Epidemiology

Question 1

Describe tooth loss epidemioloigcally?

Answer 1

Debilitating and irreversible condition
Final marker for oral health
Prevalence of complete tooth loss has declined over the last decade

Question 2

Name 5 local factor for the aetiology of tooth loss?

Answer 2

Caries
Periodontal disease
Treatment related
Trauma
Iatrogenic factors

Question 3

Name 2 systemic factors for the aetiology of tooth loss?

Answer 3

Developmental

Systemic diseases

Question 4

Name 3 patient factors for the aetiology of tooth loss?

Answer 4

Smoking
Dental attendance
Socioeconomic

Question 5

Name the 4 human impacts of tooth loss?

Answer 5

Function (mast and speech)
Pain
Social aspects (social)
Psychological aspect (appearance and self-esteem)

Question 6

What can tooth loss give us information about?

Answer 6

History of dental disease
Treatment by dental services over the life course
Patients’ and dentists’ attitudes
Dentist-patient relationship
Availability & accessibility of dental services
Prevailing philosophies of dental care

Question 7

What are the tooth loss trends in the England?

Answer 7

Proportion of adults with total tooth loss has fallen from 28 % in 1978 to 6 % (2.7 million) in 2009
Proportion of adults with 21 or more natural teeth increased from 74% in 1978 to 86% in 2009

Question 8

How many teeth are needed for a functional dentition/

Answer 8

21 or more

Question 9

What are the tooth loss trends in Scotland?

Answer 9

Prevalence of edentulism in 65+ in 2008/9 was 40%

Prevalence of edentulism was highest for the most deprived & lowest for the least deprived groups

Question 10

What are the implications of trends in tooth loss?

Answer 10

Important for planning dental services and workforce
Needs Assessment
Updating the dental curriculum
Evidence base for research, policy and funding

Question 11

Describe the evidence level tree?

Answer 11

1 - systematic review with meta analysis
2 RCT
3 Cohort
4 CAse control
5 Case series and case reports
6 Expert opinion, narrative review and editorial

Question 12

What is the definition of sensitivity?

Answer 12

The ability to detect people who do have the disease

Question 13

What is the definition of positive predictive value?

Answer 13

The likelihood that a person with a positive test result actually has disease

Question 14

What is the definition of specificity?

Answer 14

ability to detect people who do not have disease

Question 15

What is the definition of negative predictive value?

Answer 15

likelihood that a person with a negative test result truly does not have disease

Question 16

What is the equation of sensitivity?

Answer 16

TP/TP + FN

Question 17

What is the equation for specificity?

Answer 17

TN/TN + FP

Question 18

Why do meta-analyses give high a high evidence level?

Answer 18

Statistical technique for combining the findings from independent studies
Often used to assess the clinical effectiveness of healthcare interventions
Hallmark of evidence-based medicine
Unbiased synthesis if empirical data
Investigates consistency of effect across different samples (heterogeneity)
Quantifies strength of evidence for the effect (quality assessment)

Question 19

What is the definition of precision?

Answer 19

A test with more power than separate studies to detect small but clinically significant changes

Question 20

Give examples of statistical data analysis?

Answer 20

Effect Size (e.g. Odds ratio)
95% Confidence Interval
Test of heterogeneity
Forest Plot
Funnel Plot

Question 21

What is the definition of Odds ratio?

Answer 21

compare the relative odds of the occurrence of the outcome of interest (e.g. disease), given exposure to the variable of interest (e.g. health characteristic, aspect of medical history)

Question 22

OR = 1?

Answer 22

Exposure does not affect odds of outcome

Question 23

OR >1?

Answer 23

Exposure associated with higher odds of outcome

Question 24

OR <1?

Answer 24

Exposure associated with lower odds of outcome

Question 25

What is the definition of a confidence interval?

Answer 25

range of values that is likely to contain an unknown population parameter (e.g. population mean)

Question 26

What is the definition of publication bias?

Answer 26

Much research is never published
Positive results are more likely to be published
Published trials are generally larger and may show an overall greater treatment effect than trials not published in journals