Oral Health strategies

Question 1

What is a strategy? And what is the purpose of planning?

Answer 1

organisational plan for obtaining a specific goal

Planning aims to guide choices
Maximise results with limited resources
Make proactive decisions rather than reactive
Enables priorities to be set

Question 2

why do we need oral health strategies?

Answer 2

oral diseases are preventable but still common and

1. To improve oral health
2. To ensure access to high quality NHS dental services
3. Can be at an international local and national level

Question 3

what are the three princples of designing a strategy?

Answer 3

AIM
Objectives
Data collection

Question 4

What is the purpose of the aim?

Answer 4

Identify what is to be achieved

Question 5

What is the purpose of the objectives?

Answer 5

steps needed to achieve aim

Question 6

what is the final stage in writing a strategy and what does this entail?

Answer 6

This is data collection
identifies the problem, understands the problem and considers possible solutions and then evaluate whether the strategu has worked

Question 7

What does Mc Carthys 1982 rational planning cycle show?

Answer 7

AODAIE

1. assessment of need
2. options: evaluate interventions available using evidence based and critical analysis and consider the level of evidence eg systematic review
3. decisions of policy
4. available resources
5. implementation
6. evaluation: should be built in to the project and not just an afterthought. Ask questions such as: is it working, is it acceptable, is it reaching the people who need it and how are resources being used

Question 8

What is the purpose of a needs assessment?

Answer 8

this identifies and quantifies the problem by looking at the wants, demands and needs

Wants: individuals subjective analysis
Needs: professional judgement about the capacity to benefit
Demands: willingness to pay

Question 9

what is a need for medical care?

Answer 9

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

it is subjective: professional judgment varied
dynamic: new technologies drugs and information.
relative: wealth of the population
not finite

Question 10

Define needs assessment

Answer 10

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

Question 11

Why do we need to do a needs assessment?

Answer 11

to facilitate planning and commissioning
-Health care inflation 
-changing demographics
-limited resources 
- inequalities in health
-consumerism and accountability
Inverse care law
Competing priorities

Question 12

WHat are the three strategies to improving oral health?

Answer 12

Whole population
High risk
Targeted Population

Question 13

How does the whole population approach work?

Answer 13

aims to lower average level of risk of a population by reducing entire populations exposure to disease

Question 14

according to the whole population approach, who is affected by risk factors?

Answer 14

the entire population

Question 15

What are the advantages to whole population strategies?

Answer 15

tackles underlying health determinants
avoids victim blaming
enables healthy choices to be made
benefits the whole society

Question 16

Give examples of whole population strategies

Answer 16

Fluoridated tooth pastes and water

Question 17

What are the disadvantages to whole population strategies?

Answer 17

They have long time scales
need to do alot of lobbying and gaining support
adverse effects on companies eg sweet shops
removes individual free choice
prevention paradox

Question 18

What is the prevention paradox?

Answer 18

Rose 1981

Contradictory situation where for majority of cases come from a population at low risk of disease and a minority come from Hugh risk population because number of people at high risk are small

for a minoroty of people to beneift many people have to change their behavioureven though they will receieve no benefit themselves

Question 19

What us the high risk strategy?

Answer 19

aims to reduce the risk for individuals that are identified as being at higher risk than the gernal population

Question 20

What is an example of high risk strategy being implemented?

Answer 20

mammograms in women under 50 wkth a family history of breast cancer

Question 21

What are the advanatges of a high risk strategy?

Answer 21

cost effective

intervention is apprporate to the individual

Question 22

What are the disadvanatages of high risk strategies?

Answer 22

medicalises prevention
non selcted indivudals are not at no risk, they are at lower risk
contribution to the overall control of disease maybe small
poor ability to predict future outcome for individuals

Question 23

What is a targeted population strategy?

Answer 23

A whole population apporach which is then adapted for a local community

Question 24

Which individuals are targeted in the targeted population approach?

Answer 24

those that are high risk

Question 25

What are the disadvantages of the targeted population approach?

Answer 25

Not all people at risk will be included in the target group and not everyone in the target group is at high risk

Question 26

What are the advantages of the targeted population approach?

Answer 26

it places an emphasis on reducing inequalities and a variety of interventions can be used eg clinical intervention, environmental approach, developing community or individual skills

Question 27

What are the threeWHO oral health action areas?

Answer 27

Diet, nutrition and oral health
Fluorides and oral health
Tobacco and oral health

Question 28

Give an example of a national dental strategy aimed at improving oral health?

Answer 28

Choosing better oral health 2005 DoH

Question 29

What were the aims of the choosing better oral health programme?

Answer 29

reduce the prevalence of oral disease

reduce oral heath inequalities across all age groups in England and Wales

Question 30

How can you tell if the strategy has worked?

Answer 30

measuring level of satisfaction of those individuals that are involved

Question 31

What did the choosing better oral health national strategy focus on?

Answer 31

Improving diet and reducing sugar
Improving OH
increase fluoride exposure
Tobacco control and sensible alcohol use
research and development
reducing dento facial injuries

Question 32

What other types of strategies exist other than whole population, high risk and targeted populations?

Answer 32

Integrated

Question 33

How do whole population integrated strategies work?

Answer 33

They can be used at in international and national level

Question 34

How can targeted population strategies be integrated with other strategies?

Answer 34

Integrated with while population eg diet water fluoridation

Question 35

How can local high risk strategies be integrated?

Answer 35

They can be integrated with targeted strategies

Question 36

What is the common risk factor approach?

Answer 36

Many diseases share risk factors eg heart disease, stroke, cancer, diabetes therefore action is directed to co,,ok risks and underlying social determinants using partnership working

Question 37

Give an example of a targeted population strategy at an international level.

Answer 37

WHO oral Health strategy
Aimed at reducing the burden if oral disease In poor populations by rejecting risk factors to oral health that arise from environmental economic social and behavioural causes