Community%20Dental%20Health

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Community Dental Health

• Review

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Dental Hygienists Key Responsibilities

• 1. Health Promotion Awareness/Improvement/Respons
  ibility
• 2. Education
• Teaching/Learning/Behavior Modification
• 3. Clinical Therapy
• Care/Treatment

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Dental Hygienists Key Responsibilities

• 4. Research
• Scientific Investigation/Study/Reporting
• 5. Change Agent
• Catalyst for process of change
• 6. Administration
• Policy Development/Management Processes
• All responsibilities mean a commitment to
• Lifelong Learning to maintain competence.

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Dental Hygienists Key Responsibilities In
Private Practice

• Health Promoter
• Enabling clients to increase awareness,
  responsibility and improvement of their health
• Practice prevention
• Educator
• Teaching / learning from clients
• Motivating and modifying behaviour of clients

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Dental Hygienists Key Responsibilities In
Private Practice

• Clinician
• Preventive, therapeutic and ongoing care
  procedures
• Technology used appropriately
• Researcher
• Investigating, studying and keeping current with
  knowledge that validates D.H. practice

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Dental Hygienists Key Responsibilities In
Private Practice

• Change Agent
• Managing the process of change
• catalyst, solution giver, resource link/process
  helper
• advocator for rights and well-being
• Administrator
• Management process and policy development
• Record keeping
• Office policy
• Cost Effectiveness

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Dental Hygienists Key Responsibilities In
Community Health

• Health Promoter
• Increase awareness, personal responsibility and
  improvement of oral health in the community
• Resource person for other health professionals
• Educator / Program Planner
• In response to needs and resources in the
  community
• Dental health advisor

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Dental Hygienists Key Responsibilities In
Community Health

• Clinician
• Screening surveys
• Preventive care, referrals and client follow-ups
• Researcher
• Keeping current

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Dental Hygienists Key Responsibilities In
Community Health

• Change Agent
• For health policies rights and well-being
• Catalyst, solution-giver, resource link
• Process helper
• Administrator
• Maintains records, data input, analysis and
  dissemination
• Policy and procedure management
• Ensures cost-effectiveness

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Phases Of Process Of Care

• Private Practice
• Assessment of
• Clients medical and dental history
• Socio-cultural history
• Oral exam
• Diagnosis of
• - Patients oral hygiene status

• Public Health
• Assessment of
• Needs of the community and the target population
• Analyzes assessment
• Diagnosis of
• - Community dental hygiene status

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Phases Of Process Of Care

• Private Practice
• Planning of
• Treatment needs and priorities
• Method of payment

• Public Health
• Planning of
• Program based on data, priority and resources
• Funding sources

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Phases Of Process Of Care

• Private Practice
• Implementation of
• Treatment plan and co-ordination of treatment
  with other professionals
• Changing when necessary

• Public Health
• Implementation of
• Varied personnel are involved
• Changing plan when necessary

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Phases Of Process Of Care

• Private Practice
• Evaluation
• During treatment, specific intervals or on
  completion of treatment

• Public Health
• Evaluation
• Ongoing in terms of
• - effectiveness
• - efficiency
• - appropriateness
• - adequacy

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Role Of Dental Hygienist In Community Health

• School dental health program
• Screening, referrals, follow ups
• Resource person in dental health to staff
• Providing clinical services where appropriate
• Maintaining records and data input
• Assisting in developing education materials

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Role Of Dental Hygienist In Community Health

• Dental indices surveys
• Organizing and implementing
• Dental health advisor in the community
• Multidisciplinary
• Dental health programs
• Plan, organize, implement
• In-service trainer to the community
• On request
• Special dental health activities
• Dental hygiene week, dental health month, health
  fairs

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Role Of Dental Hygienist In Community Health

• As well as
• Be familiar with all current legislation and
  regulations
• Compile records, reports and statistics for
  dissemination
• Role model for dental services on committees and
  programs as assigned
• Function as a team member in all activities

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Target Populations

• Family caregivers (parents, relatives, etc.)
• School teachers / staff
• Health care workers providers of direct patient
  care
• Hospice workers for terminally ill
• Persons with medical conditions
• Developmentally disabled
• Hearing impaired / deaf
• Visually impaired / blind

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Target Populations

• Things to consider
• Age specific competencies
• Cultural diversity
• Beliefs, values, attitudes, perceptions,
  expectations and needs
• Barriers to dental care age, language,
  disabilities, finances, transportation, access to
  care, fear, misunderstanding, trust, illiteracy,
  denial of disease, social issues and habits

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Criteria For Public Health Decisions

• Disease or other threat to health is widespread
• Knowledge exists on how to prevent or cure the
  condition
• Such knowledge is not being applied
• W.H.O. Definition of health
• A state of complete physical / mental and social
  well-being and not merely the absence of disease

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Community Prevention Programs

• Prevention primary goal
• Primary prevention
• - Most effective
• - Prevents disease before it occurs
  fluoridization / immunization,
  diet, physical activity

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Community Prevention Programs

• Prevention primary goal
• Secondary prevention
• - Treats disease after it occurs
• - Promptly
• - Reduce prevalence
• - Shorten duration
• - Screening / referrals
• - Early accurate diagnosis

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Community Prevention Programs

• Prevention primary goal
• Tertiary prevention
• - Limits or rehabilitates a disability
  from disease
• e.g. - Prostheses provided
• - Reduce complications
• Community prevention programs used only when
  shown to be effective by well-designed clinical
  studies and evidence-based research

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World Health Organization

• Activities
• Maintains country profile development
  (information on oral disease and services,
  tobacco use, sugar consumption,
  fluoride/fluoridization)
• Implements and evaluates community preventive
  programs (affordable oral care)
• Public education / health promotion

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World Health Organization

• ACTIVITIES
• Advocacy and legislation promotion
• Information dissemination
• (41 W.H.O. centers worldwide)

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Current Dental Public Health Practice

1. Water Fluoridization
2. Prevention of oral cancer
3. Reduction of dental problems
4. Education
5. Nutrition
6. Injury prevention
7. Research and development

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1. Water FLUORIDIZATION

• 1901-08 Dr. Fredrick McKay observed Colorado
  Brown Stain
• (Motteling and brown opacities of the teeth
  less caries)
• 1920 Common link shared water source
  water analysis showed nothing
• 1925 McKay advised using water from outside
  source resulted in less motteling

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1. Water FLUORIDIZATION

• 1930 Improved water analysis method showed
  correlation between increased fluoride
  resulted in more motteling then termed
  Dental Fluorosis
• 1931 Dr. H. Trendley Dean
• Goal to define the minimal level of
  fluoride to inhibit caries without Fluorosis
• - developed Fluorosis index
• Result caries rate down at F. Level up to
  1.0 p.p.m.

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2. Prevention Of Oral Cancer W.H.O. A
Global Concern

• Tobacco Cessation
• How to reduce oral cancer
• Train health care workers to look for early signs
• Education of the public advertising (causes and
  signs)
• Involve other educators (teachers)
• Public policy taxes / bans
• Individual counseling
• Prevention / cessation programs
• Social acceptance changes

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3. Reduction Of Dental Problems

• Technology / research development
• Fluoride variety of sources
• Improved access to care
• Early interventions / injury prevention campaigns
• Improved oral health education / promotion
• Improved nutrition awareness

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Preventive Properties Of Fluoride

• CLASSICAL EPIDEMIOLOGICAL STUDY SIX PRINCIPALS
• 1.Studied groups not individuals Colorado
  Springs Community
• 2.Examined well and ill people long term
  residents more affected
• 3.Looked at relative prevalence surrounding areas
  studied

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Preventive Properties Of Fluoride

• CLASSICAL EPIDEMIOLOGICAL STUDY SIX PRINCIPALS
• 4.Broad goal established, e.g. association
  between prevalence of fluorosis or caries and
  fluoridated and non-fluoridated areas
• 5.Required 2 demonstrations
• - association itself is dependable and
  predictable from population to population
• - other factors could not be responsible

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Preventive Properties Of Fluoride

• CLASSICAL EPIDEMIOLOGICAL STUDY SIX PRINCIPALS
• 6.Support for association between fluoride and
  dental health is gained through additional
  studies
• FINAL CONCLUSION
• Water can be fluoridated to optimal level to
  reduce caries without increasing fluorosis

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Ministry Of Health ProgramChildren In Need Of
TreatmentC.I.N.O.T.

• Dental Screening Program 3 Hygienists
• High/Moderate Risk Elementary Schools
• - screening of selected students and data
  recording
• - intensive follow-ups and referrals
• - take home notice
• - phone contact/consultation
• - follow up school screening
• - provision of preventive services
• - exam, prophylaxis, sealants, fluorides

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Ministry Of Health ProgramChildren In Need Of
TreatmentC.I.N.O.T.

• Dental Screening Program 3 Hygienists
• High/Moderate Risk Elementary Schools
• - Dental Health Education and Promotion
• - clients, caregivers, school staff
• - resource person
• - for students / caregivers
• - in the community
• - for other health care providers
• Year 2000 - 60 schools screened
• - 1500 CINOT referrals
• - 480 clinic services

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Terminology

• EPIDEMIOLOGY
• The study of the amount, distribution,
  determinants and control of diseases and health
  conditions among given populations.
• Endemic
• A relatively low, but constant level of
  occurrence of a disease or health condition in a
  population.

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Terminology

• Epidemic
• A disease or condition occuring among many
  individuals in a community or region at the same
  time and usually spreading rapidly. Often called
  an outbreak of disease. Widespread outbreaks
  across a region or continent may be termed
  pandemic in extent.
• Disease rates
• The number of cases or deaths among a population
  or target group during a given time period,
  expressed as a ratio. Rates are often
  statistically adjusted to make valid
  comparisons across different populations or to
  detect trends within the same population.

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Terminology

• Mortality
• The ratio of the number of deaths from a given
  disease or health problem to the total number of
  cases reported.
• Morbidity
• The ratio of sick (affected) individuals to
  well individuals in a community. It often
  measures the level of nonfatal health
  consequences (severity) of a disease or condition.

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Terminology

• Prevalence
• A numerical expression of the number of all
  existing cases of a disease or problem in a
  population measured at a given point or period of
  time.
• Case rate
• Frequency of occurrence of a condition.
• Incidence
• The number of new cases of a disease in a
  population over a given period of time.

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Terminology

• Etiology
• The theory of causation for a disease or
  condition.
• Risk factors
• Characteristics of an individual or population,
  which may increase the likelihood of experiencing
  a given health problem (e.G., Age, gender,
  educational level, socioeconomic status).

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Terminology

• Index
• A standardized method used to describe the
  status of an individual or group with respect to
  a given condition. Indexes usually involve a
  graduated scale for measuring the extent of the
  health problem.
• Surveillance
• Methods or systems used to monitor disease and
  morbidity in a population periodically or on an
  ongoing basis. It is an important function of the
  centers for disease control (CDC) and health
  departments, etc.