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Need to Know > PMHP need to know > Flashcards

PMHP need to know Flashcards

1
Q

what is the optimal dose of fluoride in drinking water?

A

1ppm
1mg/l

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2
Q

name 2 foods and/or drinks other than water which are good natural sources of fluoride

A
  • fluoridated salt
  • fluoridated milk
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3
Q

list 4 methods of topical fluoride application for an 8 year old

A
  • fluoride varnish 22,600ppm at least 2x per year
  • fluoride toothpaste 1500ppm
  • fluoride tablets 1mg fluoride daily
  • fluoride mouth rinse 225ppm
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4
Q

how does topical fluoride help prevent caries?

A
  • fluoride slows down development of decay by stopping demineralisation of dentine
  • makes enmale more resistant to acid attack from plaque bacteria
  • speeds up remineralisation
  • can stop bacterial metabolism at high concentrations to produce less acid
  • fluoride that enters the tooth produces fluoroxyapatite which makes the tooth much stronger once remineralisation occurs
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5
Q

what daily dose of fluoride tablet would you give to a child…
* age 4 yeats
* high caries risk
* area with <0.3ppm fluoride in water supply

A

o.5mg/day

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6
Q

what is the recommended maximum weekly alcohol intake?

A
  • no more than 14 units per week
  • should be spread evenly over 3+ days
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7
Q

what acts regulate alcohol in Scotland?

A
  • criminal justice and licensing act 2010
  • alcohol etc. act 2010
  • air weapons and liscensing act 2015
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8
Q

what has reduced alcohol consumption in Scotland?

A
  • minimum pricing
  • ban on multi-drink promotions
  • lower drink drive limits
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9
Q

what are the chairside interventions that can be used to help somoene with an alcohol problem?

A
  • 5As (ask, advise, assess, assist, arrange)
  • 2as 1R (ask, advise, refer)
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10
Q

describe what incidence means

A
  • number of new disease cases developing over a specific period of time in a defined population
  • obtained from longitudinal studies or derived from registers
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11
Q

what is the incidence rate?

A

the number of new cases of a disease in a period/number of individuals in the population at risk

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12
Q

define prevalence

A

the number of affected indivduals in a population at a given time
estimates are obtained from cross-sectional studies or derived from registers which can relate to attributes to absence or presence of disease

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13
Q

what does SIMD stand for?

A

scottish index of multiple deprivation

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14
Q

what is the SIMD?

A

an area based index which uses a range of data to decide which neighbourhoods are most deprived by ranking data such as education and employment in order of deprivation from 1-5/10

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15
Q

what are the 7 factors of deprivation measured in the SIMD?

A
  • employment status
  • income
  • health and care services
  • geographic access to services
  • crime
  • housing, living and working conditions
  • education, skiils and training
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16
Q

what are the four key design elements of randomised control trials?

A

specification of participants
control/comparison groups
randomisation
blinding/masking

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17
Q

name an advantage of randomised control trials

A

provide the strongest and most direct epidemiologic evidence for causality

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18
Q

give disadvantages of randomised control trials

A

more difficult to design and conduct than oberservational studies
not suitable for all research questions
high costs
still some risk of bias

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19
Q

what is a cross-sectional study?

A

observational study that analyses data collected from a population, or a representative subset, at a specific point in time

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20
Q

what is a case-series report?

A

description of the medical history of one or more patients

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21
Q

what is a case-control study?

A

people with a disease are matched to those without it and earlier exposure to different factors are compared

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22
Q

what is a cohort study?

A

participants are recruited to a study and followed up over time. Exposures and diseases are measured prospectively

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23
Q

what is a systematic review and meta analysis?

A

all the evidence for RCTs looking at effectiveness of a particular treatment are synthesised

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24
Q

what are case-series reports used for?

A

hypothesis generation
to identify a new disease outcome

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25
Q

what are the disadvantages of case series reports?

A

cannot demostrate valid statistical associations
lack of control group

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26
Q

what are cross sectional studies used for?

A

estimating prevalence of a disease
to investigate potential risk factors

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27
Q

what are the disadvantages of cross-sectional studies?

A

recall bias
causality
confounding factors

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28
Q

what are case-control studies used for?

A

looking at potential causes of a disease

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29
Q

what are the disadvantages of case-control studies?

A

confounding factors
recall/selection bias
time relationships (did exposure occur before disease)

30
Q

what are cohort studies used for?

A

estimating incidence of disease
investigating cause of disease
determining prognosis
timing and direction of events

31
Q

what are disadvantages of cohort studies?

A

controls are difficult to identify
confounding factors
blinding is difficult
need large samples for rare diseases
very expensive and time consuming

32
Q

what does a confidence interval do?

A

tells us the range of values that a true population treatment effect is likely to lie

33
Q

what does a confidence interval that overlaps the value of no difference between treatments indicate?

A

there is insufficient evidence for a difference. between the treatment and control group in the population

34
Q

what does it mean if the confidence interval overlaps 1?

A

there is insufficient evidence that there is a difference between the drug and the placebo

35
Q

what is the absolute risk difference?

A

the difference in risk between groups

36
Q

what is the value of no difference?

A

when there is no absolute risk difference

37
Q

what is the ‘number needed to treat’ (NNT)?

A

the number of patients you would need to treat to prevent one patient from developing the disease/condition/outcome

38
Q

what is the risk ratio?

A

number of events of interest/
total number of observations

39
Q

what is the odds ratio?

A

number of events of interest/
number without the event

40
Q

what does a P value less than 0.05 mean?

A

you reject the null hypothesis
your results are significantly significant

41
Q

what is the dosage of fluoride tablets given to children?

A

6 months- 3 years= 0.25mg/d
3-6 years= 0.5mg/d
6+years= 1mg/d

42
Q

what dosage of fluoride mouthwash would you prescribe to children?

A

225ppm
age 6+ only

43
Q

what are the symptoms of fluoride toxicty?

A
  • nausea
  • abdominal pain
  • diarrhoea
  • vomiting
44
Q

what are the general health effects of smoking?

A
  • narrows arteries and increases atherosclerosis
  • increased risk of stroke
  • increased chest infections, COPD, bronchitis and lung cancer
  • increased stomach ulcers and stomach cancer
  • increased risk of CHD and heart attack
  • can cause macular degeneration and peripheral vascular disease
45
Q

what are the oral health effects of smoking?

A

increased risk of oral cancer
increase in periodontal disease, alveolar bone loss, attachment losss, pocket formation
increased risk of dry socket after dental extractions
halitosis and xerostomia
staining of teeth and restorations
nicotine stomatitis

46
Q

what are recent health promotion approaches in Scotland that have reduced smoking?

A
  • age of purchase went from 16 -18
  • plain packaing onf tobacco with health warnings
  • packets no longer visibly on sale
  • no longer in vending machines
  • public smoking ban in 2006
47
Q

what types of approaches can be used for smoking cessation in the dental practice?

A

5 As- ask, advise, assess, assist, arrange
ask, advise, refer

48
Q

what periodontal phenomenom is experienced by smokers when trying to quit?

A

rebound gingivitis due to increased vascularity

49
Q

what is a null hypothesis?

A

general statement suggesting that there is no statistical significance in a set of data

50
Q

how do you calculate an odds ratio?

A

no. time x occurred/no. times x never occurred
DIVIDED BY
no. times y occurred/no. times y never occurred

51
Q

give roles of epidemiology

A

to assess people’s risk of disease
to study the causes and determinants of disease
to develop preventive programmes
to evaluate interventions e.g.oral cancer screening

52
Q

What are the forms of abuse that may be involved in domestic abuse?

A

Physical violence
Verbal abuse
Emotional abuse
Sexual abuse
Financial Abuse

53
Q

What process should you follow to ask about the possibility of domestic abuse

A

AVDR

Ask - ask about abuse in a private setting

Validate - show you are concerned about them

Document - be specific and detailed, use patients own words and describe injuries in as much detail as possible

Refer - signpost to appropriate services

54
Q

What are physical signs you may see in domestic abuse ?

A

repeated injuries
Bruises at different stages if healing
dental/maxillofacial injuries
facial bruising, strangle marks around the neck or fingertip bruising
TMJ problems
-Orofacial pain

55
Q

What questions would you ask a patient who smokes?

A

what do they smoke?
How often do they smoke?
How long have they smoked for?
Have they ever tried to quit before?

56
Q

What advice would you give to patients about vaping?

A

Explain there is not enough research to determine long term effects of vaping however they are considered safer than normal cigarettes

recommend research backed methods to quitting smoking (e.g. nicotine patches)

don’t use as an alternative to smoking - use as a method of quoting

try not to use in public or infront of children

57
Q

What are the 5 A’s in smoking sessation?

A

Ask - about smoking

Advise

Assess

Assist

arrange follow up for patients

58
Q

What is the shortened approach to smoking cessation ?

A

Ask - establish smoking status and record
Advise
Act - offer referal to local stop smoking services

59
Q

What are services to refer to for smoking cessation

A

local stop smoking services
Local pharmacy

60
Q

What periodontal issue might occur when patients stop smoking?

A

increased bleeding when brushing due to gingival blood flow increasing

61
Q

give examples of primary study designs

A

randomised control trials
cohort studies
case-control studies

62
Q

define dependence

A

a compulsive physiological and psychological need for a habit forming substance

63
Q

what are evidenced based treatments to support quitting smoking

A

nicotine patches
champix
e cigarettes

64
Q

what are local services that could be referred to for smoking cessation

A

local pharmacy
specialist services

65
Q

what do you do if a patient decides now is not the right time to quit smoking

A

record the advice given in the notes
make a note to bring it up in the future
give leaflet to patient and let them know advice is available when they want it

66
Q

what standards were developed to improve the reporting of RCT

A

consort - consolidated standards of reporting trials

67
Q

what does a confidence interval do?

A

tells us the range of values that a true population treatment effect is likely to lie

68
Q

how do you reduce bias in a study design?

A

randomising
double blinding

69
Q

what advise do you give to a patient about e-cigarettes?

A
  • reducing exposure to tobacco
  • likely to be safer but evidence base is still developing
70
Q

how is PICO used in study design?

A

population
intervention
comparison
outcome

71
Q

define significance

A

a measure of the probability of the null hypothesis being true compared to the acceptable level of uncertainty regarding the true answer

Need to Know (21 decks)

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