EBD - Prevention

Question 1

What is DBOH based on?

Answer 1

Systematic reviews

Regularly updated in light new evidence

Question 2

Levels of evidence?

Answer 2

Systematic reviews
RCTs - randomised controlled trials
Intervention studies
Non-experimental studies
Expert opinions

Question 3

Basic evidence for caries prevention?

Answer 3

Brush fluoridated toothpaste 2x day (I)
use at least 1350ppm toothpaste (I)
Brush last thing at night and one other occasion (III,I)
Spit don’t rinse (III)
Restrict sugar mealtimes and less 4x day (III)

Question 4

When would adults be classified as giving concern?

Answer 4

Active caries

Predisposing factors e.g dry mouth

Question 5

What advice and professional interventions given adults giving concern?

Answer 5

Advice: use daily F- mouthwash (0.5%) diff time brushing (I)
Professional: 2.2% NaF varnish 2x year (I), prescribe 5000ppm toothpaste (II), diet invetigation (III)

Question 6

How prevent gingivitis?

Answer 6

Encourage daily, effective plaque removal by patient (more important professional measure)
Manage RFs: smoking, diabetes, medication

Question 7

Advice for all adults regarding periodontal health?

Answer 7

Brush gum line and each tooth 2x day
Manual or powered brush
Small head w/ medium texture
Don't smoke
Use interdental aids

Question 8

Professional interventions of periodontal disease?

Answer 8

Demonstrate method plaque removal
Investigate control systemic condition
AAA - tobacco

Question 9

Advice given for prevention oral cancer?

Answer 9

Avoid tobacco - smoked and chewed

Reduce alcohol consumption - less 14 units

Question 10

How to advice on smoking?

Answer 10

Ask - and record smoking status
Advise - best way of quitting
Act - on pt response

Question 11

Why offer smoking cessation?

Answer 11

Pt can be referred stop smoking services

4x more likely to quit w/ support

Question 12

Advice for e-cigs?

Answer 12

Long-term safety not established
Use of smoking cessation tool not established
Potential for advice e-cigs to change as research published

Question 13

Why hard to change pt behaviour?

Answer 13

Social, cultural and personal environment

Behaviour change is lengthily and difficult process

Question 14

Purpose of behaviour change therapy?

Answer 14

Raise issue and build motivation
Assessment pt readiness to change
Support pt

Question 15

How to set goals in behaviour change therapy?

Answer 15

SMART

Specific, measurable, achievable, relevant, timely

Question 16

How to carry out behaviour change?

Answer 16

Identify barriers and how to overcome
Plan to cope w/ relapse
Provide encouragement 
Suitable/ appropriante reward for progress
Signpost local services

Question 17

5 broad actions of health promotion?

Answer 17

1. Creating supportive environment
2. Healthy pubic policy
3. Strengthen community action
4. Develop personal skills
5. Reorientating health service

Question 18

Examples of health promotion in Sheffield?

Answer 18

Toothbrushing packs - health visitors (receive oral health training)
Toothburshing clubs in deprived areas
Training staff in care homes