Oral Health Promotion

Question 1

What is the global prevalence of oral conditions in the population?

Answer 1

Nearly 48% of the world population (3.5 billion people) suffer from some sort of oral conditions - 2.5 billion of them suffer from dental caries.

Question 2

Have prevalence of oral conditions increase?

Answer 2

Not in terms of percentages of instances but the number of people with the conditions have increased due to increased population.

Question 3

What can you comment on the general oral health status pattern in Australian population?

Answer 3

It is socially patterned

Question 4

Can you state that “caries is a multifactoria disease”?

Answer 4

In a sense - no.

Because caries is primarily driven by free sugars - remove the sugars and there will be no caries.

But only because there other modifying factors - we claim that caries is a multi-factorial disease.

This is an argument made by Aubrey Sheiham, a dential rsearch of University College London

Question 5

What is the potential issues with increasing the oral health workforce in order to improve overall oral health in global population?

Answer 5

1. Logistic challenge with the geographical distribution of dental practitioners
2. Dentist-to-population ratios are only a crude measure of oral health-care service availability, and are not correlated to disease prevalence
3. Individual actions in clinical settings are unlikely to prevent future disease

Question 6

What is the potential issues with increasing awareness about oral health-related behaviours in the population to improve overall oral health in global population?

Answer 6

1. If this worked (alone) and actually changed behaviours, we would have different figures by now
2. Dental education campaigns, when not articulated with other actions may not be effective overall and may also increase inequalitie

Question 7

Why behavioral interventions that do not take into account the social determinants of health are unlikely to work?

Answer 7

1. Since patterning of health behaviours reflects underlying inequalities in material and social resources, it is unlikely that the growing inequality in health behaviours can be addressed without tackling these social factors
2. The likelihood of adhering to health-related behaviours following universal education campaigns is also shaped by the social determinants of health

Question 8

What is health promotion?

Answer 8

Health promotion is a process of enabling people to increase control over and to improve their health.

Question 9

Please describe the health impact pyramid from least population impact to most population impact.

Answer 9

1. Counseling & Education
2. Clinical interventions
3. Long-lasting protection interventions
4. Changing the context, so the defaul choice is healthy
5. Socioeconomic factors

Question 10

What is an example of increased indivdual effort and low population impact activity?

Answer 10

Counselling & education of an individual in regards to caries.

It result in the ost benefit to the individual but the efforts by the individuals must be high, it is more suseptible to socio-economic difference and has minimal impact on overall population.

Question 11

What is an example of low level individual effort and high impact on population?

Answer 11

Universal water fluoridation to prevent caries.

This is an example where an individual needs to put low effort, yet statistically we have evidence of high impact on populations.

These universal adjustments also help to deal with socio-economic inequalities as we can regulate the aount of fluoridation depending on the gneral community need.

Question 12

What is health according to the 1948 WHO definition?

Answer 12

It is a state of complete physical, mental and social well-being and not merely the absence of disease and infirmity.

Question 13

What are the principles of health promotion?

Answer 13

1. Consider the population as a whole
2. Action directed towards determinants/ cause of health
3. Diverse approach
4. Encourage public participation
5. Recognise the importance of health professionals in promoting health

Question 14

What are some of the pre-requisites for health according to the Ottawa Charter?

Answer 14

1. Peace
2. Shelter
3. Education
4. Food
5. Income
6. A stable exosystem
7. Sustainable resources
8. Social justice and equity

Question 15

What are some of the action areas of health promotion according to Ottawa charter?

Answer 15

1. Build healthy public policy - think sugar tax
2. Create supportive environments - think ban of sugary foods in schools
3. Strengthen community action - support your local dental programs such as the indigenous oral health unit
4. Develop personal skills - raising awareness with patients
5. Reorient health services - focus on both high risk and popuation approach

Question 16

What are the different types of “needs”?

Answer 16

1. Normative need - expert opinion on needs of an individual
2. Perceived need - based on the individual’s perception
3. Expressed need - defined based on people’s use of service
4. Comparative need - when different types of need are interpreted considering other populations’ standards

Question 17

What is an unmet need?

Answer 17

Differences between services that are needed and services that were actually received

Question 18

What are the components of an oral health needs assessment?

Answer 18

1. Systematic approach
2. Normative/ preceived/ expressed needs addressed
3. Likelihood of engaging in interventions
4. Workforce and skills requirement
5. Effectiveness of interventions

Question 19

What are three aspect of pubic health that helps us to view it?

Answer 19

1. Disease prevention - action to reduce or eliminate or reduce the onset, causes, complications or recurrence of disease
2. Health protection - crafting a safe environment
3. Health promotion - process of enabling people to increase control over and to improve their health

Question 20

What is the main difference between high risk approach vs the population approach?

Answer 20

The main difference are:

• Exposures with high individual risk can have a small impact on population risk if the exposure is rare (aka people with sever conditions are very rare - thus intervention is not as widespread)
• Exposures with low individual risk can have a big impact on population health if exposure is widespread (aka people with not so severe conditions are common - thus intervention is more widespread)

Question 21

What is a relative risk?

Answer 21

It is risk compared to other populations with 1.00 being equal risk between populations and values of more than 1.00 results in higher risk.

Question 22

What are the advantages of high risk approach?

Answer 22

1. Beneficial for the individuals
2. Important in addressing inequalities

Question 23

What are the disadvantages of high risk approach?

Answer 23

1. Does not change population levels of disease
2. Issues in identifying who is at risk
3. Does not change the drivers in the population

Question 24

What are the advantages of population approach?

Answer 24

1. Tries to remove the reason why the disease is common
2. Almost everyone benefits
3. May have a large impact at a population level

Question 25

What are the disadvantages of population approach?

Answer 25

1. May not address health inequalities
2. Does not represent a large benefit to the individual

Question 26

What are some of the levels of prevention?

Answer 26

1. Primary prevention
2. Secondary prevention
3. Tertiary prevention

Question 27

What are some of the example of secondary prevention?

Answer 27

Secondary prevention occurs to treat asymptomatic disease - example: small restorations

Question 28

What are some of the example of primary prevention?

Answer 28

Primary prevention occurs to stop the disease - example: water fluoridation

Question 29

What are some of the example of tertiary prevention?

Answer 29

Tertiary prevention occurs in established diseases or established disease with complications - example: full mouth rehabilitation

Question 30

What are the basic principles that guide health promotion strategies?

Answer 30

1. Using evidence to guide our decisions about interventions
2. Consistently evaluating the effectiveness of interventions in terms of their impact