Community Dental Health

Front 1

Community Health Practice vs. Private Practice
Community Health Practice
1. survey and Needs assemment <-->
2. data analysis <-->
3. program planning <-->
4. program operation <-->
5. funding <-->
6. appraisal or evaluation <-->

Back 1

Community Health Practice vs. Private Practice
Private Practice
<--> 1. health history and examination
<--> 2. diagnosis
<--> 3. treatment planning
<--> 4. treatment
<--> 5. payment
<--> 6. evaluation

Front 2

Four Gov. Levels of Community Dental Health

Back 2

1. International (WHO - world health organization)
2. Federal - national significance (DHHS- dept. of health and human services) <-- published Healthy People 2012 ex: CDC (atlanta, ga)
3. State (state wide)
4. Local (county and city programs) ex: fluoridationa

Front 3

Epidemiology

Back 3

#s!
measured quantitatively

Front 4

prevalence

Back 4

estimated population of poeple who are managing a disease at *any given time*

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Incidence

Back 5

new cases of a particular disease *diagnosed each year

Front 6

Uses of Epidemiology

Back 6

* collecting data to describe normal biological processes
*understanding the natural hystory of a disease process
* measuring the distribution of a disease in a given population
* identifying determinants of dease
*testing hypotheses for prevention and control of a diease through studies
*planning and evaluating healt care services

Front 7

Epidemic

Back 7

unexpectedly large number of cases of diseaes in a particular population at a particular place and time
Ex: menigitis outbreak among senior hs students enrolled at Borah High School during fall quarter 2010)

Front 8

Endemic

Back 8

a disease that occurs regularly in a population as a matter of course
ex. hay fever during spring

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pandemic

Back 9

an outbreak of disease over a wide geographical area (often worlwide)
ex: worldwide swine flu scare

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Descriptive studies

Back 10

determines *who* is getting the disaese *where* and *when* the disease is occuring

Front 11

Experimental studies

Back 11

test *hypothesis* to establish CAUSE

Front 12

null hypothesis
(experimental studies)

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("H0" researcher prefers a null hypothesis)

researcher tries to disprove or nullify ***

ex of H0: Daily flossing does not lower interproximal caries rates

Front 13

alternative hypothesis
(experimental studies)

Back 13

"H1" al alternate way to the explain the phenomenon

ex of H1: Daily flossing decreases interproximal caries rates

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Control Groups
(experimental studies)

Back 14

experimental treatment is withheld: test subjects receive *placebo*

Front 15

Treatment groups
(experimental studies)

Back 15

receive experimental treatment

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blindness
(experimental studies)

Back 16

researcher is unaware of whether the subject is in the control or treatment group during the study
***helps prevent bias***

Front 17

double blinded
(experimental studies)

Back 17

NEITHER researcher nor subject knows who is receiving experimental treatment
***BEST way to prevent bias***

Front 18

Analytical studies - three types

Back 18

aimed at testing hypotheses
1. Retrospective (case-control) study - back in time
2. Prospective study - go into future
3. Longitudinal study - long period of time (1 week-10 years)

Front 19

Random sample

Back 19

every element in the population has an EQUAL chance of being selected (reduces chance of bias)

ex: pick names out of a phone book

Front 20

Stratified sample

Back 20

selecting an element according to certain subgroups

ex: identify all of the dental hygiene schools attending this board review and select two members from each school

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systematic sample

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select every 'nth' to participate

ex:count off by 6 and then form groups based on like numbers

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Judgment sample

Back 22

someone familiar with the population selects the sample
HIGH chance of bias!!

ex: your class president selects fellow students to be in one of four table clinic groups

Front 23

Convenience sample

Back 23

sample group is chosen based solely on conveniance

ex: the first 10 people to walk through the door today were asked to fill out a questionaire

Front 24

Variables
(two types)

Back 24

what is being observed or measured

1. dependent variable
2. independent variable

Front 25

dependent variable

Back 25

outcome of interest
change in response to some intervention

(the DEPENDent variable DEPENDS on the independent variable)

Front 26

independent variable

Back 26

the intervention
manipulated to produce a response

('In' is in BOTH INdependent and INtervention)

Front 27

Descriptive Statistics

Back 27

Measures of Central Tendency

Front 28

data matrix

Back 28

arranges data scores from lowest to highest measures

pg. 95

Front 29

frequency of distribution

Back 29

how often each score occurs

pg. 95

Front 30

ungrouped scores

Back 30

data is presented in ascending or descending order along with the frequency of each score

just count how many people have each score

pg. 95

Front 31

cumulative scores

Back 31

frequency of occurence of scores up to and including any given value

pg. 95

Front 32

grouped scores

Back 32

consecutive intervals (ex: grading)
pg. 95

Front 33

Measures of Central Tendency

Back 33

x-y graph
the mean, the median, and the mode

Front 34

mean

Back 34

average
most common measure of central tendency***
**sensitive to extreme values (range)

Front 35

median

Back 35

divides the distrubition of scores into two equal parts
50% of scores will be above the median; 50% will be below
**NOT affected by extreme high or low scores

Front 36

Mode

Back 36

*BOARD FAVORITE*

MOST frequently occuring score
Affects the skew

Front 37

When data is plotted using a NORMAL curve, the mean, median, and mode are _______!

Back 37

EQUAL!

* a noraml curve is a "bell" or "gaussian"

Front 38

Measures of Dispersion

Back 38

describe how WIDE the scores are around a contral point (in a normal curve, the central point would be the mean, median, and mode)

Front 39

Range

Back 39

the difference between the high and low score of a data matrix ; affected by extremely high or low scores

Front 40

standard deviation

Back 40

Most commonly used method of dispersion in oral hygiene reasearch and reflect the range within the data matrix

the bigger the rang or 'standard deviation' , the wider the distribution curve.

Front 41

Positive skew

Back 41

when more scores fall in the lower range, the curve will have a positive skew when plotted

pg.99

Front 42

Negative skew

Back 42

when more sscores fallin the higher range, the curve will have a negative skew potted

pg. 99

Front 43

Validity

Back 43

does it answer the questions

Front 44

Reliability

Back 44

extent to which the method of measurement CONSISTENTLY performs

Front 45

two groups of examiner reliability

Back 45

intraexaminer reliability
interexaminer reliability

Front 46

intraexaminer reliability

Back 46

consistent performancy by the SAME EVALUATIOR

Front 47

interexaminer reliability

Back 47

consistent performance BETWEEN different examiners is INCREASED by *calibration*

Front 48

Sansitivity

Back 48

diagnosis
presence of a disease

Front 49

specificity

Back 49

absence of a diseaes

Front 50

Correlation Co-efficient

Back 50

determines strength of relationship between two variables
shows probable cause and effect
given as a number between +1 and -1

(the closer the correlation co-efficient is to EITHER +1 or -1 (.8 for example) the stronger the correlation

Front 51

positive correlation

Back 51

as the value of x increases the value of y increases
Direct association

Front 52

negative correlation

Back 52

as the value of x increases the value of y decreases

Front 53

t-test

Back 53

statistical measure used to test the hypothetical difference between TWO mean scores

Front 54

ANOVA "Analysis of Variance"

Back 54

used when testing hypothesis
refers to the probability that a condition or circumstance would happen just by chance whithout experimental intervention
standard of acceptability is 1 out of 20 or p-value of < or = 0.05
a p-value greater than 0.05 will affect study results (negatively)

Front 55

Primary services

Back 55

preventive therapies (cleaning)

**sports mouth guard**

Front 56

secondary services

Back 56

controlling a disease or condition after it occurs (periodontal therapy and composites or crowns)

Front 57

tertiary services

Back 57

replacing lost tissues (implants or bridges)

Front 58

Characteristics of an ideal index

Back 58

simple
valid
reliable
clear
sensitive
quantifiable
objective
accepted

Front 59

Reversible

Back 59

can be resolved or reversed
(gingivitis)

-measures-

Front 60

irreversible

Back 60

CANNOT be resolved
(periodontal disease)

-measures-

Front 61

Simples

Back 61

presence or absence of disease

-measures-

Front 62

Cumulative

Back 62

both past and present

Front 63

DMFT/DMFS

Back 63

decayed,missing,filled,Teeth / Surface
irreversible
measures past and present caries experience in populations with adult dentitions (because they're capitalize)

Front 64

deft

Back 64

decayed, need for extraction,filled teeth
irreversible
measures observable caries experience in deciduous teeth

***does not take into account teeth that have been extracted or exfoliated due to past caries experience!***

Front 65

dft/ dfs

Back 65

decayed fiiled teeth / surfaces
irreversible
measure observable caries experience in decidious teeth (because they're lower cased)

Front 66

RCI

Back 66

root carries index
requires recession!!!

Front 67

CAMBRA

Back 67

caries management by risk assesment
measures risk factors and manages them through minimally invasive procedures

CDA's (california dental associations most well known for this. list *24 factors*

seperate form for pediatric patients

Front 68

GI

Back 68

gingival index
reversible
based on severity versus extent
individuals or study participants

Front 69

SBI

Back 69

sulcular bleeding index
reversible
detects EARLY signs of gingivitis
short term trials

Front 70

PDI

Back 70

periodontal disease index
both irreversible AND reversible
RAMFJORD (can be aka Ramfjord index)

Front 71

PI

Back 71

Periodontal Index
irreversible
Russell
questionable for validity (no CAL) - LIMITATIONS

Front 72

PSR

Back 72

periodontal screening and recording
special probe - nehbors
useful as a preliminary screening technique or large populations

Front 73

CPITN

Back 73

community periodontal index of treatment needs
requires special probe

Front 74

OHI-S

Back 74

Simplified Oral Hygiene Index
better for group
measures oral hygiene status by assessing sub and supragingival plauqe and calcluas

Front 75

P1I

Back 75

plaque index
reversible
silness and low
conjuction with the gingival index
scores plaque thickness at gingival margin

Front 76

PHP

Back 76

patient hygiene performance
reversible
plauq after toothbrushing (how well patient performs)

Front 77

VMI

Back 77

volpe-manhold index
used to test agents for plaque control

Front 78

NEEDS ASSESSMENT!

Back 78

process by which the planner identifies gaps between what is and what ought to be
target population
***collects baseline data!!!****

Front 79

ways to conduct needs assessment

Back 79

direct observation
interview
questionnair
survey
epidemiological surveys
records,documents, charts

Front 80

access to care issues

Back 80

need : type of care available
demand: type of care desired
utilization: actual use
barriers: obstacles which interfere with care

Front 81

ways to observe ned

Back 81

through eyes of the PLANNER
objective
through eyes of TARGET POPULATION
subjective (what they want, may not be what they need)

Front 82

Type 1 Examination method

Back 82

comprehensive examination usesing mouth mirror, explorere, lightlign, radiographs, study models, etc

not practical for most community programs

Front 83

Type II examination method

Back 83

limitied examination including mouth mirror, explorer, lighing, radiographs if available

limits use in community

Front 84

Type III Examination method

Back 84

mirror and lighting ONLY

Front 85

Type IV Examination method

Back 85

tongue depressor and lighting ONLY

Front 86

populations profile

Back 86

gathers info about target population
# of individuals who will take part
geographical distribution of target population
rate of growth in the community
degree of urbanization
ethnic language profile
nutritional status
standard of living
amount and type of community services and utilities available
profile of school system
general health profile

Front 87

Medicare

Back 87

elderly and disabled

Front 88

Medicaid

Back 88

poor
security act of 1965

Front 89

COBRA

Back 89

consolidation omnibus budget reonciliation act of 1985 continue temporary health care coverage (18 months)

Front 90

Block grants

Back 90

lump sum
use at discretion to meet a need

Front 91

line item grant

Back 91

specifies where monies are to go

Front 92

Goals

Back 92

broad-based statment of desired outcome of a program

Front 93

objectives

Back 93

steps that must be taken
MUST BE MEASURABLE

Front 94

Drafting a Plan

Back 94

develop a lesson plan and implementation strategy

****choose activities or procedures that have been successful in the PAST!!! No need to re-invent the wheel****

Front 95

external motivation

Back 95

promise of a reward (children)

Front 96

internal motivation

Back 96

change as a result of self awareness (adult)

BETTER predictor of behavior change

Front 97

principles of teaching

Back 97

teach the way skills are to be used
establish goals and objectives
evaluation need to be ONGOING (beginning to end)

Front 98

formal delivery

Back 98

lecture, demonstration, discussion etc

active

Front 99

informal delivery

Back 99

brochures, pamphlets, bullboards, video etc

passive

Front 100

Stages of Learning

Back 100

Ugly Apes Sit In A Hut
unawareness
awareness
self-interest
involvement
action
habit

Front 101

Evaluation of a program

Back 101

program appraisal
analyses whether or not goals and objectives were met***
may be formal (written, pre and post test) or informal (questions audience during presentation

Front 102

Evaluation must be continuous!!! from beginning to end!
you need _______

Back 102

baseline data from the needs assesment to determine groups progress

Front 103

summative evaluation

Back 103

outcome evaluation

Front 104

formative evaluation

Back 104

conducted during the program