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BDS3 PMHP > Epidemiology III > Flashcards

Epidemiology III Flashcards

1
Q

why study epidemiology

A

To understand burden and causes of disease

Population studies

Unnecessary to study whole population to obtain valid information about a population

Sample population must be representative of population being investigated
- Some tests only received by those who suspect they have – miss asymptomatic carriers

Evidence Based Dentistry (Medicine)

  • Make sense of epidemiological studies And studies in general
  • Should we believe the results
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2
Q

role of epidemiology

A

Measurement of amount and distribution of disease, and natural history of disease

Study of causes / determinants of diseases

Assess people’s risk of disease

Health care needs assessment and Service planning:
- Development of preventive programmes

Evaluation of interventions e.g.:

  • caries preventive programme
  • oral cancer screening
  • clinical trials for drugs / treatments
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3
Q

3 aspects of epidemiology

A

descriptive

analytical

intervention - assessing intervention/programme

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4
Q

prevalance

A

Number of disease cases in a population at a given time

P - Point in time = Prevalance

Prevalence estimates obtained from cross-sectional studies or derived from registers

Can relate attributes to absence / presence of disease lead to development of a hypothesis

Used for chronic disease or high fatality e.g. diabetes

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5
Q

Prevalence =

A

Number of affected individuals (cases) /

Total number of persons in population

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6
Q

prevalence used for

A

chronic disease or high fatality e.g. diabetes

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7
Q

incidence

A

Number of new disease cases developing over a specific period of time in a defined population

Incidence estimates obtained from longitudinal studies or derived from registers

E.g. cancer (10 per 100,000 per annum), covid

Need timeframe and population size

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8
Q

incidence Rate =

A

no. of new cases of a dis. in a period /

no. of individuals in the pop. at risk

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9
Q

incidence needs

A

Need timeframe and population size

rate

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10
Q

prevalence estimates obtained from

A

cross-sectional studies or derived from registers

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11
Q

incidence estimates obtained from

A

longitudinal studies or derived from registers

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12
Q

distribution

A

How common is X?

How is X distributed in the population?

When OR time
Where place
Who person

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13
Q

dental caries in children

epidemiology

A

Epidemiology in the community

Dental Indices: DMFT / dmft

Sources of information / routine data

SHBDEP and NDIP (national dental inspection programme)

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14
Q

dental examples of epidemiology studies

A

dental caries in children

adult oral health

periodontal disease

oral cancer

oro-facial trauma

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15
Q

epidemiological indices

A

To measure disease an appropriate index is needed

Measuring for the purposes of epidemiological studies is different from recording disease for patient treatment purposes

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16
Q

dental epidemiology in the community - measuring caries

A

p1 and P7 children (5 and 11 year olds)

on a school table, public dental service

a simple assessment of the mouth of each child using a light, mirror and ball-ended probe
- specific strength of lightbulb with safety catch - standardised

DMFT / dmft

recorded on a laptop

letter sent to parent/carer - done on opt out (negative consent basis)

data analysed

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17
Q

properties of ideal index

A

clear, unambiguous, objective not subjective

ideally correspond with clinically important stages of the disease

indicate treatment need
within the ability of examiners
- train to be standardised

reproducible

not time-consuming

acceptable to patient

amenable to statistical analysis

allow comparison with other studies

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18
Q

DMF/dmf Index

A

DMF (permanent)
dmf (deciduous)

DMFT: decayed, missing & filled teeth (0-32)

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19
Q

DMFS index

A

decayed, missing & filled surfaces (0-148)

- Not incisal of upper and lower 3-3

20
Q

def/dmf index

A

dmft: decayed, missing filled teeth (0-20)

‘e’ = indicated for exfoliated

21
Q

D3MFT/ d3mft

A

signifies decay into dentine

22
Q

D1MFT/d1mft

A

decay into enamel

- obvious to naked eye

23
Q

when DMF index created

A

1937

worldwide use

24
Q

reasons for teeth to be missing

A 
caries
periodontal disease
trauma 
exfoliation (age - mixed dentition from 6)
congenitally missing
25
Q

issue with reporting sample no of missing teeth in 15 years

A

Orthodontic extractions – could have been healthy or diseased – don’t know when missing

Need to know history to decay – as only see snapshot

26
Q

extensive decay

A

lesions into oulp

27
Q

moderate decay

A

lesions into pulp +

clinically detectable lesions in dentine
/
clinically detectable cavities limited to enamel

+ hidden decay not seen by visual inspection

28
Q

initial decay

A

clinically detectable enamel lesions with intact surfaces

+ hidden decay not seen by visual inspection

29
Q

very early stage decay

A

sub clinical initial lesions in a dynamic state of progression/regreesion

30
Q

obvious decay (as assessed by NDIP inspections)

A

lesions into pulp

clinically detectable lesions in dentine

31
Q

limitations of DMF/dmf index

A

Teeth are extracted for reasons other than caries

Influenced by access, e.g. interproximal surface

Difficulty in differentiating fissure-sealant from restorations – underestimate caries

Influenced by past disease activity

Cannot be used for root caries

32
Q

D/DMF use

A

indication of treatment need

proportion that is decayed of all DMF

33
Q

F/DMF use

A

indication of treatment provision (The “Care” Index)

proportion treated

34
Q

M/DMF use

A

indication of treatment failure

35
Q

sources of routine information

A

UK Children’s dental health surveys (1973, 1983, 1993, 2003)

National Diet and Nutrition Surveys

BASCD – British Association for the Study of Community Dentistry) surveys - UK

SHBDEP – Scottish Health Boards’ Dental Epidemiology Programme – Scotland (old)

NDIP – National Dental Inspection Programme: Scotland. (now)

WHO – World Health Organisation: Oral Health Country/Area Profile Programme

http: //www.scottishdental.org
http: //www.whocollab.od.mah.se/

36
Q

detailed NDIP

A

epidemiology

high level planning / evaluation of interventions
dmf/ DMF
sample 20%

37
Q

basic NDIP

A

monitoring / targeting interventions

informing parents / children oral health status and need for dental services / basic feedback

everyone receives

38
Q

adult oral health sources of information

A

Adult Dental Health Survey (ADHS)

recent trends and future projections

39
Q

generic information source for adult health

A

General surveys : Scottish Health Survey

Specific health related surveys

40
Q

dental information source for adult health

A

UK Adult Dental Health Survey

Scottish Adult Dental Health Survey

41
Q

service related information source

A

public health scotland

- Databases, Journals, Publications - Regional / Local, National, International.

42
Q

adult dental health survey measures

A

Total tooth loss, number of teeth and function

Condition of natural teeth, restorative treatment and supporting structures

Social and behavioural characteristics and oral health

Trends in tooth loss and the condition of natural teeth

Dental attitudes and reported behaviour

Reports by country

43
Q

tooth mortality

A

Tooth loss has been considered a form of “dental mortality”

It is a crude (but still a good) measure of general oral health

  • either as partially dentate (number of natural teeth)
  • or as total tooth loss (edentulous).
44
Q

black and minority adult ethnic groups are less likely to experience … compared to white adults

A

edentulous
toothache

(after controlling for SEP)

45
Q

periodontal disease indices (3)

A

Plaque indices, e.g.

  • Debris Index (Green & Vermillion, 1960)
  • Plaque Index (Silness & Loe, 1964)

Gingivitis indices, e.g.

  • Modified Gingival Index (Loe, 1967)
  • Lobene Index (Lobene, 1986)

Periodontitis indices, e.g.
- CPITN / BPE

46
Q

CPITN measurement

A

WHO Community Periodontal Index of Treatment Need

Established mid 1980s

Internationally accepted method of estimating levels of periodontal conditions in populations

Relatively simple and quick to perform

BDS3 PMHP (14 decks)

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