oral health and disease in the population Flashcards

1
Q

Why do we insteps groups of people in the population?

A

In order to record the pattern of oral health and disease for geographical areas or groups of people

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2
Q

What is epidemiology?

A

the study of the distribution and determinants of health-related states or events (including disease), and the application of this study to the control of diseases and other health problems

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3
Q

How can information gathered about oral health be used?

A

Can be used to help look at what the dental care need are in the population and help direct appropriate acre to locations

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4
Q

What can epidemiology help us target?

A

targeting of prevention of oral diseases where the patterns in particular locations indicate that extra effort is required to reduce the burden of disease in certain areas or groups.

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5
Q

Name three different approaches ew can take in epidemiology

A
  1. Surveillance and descriptive studies
  2. Analytical studies
  3. Experimental epidemiology
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6
Q

What are the majority of epidemiological studies concerned with?

A

With the surveillance of disease patterns

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7
Q

Give an example of a dental survey that is conducted in the UK

A

Regular surveys conducted to examine how healthy the dentition of children is

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8
Q

What does the term proportionate universalism mean?

A

That you would give healthcare or preventive efforts which are proportional to needs

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9
Q

What can surveillance and descriptive studies be used for?

A

To study distribution of disease

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10
Q

What can analytical studies be used for?

A

To study determinants of disease

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11
Q

What does experimental epidemiology assess?

A

Assess the effects if treatments, preventative measured and interventions programmes

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12
Q

Who do epidemiological surveys help?

A

They help those who plan community health improvements to know whereto target their efforts

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13
Q

What does descriptive epidemiology describe?

A

The distribution of disease, risk factors and determinants of health in population or sub group

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14
Q

Give some features of descriptive epidemiology

A
  1. Theres no hypothesis
  2. Often makes use of routinely collected data
  3. Describes disease in relation to characteristic of the population
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15
Q

What can descriptive epidemiology be useful for?

A

Can be useful in identifying scope for research into causation, service planning and identifying high risk groups and inequalities

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16
Q

Name the most common type of epidemiology

A

Descriptive epidemiology

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17
Q

What stuff do you need to collect when carrying out a descriptive epidemiology survey?

A
  1. What you see in the mouth
  2. Age
  3. Sex
  4. Ethnicity
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18
Q

Give examples of some descriptive epidemiology studies

A

The caries surveys conducted by the British Association for the Study of Community Dentistry (BASCD)

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19
Q

How is the information collected by the caries surveys conducted by the British Association for the Study of Community Dentistry (BASCD) used?

A

Used to study the distribution of disease ie which areas of the UK have higher to lower levels of caries
This is used to compare percentages between different geographical areas and also monitor year on year whether there is more or less caries in the population.

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20
Q

Descriptive epidemiology was pivotal in demonstrating the oral healthy improvements which too place when __________ was introduced

A

Fluoride toothpaste

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21
Q

Who was noted as the first person to conduct epidemiological research?

A

John snow

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22
Q

Give an example of descriptive epidemiology in a noon dental setting

A

study is that conducted by John Snow to study the outbreakof a very dangerous disease

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23
Q

Give examples of descriptive epidemiology for oral health and disease

A
  1. Hopewood house study
  2. Adult dental healthy survey
  3. BASCD survey
    4 General lifestyle survey
  4. National diet and nutrition survey
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24
Q

What does analytical epidemiology explore?

A

Explores the causes an determinants of a certain disease

It is hypothesis testing

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25
Q

Give the types of analytical epidemiology

A

1 Case control

2. Cohort studies

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26
Q

What is the purpose of a case control study?

A

To establish association between exposure to risk factors and a disease

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27
Q

How is a case control study carried out?

A

Members of the population with disease are selected as cases and risk factor information considered retrospectively

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28
Q

What can case control studies be prone to?

A

Bias and confounding

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29
Q

Give an example of a dental case study

A

Risk factors fo dental fluorosis in a fluoridated community

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30
Q

What do we mean by the term incidence?

A

Rate at which new cases of the disease occur in a population during a specified time period

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31
Q

What do we mean by the term prevalence?

A

Proportion of a population that are cases at a specific point in time

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32
Q

Name the types of prevalence?

A
  1. Point prevalence

2. Period prevalence

33
Q

What is point prevalence?

A

Single examination at one point intake

34
Q

What is period prevalence?

A

Proportion of the population that have the disease within a state time period

35
Q

What reduces the prevalence of a disease?

A

Recovery or death

36
Q

How is a cohort study carried out?

A
  1. A group of people in the population are picked (a cohort)
  2. They are split int people exposed with the disease and people who are not
  3. These people are then monitored over time
37
Q

What are the 2 types of cohort Judy?

A
  1. Retrospective

2. Prospective

38
Q

Describe prospective cohort studies

A

They can be tailored to collect specific info into the future

39
Q

What are the drawbacks of a prospective cohort study

A

Might be long wait until you can xaminefor the effects of the exposure adhere might be a high number of drop outs so it can be expensive

40
Q

Describe retrospective cohort studies

A

Looks at historical information at evens of the past info immediately available

41
Q

What are he drawbacks of retrospective cohort studies ?

A

May be incomplete or unreliable

My be relying on peoples memories of distant events

42
Q

Data collected during a cohort study has sat done to it and why?

A

It must be manipulated to take into account the age ad sex distribution
It is then presented as standardised ratios

43
Q

Give an example of a cohort study?

A

Social class difference in ischaemic heart disease (IHD) in men

44
Q

Give some strengths of case controlled studies

A
  1. More suitable for rare diseases
  2. Can examine one effect but in several exposures
  3. Cheap and quick to conduct
45
Q

Give some disadvantages of case controlled studies

A
  1. Prone to bias in measuring exposure

2. may be difficult to elucidate cause and effect

46
Q

Give some advantages of cohort studies

A
  1. Suitable for rare exposures
  2. Can examine multiple effects of single exposure
  3. Can minimise bias in measuring exposure
  4. better at elucidation cause and effect
47
Q

Give some disadvantages of cohort studies

A
  1. Expensive and slow to conduct

2. Prone to drop out

48
Q

What do both cohort and can control have in common?

A

They both study test hypothesis about the possible causes and determinants of disease

49
Q

What are experimental epidemiological most appropriately used for?

A

They are the most appropriate mechanism through which casual relationship can be established

50
Q

What is experimental epidemiology based on?

A

Based on the principle of comparing outcomes between two groups which are identical in respects except that one grip is expose to a suspected casual agent or preventative treatment

51
Q

What is experimental epidemiology most useful in evaluating?

A

Most useful in evaluating new materials and drugs

52
Q

Give an example of an experimetnal epidemiology study

A

The vipeholm study which investigated how caries activity was influenced by inferring diets

53
Q

How is epidemiology used?

A

To help plan services part of oral health needs assessment

54
Q

What can epidemiology show us?

A
  1. The pattern and prevalence of disease by location over time
  2. Possible associations between diseases and their causes
  3. Experiments to determine whether a risk or prevention is truly associated with a particular disease or with health
55
Q

What does epidemiology tell planers?

A

Tells planners and policy makers about the geographical distribution of disease and its pattern within the population itself

56
Q

What have surveys shown us regarding healthy care and equality

A

That there are many inequalities in health

57
Q

Give examples of some inequalities in health

A
  1. Health divide between rich and poor remains
  2. Life expectancy the same as in the 1950’s
  3. The more affluent you are the healthier you will be
  4. Differences in opportunity, access to services material resources and lifestyle choices
  5. Health inequalities can continue through generations
58
Q

Why do health inequalities occur?

A

Due to differences in health experiences and hath outcomes

59
Q

What are health inequalities often related to?

A
  1. Socio-economic status
  2. Geographical area
  3. age
  4. Disability
  5. Gender
  6. Ethnic group
60
Q

What are social determinants of health?

A

They are conditions of daily living that determine a persons chance of maintaining good health

61
Q

What did sir Micheal marmot review assess?

A

assessed the most effective evidence based strategies for reducing health inequalities in England.

62
Q

What did sir Micheal marmot review find

A
  1. There is a social gradient in health
  2. Health inequalities result from social inequalities
  3. To reduce the gradient actions must be universal, but proportionate to the level of disadvantage ‘proportionate universalism’
63
Q

To reduce health inequalities action is required on which six policy objectives:

A
  1. Give every child the best start in life
  2. Enable all children young people and adults to maximise their capabilities and have control over their lives
  3. Create fair employment and good work for all
  4. Ensure healthy standard of living for all
  5. Create and develop healthy and sustainable places and communities
  6. Strengthen the role and impact of ill health prevention.
64
Q

What is the relationship between general and oral health is affected by

A

social determinants

65
Q

What does the social ecological theory of health explore

A

the relationships between the individual, their environment and disease are brought together

66
Q

How do we address health inequalities?

A
  1. Reduce exposure to risk
  2. Address underlying causes of ill health
  3. Social, economic, environmental factors
  4. Individuals, families
67
Q

Is our Healthcare system based pn need or demand

A

demand

68
Q

What is the inverse care law

A

There will always be those who need healthcare but do not ask for it and those who do not need care but present at healthcare services

69
Q

What was the key milestones in NHS dental care achieved in 2005

A

Choosing Better Oral Health

This describes a move away from a treatment focused dental service to a more preventive one

70
Q

What was the key milestones in NHS dental care achieved in 2006

A
  1. NHS dental contract

2. PCTs take over the statutory duty to monitor the oral health of their local populations

71
Q

What did NHS dental contracts aim to do

A

This aimed to focus dental services on prevention and give PCTs the flexibility to commission services appropriate to their populations’ needs and reduce inequalities in access.

72
Q

How did PCTs taking over the statutory duty to monitor the oral health of their local populations benefit dental care

A

informs the evidence-based commissioning of new services, and facilitates the best use of resources in improving dental health and reducing inequalities through oral health promotion programmes and wider public health measures.

73
Q

What was the key milestones in NHS dental care achieved in 2009

A

Delivering Better Oral Health advises population approach with advice and actions for all patients with additional interventions aimed at those patients at risk

74
Q

What was the key milestones in NHS dental care achieved in 2010

A

PCTs and SHAs are disbanded and a new organisation for healthcare is initiated

75
Q

What are the 2 parts that make up the structure of dentistry?

A
  1. Primary care

2. Secondary care

76
Q

Who provides Primary care

A

provided by General Dental practices

77
Q

What is Primary care

A

salaried dental services

78
Q

Who provides Secondary care

A

provided in Hospital trusts

79
Q

What is included in Secondary care

A

restorative, orthodontics, oral surgery, maxillo- facial surgery