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Dental Public Health > DDPH > Flashcards

DDPH Flashcards

1
Q

What does proportionate universalism mean? What review highlighted this?

A

All pts should be given the benefit of advice and support to change behaviour regarding their general and dental health but with a scale and intensity that is proportionate to the level of disadvantage faced

The Marmot review

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2
Q

What does grade I evidence mean? DBOH

A

Strongest, from at least 1 systematic review of multiple well designed RCTs

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3
Q

What does grade II evidence mean? DBOH

A

Strong evidence from at least 1 properly designed RCT of appropriate size

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4
Q

What does grade III evidence mean? DBOH

A

Evidence from well designed trails without randomisation - cohort, time series etc

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5
Q

What does grade IV evidence mean? DBOH

A

Evidence from well designed non experimental studies from more than 1 centre or research group

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6
Q

What does grade V evidence mean? DBOH

A

Opinions of respected authorities based on clinical evidence or descriptive studies

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7
Q

What groups in DBOH are referred to as those giving concern to their dentist?

A
  • Likely to develop caries
  • Special needs
  • Dry mouth
  • Obvious current active caries
  • Ortho appliances
  • Other predisposing factors
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8
Q

What is the reference in the key systematic review (2012) to demonstrate that oral health professionals increased quit rates within the dental setting?

A

West and Brown

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9
Q

What is the name of a quick screening tool for alcohol identification/misuse?

A

AUDIT-C

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10
Q

What is this study design:

Well participants are chosen on the basis of a different exposure. Wait to see if they develop disease.

A

Cohort study

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11
Q

What is this study design:

A representative sample of people are surveyed to answer a question

A

Cross-sectional survey design

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12
Q

What is this study design:

Participants randomly allocated to different interventions then followed and outcomes assessed

A

Randomised Control Trial

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13
Q

What is this study design:

People with a disease are matched to those without it and earlier exposure to different environmental factors compared

A

Case-control study

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14
Q

What is this study design:

Description of the MH of one or more patients

A

Case study/ series

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15
Q

What is this study design:
Critical assessment, evaluation and synthesis of multiple high quality research studies to answer a single specific question

A

Systematic review

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16
Q

Rank the study designs from highest quality to lowest quality

A

1) Systematic reviews and meta analysis of RCTs
2) RCTs
3) Cohort studies
4) Case-control studies
5) Cross-sectional studies/surveys
6) Case reports
7) Mechanistic studies
8) Expert opinions and editorials

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17
Q

When was Oral Health Surveillance established?

A

60s

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18
Q

What is needs assessment and what are its risks?

A

Local data for local services

Small scale surveys so poor sampling and no wider comparison group

19
Q

What is used for policy advice?

What is used for research into disease?

A

Cross sectional data but risk of misinterpretation

Comprehensive data set but expensive

20
Q

When was the last adult dental health survey?

How many households and what was the response rate?

A

2009

13,400 and 60% response

21
Q

What are the issues with using the following sampling frameworks

a) Postcode address files
b) GP lists
c) Dentist lists

A

a) From census, need consent
b) wont show where they live
c) do not use due to dental access/ not registered

22
Q

What do you need to have a good sample?

A
  • Inclusion and exclusion criteria
  • Meaningful response rate
  • Big enough sample to increase confidence
  • Know what proportion of those sampled agreed to take part
  • Stratified
23
Q

Where is the Health Promotion emblem from?

A

The Ottowa Charter 1986

24
Q

What is health promotion?

A

Starts with health, seeks to develop community and individual measure to help develop lifestyles that can maintain and enhance state of wellbeing

25
Q

What is disease prevention?

A

Begins with threat to health. Disease or environmental hazard and seeks to protect as many people form the harmful consequences of that threat

26
Q

What is upstream prevention and what is downstream prevention?

A 
Upstream = national policy, legislation
Downstream = chairside health education, schools, clinical prevention
27
Q

What is the Tannahill Model of Health Promotion?

A
  • Prevention
  • Health protection
  • Health education
28
Q

What is primary prevention?

A
  • Attempt to prevent onset of disease
  • Carried out on healthy populations
  • Health promotion and specific protection
29
Q

What is secondary prevention?

A
  • Aim to terminate a disease process and prevent complication e.g. WSL and fluoride varnish
  • Restorative care - restore tissues to as normal as possible
30
Q

What is tertiary prevention?

A
  • Replace lost tissues in an attempt to reduce or limit impairment, disability and death
  • Reconstructive and rehabilitative
31
Q

When evaluating oral health interventions what is meant by effectiveness?

A

Ability of an intervention to meet its intended effect in the real world

32
Q

When evaluating oral health interventions what is meant by efficacy?

A

Ability of an intervention to meet its intended effect under optimal conditions ie the ideal world

33
Q

In disease prevention evaluation, what is meant by considering process measures?

A

Assess if the intervention has been implemented as planned e.g. levels of pt satisfaction/quality assurance

34
Q

In disease prevention evaluation, what is meant by considering outcome measures?

A

Assess the long term effects ie did it achieve its goal

35
Q

In disease prevention evaluation, what is meant by considering process evaluation?

A

Intervention acceptability, integrity, quality and reach (include the people we wanted it to)

36
Q

In disease prevention evaluation, what is meant by considering outcome evaluation?

A

Were the objectives met, what was achieved, outcome measures appropriate

37
Q

Why should we challenge the high risk approach with caries prevention?

A

Majority of new lesions in lower risk >50% in initial DMFS scores of 0
Should be population or directed population approach

38
Q

Why do diseases fall before medical model intervention?

A
  • Efficacy overplayed, nutrition sanitation and reproduction more important
  • Material circumstances/ social circumstance
  • Subjective nature of illness
  • Ignores other forms of healing
39
Q

What classification did the CDH survey 2013 use for socioeconomic circumstances?

A

2011 ONS Output area classification - groups together similar geographic areas according to characteristics common to the population
Statistical neighbours CIPFA - compares local authorities with similar demographic profiles

40
Q

What classifications are there for social groups?

A

Registrar Generals Occupational Social Class index 1911 (I-V)
Revised Socioeconomic classification

41
Q

In what social class is smoking in pregnancy, edentulism and caries experience greater?

A

Social Class V (unskilled)

42
Q

What are the 3 ways of measuring deprivation to target regeneration policies to the most deprived areas?

A
  • Jarman Index
  • Townsend Index
  • Index of Multiple Deprivation (IMD)
43
Q

Summarise the findings of the Marmot Review (2010)

A

The lower a person’s socio-economic status the poorer their health is likely to be (die earlier and live with disability longer)
Health inequalities are largely preventable and occur from a complex interaction of many factors e.g. housing income education social isolation disability

Dental Public Health (1 decks)

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