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NBDHE May 2022 > Community DH > Flashcards

Community DH Flashcards

1
Q

Cross-Sectional Study

A

snapshot of a population at any given time

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2
Q

Goal VS Objective

A

Goal: Outcome intended

Objective: Specific way of attaining outcome

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3
Q

SMART Goals

A

Specific
Measurable
Attainable
Relevant
Time-Based

  • how to make an objective
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4
Q

Incidence VS Prevalence

A

Incidence: number of new cases in x time
Prevalence: All cases in x time

Acute disease - Incidence increases, prevalence decreases
Chronic disease - Incidence decreases, prevalence increases

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5
Q

Endemic

A

disease that occurs frequently and predictably in a population

eg. common flu

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6
Q

Epidemic

A

Unexpectedly large number of cases of disease in a particular population

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7
Q

Pandemic

A

Outbreak over a large geographical area - often worldwide

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8
Q

Morbidity rate

A

Disease rate

actual disease / # possible diseases

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9
Q

Mortality rate

A

actual deaths / #possible deaths

Deaths

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10
Q

Random Sampling

A

Every member of population has an equal chance of being selected

Lease Bias

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11
Q

Stratified Sampling

A

Population is divided into subgroups

ie. to sample all students in Canada, select 2 students from each school

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12
Q

Systematic Sampling

A

Selection of every Nth person on the list

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13
Q

Convenience Sampling

A

Selection based on convenience

ie. people that come to the grocery store today

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14
Q

Judgement Sampling

A

Selection based on familiarity with subject to researcher

Most amount of bias

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15
Q

Independant VS Dependant Variable

A

IV: Intervention of exp.
produces a response to DV
(x)

DV: outcome of experience
will change due to IV
(y)

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16
Q

PICO

A

Problem
Intervention
Comparison
Outcome

  • formatting for a good question
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17
Q

EBDM

A

Evidence Based Decision Making
- does not replace clinical skills, judgement, or experience

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18
Q

Reliability

A

Same results can be reproduced

  • Intraexaminer: same evaluator
  • Interexaminer: Change evaluator
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19
Q

Validity

A

Research measures what its intended to

  • sensitivity: identify presence of disease
  • specificity: identify absence of disease
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20
Q

Correlation

A

Negative: x and y are inverted

Positive: x and y increase/decrease together

Correlation closer to 1 is stronger
- +/- 0.95 correlates more than +/- 0.02

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21
Q

T-Test

A

Compares 2 groups on variables of interest

eg. girls vs boys

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22
Q

ANOVA

A

Analysis of Variance
- compares 3+ groups for significance

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23
Q

Chi-Square Test

A

Measures difference between 2 or more qualitative data

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24
Q

P-Value

A

Probability Value
- measures whether results occur by chance when testing a hypothesis

P<0.5, results are significant
P = 0.5, occurred by change
P>0.5, results are insignificant

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25
Q

Skew

A

describes a curve thats non symmetrical

  • Positive: scores gathered in lower range (Mean>Median>Mode)
  • Negative: scores gathered in higher range (Mean
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26
Q

Standard Deviation

A

How much scores deviate from mean

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27
Q

Mean

A

Average

3,3,5,9,11,14,17,20,23

Mean = 11.67

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28
Q

Median

A

Middle number

3,3,5,9,11,14,17,20,23

Median = 11

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29
Q

Mode

A

Most frequent

3,3,5,9,11,14,17,20,23

Mode = 3

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30
Q

Range

A

Difference between the highest and lowest score

3,3,5,9,11,14,17,20,23

Range = 20

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31
Q

Dispersion

A

Spread of scores around the mean, median, and mode

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32
Q

Descriptive Statistics

A

observational, no manipulation

WHO is getting a disease WHERE and WHEN

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33
Q

Inferential Statistics

A

Data thats used to reach conclusions that extend beyond immediate data

  • average score of 100 students is 80% therefore average of students in students in city is 80%
  • making an inference based on data
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34
Q

Case Control Studies

A

use existing records to identify people with a certain problem

  • compare exposure to risk factor
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35
Q

Case Reports

A

Detailed description of an event and patient profile

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36
Q

Cohort Studies

A

Any group of people who are linked and followed and observed over time

  • no manipulation
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37
Q

Randomized Clinical Trials

A

Randomly assigns participants to experimental or control group

  • gold standard for reliable evidence
  • reduces population bias
  • time and money intensive
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38
Q

Meta - Analysis

A

Highest statistical power

  • comprehensive review of all relevant studies of a particular topic
  • total subjects treated as one large population
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39
Q

Systematic Review

A

Comprehensive review of all relevant studies of a particular topic

  • more reliable than individual studies
40
Q

Evidence ranking in research

A

CRITICAL APPRAISAL

  • Meta analysis
  • Systematic review

EXPERIMENTAL
-RCC

OBSERVATIONAL

  • cohort studies
  • case series
  • case reports
41
Q

Descriptive/Observational Studies

A

Describes a situation without predictions, cause, or effect

No manipulation is used (ie. Average cholesterol levels in 40-60y/o)

Usually retrospective

42
Q

Analytic Studies

A

Quantifies relationship between intervention and outcome

Uses a hypothesis

43
Q

Prospective Study

A

Observe outcome over time

44
Q

Longitudinal Study

A

Observed over a long period of time (often decades)

45
Q

Retrospective Study

A

After an outcome is developed (applying past studies to current)

46
Q

Experimental Study

A

Researchers manipulate exposure

control vs treatment group
RCT’s
Pre/Post test

47
Q

Null vs Alternative Hypothesis

A

Null: H0 - try to reject
Alternative: H1/2 - will be observed effect

ie: The amount of caries in children increased from 2001 to 2010

H0: the amount of caries did not increase between 2001-2010

H1/2: The amount of caries did increase from 2001-2010

The null hypothesis is rejected

48
Q

Learning Ladder Model

A

Unawareness: patient lacks correct information/ has incorrect information
Awareness: patient knows about problem but doesnt take action
Self-Interest: patient shows interest in taking action
Involvement: patient wants more knowledge and to participate
Action: patient forms new behaviours
Habit: patient has a changed lifestyle

49
Q

Health Belief Model

A

Explain and Predict a patients actions

Perceived Susceptibility: believe their susceptible to condition
Perceived Severity: believe condition has serious actions
Perceived Benefits: taking action reduces susceptibility to condition
Perceived Barriers: believe cost outweighs benefits
Cue to Action: exposed to factor that prompts action
Self-Efficacy: confidence in their ability to perform an action

50
Q

Learning Domain Model

A

Cognitive: knowledge, intellectual ability

Affective: interest, attitude, values

Psychomotor: motor skills, performance

51
Q

Motivational Theories

A

Internal locus of control: patient believes they have control of their life

External locus of control: pt believes their decisions are controlled by the environment/fate

52
Q

Hierarchy of Needs

A
53
Q

Assessment

A

create community profile to serve as baseline

  • population characteristics
  • resources
  • oral disease
  • direct observation and interviewing (survey is best method)
54
Q

Types of Oral Health Examinations (4)

A

Type 1: complete exam - mouth mirror, explorer, light, rads, tests, study models

Type 2: limited exam - mouth mirror, light, explorer, rads

Type 3: inspection - mouth mirror, explorer, light

Type 4: screening - tongue depressor and light

55
Q

Steps in Community vs Private Practice

A

COMMUNITY PRIVATE PRACTICE

Survey ⇒ Assessment/Examination

Analysis ⇒ Diagnosis

Planning ⇒ Planning

Implementation ⇒ Implementation

Financing ⇒ Payment

Evaluation ⇒ Evaluation

(SAP (L)IFE)

56
Q

Analysis Step

A

AKA Prioritization of needs

Normative Needs: amount of OH care to keep a community healthy

  • use: proportion of a population who receives dental treatment in x time
57
Q

Community Program Financial Aids

  • Medicare
  • CHIP
  • COBRA
  • Block Grant
  • Line Item Grant
A

Medicare: 65+ y/o

CHIP: Children Health Insurance Program

COBRA: work benefits

Block Grant: given to use at users discretion

Line item grant: specifies where money goes

58
Q

Planning

A

Choose activities/programs that were successful in the past

59
Q

Implementation & Evaluation

A

formal (lecture) or informal (pamphlet) delivery

formal (tests) or informal (feedback) evaluation methods

must be continuous from beginning of program

were objectives met?

60
Q

Community Water Fluoridation

A

most effective measure to prevent decay

  • inexpensive
  • concentration 0.7ppm
  • food made with water is considered systemic intake of fluoride
61
Q

School Water Fluoridation

A

fluoride concentration 4-5x higher than community water

limited success

best to start at younger age

parent consent required

62
Q

School Fluoride Rinse Programs

A

not common

not cost effective

Rx 0.2% 60sec/day for 1 week

parent consent required

63
Q

Fluoride Dentrifrice

A

3yo and above

<3yo - rice size

3-6yo - pea size

64
Q

Fluoride Supplements

A

AGE <0.3ppm 0.3-0.6ppm

Birth-6mo NONE NONE

6mo-3yo. 0.25mg/day NONE

3yo-6yo 0.5mg/day 0.25mg/day

6yo-16yo 1.0mg/day 0.5mg/day

65
Q

Fluoride Varnish

A

more effective than gels/foams

  • high caries risk apply every 3mo
    • moderate caries risk apply every 6mo
66
Q

Simple Dental Indicies

A

measures presence/absence of a condition

67
Q

Cumulative Dental Indices

A

measures all evidence of past occurances

68
Q

Irreversible Dental Indicies

A

measures condition that cant be reversed (ie. periodontal disease)

69
Q

Reversible Dental Indicies

A

Measures condition that can be reversed (ie. gingivitis)

70
Q

Criteria of an ideal index (8)

A

Clarity - easy to understand

Simplicity - easy to apply

Objectify - not ambiguous

Validity - measures what its intended to

Reliability - measures consistently between subjects

Quantifiable - expressible in numbers

Sensitivity - detects small changes

Acceptability - not harmful to the subject

71
Q

Primary Prevention

A

prevent onset, reverse/arrest disease

  • fluoride, prophylaxis, vaccinations
72
Q

Secondary Prevention

A

Terminate disease and restore function

  • filling a cavity, periodontal screening
73
Q

Tertiary Prevention

A

replace and rehabilitate lost tissue

  • implants and bridges
74
Q

4 Root Caries Risk Facors

A
  • age
  • gingival recession
  • medications (xerostomia)
  • lack of OSC
75
Q

Sealant Programs

A

For Children *

most effective when placed within 6mo of eruption

76
Q

5A’s Intervention Model

A

ie. Tobacco Cessation

Ask (about tobacco use)

Advise (all users to quit)

Assess (willingness to quit)

Assist (patient in quitting)

Arrange (follow-up contact)

77
Q

Deans Fluorosis Index

A
  • based on most severe score on 2+ teeth (whole dentition based on one score)

Normal (0): translucent, pale

Questionable (0.5): few white flecks

Very Mild (1): opaque, <25% of dentition affected

Mild (2): white opacities, <50% dentition affected

Moderate (3): brown stains

Severe (4): pitting and brown stains

78
Q

Dental Caries Indicies

(Permanent Dentition)

A

DMFT: decayed, missing, filled teeth

DMFS: decayed, missing, filled surfaces

*M+F due to caries

79
Q

Dental Caries Indicies

(Primary Dentition)

A

deft - decayed, extraction needed, filled teeth

defs - decayed, extraction needed, filled surfaces

dmft - decayed, missing, filled teeth

dmfs - decayed, missing, filled surfaces

dft - decayed, filled teeth

dfs - decayed, filled surfaces

80
Q

Which teeth are not included in a Dental Caries Indicies?

A
  • 3rd molars
  • congenitally unerupted
  • supernumerary
  • teeth removed/restored NOT due to caries
81
Q

Root Caries Index (RCI)

A

evaluates extent of root caries

calculated as a %

82
Q

PSR

A

Periodontal Screening and Recording

Distractor on boards (;

83
Q

Community Periodontal Index of Treatment Needs

(CPITN)

A

Determines need of status vs needs of disease

highest depth in each sextant is recorded

Code 0: healthy, no bleeding (recommend biofilm control)

Code 1: healthy, BOP (recommend biofilm control)

Code 2: healthy, BOP, calculus present (recommend biofilm control and calculus removal)

Code 3: pockets >3.5mm (recommend biofilm control, comprehensive periodontal assessment, and treatment counselling)

Code 4: pockets >5.5mm (recommend biofilm control, comprehensive periodontal assessment, treatment counselling, and non-surgical periodontal therapy)

84
Q

Main problem with periodontal index?

A

Questionable validity

(CAL not included)

85
Q

Periodontal Disease Index

(PDI)

A

measures gingivitis and periodontitis seperately

  • rarely used anymore
  • 6 teeth
  • good for individual and group studies
86
Q

Eastman Interdental Bleeding Index

A

uses wooden wedge interproximal for 15 sec

0: absence
1: presence

87
Q

Sulcular Bleeding Index

(SBI)

A

Detects early gingival disease by probing

  • 0: healthy, no BOP
  • 1: Healthy, BOP
  • 2: BOP, slight swelling
  • 3: BOP, obvious swelling
  • 4: heavy BOP, swelling, possible ulcerations
88
Q

Gingival Bleeding Index

(GBI)

A

Assesses bleeding

insert floss under gingival margin for 30 sec

0: absence
1: presence

89
Q

Gingival Index

A

Based on severity and extent of inflammation

0: normal gingiva
1: mild inflammation, mild BOP
2: moderate inflammation, BOP
3: severe inflammation, ulcerations

useful for individual and group studies

90
Q

Plaque Index

(PlI)

A

measures thickness of plaque at gingival margin

0-3 on all or some teeth

useful for clinical studies

AKA: stillness and low plaque index

91
Q

Volpe-Manhold Index

(VMI)

A

everyone receives treatment at same time

used to test and compare AGENTS for plaque control and calculus inhibition

measures supracalculus formation following prophylaxis

92
Q

Oral Hygiene Index

(OHI)

A

measures presence of plaque and debris

6 teeth evaluated

not useful for individual evaluation

useful for small and large population studies

93
Q

Patient Hygiene Performance

(PHP)

A

measures plaque after toothbrushing

uses disclosing solution on 6 teeth

useful for assessing groups rather than individuals

94
Q

Plaque Free Scores

(PFS)

A

measures % of teeth with no plaque

entire dentition is disclosed

score of 100% is ideal

easy at home follow-up

95
Q

Plaque Control Record

(PCR)

A

measures % of teeth with supra plaque

entire dentition is disclosed

lower percentage is better

useful for assessing individual performance and OSC

NBDHE May 2022 (12 decks)

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