Strategies for Oral Health

Question 1

What information is required to understand problems with oral health ?

Answer 1

Socio demographic population profile - age, ethnicity, deprivation
Disease levels - epidemiology, distribution, trends
Public concerns - priorities, views of services, demands
Existing service provision - availability, cost, location, access, range of treatment

Question 2

What is the purpose of a needs assessment ?

Answer 2

Identify and quantify the problem in terms of wants, demands and needs

Question 3

What are wants, demands and needs?

Answer 3

Wants - individuals subjective assessments eg white fillings
Demands - willingness to pay
Needs - professional judgement about capacity to benefit

Question 4

What is the definition of a “need for medical care” ?

Answer 4

When an individual has an illness or disability for which there is an effective and acceptable treatment or cure

Question 5

Need is …

Answer 5

Subjective - professional judgment varies
Dynamic - new technology, drugs, information
Relative - wealth of the population
Not finite

Question 6

What is a needs assessment ?

Answer 6

Evidence based approach to commissioning and planning health services using objective and valid methods

Question 7

What are needs assessments necessary ?

Answer 7

Facilitates planning and commissioning,
Health care inflation,
Advances in medical care,
Changing demographics,
Limited resources,
Inverse care law,
Consumerism and accountability,
Competing priorities

Question 8

How are oral health strategies evaluated ?

Answer 8

Evaluation built into project not just at the end,

Does it work, is it acceptable, correct target population, how are resources being used ?

Question 9

How can strategic approaches to health improvement affect the whole population ?

Answer 9

Lower average level of risk

Question 10

How can strategic approaches to health improvement affect high risk groups ?

Answer 10

Identify high risk population through screening and offer treatment or prevention

Question 11

What are the advantages of whole population strategies?

Answer 11

Tackles underlying health determinants, 
Avoids victim blaming,
Enables healthy choices to be made,
Benefits the whole of society,
Generally very effective

Question 12

What are the disadvantages of whole population strategies ?

Answer 12

Long timescale,
Powerful vested interests,
Mobilising action - need to form alliances, lobbying and gaining support
Adverse effects,
Issues of individual free choice,
Prevention paradox - small individual risk reduction

Question 13

What is meant by the term “prevention paradox” ?

Answer 13

For one person to benefit, many people have to change their behaviour even though they receive no benefit or even suffer from the change

This is because the majority of people are at low risk and only a minority are in the high risk group

Question 14

What is the aim of a high risk strategy ?

Answer 14

Reduce the risk for individuals identified as being at greater risk than the general population

Question 15

What are the advantages of the high risk strategy ?

Answer 15

Cost effective use of resources,
Intervention appropriate to individual,
Readily accommodated within ethos and organisation of medical care

Question 16

What are the disadvantages of the high risk strategy ?

Answer 16

Medicalises prevention,
Non selected individuals at low risk not no risk,
Contribution to overall control of disease may be small,
Poor ability to predict future of individuals

Question 17

What is a targeted population strategy ?

Answer 17

Whole population approach adapted for a local community

Question 18

What is involved in a targeted population strategy ?

Answer 18

Identify high risk groups,
Apply intervention,
Not all people at risk will be included in target group,
Not everyone win target group is at increased risk

Question 19

What is the purpose of a targeted population strategy ?

Answer 19

Reducing inequalities

Question 20

What are the features of the common risk factor approach to strategies for oral health ?

Answer 20

Recognises many diseases share risk factors,
Takes direct action to common risks and underlying social determinants,
Improvements in a range of common conditions,
Partnership working

Question 21

what is a strategy ?

Answer 21

a plan of action for obtaining a specific goal or result

Question 22

why should oral health strategies be planned ?

Answer 22

maximises results with limited resources, proactive rather than reactive decisions, enables priorities to be set

Question 23

what are the principles of health strategy design ?

Answer 23

aim - what is to be achieved,
objectives - what steps need to be taken to achieve aim,
data collection - identity problem, understand problem, possible solutions, evaluation and feedback

Question 24

what are the stages of the rational planning cycle?

Answer 24

assessment of need,
options,
decisions policy,
available resources,
implementation, 
evaluation

Question 25

why are strategies needed ?

Answer 25

oral diseases are preventable but very common,
understand why diseases have not been prevented,
complex array of factors,
many outside health

Question 26

give an example of dental health strategy

Answer 26

national strategy, Choosing Better Oral Health - An Oral Health Plan for England, 2005 informed 2006 dental contract based on UDA’s

Question 27

what were the key aims for choosing better oral health 2005 ?

Answer 27

reduce prevalence of oral disease ,

reduce oral health inequalities across all age groups in England