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Dental Public Health and outreach for FINALS > Trends in oral health > Flashcards

Trends in oral health Flashcards

1
Q

What is epidemiology? (1)

A

“the orderly study of diseases and other
conditions in human populations where
the group and not the individual is the
unit of interest”

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2
Q

Epidemiology may be viewed as based on two assumptions about human disease… (2)

A
  1. … does not occur at random,
  2. … has causal and preventive factors that can
    be identified through systematic investigation of
    different subgroups of individuals within a
    population in different places or at different
    times.”
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3
Q

Uses of epidemiology (3)

A
  • Assess oral health & need for dental services
  • Identify causes of disease
  • Evaluate effectiveness of care
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4
Q

Importance of epidemiology for you: describes (2)

A
  • levels of dental disease and

* needs of population served by you

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5
Q

Importance of epidemiology for you: distribution of disease (2)

A
  • Determines way you should diagnose

* Determines type of work you will do during week

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6
Q

How do we measure disease? (2)

A

An index: a systematic method of measuring or
recording a disease or condition from established
criteria

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7
Q

Choice of index depends on (3)

A

– Type of investigation
– Nature of information required
– Ability to reproduce the findings

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8
Q

Dental conditions measured in surveys (6)

A
  • Caries
  • Periodontal disease
  • Trauma
  • Malocclusion
  • Oral cancer
  • Fluorosis
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9
Q

Dental caries and treatment experience (5)

A 
DMF / dmf
Covered in Y1
Decayed (D or d) - untreated disease
Missing due to caries (M or m)
Filled due to caries (F or f)
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10
Q

Scoring dmft/ DMFT (5)

A 
Record of previous and current disease
Score of 1 given to each D, M or F tooth
Usually expressed as D + M + F = total DMFT
Max possible score = 28 DMFT or 20 dmft
For groups, calculate mean dmft/DMFT
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11
Q

Dental indices - caries (3)

A

Care index = F x 100
DMF
• Access and utilization of dental care
• Type of dental care provided

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12
Q

Problems with DMF (5)

A

• Assumes missing and filled teeth were once carious
but could be missing for other reasons (e.g.
periodontal disease or dental trauma)
• Restorations could have been placed for other
reasons (e.g. Preventive Resin Restorations, dental
fractures)
• Assigns equal weight to filled, missing and decayed
• DMF is irreversible (can’t be reduced)
• See lecture in Y2

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13
Q

Dental indices: periodontal disease (3)

A

Community periodontal index of treatment need (CPITN)
• within NHS adapted & re-named Basic Periodontal Exam
• special blunted probe

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14
Q

Dental indices: dental trauma index (4)

A

0 Tooth present without any evidence of trauma
1 Unrestored enamel fracture that does not include dentine.
2 Unrestored fracture including enamel and dentine.
3 Unrestored fracture including enamel and dentine with pulp
exposure
4 Missing tooth due to dental trauma

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15
Q

Dental indices: malocclusion - IOTN components (2)

A

Aesthetic component:
• Grade 1 to Grade 10 = most to least aesthetic
arrangement of the dentition
Dental health component:
• 1 to 5 = no need to great need for treatment

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16
Q

Dental indices: oral cancer

A

Incidence
= no. of new cases in a given time period
no. at risk

17
Q

Oral health-related quality of life(5)

A

• Interviews/questionnaires about experience of mouth
• Included in surveys to supplement clinical data
• Oral Health Impact Profile (OHIP-14) widely used
• Includes items on symptoms, function, social &
emotional aspects
• E.g. > 50% of dentate adults reported an oral problem in the past 12 months, most commonly pain

18
Q

Global Oral Health (5)

A

• 60–90% of school children and nearly 100% of adults
have dental cavities.
• Severe periodontal disease is found in 15–20% of middle-aged (35-44 years) adults.
• About 30% of people aged 65–74 have no natural teeth.
• The incidence of oral cancer ranges from one to 10 cases
per 100 000 people.
• 16-40% of children in the age range 6 to12 years old are affected by dental
• provides for the outcome evaluation of national and
community oral health promotion and disease prevention
programmes.
• The data stimulate providers of oral health care in
countries and health authorities to implement preventive oral care programmes by sharing experiences and
ensures data for adjustment of ongoing programmes.
• The information system addresses oral diseases as part of the NCD burdens and it incorporates data on oral
manifestations of HIV/AIDS and oral cancer. trauma.

19
Q

Trends: variations or differences may be (4)

A
  • Age
  • Geographic
  • Socioeconomic
  • Temporal
20
Q

International trends (4)

A 
• Differences between
countries
• Oral disease surveillance
systems introduced by WHO
in 1960s allows comparisons
• From year 2000 database
includes 184 countries
• WHO & Fédération Dentaire
Internationale set a global
goal for 2000 of not > 3
DMFT for 12-year-olds -
achieved by 68% of countries
21
Q

Oral cancer: variation in incidence between countries (5)

A

• E.g. within Asia incidence per 100,000 population is:
– 12.6 in India where oral cancer accounts for up to 40% of all
malignancies among men.
– 4.6 in Thailand
– 0.7 in China
• Worldwide mortality rate for males:
– 3.25 per 100,000 less developed countries
– 2.78 more developed countries

22
Q

Socio-economic trends: five year olds in UK (3)

A

7-fold difference in mean dmft in areas
with lowest & highest caries experience:
– dmft in Maidstone Weald = 0.47
– dmft in North Kirklees = 3.69

23
Q

Socio-economic trends in USA (2)

A

– poor compared to higher income children:
• have twice the caries
• higher risk of caries remaining untreated
– poor compared to higher income adults:
• higher proportion of untreated caries
• more likely to become edentulous

24
Q

Trends in ethnicity (4)

A

• Studies around world have been conducted
to establish trends in ethnicity
• No consensus reached
• Disagreements due to confounding between
ethnicity & socio-economic status
• Data complicated by different dentitions,
assignment of ethnicity, religious differences
& maternal literacy

25
Q

Temporal trends (3)

A

• Regional variations persist
• Caries levels in deciduous teeth not improved
since 1993
• Improvements in permanent teeth continued

26
Q

Implications for dentistry (4)

A
  • Greater specialisation
  • Fewer full dentures for GDPs
  • More domiciliary care
  • Net change in dental workforce?
27
Q

Oral cancer stats (4)

A

• 2% of all cancer cases in the UK.
• Incidence = In 2005 there were 4,926 new
cases of oral cancer
• 2006: 1,696 deaths from oral cancer in the UK.
• Survival rate: 50% at 5 years

Dental Public Health and outreach for FINALS (8 decks)

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