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PMHP > health promotion > Flashcards

health promotion Flashcards

1
Q

what is the role of epidemiology?

A

measure amount, distribution and natural history of disease
study causes and determinants of disease
assess peoples risk if disease
assess healthcare needs
develop prevention programmes

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2
Q

define prevalence

A

number of disease cases in a population at a given time

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3
Q

how is prevalence calculated?

A

number of affected individuals/total number of persons in population

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4
Q

define incidence

A

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

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5
Q

how do you calculate incidence?

A

rate = number of new cases of disease in a period/number of individuals in the population at risk

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6
Q

which studies can obtain prevalence?

A

cross sectional

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7
Q

which studies obtain incidence?

A

longitudinal

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8
Q

what are the properties of an ideal index?

A

clear unambiguous
objective not subjective
reproducible
indicate treatment need
correspond with clinically important stages of disease
not time consuming

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9
Q

what is the d3mft index?

A

decay into dentine missing and filled teeth

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10
Q

which teeth are scored for dmft in patients 6+?

A

c d e teeth

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11
Q

what are the limitations of the DMFT/dmft index?

A

teeth are extracted for reasons other than caries
can’t see inter proximal
FS or restoration?

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12
Q

what do the components of DMF show?

A

D - indicates treatment need
F - indicates treatment provision
M - indicates treatment failure

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13
Q

what is the difference between systemic and topical effects of fluoride?

A

systemic is pre eruptive incorporation of fluoride during tooth development
topical is post eruptive involvement in demineralisation/remineralisation

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14
Q

is systemic or topical fluoride the main source of fluoride?

A

topical

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15
Q

how does fluoride prevent caries?

A

promotes remineralisation
forms fluoro-appetite which is less susceptible to demineralisation

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16
Q

what are the two oral reservoirs of fluoride?

A

mineral deposits CaF2 in saliva
biologically/bacterially bound calcium-fluoride

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17
Q

what are community based examples of fluoride therapy?

A

water
school based brushing
varnish

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18
Q

give an advantage and a disadvantage of fluoridated salt

A

ad- provides element of choice and effect is comparable to water fluoridation
dis- risk of CV disease

19
Q

what re the advantages of fluoridated milk?

A

natural healthy drink
rich in nutrients
targeted at those who need it most

20
Q

what are the disadvantages of fluoridated milk?

A

distribution delayed until nursery
not all children drink milk
shelf life/cost
limited evidence of effectiveness

21
Q

what are the benefits of fluoridated mouth rinse?

A

available for home use
reduces caries by around 30%
good compliance

22
Q

what is the fluoride concentration of duraphat varnish?

A

22600ppmF

23
Q

sustained contact of varnish on teeth allows what?

A

precipitation of calcium fluoride
progressive release of fluoride

24
Q

what factors determine the antiquaries activity of fluoride toothpaste?

A

fluoride concentration
frequency of application
rinsing behaviors
when brushing happens

25
Q

what is optimal brushing key points?

A

twice daily
1450ppmF toothpaste
don’t rinse

26
Q

what are the disadvantages of fluoride toothpaste?

A

ingestion risk - acute or chronic toxicity
acute - rare
chronic - fluorosis
increased risk of enamel fluorosis

27
Q

how much fluoride do young peoplee need to swallow to risk fluorosis?

A

0.1mgF/kg body weight

28
Q

how can you reduce fluorosis risk in young children while maximising anti-caries benefit?

A

keep toothpaste out of reach of young children
brush twice daily - evening and one other time
supervise brushing
use small amount - pea of toothpaste
discourage swallowing
encourage spitting
use lower F formula if low caries risk

29
Q

what are the principles of Childsmile nursery and school?

A

targeted to priority nurseries and schools based on SIMD - Scottish index multiple deprivation
6 monthly F varnish in nursery and primary

30
Q

describe the Childsmile tooth brushing programme

A

oral health pack given at least 6 times by age of 5 starting 1st year of life
all nursery schools invited to participate in daily supervised brushing
primary schools in most deprived area invited to participate in daily supervised toothbrushing p1 and p2

31
Q

list some targeted approaches of Childsmile

A

additional home support via DHSW
p1 and p2 supervised toothbrushing targeted to the 20% highest need primary schools

32
Q

what is community water fluoridation?

A

the adjustment of natural fluoride content of a community water supply to achieve caries prevention while minimising fluorosis risk

33
Q

what quantity fluoride is added to water?

A

0.5-1.2ppm depending on climate

34
Q

what sources of fluoride are added to water?

A

hydrofluorosilicic acid or
hexafluosilicic acid or
sodium fluorosilicate or
sodium silicofluoride

35
Q

what is the mean natural fluoride content in water?

A

0.1mgF/l

36
Q

what legislation is in oplace related to water fluoridation in Scotland?

A

water (fluoridation) act 1985

37
Q

what are the barriers to water fluoridation?

A

objections/acceptability
moral
political barriers
geographical barriers
financial barriers

38
Q

what are the effects of water fluoridation on dmft and DMFT?

A

35% reduction in mean dmft
26% reduction in mean DMFT
also 15% more children caries free

39
Q

what is absolute risk in epidemiology?

A

incidence rate of disease amongst people exposed to agent

40
Q

what is attributable risk?

A

difference between incidence rates in exposed and non-exposed groups - represents the risk attributable to factor being investigated

41
Q

what is a cohort study?

A

people exposed and not exposed to risk factors are exposed over a period of time to measure frequency of disease occurrence

42
Q

what are the two main types of analytic observational studies?

A

cohort
case-control

43
Q

what is a case-control study?

A

compare individuals with disease (cases) with those without disease (control) and trace back to assess risk factors

44
Q

which is the more robust study between case-control and cohort?

A

cohort

PMHP (2 decks)

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