Community Dental Hygiene Flashcards
NBDHE
1
Q
what are the different levels of prevention?
A
- primary
- secondary
- teritary
2
Q
what is primary prevention? what are examples?
A
- prevent the onset of a disease and reverse the initial stages of a disease
- EX. prophylaxis, fluoride, dietary counseling, vaccination
3
Q
what is secondary prevention? what are examples?
A
- terminating the disease and restoring tissues to near-normal function including early detection of disease
- EX. drilling and filling a cavity, periodontal therapy, periodontal screening
4
Q
what is tertiary prevention? what are examples?
A
- replace lost tissues and rehabilitate them to near-normal function
- EX. dental implants, bridges, etc
5
Q
why is fluoride varnish an important part of caries prevention?
A
fluoride therapy creates a stronger enamel by the formation of fluorapatite from existing hydroxyapatite
6
Q
what is the primary cause of periodontal disease?
A
bacteria!
7
Q
what are the two major risk factors for oral cancer in adults?
A
smoking and alcohol
8
Q
what are the five A’s of tobacco cessation?
A
- ask
- advise
- assess
- assist
- arrange
9
Q
periodontal disease can manifest differently according to the patients:
age
smoking habit
gender
economic status
all of the above
A
all of the above
10
Q
the patient demographic is “over 60 years old, lives on government support, rural area, no specific jobs.” which of the following recommendations could you provide?
- check for abnormalities that look like oral cancer
- look for bleeding and swelling of the gums
- eat more fruits and vegetables
- look for over the counter fluoride products
A
- look for bleeding and swelling of the gums
- not option 1 because we are not talking about alcohol or smoking
- not option 3 because there is no indication the patient has a bad diet
- not option 4 because it does not indicate they have high caries
11
Q
root caries are more comon in:
A
seniors
12
Q
what is the single most effective public health measure to prevent tooth decay?
A
community water fluoridation
13
Q
what is the recommended level of water fluoridation?
A
0.7 ppm
14
Q
when does water defluoridation need to occur?
A
2 ppm
15
Q
what condition occurs when there is too much fluoride in the water?
A
fluorosis
16
Q
WRITE OUT FLUORIDE SUPPLEMENTATION CHART
A
WRITE OUT FLUORIDE SUPPLEMENTATION CHART
17
Q
the most effective method to prevent decay in public health is
A
water fluoridation
18
Q
T/F: the temperatures of the southern regions are warmer when compared to the northern regions. water fluoridation level os 0.7-1.2 ppm is recommended for the warmer regions.
A
false - recommended amount is 0.7 ppm
19
Q
if the child is showing decay on the occlusal surfaces of the mandibular first permanent molars and the next tooth to erupt is the maxillary canine, how often should you apply fluoride?
every 3 months
every 6 months
every 9 months
every year
A
every 3 months - the child is already showing signs of decay on permanent dentition
20
Q
what are the steps in community health programs?
A
SAPIFE
S - needs assessment Survey
A - Analysis, prioritization of needs
P - Program Planning
I - program Implementation
F - Financing
E - Evaluation
21
Q
what are the steps in private practice health programs?
A
EDPIPE
E - Examination
D - Diagnosis
P - treatment Planning
I - treatment Implementation
P - Payment
E - Evaluation
22
Q
what does it mean to assess in community health programs?
A
create a community profile that serves as baseline data
23
Q
what are assessment methods in community healthy programs?
A
- interview
- direct observation
- questionnaires
- phone call
24
Q
what are the types of oral health examinations?
A
- type I: complete examination
- type II: limited examination
- type III: inspection
- type IV: screening
25
what does type I examination consist of?
- mirror
- explorer
- light
- RADIOGRAPHS
- STUDY MODELS
- tests
** seldom used in a public health setting **
** REMEMBER: all in one **
26
what does type II examination consist of?
- mirror
- explorer
- light
- bitewings
- selected PAs
27
what does type III examination consist of?
- mirror
- explorer
- light
** commonly used in public health surveys **
** REMEMBER: three items needed in type III **
28
what does type IV examination consist of?
- light
- tongue depressor
** too unreliable for public health **
** REMEMBER: type IV you ask your patient to stick their tongue FORward **
29
what is analysis in community health planning?
prioritization of needs - identifies the focus of the program and directs resources
30
what is planning in community health programs?
formulate goals and objectives
31
what is important when considering objectives when planning a community health program?
- it should be specific (providing details)
- it should be measurable (outcomes can be compared)
- it should be time-limited (endpoint is stated)
32
what is an example of an objective for community health programs?
by the end of the semester, school children plaque score will be under 25%
33
in a public health environment, analysis comes after?
survey
financing
evalution
planning
survey
34
you and your classmates are going to a public school to provide dental "screening" today. Your professor tells you to provide a type III examination. which instruments should you prepare?
- mirror
- explorer
- light
35
differentiate between a goal and an objective in a community health program?
goal: a general statement that describes the major purpose of the plan
Objective: a statement that describes specific details in order to achieve a goal
36
what does the learning ladder assess?
where the patient is standing and creates a more customized plan for an effective program
37
what are the steps of the learning ladder?
- unawareness: lacks information and/or has incorrect information
- awareness: knows about a problem but does not take action
- self-interest: knows about the problem and shows interest
- involvement: patient wants more knowledge and wants to participate
- action: acts to resolve the problem
- habit: lifestyle has changed
38
what does a health belief model explain?
how a patient's belief leads to behavior and it is useful to explain and predict a patient's actions
39
if the patient believes they are susceptible to the condition
perceived susceptibility
40
if the patient believes that the condition has serious consequences
perceived severity
41
if the patient believes taking action would reduce their susceptibility to the condition or its severity
perceived benefits
42
if the patient believes the costs of taking action are outweighed by the benefits
perceived barriers
43
if the patient is exposed to factors that prompt action
cue to action
44
the patient is confident that their ability to act successfully
self-efficacy
45
what are the five parts to the hierarchy of needs?
- self-actualization
- esteem
- love and belonging
- safety
- physiological
** listed in the wrong order - Think of going on a trip with a friend **
46
which health promotion model can be used for implementing positive behavior, such as flossing?
health belief model
** implementing positive behavior are the key words **
47
a person's belief about what factors determine his or her outcome is called:
locus of control
48
what does the simple index measure?
the presence or absence of a condition (EX. plaque control record)
49
what does a cumulative index measure?
measures all evidence of past occurrences (EX. dental caries)
50
what does an irreversible index measure?
a dental condition that cannot be reversed (EX. dental caries)
51
what does a reversible index measure?
a dental condition that can be reversed (EX. gingival index)
52
what are the plaque measuring indices?
- plaque index (PLI)
- plaque control record (PCR)
53
what does the plaque index measure?
the thickness of dental biofilm at the gingival margin (cervical third only)
54
what type of studies is the plaque index useful for?
clinical studies
55
what does the plaque control record measure?
the percentage of teeth with supragingival plaque
56
how does the PCR index work?
the entire dentition is assessed and the plaque is disclosed
57
what is the PCR index useful for?
assessing individual performance and monitoring oral self-care
58
what does the gingival index examine?
the color, consistency, and bleeding of the gingiva
59
what is the most frequently used index for evaluating gingivitis
gingival index
60
how does the gingival index work?
used on 6 selected teeth using four surfaces - the D, F, mesio-facial, and L - the higher the score the higher the severity of gingival disease
61
what do the scores 0, 1, 2, and 3 mean in the gingival index?
0: normal gingiva
1: mild inflammation, slight change in color, slight edema, and no bleeding on probing
2: moderate inflammation, redness, edema, glazing, and BOP
3: severe inflammation, marked redness and edema, ulceration, and tendency to spontaneous bleeding
62
after scoring the gingiva in the GI, how is the data interpreted?
add up the scores and divide by four to the the GI score
63
what do the 0.1-1.0, 1.1-2.0, and 2.1-3.0 ranges mean in the GI index?
0.1-1.0 mild gingivitis
1.1-2.0 moderate gingivitis
2.1-3.0 severe gingivitis
64
what is the GI study useful for?
individuals and group studies
65
what does the sulcus bleeding index determine?
the presence of gingival disease by probing
66
what do the scores 1-4 mean in the SBI?
0 healthy abd no BOP
1 apparently healthy, no change in color or swelling, but BOP
2 BOP, change in color, slight swelling
3 BOP, obvious swelling, maybe a change in color
4 BOP, spontaneous bleeding, change in color, marked swelling with or without ulceration
67
what does the gingival bleeding index (GBI) determine
the presesnce of gingival disease by assessing bleeding - insert floss into the interproximal areas below the gingival margin and observe the presence of bleeding after 30 seconds
68
how is the GBI scored?
0 = absence of bleeding
1 = presence of bleeding
69
what does the Eastman Interdental Bleeding index (EIBI) measure?
the presence of gingial disease by assessing bleeding - insert a triangular wooden interdental cleaner into the interproximal areas and record the presence of bleeding within 15 seconds
70
how is the EIBI scored?
0 = absence of bleeding
1 = presence of bleeding
71
which of the following requires a tool other than probing to measure bleeding?
gingival index
sulcular bleeding index
gingival bleeding index
gingival bleeding index
72
using the gingival index, if the final score is 1.2, the patient has:
mild gingivitis
moderate gingivitis
severe gingivitis
moderate gingivitis
73
what is the big difference between the gingival and periodontal index?
in the gingival index, you are recording signs of inflammation vs. the periodontal index you measure deposits and pocket depths
74
what does the periodontal disease index (PDI) or Ramfjords's Periodontal Disease Index measure?
the presence and severity of periodontal disease - rarely used
75
how is the PDI measure and scored?
measures gingival health, probing depths, dental biofilm, and calculus deposits by selecting six teeth (3, 9, 12, 19, 25, 28)
gingiva is scored 0-3, pockets 4-6
76
what type of studies is the PDI useful for?
individual and group studies but is rarely used
77
what does the community periodontal index of treatment needs (CPTIN) and the periodontal screening and recording (PSR) measure?
pocket depths, bleeding, and dental biofilm retention factors
78
how do the CPITN and PSR indices work?
the mouth is divided into sextants and only the highest probe reading in the sextant is recorded - the teeth are scored 0-4
79
what probe is used in the CPITN-E and PSR indices? how is it divided?
CPTIN-E probe - has a small ball tip with a black band - the black band ranges from 3.5-5.5 mm
80
how do you record the scores for the peridontal health indices?
each sextant gets a score Code 0-4
Code 0: color-coded reference band is completely visible in the deepest pocket, no calc, gingiva is healthy with no BOP
Code 1: color-coded reference band is completely visible in the deepest pocket, no calculus, there is BOP
code 2: color-coded reference band is completely visible in the deepest pocket, supra or subgingival val is present or defective margins are present
code 3: color-coded reference band is paritally visible in the deepest pocket, indicating a pcoket depth great than 3.5
code 4: color-coded reference band is NOT visible in the deepest pocket,indicating a deeper pocket than 5.5
81
how is treatment indicating based on the coding system for the periodontal indicies?
0 preventative care, biofilm control
1 preventative care, biofilm control
2 preventative care and calculus removal, biofilm control
3 comprehensive periodontal assessment and treatment plan, counseling, and biofilm control
4 comprehensive periodontal assessment and treatment plan for non-surgical perio therapy, counseling biofilm control
82
which periodontal health status index evaluates bleeding, deposits, and pocket depths?
periodontal score record
periodontal screening and recording
gingival index
Eastman international bleeding index
periodontal screening and recording
KEY WORDS: deposits and pocket depths
83
in the CPITN-E, if the color is band is still visible but you see calculus on the deepest pocket of the sextant, it is classified as:
Code 0
Code 1
Code 2
Code 3
Code 4
code 2
KEY WORDS: color band visible and calculus
84
what does the Dean's Fluorosis Index examine?
the result of excessive ingestion of fluoride during tooth formation
85
what is the dean's fluorosis index score based on?
the most severe form of fluorosis found on two or more teeth
86
how is the dean's fluorosis index scored?
0-4
normal 0: translucent, pale color
questionable 0.5: few white flecks
very mild 1: opaque, paper-white areas, less than 25% of dentition affected
mild 2: white opacities, less than 50% of dentition affected
moderate 3: brown stains
severe 4: pitted areas, brown stains
87
what level of fluorosis is shown?
mild
88
what level of fluorosis is shown?
moderate
89
what level of fluorosis is shown?
normal
90
what level of fluorosis is shown?
questionable
91
what level of fluorosis is shown?
severe
92
what level of fluorosis is shown?
very mild
93
what is a mnemonic used to remember the levels of fluorosis?
Never - normal
Question - questionable
Very - very mild
Mean - mild
Mosquitoes - moderate
Seriously - severe
94
what are the dental caries indices used to monitor permanent teeth?
DMFT = decayed, missing, filled teeth
DMFS = decayed, missing, filled surfaces
95
"missing" and "filled" teeth represent teeth that are missing or filled because of what?
caries
96
what teeth are not counted in permanent teeth dental caries indices?
- third molars
- congenitally unerupted or supernumerary teeth
- teeth removed or restored for reasons other than caries
** if caries and restoration are presents, record as decay **
97
what dental caries indices are used for primary teeth?
- deft
- defs
- dmft
- dmfs
- dft
- dfs
98
what is important to remember in a patient with mixed dentition?
record DMF and def/dft indices separately - do not add them together
99
what is the root caries index (RCI)?
evaluates the risk and extent of root caries (with gingival recession)
(decayed and filled root surfaces / total # of exposed root surfaces) x 100
100
what is the early childhood caries (ECC) index?
presence of 1 or more decayed surfaces in a child younger than 6 years old
101
what is the severe early childhood caries (S-ECC) index?
presence of decay in a child younger than 3 years of age
102
if a patient has a DMFT score of D = 12, M = 2, and F = 5, you can conclude that:
he had extensive dental treatments done
he is going to need much more treatment
he is smoking or drinking
he will have more missing teeth in the future
he is going to need much more treatment
** key to remember that D = the treatment that needs to be done and M and F = things that have already happened **
103
a child is 10 years old which of the following records will you take?
dmft
defs
DMFT
DMF and def
DMF and def
104
what type of study describes a situation "right now" without predictions, causes, or effects
descriptive (observational) studies
105
a study that quantifies the relationship between an intervention (exposure) on an outcome including case-control studies, cohort studies, and some cross-sectional studies
analytical studies
106
a study where subjects are observed over time to determine how certain factors affect rates of a certain outcome
prospective study
107
a study of an observation over a long period of time (often decades)
longitudinal studies
108
a study that is formed after some people have developed the outcomes of interest
retrospective studies
109
a study in which researchers manipulate the exposure by allocating subjects to the treatment or control group
experimental study
110
the most valid of all studies where neither the examiner nor the participant knows which is the control or treatment group
double-blind study
111
predictive statement of the expected result
hypothesis
112
hypothesis by which the researcher tries to reject
null hypothesis
113
a hypothesis that reflects that there will be an observed effect in the experiment
alternative hypothesis
114
which of the following are correct as related to statistical significance EXCEPT for one. which one is the exception?
it is expressed as a p value
it refers to the level of significance
it is the only factor to consider for patient care decision making
it is the level of probability that is an association between two or more variables occurred by chance alone
it is the only factor to consider for patient care decision making
115
which type of study examines a large population and follows it over time?
case-control
double-blinded study
longitudinal study
retrospective study
longitudinal study
116
- highest statistical power
- comprehensive review of all relevant studies of a particular topic where the researcher pools populations from all of them and the total number of subjects are treated as one large study population
meta-analysis
117
- comprehensive review of all relevant studies of a particular topic
- more reliable and accurate than individual studies
systemic reviews
118
faciliates the search for evidence
evidence search
119
what does PICO stand for in evidence search?
- P = patient or problem
- I = intervention
- C = comparison
- O = outcome
120
representation of the general population
sampling
121
Every member of the population has an equal chance of being selected, preventing researcher bias
random sampling
122
population is divided into subgroups before selection to ensure that all subgroups are sampled preventing examiner bias
stratified sampling
123
selection of every nth member on the list and not all members have an equal chance of being selected
systematic sampling
124
selection based on availability - what is "easiest"
convenience sampling
125
selection based on the familiarity with the subject to the researcher with the most chance for bias
judgment sample
126
study of disease precalence in populations
epidemiology
127
total number of ALL cases of a disease in a given population at a given time
prevalence
128
disease occurring frequently and at a predictable rate in a specific location or population
endemic
129
disease unexpectedly large in number that spreads rapidly through particular segments of the population
epidemic
130
disease that occurs throughout the population of a country, people, or the world
pandemic
131
number of actual disease divided by the number of possible disease
morbidity rate
132
number of actual deaths divided by the number of possible deaths
mortality rate
133
outcome of interest of the experiment that changes because of the intervention
dependent variable
134
intervention of the experiment that investigators manipulate
independent variable
135
the analysis and interpretation of data in healthcare (medicine, dentistry), public health, and biology
biostatistics
136
description of the data as is and the data is not used to make any further conclusions
descriptive statistics
137
data is used to reach conclusions that extend beyond the immediate data alone
inferential statistics
138
data that cannot be measured numerically
qualitative
139
data that is measured numerically and can be expressed as counts, percentages, and means
quantitative
140
data with no numerical value and can be arranged logically in categories or groups
categorical
141
categorical data that is placed in only two groups
dichotomous
142
numeric data with a set of fixed of finite values
discrete
143
numeric data that is expressed by a large or infinite number of measures along a continuum
continuous
144
a scale where the data is organized in named, exclusive categories and they have no rank order of value
nominal scale
145
data organized in named, exclusive categories where the categories have rank order but differences in rank may not be equal in value
ordinal scale
146
a scale where there is equal distance between measures along a continuum and there is no absolute zero point
interval scale
147
a scale where there are equal intervals between measures along a continuum and it has an absolute zero point
ratio scale
148
relationship between mean, median, and mode can be graphically displayed
frequency of distribution
149
spread of scores around the mean, median, and mode
dispertion
150
what are examples of measures of dispersion
range, variance, and standard deviation
151
how much the score deviate from the mean, positive square root of variance
standard deviation
152
nearly all of the data in a normal distribution will fall within 3 standard deviations of the mean
empirical rule
153
describes a curve that is NOT symmetrical
skew
154
scores are gathered in a lower range where the mean is greater than the median and mode
positive skew
155
scores are gathered in a higher range and the mean is lower than the median and mode
negative skew
156
what type of skew is shown in the image?
negative skew
157
what type of skew is shown in the image?
positive skew
158
results can be reproduced with the same experiment
reliability
159
consistency performed by different examiners
interexaminer (rater) reliability
160
consistency performed by the same examiner
intraexaminer (rater) reliability
161
research measures what it is intended to measure
validity
162
probability of a positive test among patients with disease
sensitivity
163
probability of a negative test among patients without disease
specificity
164
the relationship between two variables
correlation
165
what is important to remember about the variables when considering correlation?
Variables closest to 1 (either negative or positive) have the strongest correlation
166
when x increases, y decreases or the opposite
negative correlation
167
when x increases, y increases or the opposite
positive correlation
168
a test that compares two different groups on some variable of interest
t-test
169
a test that compares three or more groups for statistical significance
ANOVA (analysis of variance)
170
a test that measures the difference between two or more qualitative data
chi-square test
171
a test that measures results that occurred by chance during an experiment
p-value
172
results are not happening by chance (coincidence) but because of the independent variable
statistical significance
173
a comprehensive review of all relevant studies of a particular topic that has the highest statistical power
meta analysis
174
a comprehensive review of all of the relevant studies of a particular topic and is more reliable and accurate than individual studies
systemic review
175
a study design that randomly assigns participants to an experimental or control group that is considered the gold standard for producing reliable evidence
randomized controlled
176
similar to RCT trials except that subjects are not randomly assigned to treatment and control groups which increases the chance for bias
controlled clinical trials
177
any group of people who are linked in some way and followed over time which is useful to research risk factors to disease
cohort studies
178
a study where researchers use existing records to identify people with a certain problem (case) and people without the problem (control) and then look back retrospectively to compare the exposure to a risk factor
case control study
179
detailed description of an event and a patient's profile
case report
180
which of the following has a higher level of evidence?
case cotrol
randomized control trie
cohort study
systematic review
systematic review
181
if the study design included two groups, one with the drug and another with a placebo. which type of study it is?
randomized control clinical trial
** keyword is placebo, which indicates an experiment **
182
specialized agency of the United Nations (UN) that is concerned with international public health
WHO (World Health Organization)
183
federal agency responsible for improving the health, safety, and well-being of Americans - generates the Surgeon's General's reports or Healthy People
Department of Health and Human Services
184
conducts research, prevention, planning, and development programs related to health
NIH (National Institutes of Health)
185
governmental program that helps individuals who are under 21 years of age
Medicaid
186
governmental program that helps individuals who are over 65 years of age and/or disable
Medicare
187
federal organization that protects the nation from health, safety, and security threats
CDC (center for disease control and prevention)
188
