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Flashcards in DPH Approaches to Oral Disease Deck (20)
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1

Define dental public health

The science and art of preventing oral diseases, promoting oral health and improving quality of life through the organised efforts of society

2

What does dental public health do?

Serves community rather than individual patient
Is concerned with the public as individuals and as a whole
Applies dental research to community settings
Focuses on the causes of the causes of dental disease
Administers group dental care programs

3

List the criteria that makes a disease a public health problem

Must be widespread or serious
Severe consequences to community and individuals
Costs to community and to individs are great
Effective methods available to prevent, alleviate or cure

4

If dental public health were to act, what must there be?

Strong evidence supporting need for action, feasibility and effectiveness
Good public support and acceptability
Good professional support
Economic benefits

5

Periodontitis vs gingivitis?

Gingivitis and periodontitis are not the same
Gingivitis is common - seldom causes discomfort or loss of function
<10% of people get severe perio
Perio is not a major cause of tooth loss

6

Aetiological factors for PD?

Plaque
Dental restorations and prostheses
Tobacco
Stress

7

What makes periodontal disease a public health problem?

Widespread/serious
Severe consequences to community and individuals
Costs to community and to individs
Effective prevention, alleviation or cure

8

How can we act against PD?

Have goals which are:
Appropriate
Realistic
Measurable
Positive
Important

9

Aims for dental health?

Retention throughout life of a functional, aesthetic, natural dentition of not less than 20 teeth and not requiring recourse to a prosthesis - WHO 1982

Plaque free mouth = unrealistic

Achieve a level of plaque compatible with a rate of disease that will maintain an acceptable dentition for life

10

Possible public health approaches for PD?

Health education
Chemotherapeutic approaches - no real place for entire populations
Screening
Dental treatment
Health promotion

11

Health education?

Ineffective and expensive
80-90% brush 2x daily
Incorporate personal hygiene and grooming into socialisation

12

Screening for early diagnosis and tx?

Screening is not justified
No valid methods to assess risk
Seems to be gradient of greater risk rather than cut off point
Treatment is expensive and not very effective

13

Clinical treatment for PD?

At best only moderately effective for individuals
Removal of calculus not shown to improve progression of periodontitis
Professional cleaning at 3-6 month intervals not significant improvement
Benefit for an entire population attenuated by low attendance, sub-optimal Rx etc
Cost for entire population is huge

14

Periodontal health promotion?

Create supportive environments
- Better washrooms at work

Healthy public policies
- Improve standards of living
- Tobacco use

Strengthen community action
- Educate community leaders

Develop personal skills

Reorientate health services - referral to stop smoking services, less plaque retentive features

15

Dental trauma risk factors?

Orthodontic problems
Contact sports
Violence
Deprivation – crowding
Falls
Traffic and bike accidents
Poor environment

16

What percentage of children experience dental trauma?

23%

17

Public health approaches to trauma?

Supportive environments - soft surfaces in play areas, CCTV for early detection

Healthy public policies - mouthguards for sports

Strengthen community action - move fast food restaurants

Develop personal skills - alcohol education

18

Oral cancer statistics?

In UK approx. 12,000 new cases of H&N cancer per year, 3% of all cancers
Sex difference and interaction with social class
Ethnic differences related to tobacco use
No marked improvements in cure rates for years though Rx improves QoL in interim

19

Risk factors for oral cancer?

Tobacco
Alcohol
Premalignant lesions
Sunlight
Trauma
Human Papilloma Virus

20

Public health approaches for oral cancer?

Create supportive environment - restrict tobacco use in public, use SPF

Healthy public policies - improve standards of living

Strengthen community action - Action against tobacco use

Develop personal skills
- Alcohol and smoking education

Reorientate health services - early diagnosis