caries

A
  • diet
  • hygiene
  • tobacco
24
Q

what are the 3 sections of circumstances and risks of oral health inequalities

A
  • upstream actions
  • midstream actions
  • downstream actions
25
Q

what are upstream actions

A
  • socioeconomic and political context (structure and systems)
  • policies put in place (macroeconomic, social and welfare, food, education and health system)
26
Q

what are midstream actions

A
  • community context

- community workforce, schools, nurseries , environment

27
Q

what are downstream actions

A
  • behaviour and biological factors = age, biofilm, diet
  • psychosocial factors = stress
  • health services = quality of care
28
Q

what are health improvement approaches

A
  • theory based
  • evidence based
  • common risk factor approach
  • community engagement
  • multi-agency working
29
Q

what are the child smile guidelines

A
  • importance of fluoride
  • register child with dentist = as early as possible, and attend regularly
  • standard risk of caries = all children
  • enhanced risk children = SIMD of 1-3, and daft experience
30
Q

what are some integrated programmes with child smile

A
  • supervised brushing

- FVA (fluoride varnish application) in nursery and schools

31
Q

who gets fluoride varnish

A
  • 2-5 year olds

- for children from 2 year olds apply varnish 2 times a year

32
Q

what is oral health improvement advice

A
  • demonstrate and observe hands-on brushing instruction
  • tailored advice on diet and nutrition
  • have an action plan