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Public Dental Health & Behavioural Management > DPH & BS > Flashcards

DPH & BS Flashcards

1
Q

Define public health

A

it’s the science and practice of preventing oral diseases, promoting oral health and improving the quality of life through the organised efforts of society.

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2
Q

List a range of sciences and disciplines of dental public health

A 
Epidemiology
Health promotion
Medical statistics
Sociology and psychology
Health economics
Health services management & planning
Evidence based practice
Demography
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3
Q

What are the main determinant of health

A

Age, gender, genetics
Lifestyle factors
Social and community networks
Living and working conditions - (agriculture & food production, education, work environment, unemployment, water & sanitation, health care services, housing)
Socioeconomic, cultural and environmental conditions

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4
Q

Define Epidemiology

A

The study of the distribution of diseases or health outcomes within a population

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5
Q

Define Screening

A

An examination of people without pain to classify them as likely or unlikely to have disease or health condition

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6
Q

What is Prevalence

A

The number of cases of a disease in a given population at a designated time

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7
Q

What is Incidence

A

The number of new cases of a disease in a population within a specific time

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8
Q

Define Health Education

A

A communication activity which provides the individual, family, & community with information & skills which gives them the knowledge to make informed decisions

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9
Q

Properties of an ideal epidemiology index

A

Simple - easily applied
Objective - clear & unambiguous
Valid - measures what its intended to do
Reliable - consistently even at different times
Quantifiable - amendable to statistical analysis
Sensitive - detect small shifts
Acceptable - accepted by subject (people)

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10
Q

Barriers to Dental Care

A

Service based barriers
Economic barriers
Psychological barriers

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11
Q

5 A’s of Access to Dental Care (Penchansky & Thomas 1981)

A 
Availability
Accessibility
Affordability
Acceptability
Accommodation
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12
Q

What are Service based barriers

A 
availability to service
accessibility to service (location/disable friendly)
registration
appointment systems
environment of surgery
level of service provided
accommodation (opening times/waiting time)
Affordability (direct/indirect cost)
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13
Q

What are Economic barriers

A

cost of check up/regular attendance might not be possible
cost of potential treatment might be prohibitive
patient concern about unknown cost
time away from work - reduce income
travel cost to surgery

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14
Q

What are Psychological barriers

A 
perceived need
treatment need but no pain experienced
perception of value for money
perception of available local NHS
anxiety or fear
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15
Q

What are the three stages of prevention

A

Primary - preventing a person getting a health outcome or disease (vaccinations)

Secondary - after the disease has occurred but before the person notices symptoms, it helps to find diseases early (screening)

Tertiary - person already has symptoms of disease, to prevent damage or pain (dietary advice to manage disease & prevent complications)

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16
Q

What is the Ottawa Charter (WHO 1986)

A

Its a guidance document on health promotion by the WHO

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17
Q

What are the priority areas for Health promotion by Ottawa Charter

A 
Built healthy public policy
Create supportive environments
Strengthen community action
Develop personal skills
Re-orient health services
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18
Q

Define equality

A

creating a fairer society where everyone can participate and have same opportunities to fulfil everyone potential

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19
Q

Define diversity

A

recognising everyone is different and respecting and valuing their difference.

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20
Q

Bradshaw (1972) Taxonomy of Need

A 
Normative Need 
Felt Need  
Expressed Need 
Comparative Need  
(Hidden Need)
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21
Q

What is Normative Need

A

defined by healthcare professionals based on an assessment against an agreed set of criteria

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22
Q

What is Felt Need

A

defined by what people perceived as being important (what they really want)

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23
Q

What is Expressed Need

A

defined as felt need but expressed in words or action (this becomes demand)

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24
Q

What is Comparative Need

A

defined as needs that when compared with similar individuals are considered lacking with regards to services or resources

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25
Q

What is Hidden Need

A

this is normative need which is not expressed, it doesn’t come to the attention of the dental service. (ref: clinical iceberg)

26
Q

What treatment choices can enable DCPs to provide patients with information

A

Evidence based research
Clinical governance process
Self Audit

27
Q

How do health problems develop?

A

infections
toxic chemicals
genetics
lifestyle/behaviours (smoking, diet, alcohol, drugs)
accidents
social factors ( poverty, lack of education, medical care, poor sanitation)

28
Q

What are the advantages and disadvantages of UK National Surveys

A

Advantages

  • comparable data
  • all age groups surveyed
  • provides information of all major oral conditions

Disadvantages

  • only once every 10 years
  • data only available for large regions
  • lack of local data for planning
29
Q

What factors are linked to differences in dental health

A

poverty levels
ethnic/cultural groups
access to dental services

30
Q

What are risk indicators

A

poverty and ethnicity are indicators for untreated decay and identifying groups at risk

31
Q

What is a risk factor

A

the cause of the difference, i.e. areas with no fluoridation of water, has availability to fluoride toothpaste but the lacks of daily use from early age leads to caries

32
Q

What are the advantages and disadvantages of the dmft index

A

Advantages

  • measures caries experience
  • easy to use
  • use world wide

Disadvantages

  • diagnostic criteria can be different between countries and through time
  • assumes all extractions due to caries
  • assumes all fillings due to caries
  • decay component includes arrested, dentinal and pulpal involvement caries and filled teeth with caries
  • its irreversible
33
Q

What are the uses of epidemiology

A

describe ageing processes
identify cause of disease
test theories for control of disease
providing information to planning health services

34
Q

What are the types of epidemiology studies

A

Descriptive - describes patterns not cause ( in other words - describes the prevalence & incidence of disease or disorders) (BASCD & ADH surveys)

Analytical - establishes cause and effects through studies such as observational (which are case controlled/cohort) and experimental (Randomised Controlled studies)

35
Q

What is a case controlled study

A

its an observational study which observes and collects information from present to past

36
Q

What is a cohort study

A

its an observational study which observes and collects information from present and compare it to data collected over a period of time (i.e. in a years time)

37
Q

What is a randomised controlled trail

A

its an experimental study which intervenes to make changes and observes outcome.

38
Q

Causation & Association criteria

A

Sir Austin Bradford Hill’s criteria:

  • strength of association
  • dose related
  • consistency of association
  • correct with respect to time
  • specificity of association
  • biologically plausible
  • reversibility
39
Q

Define Anxiety

A

A feeling of unease or nervousness about something about to happen

40
Q

Define Fear

A

a biological response to threat such as danger, pain or harm

41
Q

Define Phobia

A

an irrational fear of something

42
Q

What are the effects of dental anxiety

A

Physiological and Somatic sensations
- breathlessness, palpitations, sweating, dry throat, muscle tension

Cognitive Features
- poor concentration, poor recall of events, imagining the worst, hypervigilance

Behavioural Reactions

  • avoidance (cancelling or DNA or asking for all treatment at one visit)
  • late for appointments
  • breathing deeply
43
Q

What can cause dental anxiety

A 
previous experience
other family members experience
lack of control
fear of unknown
anxious personality
44
Q

How can anxiety be assessed

A

through physiological assessment
behavioural observation - children & adult
self-report - ask patient, or through questionnaires (modified dental anxiety scale, modified child dental anxiety scale, children’s dental fear picture test)

45
Q

What non-pharmacological techniques are available to manage anxiety

A 
having good communication skills
welcoming dental environment
treatment planning
being prepared
enhancing control
acclimatisation
tell show do 
distraction
positive reinforcement
modelling
voice control
relaxation
timing of appointments
systemic desensitisation 
hypnosis
showing empathy
46
Q

Why is it important to recognise and manage anxiety

A

can affect future anxiety, especially childhood experiences
creates a barrier to accessing services
creates a barrier to communication
to ensure pain control

47
Q

Define health psychology

A

study of the mind and behaviours in health and illness

48
Q

What are the types of models used in behavioural science

A

mathematical model - system using maths and language (nature verse science)

mental model - explanation of someone’s thought process of how something works in reality

psychological model - theoretical representation that stimulates mind or social processes.

49
Q

What is the most effective model in health behaviour

A

Transtheoretical model which specifies when a patient is ready to change behaviour by identifying stages that precede behaviour change

50
Q

What are the stages of the transtheoretical model

A

1) Precontemplation
2) Contemplation
3) Preparation
4) Action
5) Maintenance
6) Relapse

51
Q

What is Maslow’s Hierarchy of Needs

A

its a motivational theory that encourages achievement of certain needs, covering:

  • self actualisation (creative, acceptance, need to exceed)
  • self-esteem ( confidence, achievement, respect of others, unique)
  • love & belonging (friendship, family, intimacy, connections)
  • safety & security (health, employment, property, family and social ability)
  • physiological needs (breathing, food, water, shelter, clothing, sleep)
52
Q

What is communication

A

a process where information, meanings and feelings are shared through verbal & non-verbal messages

53
Q

What are the main factors of communication

A

environment (sounds, smell, sight, feelings)

non-verbal communication (appearance, touch proximity, body language)

verbal communication (vocabulary, meaning, paralanguage, perceived meanings)

written communication
listening

54
Q

What can good communication skills lead to

A 
better diagnosis & understanding of patients problems
reduce patient anxiety
greater patient satisfaction 
reduce patient complaints
increase commitment to advice given
55
Q

What are the three phases during a dental consultation

A

Introductory - greeting, preliminary chat & explanation
Intervention - carrying out treatment
Closing - summary of treatment, health education and dismissal

56
Q

What techniques can be use to improve communication skills

A 
learn to listen
be aware of patients emotions
empathise
encourage
think before you speak
57
Q

What are the advantages and disadvantages of water fluoridation

A

Advantages

  • benefits everyone
  • cheap
  • up to 40% reduction in caries over lifetime
  • 15% of water fluoridated in UK
  • caries increases after fluoride removed from water
  • safe, cost effective, consistent, good population coverage, compliance not needed, low risk of overdose

Disadvantages

  • mass medication
  • takes away freedom of choice
  • requires complex infrastructure
58
Q

List the methods of fluoride delivery

A 
Water fluoridation
topical fluoride application
fluoride toothpaste
fluoride tables/drops
fluoride salt 
fluoride milk
fluoride in fruit juices
59
Q

Define barriers to dental care

A

a circumstance, perception or behaviour which prevents a person from gaining access to dental care

60
Q

a) What information can be use to determine local need

b) How are these carried out

A

a) Using local surveys, such as BASCD, Adult Dental Health surveys and National surveys
b) through school screening, population count, dmft index, identifying the area (what is the deprivation, is the water fluoridated), using Townsend & Jarman (aka Carr-Hill formula) deprivation index.

Public Dental Health & Behavioural Management (1 decks)

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