Trends in Oral Health Flashcards
Define epidemiology
Orderly study of diseases and other conditions in human populations where the group and not the individual is the unit of interest
Importance of epidemiology?
Shows distribution and determinants of dental diseases
Can assess oral health and need for dental services, identify determinants of disease, evaluate effectiveness of care
Describes levels of dental disease and needs of population served by you - it will determine the type of work you will do
What is an index?
A systematic method of measuring or recording a disease or condition from established criteria
Choice of index depends on:
- Nature of information required
- Ability to reproduce findings
What dental diseases are measures?
Caries PD Trauma Malocclusion Oral cancer Fluorosis
Caries most popular index?
DMF/dmf (lower case primary teeth)
Decayed - untreated disease (D or d)
Missing due to caries (M or m)
Filled due to caries (F or f)
How does the DMFT work?
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
Limitations of DMFT/dmft?
Assumes missing and filled teeth were once carious but could be missing for other reasons (trauma, perio)
Restorations could have been placed for other reasons (PRR, fractures)
Assigns equal weight to filled, missing and decayed:
- Assigns equal weight to be filled, missing and decayed
- DMF is irreversible
- Age sensitive
- No indication of current disease status
What is the care index?
Shows access and utilisation of dental care
Some indication of type of care provided
Care index = F/DMF x 100
Community periodontal index of treatment need (CPITN) - What is this?
Dental indices for periodontal disease
Within NHS adapted and re-named Basic Periodontal Exam
0-4 grading
Shallow pockets 4.5-5mm = 3
Deep pockets >5.5mm = 4
Dental indices for dental trauma?
Dental trauma index (O’Brien)
Assessed through the extent of the trauma
0 = No evidence of trauma to tooth 1 = Unrestored enamel fracture, 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
Dental indices for malocclusion?
Index of ortho treatment need (IOTN) Aesthetic component - Grade 1 to grade 10 (10 = most) Dental health component - 1 to 5 = no need to great need for treatment based on occlusal deviations
NHS tx if index greater than 3.6
How to work out the incidence of oral cancer?
No of new cases/no at risk (whole population)
in a given time period
Other measures to record oral health related quality of life issues?
Interviews/questionnaires about experience of their mouth
Included in surveys to supplement clinical date
Oral health impact profile
Items on symptoms, function, social, emotional aspects
Percentage of population with cavities and perio?
60-90% of school children and nearly 100%of adults have dental cavities
Severe periodontal disease in 15-20% of middle aged (35-44yrs) adults
England’s dmft and care index?
0.94
Care index = 11.2%
Why may indices differ across the UK?
Age
- Gingival inflammation and dentures increase with age
Geographic
Socioeconomic status
- 7 fold difference in mean dmft in areas with lowest and highest caries experience
Ethnic groups
- Apparently no difference, socio-economic status is reason
Temporal (time)
- Improvements in permanent teeth continued but caries in primary teeth not improved
- People are more likely to retain teeth now
Examples of dental epidemiological surveys?
National - Child dental health - Adult dental health Local - Public health England dental epidemiology programme - Cancer registeries
What to the epidemics mean for service planning in dentistry?
Fewer full dentures Greater specialisation More domiciliary care Change dental workforce? More dental public health?
Oral cancer epidemics?
2% of all cancers is UK
Survival rate 50% at 5yrs
Rising
Effectiveness of interventions?
Toothpaste
- Decrease decay in 5yr olds
Water fluoridation
What did the health monitoring report 2018 find?
5yr olds caries experience reduced by 17% in least deprived and 28% in most deprived
Hosp admissions reduced by 59%
Fluorosis 10.3% v 2.2%
