health promotion

Question 1

what is the role of epidemiology?

Answer 1

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

Question 2

define prevalence

Answer 2

number of disease cases in a population at a given time

Question 3

how is prevalence calculated?

Answer 3

number of affected individuals/total number of persons in population

Question 4

define incidence

Answer 4

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

Question 5

how do you calculate incidence?

Answer 5

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

Question 6

which studies can obtain prevalence?

Answer 6

cross sectional

Question 7

which studies obtain incidence?

Answer 7

longitudinal

Question 8

what are the properties of an ideal index?

Answer 8

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

Question 9

what is the d3mft index?

Answer 9

decay into dentine missing and filled teeth

Question 10

which teeth are scored for dmft in patients 6+?

Answer 10

c d e teeth

Question 11

what are the limitations of the DMFT/dmft index?

Answer 11

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

Question 12

what do the components of DMF show?

Answer 12

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

Question 13

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

Answer 13

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

Question 14

is systemic or topical fluoride the main source of fluoride?

Answer 14

topical

Question 15

how does fluoride prevent caries?

Answer 15

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

Question 16

what are the two oral reservoirs of fluoride?

Answer 16

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

Question 17

what are community based examples of fluoride therapy?

Answer 17

water
school based brushing
varnish

Question 18

give an advantage and a disadvantage of fluoridated salt

Answer 18

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

Question 19

what re the advantages of fluoridated milk?

Answer 19

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

Question 20

what are the disadvantages of fluoridated milk?

Answer 20

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

Question 21

what are the benefits of fluoridated mouth rinse?

Answer 21

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

Question 22

what is the fluoride concentration of duraphat varnish?

Answer 22

22600ppmF

Question 23

sustained contact of varnish on teeth allows what?

Answer 23

precipitation of calcium fluoride
progressive release of fluoride

Question 24

what factors determine the antiquaries activity of fluoride toothpaste?

Answer 24

fluoride concentration
frequency of application
rinsing behaviors
when brushing happens

Question 25

what is optimal brushing key points?

Answer 25

twice daily 1450ppmF toothpaste don't rinse

Question 26

what are the disadvantages of fluoride toothpaste?

Answer 26

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

Question 27

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

Answer 27

0.1mgF/kg body weight

Question 28

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

Answer 28

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

Question 29

what are the principles of Childsmile nursery and school?

Answer 29

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

Question 30

describe the Childsmile tooth brushing programme

Answer 30

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

Question 31

list some targeted approaches of Childsmile

Answer 31

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

Question 32

what is community water fluoridation?

Answer 32

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

Question 33

what quantity fluoride is added to water?

Answer 33

0.5-1.2ppm depending on climate

Question 34

what sources of fluoride are added to water?

Answer 34

hydrofluorosilicic acid or hexafluosilicic acid or sodium fluorosilicate or sodium silicofluoride

Question 35

what is the mean natural fluoride content in water?

Answer 35

0.1mgF/l

Question 36

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

Answer 36

water (fluoridation) act 1985

Question 37

what are the barriers to water fluoridation?

Answer 37

objections/acceptability moral political barriers geographical barriers financial barriers

Question 38

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

Answer 38

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

Question 39

what is absolute risk in epidemiology?

Answer 39

incidence rate of disease amongst people exposed to agent

Question 40

what is attributable risk?

Answer 40

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

Question 41

what is a cohort study?

Answer 41

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

Question 42

what are the two main types of analytic observational studies?

Answer 42

cohort case-control

Question 43

what is a case-control study?

Answer 43

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

Question 44

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

Answer 44

cohort