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BDS2 - PMHP > intro to dental public health > Flashcards

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)
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2
Q

what are the 3 broad structures to disease

A
  • disease
  • service
  • risk factors
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3
Q

what is the biggest preventable cause of cancer after smoking

A
  • obesity

- link is widely unknown

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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

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5
Q

what is another preventable cause of cancer

A

alcohol

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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
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7
Q

what is the life expectancy in Scotland currently like

A
  • currently declining

- unsure why

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8
Q

what is the infant mortality like in Scotland

A
  • higher than it should be
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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
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10
Q

how many priorities does PHS have

A

6

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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
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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
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13
Q

what is the best medical journal

A
  • the Lancet

- rarely do oral health however

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14
Q

what is the mouth cancer organisation called

A
  • called mouth cancer foundation

- ‘bite back at it’

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15
Q

when is world AIDS day

A

1st December

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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
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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

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18
Q

what are the 3 levels of prevention

A
  • policy
  • community
  • clinical
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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
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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
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21
Q

what factors drive access to care the most

A
  • socio-economic factors

- low paid jobs may mean people can’t miss work

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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
Q

what is the most common reason for children to go to hospital for GA

A

tooth extractions

26
Q

what is realistic medicine

A
  • patient centred care, shared decision making, avoiding harm, give clinicians and teams power to change what they fo
  • working closely with patients
27
Q

is there any realistic medicine for dentistry yet

A

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
Q

what are the definitions of public health

A
  • 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
Q

what are the 2 things you can talk about in relation to public health

A
  • improving health of population

- improving services

30
Q

what are the stages of clinical practice vs public health practice

A
  • 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
Q

what are the aims of dental public health

A
  • to improve and tackle inequalities in oral health and health care through appropriate preventive, health promotion, anticipatory care and treatment services
32
Q

what are the challenges if dental public health

A
  • reducing oral health inequalities
  • improving oral health
  • orca health importance to general health
  • ageing population = brings with it problems for OH (dexterity)
33
Q

how can you improve oral health and health care services

A
  • 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
Q

what are the main roles of dental public health

A
  • 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
Q

what is epidemiology

A
  • burden pf disease and risk factors
36
Q

what are the main role of epidemiology

A
  • 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
Q

would water fluoridation be good

A
  • would have huge public health benefit
  • would be very cost effective
  • however lots of people against it
38
Q

what is the policy part of prevention

A
  • requires understanding of social, political, economic and environmental factors
39
Q

what is the community part of prevention

A
  • implemented at community level and individual patient level
40
Q

what is the clinical part of prevention

A
  • prevention pivotal to role of clinical dental team (i.e clinicians have important DPH function)
41
Q

what are the determinants of OH status

A
  • 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
Q

what are life circumstances that influence OH

A
  • education
  • commercial influences
  • peer pressure
  • social isolation
  • environment
  • access
  • culture
  • housing
43
Q

what are lifestyle choices that influence OH

A
  • eating
  • smoking
  • alcohol
  • physical activity
  • drug misuse
44
Q

what other factors can affect OH

A
  • deprecation and inequalities
45
Q

what is the violence reduction unit

A
  • 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
Q

how is the PH policy developed

A
  • 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
Q

what are some policies that have been introduced to help public health

A
  • healthy eating bill (2007)
  • tobacco control
  • childsmile
48
Q

what caused the tobacco control to be brought about

A
  • 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
Q

what is the current target to improve OH

A
  • now its the turn of ultra processed food and soft drinks industries
  • sugar is the current target
50
Q

what are some public health policies

A
  • sugar tax
  • alcohol minimum unit pricing
  • progressive income tax - redistribution
51
Q

what are the dimension of healthcare equality

A
  • person centred
  • safe
  • effective
  • efficient
  • equitable
  • timely
52
Q

what are the priorities for NHS service provisions

A
  • 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
Q

what is the criteria for a public health problem

A
  • prevalence of condition
  • impact of condition on individual level (fatal etc)
  • impact on wider society (economic costs)
  • condition preventable and effective treatments available
54
Q

what is used for the clinical guideline for public health

A
  • SIGN

- SDCEP

BDS2 - PMHP (11 decks)

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