intro to dental public health Flashcards
1
Q
what are the major health concerns today
A
- antibiotic resistance
- caries in adults and children
- communicable and non-communicable diseases (NCD’s)
2
Q
what are the 3 broad structures to disease
A
- disease
- service
- risk factors
3
Q
what is the biggest preventable cause of cancer after smoking
A
- obesity
- link is widely unknown
4
Q
what is the cause of obesity often blamed on
A
- lifestyle choices
- but it may not be a choice to eat unhealthily for people in poverty
5
Q
what is another preventable cause of cancer
A
alcohol
6
Q
what is a problem of those with inequalities
A
- its been found that Britons socially excluded are 10 times more likely to die early
7
Q
what is the life expectancy in Scotland currently like
A
- currently declining
- unsure why
8
Q
what is the infant mortality like in Scotland
A
- higher than it should be
9
Q
what is Public Health Scotland (PHS)
A
- used to be different organisations = health promotion and information service divisionn
- PHS makes it all into one organisation
- will hopefully start in April 2020
10
Q
how many priorities does PHS have
A
6
11
Q
what are the 6 priorities of PHS
A
- 1 = a Scotland where we live in a vibrant, healthy, safe places and communities
- 2 = a Scotland where we flourish in our early years
- 3 = a Scotland where we have good mental wellbeing
- 4 = a Scotland where we reduce the use of and harm from alcohol, tobacco and other drugs
- 5 = a Scotland where we have sustainable, inclusive economy with equality of outcomes for all
- 6 = a Scotland where we eat well, have a healthy weight and are physically active
12
Q
wha is the global burden of disease
A
- estimated that oral diseases affected at least 3.58 billion worldwide
- caries of the permanent teeth being the most prevalent of all conditions assessed
- globally it is estimated that 2.4 billion people suffer from caries of permanent teeth and 486 million children suffer from caries of primary teeth
13
Q
what is the best medical journal
A
- the Lancet
- rarely do oral health however
14
Q
what is the mouth cancer organisation called
A
- called mouth cancer foundation
- ‘bite back at it’
15
Q
when is world AIDS day
A
1st December
16
Q
what treatment is used to tackle oral health problems
A
- how we assess sugar in diet at chair side is difficult
- diet diaries are unreliable
- don’t know how to assess sugar at chair side
17
Q
what is screening/anticipatory care services
A
- some services sole purpose is for early detection
- dentists have role in early detection = white spot lesion for example is early sign of caries
18
Q
what are the 3 levels of prevention
A
- policy
- community
- clinical
19
Q
what are the 3 stages of prevention for caries in children (Childsmile)
A
- policy = change contract
- community = working with schools and health support workers
- clinical = practise
20
Q
what is the Kerr report - National Framework for Service Change in NHS Scotland
A
- still trying to manage chronic problems using acute care mentality
- deprived groups often suffer under inverse care law = most healthcare is provided to those who need it least
- deprived groups often receive inappropriate care = high rates of emergency care and low rates of scheduled care
21
Q
what factors drive access to care the most
A
- socio-economic factors
- low paid jobs may mean people can’t miss work
22
Q
what are the National Reports - Recommendations for the Future
A
- reorientation services
- primary care system to be focused on prevention of ill health and detection and management of problems at an early stage
- preventative, anticipatory care where possible rather than only reactive management
23
Q
what is anticipatory care - definitions
A
- planned intervention to achieve early diagnosis and/or treatment of a condition which may not yet be producing symptoms or recognised as producing symptoms
- can take many forms - helps reduce avoidable unscheduled acute admission for people with pre-existing conditions
- care with an eye to the future
24
Q
what is the difference between reactive and anticipatory care
A
- reactive = get treatment when problem is very evident
- anticipatory = early signs of disease found and treatment starts
25
what is the most common reason for children to go to hospital for GA
tooth extractions
26
what is realistic medicine
- patient centred care, shared decision making, avoiding harm, give clinicians and teams power to change what they fo
- working closely with patients
27
is there any realistic medicine for dentistry yet
no
- currently on same contract as 80s/90s for NHS dentistry
- hardly and preventative items on that list
- it is a 500 item list of what you are allowed to do as a dentist on the NHS
28
what are the definitions of public health
- the science and practice of preventing diseases, promoting health and improving quality of life through the organised effort of society
- orca health is more than 'good teeth' - it is integral to general health, is essential for wellbeing and is a determinant of quality of life
- about improving population health = but also about putting the practise of dentistry in context within society
29
what are the 2 things you can talk about in relation to public health
- improving health of population
| - improving services
30
what are the stages of clinical practice vs public health practice
- history and exam VS assessment of need
- diagnosis VS analysis of data
- treatment planing VS planning of services to meet needs
- treatment VS programme implementation
- follow up and review VS evaluation of outcome
31
what are the aims of dental public health
- to improve and tackle inequalities in oral health and health care through appropriate preventive, health promotion, anticipatory care and treatment services
32
what are the challenges if dental public health
- reducing oral health inequalities
- improving oral health
- orca health importance to general health
- ageing population = brings with it problems for OH (dexterity)
33
how can you improve oral health and health care services
- in general, causes of main dental diseases known
- numerous preventive measure exist
- however, diseases are still prevalent
- in UK very small % if NHS budget is used on prevention
- recognised that treatment services alone have major limitations
- preventive, anticipatory care now recommended rather than reactive management
34
what are the main roles of dental public health
- epidemiology
- oral health needs assessment
- preventing disease and oral health improvement
- dressing oral health inequalities
- policy development
- development and implementation of local oral health strategies
- service development the development of clinical pathways
- improving governance systems and quality improvement
- patient safety
- evaluating oral health services
- teaching and training
- research
35
what is epidemiology
- burden pf disease and risk factors
36
what are the main role of epidemiology
- monitoring infectious diseases
- monitoring non-infectious diseases = cancer registries, caries surveys
- measuring health and inequalities in health
- determine risk factors and associated with disease
- strategic planning
- evaluation of effectiveness of service provision
37
would water fluoridation be good
- would have huge public health benefit
- would be very cost effective
- however lots of people against it
38
what is the policy part of prevention
- requires understanding of social, political, economic and environmental factors
39
what is the community part of prevention
- implemented at community level and individual patient level
40
what is the clinical part of prevention
- prevention pivotal to role of clinical dental team (i.e clinicians have important DPH function)
41
what are the determinants of OH status
- correlation between health status and social and environmental factors
- factors influencing eating habits and use of fluoride products major determinants of status = not always within control of individual, financial restraints, access issues, family and peer pressure, education
42
what are life circumstances that influence OH
- education
- commercial influences
- peer pressure
- social isolation
- environment
- access
- culture
- housing
43
what are lifestyle choices that influence OH
- eating
- smoking
- alcohol
- physical activity
- drug misuse
44
what other factors can affect OH
- deprecation and inequalities
45
what is the violence reduction unit
- high number of murders and serious assaults (mainly young males)
- locking up offenders does not work in reducing crime
- PH approach advocated by police = improvement in early years support services required if problem to be reduced
46
how is the PH policy developed
- objective of dental public health is to produce health gain and population
- requires political activity and awareness = lobbying, negotiation, facilitating change, influencing policies with impact on OH
47
what are some policies that have been introduced to help public health
- healthy eating bill (2007)
- tobacco control
- childsmile
48
what caused the tobacco control to be brought about
- decades of evidence on tobacco industry showed negative effect and brought about introduction of upstream policies = targeting pricing, marketing and availability
- alcohol industry also seen a lot of macro-level policies = mainly pricing, marketing and availability (can't get 2 for 1 deals anymore etc)
49
what is the current target to improve OH
- now its the turn of ultra processed food and soft drinks industries
- sugar is the current target
50
what are some public health policies
- sugar tax
- alcohol minimum unit pricing
- progressive income tax - redistribution
51
what are the dimension of healthcare equality
- person centred
- safe
- effective
- efficient
- equitable
- timely
52
what are the priorities for NHS service provisions
- demands on healthcare systems always greater than resources
- major financial constraints in next few years
- on response to increasing demands and limited resources is to direct resources to particular problems
53
what is the criteria for a public health problem
- prevalence of condition
- impact of condition on individual level (fatal etc)
- impact on wider society (economic costs)
- condition preventable and effective treatments available
54
what is used for the clinical guideline for public health
- SIGN
| - SDCEP
