introduction to dental public health Flashcards

1
Q

what are major health concerns today?

A
  • general health antibiotic resistance;
  • Oral health caries – globally prevalent issue;

Communicable and non-communicable diseases (NCDs), (NCDs are the global problems)

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2
Q

features of the developing Public Health Scotland

A

april 2020

- 6 priorties

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3
Q

how can we improve sugar advice?

A

more defined (like alcohol and smoking)

need to clarify how to assess (diet diaries: vague, difficult to implement, trusting patient honesty)
- Complex to assess – hidden, added, natural, frequency

need to develop better motivational messages and interventions.

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4
Q

awareness campains

A

Social marketing trying to address public health challenges (obesity, smoking).

Helps point less widely known links.

Critics say fuels a blame culture slightly – targets peoples lifestyle choices. Socieo economic factors are often the cause of the cause of the condition (e.g. poor, inequalities drive obesity sometimes)

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5
Q

what types of services are required to tackle these problems? (3)

A
treatment 
- Provision of care
Primary: GPs, GDPs
Secondary: hospitals
Tertiary care: Highly specialised units e.g. cleft palates

screening/anticipatory care
(breast/bowel cancer vans – early detection. Dentists have role in early detection for oral cancer and caries (white spot lesions))

prevention: social/environmental
(3 levels: policy, community, clinical)

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6
Q

primary care

A

GPs, GDPs

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7
Q

secondary care

A

hospitals

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8
Q

tertiary care

A

highly specialised units e.g. cleft palates

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9
Q

inverse care law

A

deprived groups often suffer

most health care provided to those who need it least

highest need, have less access (can be other barriers not just geographical e.g. socieo-economic)

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10
Q

what health care do deprived people often access?

A

inappropriate services as go straight to emergency care due to inverse care law
- high cost

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11
Q

national reports recommendation for the future

A

reorienting services

Primary care system to be focused on prevention of ill health and detection & management of problems at early stage
- Less drill and fill and more anticipatory model

Preventive, anticipatory care where possible rather than only reactive management

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12
Q

anticipatory care definition

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 admissions for people with pre-existing conditions”

“Care with an eye to the future”

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13
Q

features of realistic medicine and dentistry

A
  • Patient centred
  • Shared decision making
  • Reduce harm and waste
  • Reduce unwarranted variation in practice and outcomes
  • Manage risk better
  • Become improvers and innovators
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14
Q

public health definition

A

“The science and practice of preventing diseases, promoting health and improving quality of life through the organised efforts of society”

It is about improving population health rather than treating individuals
But, it is also about putting the practice of dentistry in context within society

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15
Q

2 activities of public health

A

improving health of population and improving equality of services

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16
Q

what does oral health consist of?

A

means more than ‘good teeth’ - it is integral to general health, is essential for wellbeing, and is a determinant of quality of life.

It allows us to speak, smile, kiss, touch, taste, chew, swallow and cry.

Conversely, oral disease can lead to significant time lost from school, work and other activities.

17
Q

features of individual clinical practice

A
  • history and examination
  • diagnosis
  • treatment planning
  • treatment
  • follow up and review
18
Q

features of public health practice

A
  • assessment of need for population
  • analysis of data
  • planning of services to meet needs
  • programme implementation ‘
  • evaluation of outcome
19
Q

dental public health aims

A

To improve and tackle inequalities in oral health and health care through appropriate preventive, health promotion, anticipatory care and treatment services

Driven by inequalities, cannot ignore this – will widen inequalities and create more issues

20
Q

4 challenges in dental public health

A

Reducing oral health inequalities – reduce gap

Improving oral health

Oral health importance to general health

Ageing population (improving: edentulous patients drop, retaining teeth to longer age - challenges)

21
Q

what is now recommended for oral health care?

A

preventative and anticipatory care over reactive management

In general, causes of main dental diseases known
- Numerous preventive measures exist

diseases still prevalent
- In UK, very small % of NHS budget on prevention (health economics)

22
Q

main roles of dental public health

A
  • epidemiology
  • (oral) health needs assessment
  • preventing disease & (oral) health improvement
  • addressing (oral) health inequalities
  • policy development
  • development and implementation of local (oral) health strategies
  • service development the development of clinical pathways
  • patient safety
  • improving governance systems (for dentistry) and quality improvement
  • evaluating (oral) health services
  • teaching and training;
  • research
23
Q

role of epidemiology in dental public health

A

Monitoring infectious diseases
- e.g. cancer registries

Monitoring non-infectious diseases
- e.g. dental caries surveys

Measuring health & inequalities in health

Determine risk factors associated with diseases

Strategic planning

Evaluation of effectiveness of service provision
(Burden and risk factors of disease)

24
Q

what does prevention and oral health improvement require?

A

understanding of social, political, economic and environmental factors

25
Q

what level is prevention and oral health improvement implemented at?

A

community and individual patient level

26
Q

determinants of oral health status

A

Factors influencing eating habits and use of fluoride products major determinants of dental health status:

  • not always within control of individual
  • financial restraints
  • access issues
    (e. g. consumables & health services )
  • family, peer pressure
  • education
27
Q

influences on health

A

life circumstances

  • general education
  • commercial influences
  • peer pressure
  • social isolation
  • environment
  • access
  • culture
  • housing

Lifestyle

  • eating
  • smoking
  • alcohol
  • physical activity
  • drug miss-use

deprivation/inequalities

28
Q

commercial determinants influence on health

A

determine what we eat (commercials, offers, product placement, targeting – very unregulated industry currently. Need to tackle like tobacco and alcohol)

29
Q

what does developing public health policy require? (3)

A

lobbying

negotiation

facilitating change

  • influencing policies with impact on oral health, eg:
    involved in drafting regulations for new Schools Health Promotion and Nutrition Bill (2007)
  • Healthy Eating in Schools (2008)
    tobacco control
  • UK: regulation to provide 15 new health warning on cigarette packages, effective 1st October 2008
    NHS dental primary care service for children
30
Q

what is the objective for dental public health?

A

produce health gain for population

31
Q

what is the root of tackling public health issues

A

Price i

  • tax (sugar (milk and fruit juices are exempt),
  • minimum unit price (alcohol),- - - ban 2 for 1 promotion
  • Progressive income tax – redistribution income (drives behaviours and risk)
32
Q

6 dimensions of healthcare quality

A
  • Person-centred
  • Safe
  • Effective
  • Efficient
  • Equitable
  • Timely
    way of viewing in a range of ways
33
Q

developing guidelines and guidance

A

large part of public health

- creating evidence base

34
Q

priorities of NGS service provision

A
  • Demands on health care systems always greater than resources
  • Major financial constraints in next few years
  • One response to increasing demands and limited resources is to direct resources to particular problem areas – cost restraints
35
Q

Public health criteria

A

Prevalence of the condition

Impact of the condition on an individual level
- e.g. fatal, debilitating etc

Impact on wider society
- e.g. economic costs to country – hospital bed is expensive

Condition is preventable and effective treatments are available

36
Q

how to decide if a public health issue?

A

use public health criteria