Upgrade to remove ads
Only $2.99/month

Board Review: Community

Terms in this set (193)

the science and art of preventing and controlling dental disease and promoting dental health through organized community efforts
community dental health
Community dental health serves the community as the patient rather than the ________.
individual
Community dental health is concerned with the dental health education of the ______?
public
Focus of private practice is on the individual and the focus of community health is on the ______.
community
WHO
World Health Organization

International Health
IFDH
International Federation of Dental Hygienist

International Health
DHHS
Department of Health and Human Services

National Health
CDC
Centers for Disease Control and Prevention

National Health
HRSA
Health Resources and Services Administration

National Health
NIH
National Institute of Health

National Health
NIDCR
National Institutes of Dental and Craniofacial Research

National Health Grants for Research
AHRQ
Agency for Healthcare Research and Quality

National Health
Medicaid Programs
For the Poor

State Program
SCHIPS Program
Comprehensive health care for children under 18

State Program
FQHCs
Federally Qualified Heath Centers which serve undeserved areas

State Program
directly administers county and city Health Department programs
Local Populations
study of disease in a target population
epidemiology
the number of existing cases of disease in a specific population at a given point or period in time
prevalence
the number of new cases of a disease in a specific population over a given period of time
incidence
Uses of Epidemiological Information:
Collect data to describe normal biological processes
Understand the natural history of disease processes
Measure the distribution of disease in a given population
Identify determinants of disease
Test hypotheses for prevention and control of disease
Plan and evaluate health care services
number of cases or deaths in a population during a given time expressed as a ratio
rates
the death of a population (ratio of deaths from a disease to the total number of cases)
mortality

t=toast
the disease rate in a population; ratio of sick to well in a population; measures severity
morbidity

b=bed
theory of causation
etiology
a disease or condition that regularly occurs in a population
endemic
unexpected number cases of disease in a specific population at a specific time
epidemic
widespread outbreaks over a continent or the world
pandemic
epidemiological studies that describe the person, place and time; determines who is getting the disease and were and when the disease is occurring; surveys
descriptive studies
epidemiological studies that are components of an experimental study design; test hypotheses to determine cause and effect
experimental studies
What are the components of an experimental study design?
1. Pre-post test design
2. A treatment group and a control group
3. Random assignment of study participants
the participants are unaware if in control group or study group
single blind study
the researcher is unaware of which group is the control group and which is the study group
double blind study
the participants, the researcher, and the final examiners are unaware of which group is which type
triple blind
a theory that has been put forward believed to be true or because it is to be used as a basis for argument, but has not been proven a hypothesis which a researcher tries to disprove or nullify
Null Hypothesis (H0)
a statement of what a statistical hypothesis test is set up to establish;
Alternative Hypothesis (H1)
most useful for testing a hypothesized association between human exposure and adverse health effects; show relationship between factor and disease and indicate risk
Analytical Epidemiological Studies
analytical study which compares individuals who have a specific disease (cases) with a group of individuals without the disease (controls)
Case Control Study
Case control studies rely on _______ data, so chance of bias due to recall is present.
retrospective
individuals with differing exposures to a suspected factor are identified and then observed for the occurrence of certain health effects over some period, commonly years rather than weeks or months
Cohort Study
Cohort studies can be performed ______ or ______ from historical records.
prospectively or retrospectively
What are the four types of epidemiological studies?
1. Descriptive Studies
2. Experimental
3. Analytical
4. Cohort Studies
What are the two types of data?
Qualitative and Quantitative
can be observed but not measured; can be described; textures, smells, tastes, appearance, colors
qualitative data
deals with numbers, can be measured, length, height, weight, speed, temperature
quantitative data
What are the types of samples?
Random
Stratified
Systematic
Convenience
Judgment
every item in the population has an equal chance of being selected
random sample
a sample based on subgroups
stratified sample
select every nth name to participate
systematic sample
based on convenience
convenience sample
based on familiarity with the population
judgment sample
Which sample has the least amount of bias?
random
Which sample has the most amount of bias?
Judgment
the event that is being observed
variable
depends on the intervention; the outcome of interest; should change in response to some intervention
dependent variable
the intervention; manipulate to produce a response to the dependent variable
independent variable
measures how often each score occurs
frequency distribution
What are the measures of central tendency?
mean
median
mode
most representative score; most useful and most familiar; may or may not be an actually occurring score; always the center of balance of distribution in a symmetrical distribution; affected by extreme scores
Mean
point in the distribution where 50% of the scores are above & 50% are below; not affected by extreme scores; may or may not be an actually occurring score
Median
most frequently occurring score; is an actually occurring score; may be unimodal, bimodal, multimodal; not affected by extreme scores
Mode
the mean, median and mode are the same and are at the middle of the distribution
normal bell curve
What are the measures of dispersion?
Range
Variance
Standard Deviation
the difference between the highest and lowest score or how much the scores vary; simplest measure of variability; highest score minus the lowest score; based on the two most extreme scores
range
area of spread in a frequency distribution; most frequently used measure of variability; extreme scores affect it
variance
average of distance from the mean; square root of the variance; extreme scores affect it
standard deviation
more scores fall in the lower range
positively skewed distribution
more scores fall in the higher range
negatively skewed distribution
a set of brief descriptive coefficients that summarizes a given data set, which can either be a representation of the entire population or a sample; the measures used to describe the data set are measures of central tendency and measures of variability or dispersion
descriptive statistics
makes inferences about populations using data drawn from the population; instead of using the entire population to gather the data, the statistician will collect a sample or samples from the millions of residents and make inferences about the entire population using the sample
inferential statistics
generalized findings from the sample to the population
inferential statistics
the degree to which the data collection instrument measures the variable it is designed to measure; accuracy
validity
the extent to which the method of measurement consistently performs
reliability
consistent performance by the same investigator when using a data collection instrument
intraexaminer
consistent performance between different examiners; increased by calibration
interexaminer reliability
the ability of a test to correctly identify the presence of disease
sensitivity
the ability of a test to correctly identify the absence of disease
specificity
determines the strength of a relationship between two or variables
correlation coefficient
A ______ correlation is a direct association between two variables
positive
statistical measure to test the hypothetical difference between two mean scores
T-test
analysis of variance; used when comparing the statistical difference between three or more mean scores
ANOVA
probability value; used when testing hypothesis; evaluates the possibility that the condition occurred without intervention
p-value
What is an acceptable p-value?
<0.05
preventive measures to prevent, reverse, or arrest the disease process before treatment becomes necessary
primary prevention
What are some examples of primary prevention?
fluoride and sealants
routine treatment to terminate a disease and restore tissues to as normal as possible; prevent the progression and recurrence of disease
secondary prevention
What are some examples of secondary prevention?
Periodontal debridement, restorations
treatment to replace lost tissues and rehabilitate patients
tertiary prevention
What are some examples of tertiary prevention?
Prosthodontics or Implants
What are the characteristics of an ideal index?
simple
valid
reliable
clear
sensitive
quantifiable
objective
measures conditions that can be resolved or reversed
reversible
What is an example of a reversible index?
gingivitis indices
measures conditions that cannot be resolved or reversed
irreversible

caries and periodontal disease
measures the presence or absence of disease
simple
measures all evidence of a condition both past and present
cumulative
What are the four dental caries indices most often used?
1. DMFT/DMFS
2. deft
3. dft/dfs
4. RCI
irreversible index that measures past and present caries experience of a population with permanent dentition
DMFT/DMFS: Decayed, Missing, Filled Teeth and Decayed, Missing and Filled Surfaces
Which is more sensitive, DMFT or DMFS?
DMFS
irreversible index that measures observed caries in primary teeth; does not take into account teeth that may be lost extracted or exfoliated that had past caries experience
decayed, need for extraction, filled teeth

deft
irreversible index that measures observable caries experience in deciduous teeth
decayed, filled teeth/decayed filled surfaces

dft/dfs
irreversible index that requires recession; only takes into consideration areas of root exposure
RCI: Root Caries Index
What are the two common gingival indices?
GI: Gingival Index
SBI: Sulcular Bleeding Index
reversible index based on severity versus extent of inflammation; can be used in individuals or study participants
GI: gingival index
reversible index that detects early signs of gingivitis; useful in short term clinical trials
SBI: Sulcular Bleeding Index
What are the four commonly used periodontal indices?
1. PDI: Periodontal Disease Index (Ramfjord)
2. PI: Periodontal Index (Russell)
3. PSR: Periodontal Screening and Recording
4. CPITN: Community Periodontal Index of Treatment Needs
irreversible index that measures the prevalence and severity of periodontal disease; measures both the reversible and irreversible of periodontal disease
PDI: Periodontal Disease Index
irreversible index that looks at surrounding tissue; questionable for validity because does not measure loss of attachment
PI: Periodontal Index
assesses periodontal health rapidly and effectively; requires a special probe; useful as a preliminary screening technique and in large populations
PSR: Periodontal Screening and Recording
established b the WHO to determine periodontal treatment needs rather than periodontal status; requires a special probe
CPITIN: Community Periodontal Index of Treatment Needs
What are four oral hygiene indices that are commonly used?
1. OHI-S: Simplified Oral Hygiene Index
2. PH: Plaque Index
3. PHP: Patient/Hygiene Performance
4. VMI: Volpe-Manhold Index
reversible index that measures oral hygiene status; involves both a debris and calculus index; better for group versus individual treatment
OHI-S: Simplified Oral Hygiene Index
reversible index used in conjunction with the Gingival Index that scores plaque according to its thickness at the gingival margin
PH: Plaque Index
reversible index that measures plaque after toothbrushing to assess patient's skill
PHP: Patient Hygiene Performance
reversible index used to test for plaque control and calculus inhibition; measures supragingival calculus formation following prophylaxis
VMI: Volpe-Manhold Index
What is the best choice for determining needs of a large group?
survey
What is the purpose of a needs assessment?
Collects Baseline Data
type of care available
need
type of care desired
demand
actual use of services available by the public
utilization
obstacles which interfere with care
barriers
What are the types of examination methods?
Type 1: Comprehensive Examination
Type 2: Limited Examination
Type 3: Mouth Mirror and Lighting
Type 4: Tongue Depressor and Lighting Only
health insurance for the elderly and disabled
Medicare
health insurance for the poor
Medicaid
a specified amount of money to use for whatever you want to
Block Grants
money goes to a designated project
line item grant
broad-based statement of desired outcome of a program
goals
measurable statements of steps to be taken to achieve goals
objectives
external motivation
reward
internal motivation
self awareness better predictor of behavior change
lecture, demonstration discussion
formal delivery
brochures, pamphlets, billboards
informal delivery
What are the steps of the learning ladder?
Unawareness
Awareness
Self-Interest
Involvement
Action
Habit

You Are Sexy Intelligent And Handsome
outcome evaluation; measures impact of the program; after the program
summative evaluation
conducted during the program; can make adjustments if necessary
formative evaluation
Who published Healthy People 2010?
Department of Health and Human Services
In an experimental study which group receives treatment?
Treatment group
In an experimental study which group does not receive treatment?
Control Group
What are the types of analytical studies?
Retrospective
Prospective
Longitudinal
examines whether a past association exists between an exposure of interest and development of a present condition
retrospective
study in which subjects are observed and data is collected over time to determine if a disease or condition develops
prospective study
group is studied over an extended period of time; any type of study over a long period of time
longitudinal study
arranges the scores from lowest to highest measures
data matrix
measures how often each score occurs
frequency distribution
What is the most common measure of central tendency?
mean
What is the most commonly used method of dispersion in oral hygiene research and reflects the range within the data matrix?
Standard Deviation
In a standard deviation where do the majority of the scores fall within?
between + and -1 standard deviation
as the value of x increases the value of y increases or as the value of x decreases the value of y decreases
positive correlation
as the value of x increases the value of y decreases or as the value of x decreases the value of y increases
negative correlation
Which index is used in conjunction with the Gingival Index?
Plaque Index
time consuming, not cost effective, requires manpower
direct observations
not time or cost effective, not recommended for large groups
interview
good choice for large population; must be well written and easy to understand for the target population
questionnaire
best choice for large groups; must be well written and understandable
survey
access dependent; time consuming
records, documents, charts
Dental Practice: Examination
Community Dental Health: Survey
Dental Practice: Diagnosis
Community Dental Health: Analysis
Dental Practice: Treatment Planning
Community Dental Health: Program Planning
Dental Practice: Treatment
Community Dental Health: Program Operation
Dental Practice: Payment
Community Dental Health: Finance
Dental Practice: Evaluation
Community Dental Health: Evaluation/Appraisal
data is presented in ascending or descending order along with the frequency of each score occurring in the data set
ungrouped frequency distribution
frequency of occurrence of scores up to and including any given value in the data set
cumulative frequency distribution
grouping variables into consecutive intervals
grouped frequency distribution
an incidence rate calculated for a particular population for a single disease outbreak
attack
Primary prevention covers those procedures that include early diagnosis and prompt treatment.
Tertiary prevention includes those services that prevent further disease and disability.
first statement false, second is true
What are the two criteria that determines if there is a public health problem?
a condition or situation that is a widespread actual or potential cause of morbidity or mortality

there is a perception on the part of the public, government, or public health authorities that the condition is a public health problem
The local governmental level is most likely to conduct a school sealant program in the U.S.

The international level is most likely to provide a grand and consultation to support the program.
first statement true, second is false
what oral health professionals assess as the needs of a population
normative need
what the public/patient perceives they need to be healthy, which affects their utilization of services
perceived needs
a systematic approach used to identify particular groups that need care and the extent of their needs
assessment
a combination of surveys used to collect oral health information from populations and is commonly used in the development of a community profile; uses a simple basic screening approach to collect oral data
Basic Screening Survey: BSS
when the examiners each modify what they are doing to meet that of the expert (trainer)
calibration
entails a period of training to bring the different examiner's observations as close as possible to one another
standardization
Program objectives should be SMART....
Specific
Measurable
Achievable
Realistic
Time
What are the three factors of epidemiology? (epidemiologic triangle)
host, agent, and environment
a study that looks at past or archival information
retrospective
a study that looks forward in time
prospective study
a study that examines a group at one point in time
cross sectional study
a study that collects data over time
longitudinal study

experimental, cohort, and case control
can be completed prior to the large scale survey or study to determine if any changes or alterations are necessary
pilot study
What is the most reliable online source of scientific articles to do a thorough literature review of a topic in preparation for planning a community program?

a. The Internet
b. Medline
c. Psych Abstracts
d. Index to Dental Literature
b. Medline
a single group is studies at a point in time to identify factors that are associate with a disease
cross sectional
a group with a disease is compared to a group without it to determine risk factors from the past that are associated with the disease
case control
a single group is followed over time to analyze the progress of disease to identify associated risk factors
cohort study
when a study meets some but not all the requirements of an experimental study
quasi-experimental
Ramfjord Teeth
3, 9, 12, 19, 25, 28
data that names or places into distinct categories
nominal
rejecting a true null hypothesis
Type I Error
accepting a false null hypothesis
Type II Error
An examination is to a dental practice what a __________ is to community dental health.
survey
What is the third step in the learning process?
Self-interest
What is the health "demand" of a given population?
the health care that is desired
An examination method which uses just a mouth mirror and some lighting would be classified as what kind of examination?
Type III (also known as inspection)
A needs assessment is conducted using the dental caries index Decayed Missing Filled Teeth (DMFT). What could be inferred from scoring a high "M" rate after reviewing the results?
there is a need for improved education among the population
THIS SET IS OFTEN IN FOLDERS WITH...