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Algonquin College - Jan Ladas 1
Community Dental Health
ReviewReview
Algonquin College - Jan Ladas 2
Dental Hygienist’s Key Responsibilities
1. Health Promotion: Awareness/Improvement/Responsibility
2. Education:
Teaching/Learning/Behavior Modification
3. Clinical Therapy:
Care/Treatment
Algonquin College - Jan Ladas 3
Dental Hygienist’s 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 toLifelong Learning to maintain competence.
Algonquin College - Jan Ladas 4
Dental Hygienist’s Key Responsibilities In Private
Practice
Health Promoter: Enabling clients to increase awareness,
responsibility and improvement of their health Practice preventionEducator: Teaching / learning from clients Motivating and modifying behaviour of clients
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Clinician: Preventive, therapeutic and ongoing care
procedures Technology used appropriately
Researcher: Investigating, studying and keeping
current with knowledge that validates D.H. practice
Dental Hygienist’s Key Responsibilities In Private
Practice
Algonquin College - Jan Ladas 6
Dental Hygienist’s 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
Algonquin College - Jan Ladas 7
Dental Hygienist’s 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
Algonquin College - Jan Ladas 8
Dental Hygienist’s Key Responsibilities In Community Health
Clinician: Screening surveys Preventive care, referrals and client
follow-ups
Researcher: Keeping current
Algonquin College - Jan Ladas 9
Dental Hygienist’s Key Responsibilities In Community Health
Change Agent: For health policies – rights and well-being Catalyst, solution-giver, resource link Process helperAdministrator: Maintains records, data input, analysis and
dissemination Policy and procedure management Ensures cost-effectiveness
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Phases Of Process Of Care
Private PracticeAssessment of:- Client’s medical and
dental history- Socio-cultural history- Oral exam
Diagnosis of:
- Patient’s oral hygiene status
Public HealthAssessment 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
Algonquin College - Jan Ladas 12
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
Algonquin College - Jan Ladas 13
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
Algonquin College - Jan Ladas 14
Role Of Dental Hygienist Role Of Dental Hygienist In Community HealthIn 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
Algonquin College - Jan Ladas 15
Role Of Dental Hygienist Role Of Dental Hygienist In Community HealthIn Community Health
Dental indices surveys Organizing and implementingDental health advisor in the community MultidisciplinaryDental health programs Plan, organize, implementIn-service trainer to the community On requestSpecial dental health activities Dental hygiene week, dental health month, health fairs
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Role Of Dental Hygienist Role Of Dental Hygienist In Community HealthIn 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 PopulationsTarget 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 PopulationsTarget PopulationsThings 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 Criteria For Public Health DecisionsHealth Decisions
1. Disease or other threat to health is widespread
2. Knowledge exists on how to prevent or cure the condition
3. Such knowledge is not being applied
W.H.O. Definition of healthW.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 Community Prevention ProgramsPrograms
Prevention – primary goal
Primary prevention
- Most effective
- Prevents disease before it occurs – fluoridization /
immunization, diet, physical activity
Algonquin College - Jan Ladas 21
Community Prevention Community Prevention ProgramsPrograms
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 Community Prevention ProgramsPrograms
Prevention – primary goalTertiary 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
Algonquin College - Jan Ladas 23
World Health World Health OrganizationOrganization
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
Algonquin College - Jan Ladas 24
World Health World Health OrganizationOrganization
ACTIVITIES Advocacy and legislation promotion Information dissemination
(41 W.H.O. centers worldwide)
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Current Dental Public Current Dental Public Health PracticeHealth 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 FLUORIDIZATION1. 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 FLUORIDIZATION1. Water FLUORIDIZATION1930 Improved water analysis method
showed correlation between increased fluoride resulted in
more motteling then termed “Dental Fluorosis”
1931 Dr. H. Trendley DeanGoal: to define the minimal level of fluoride to inhibit caries without Fluorosis- developed Fluorosis indexResult: caries rate down at F.
Level up to 1.0 p.p.m.
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2. Prevention Of Oral Cancer2. Prevention Of Oral Cancer W.H.O. – A Global Concern W.H.O. – A Global ConcernTobacco CessationHow to reduce oral cancer:1. Train health care workers to look for early signs2. Education of the public – advertising (causes and
signs)3. Involve other educators (teachers)4. Public policy – taxes / bans5. Individual counseling6. Prevention / cessation programs7. Social acceptance changes
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3. Reduction Of Dental 3. Reduction Of Dental ProblemsProblems
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 Preventive Properties Of FluorideOf 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
Algonquin College - Jan Ladas 31
Preventive Properties Preventive Properties Of FluorideOf 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
Algonquin College - Jan Ladas 32
Preventive Properties Preventive Properties Of FluorideOf 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
Algonquin College - Jan Ladas 33
Ministry Of Health ProgramMinistry Of Health ProgramChildren In Need Of TreatmentChildren In Need Of Treatment
C.I.N.O.T.C.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
Algonquin College - Jan Ladas 34
Ministry Of Health ProgramMinistry Of Health ProgramChildren In Need Of TreatmentChildren In Need Of Treatment
C.I.N.O.T.C.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
Algonquin College - Jan Ladas 35
TerminologyTerminologyEPIDEMIOLOGY:
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.
Algonquin College - Jan Ladas 36
TerminologyTerminologyEpidemic:
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.
Algonquin College - Jan Ladas 37
TerminologyTerminologyMortality:
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.
Algonquin College - Jan Ladas 38
TerminologyTerminologyPrevalence:
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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TerminologyTerminology
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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TerminologyTerminologyIndex:
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.
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