COMM Health III Final

Mean

-Average -Represented s "X" or "M" -Sensitive to extreme values -Most common measurement of central tendency -Add the numbers together -Divide by the amount of numbers

4 roles the dental hygienist can to be an advocate

-Catalyst (gets the ball rolling, brainstorms) -Solution giver (problem solver, thinks outside of the box) -Resource linker (facilitator, brings everyone together) -Process helper (understands the process and helps overcome road blocks)

Risk factors

-Characteristic of an individual or population that may increase the likelihood of experiencing a given health problem -Modifiable -Identified through longitudinal studies (observations over time) -Reliable indicators

The 8 characteristics of a good index

-Clarity: criteria are understandable -Simplicity: results are easily measured -Objectivity: results are not subject to individual interpretation -Validity: index measures what is it intended -Reliability: examiner consistency and calibration are reproducible -Quantifiable: statistics can be applied -Sensitivity: small degrees of difference can be detected -Acceptability: no pain and minimal expense

4 Major Bodies of Law

-Common (created and changed only by courts; contains the notions of common sense and precedence) -Statutory (created and changed by legislature; written law; promote justice) -Constitutional (created and changed by people through their legislators; interpretation of constitution) -Administrative (delegated legislative power to an administrative agency; rules and regulations created by government agencies)

Medicare

-Covers medical care for people who are elderly and/or disables -May provide reimbursement for dental procedures provided in the hospital not in a dental office emergency treatment)

Oral Epidemiology

-Defined by Nathe (2017) as the study of the amount, distribution, determinant and control of oral disease and oral health conditions among given populations. -Important to dental hygienists because we need to understand oral epidemiology and the methodology used in epidemiological research to have evidence-based practice -Without oral epidemiology, we would not be aware of associations of disease to each other and to risk factors

Distribution of disease

-Endemic: usual presence of disease in a geographic region (Ex. Hay fever in spring) -Epidemic: an unexpectedly large number of cases of disease in a place and time (Ex. Measles outbreak in Oregon and Washington) -Pandemic: an outbreak of disease over a large geographical area, even worldwide (ex. Ebola)

Medicaid

-Funds dental services for indigent (very poor) populations -Federally funded -State administered

Classifications of Epidemiologic Research Approaches

-Historical: to determine the meaning of past events -Descriptive: to describe and identify current events or situations -Experimental (prospective): investigated the cause and effect relationships -Quasi-Experimental: is an approximation of a true experimental approach

Stakeholders

-Individuals in organizations who have a particular vested interest in a specific topic, issue, initiative, or population -Sometimes organized in coalitions -Help assess needs of a population -Help determines goals and objectives

Teaching Methods

-Lecture: is best for formal presentations -Discussion: is interactive between instructor and audience -Presentation: is combination of lecture and discussion -Demonstration: is a learning behavi

Functions of State government branches

-Legislative (function: create laws) -Executive (function: enforce laws) -Judicial (function: interpret law

Median

-Middle -50% of values about and 50% of values below -NOT affected by extreme values -Put the numbers in order and find the middle number

Morbidity vs. Mortality

-Morbidity: extent of disease, injury, or disability in a population (people with oral cancer) -Mortality: death rate resulting from a specific disease (rate at which people die from oral cancer)

Mode

-Most "frequent" value -Affects the skew of the graph -Most common number

Private Insurance

-Paid by employers or individuals -Can include dental coverage

Ways to represent data

-Pie charts -Histograms (bars are together) -Bar graph

Childrens Health Insurance Plan (CHIP)

-Provides health insurance to vulnerable children in the U.S. -Also provides dental and vision care

Sampling

-Random sampling (Best): participants are chosen independently of each other -Stratified random sampling: participants randomly selected from an existing known population -Systemic random sampling: selection of every nth member of the population off a list (like every 10th person on the list is selected) -Convenience sampling: A sample composed of individuals who are most readily available to be selected for the study (Ex. Going to specific schools) -Judgmental or purposive sampling: Participants are specifically chosen by the researcher

Three components of a research proposal

-Research question: Hypothesis-the question to be answered -Literature review: Review of pertinent reports & studies to determine what is currently known -Research study design: Based on findings a type of study design is chosen

P-Value (Probability Level)

-Square root of sample variance -Most commonly used method of dispersion in oral hygiene research -Determines if the results are statistically significant -They range from 0-1, the lower the number, the stronger the results (.0005 is stronger than .005) -The lower the number, the more statistically significant -At value equal to or less than .05 is considered statistically significant in most situation of oral health research

Historically who has worked to expand the practice of the RDH's scope of practice?

-State dental hygiene associations -With support from the American Dental Hygienists' Association (ADHA)

Null Hypothesis

-Stated in terms of a negative outcome: the hypothesis to be tested and rejected in favor of an alternative -Example: Ultrasonic instrumentation is not significantly more effective than hand scaling during periodontal debridement. -Results: If the researcher finds a significant difference does exist, the null hypothesis is rejected, which states that a difference does exist.

Range

-The spread or dispersion of scores/data -Can be the high score minus the low score -Affected by what the high and low scores are

What is head start?

-The title "head start" describes giving children's a "head start" for their future -Provides educational, social, medical, dental nutrition, and mental health services to pregnant mother and children up to 5 years old -Federal program -Administered by: The Administration for Children and Families (ACF)

Barrier to Change

-Unexpected changes in external conditions -Lack of commitment to implement -Resistance of people involved -Lack of funding/resources

CI-S Index

0 = No calculus 1 = Supragingival calculus covering not more than 1/3 of the tooth surface 2 = Supragingival calculus covering more than 1/3 but not more than 2/3's of the exposed tooth surface 3 = Supragingival calculus covering more than 2/3's of the exposed tooth surface Individual Scores: -EXCELLENT: 0 -GOOD: 0.1-0.6 -FAIR: 0.7-1.8 -POOR: 1.9-3.0

DI-S Index

0 = no debris or stain 1 = Soft debris covering not more than 1/3rd or the presence of extrinsic stain 2 = Soft debris covering more than 1/3 but not more than 2/3's of the exposed tooth surface 3 = Soft debris covering more than 2/3's of the exposed tooth surface Individual Scores: -EXCELLENT: 0 -GOOD: 0.1-0.6 -FAIR: 0.7-1.8 -POOR: 1.9-3.0

Testlet #1

A dental hygienist employed by a dental clinic in a federal correctional institution is planning to implement a plaque control program for female prisoners. She has worked at the prison for three years and has noticed a high prevalence of gingival and periodontal disease. The prison warden has given her permission to develop a pilot program with funding for additional supplies and working hours. One of the first steps the dental hygienist performed was to distribute a survey to the seventy-five female prisoners involved in the pilot program. The questionnaire data indicated that 65 percent brush daily, 10 percent floss on a regular basis, and 80 percent of emergency dental cases are due to toothaches.

For Testlet #1 Which of the following is the MOST precise learning objective for the educational component of this program? (hint—remember the components of a SMART objective) A: Caregivers will be able to list, in the correct order, all steps of oral cancer self-assessment, as they were presented in the seminar B: Caregivers will understand the importance of daily oral hygiene C: Caregivers will be able to demonstrate correct toothbrushing, flossing, and use of other aids on a typodont D: Caregivers will be able to explain the oral-systemic health connection

A: Caregivers will be able to list, in the correct order, all steps of oral cancer self-assessment, as they were presented in the seminar

An individual who intentionally or unintentionally causes social, cultural or behavior change. A: Change agent B: Lobbyist C: Grant Writer D: Coalition

A: Change agent

Three state public health dental hygienists are identifying oral health needs of persons residing in state-subsidized drug and alcohol rehabilitation centers. One study compared oral lesions in persons who smoke cigarettes to those who do not smoke. This study was performed in three state rehabilitation centers, and patient selection was done in alphabetical order by choosing every third individual from the patient list. The two dental hygienists who worked jointly for one day at each of the three sites calibrated the index. The type of research utilized in this study is: A: Descriptive B: Historical C: Experimental D: Ex post facto

A: Descriptive

A distribution of the usual presence of disease in a particular geographic region is called: A: Endemic B: Epidemic C: Mortality D: Pandemic

A: Endemic

The accuracy of inferring (generalizing) the results from the sample to the population at large is referred to as: A: External validity B: Internal validity C: Prevalence D: Reliable indicators

A: External validity

If additional funding is needed, which of the following governments should be helpful? A: Federal government B: State government C: Local government D: A partnership between state and local governments

A: Federal government

One examiner is consistent when measuring DMFT at several examinations on the same individual. This is describing: A: Intra-rater reliability B: Inter-rater reliability C: Calibration D: Predictive value

A: Intra-rater reliability

The dental hygienists established the research hypothesis as "there is no significant correlation between cigarette smoking and oral lesions." This is an example of what type of hypothesis? A: Null B: Positive C: Correlational D: None of the above

A: Null

The primary purpose of implementing a pilot program is to: A: Perform the planned program on a small population to ascertain its success before performing it on a larger population B: Develop measurable objectives so that the program can be effectively evaluated C: Solicit more funding to implement the full program D: Encourage other federal prisons to implement similar programs into their dental clinics

A: Perform the planned program on a small population to ascertain its success before performing it on a larger population

Which of the following is the best use of the dental hygienist in this program? A: Present an in-service training program to the nursing home staff B: Conduct an educational program for the residents on oral hygiene C: Use portable equipment to make services available to the residents D: Provide daily oral hygiene care for the residents

A: Present an in-service training program to the nursing home staff

What type of study is represented by evaluating the change of knowledge as a result of the educational component? A: Prospective using pretest/post-test B: Case control C: Correlational D: Time series

A: Prospective using pretest/post-test

Three state public health dental hygienists are identifying oral health needs of persons residing in state-subsidized drug and alcohol rehabilitation centers. One study compared oral lesions in persons who smoke cigarettes to those who do not smoke. This study was performed in three state rehabilitation centers, and patient selection was done in alphabetical order by choosing every third individual from the patient list. The two dental hygienists who worked jointly for one day at each of the three sites calibrated the index. When the dental hygienists select the most effective index to measure oral lesions, which of the following is a necessary criterion? A: Reliability in calibration B: Flexibility in measurement C: Predictability of outcome D: All of the above

A: Reliability in calibration

The best way to ensure adequate representation of the whole population is to: A: Take a random sample B: Take a convenience sample C: Take a judgmental sample D: None of the above

A: Take a random sample

For Testlet #1 What would be the BEST measure of the success of the program? A: improved oral health indicators of the residents B: increased oral health knowledge of the staff C: administrative support for the program D: increased availability of oral hygiene supplies for use by the residents

A: improved oral health indicators of the residents

For Testlet #1 The success of the program is evaluated by screening the residents again a year later to identify any lesions that have not been found previously. What type of study would this exemplify? A: prospective B: case-control study C: cross-over D: retrospective

A: prospective

To evaluate the success of the program, the students return in 6 months to measure denture cleanliness. What statistic would be used to compare the mean baseline and post-test scores? A: t test B: ANOVA C: Chi-square D: Correlation coefficient

A: t test A t test is used to compare two mean scores

State agencies such as dental boards fall within which types of law?

Admistrative

Quasi-Experimental

An experimental study that lacks inherent control Used to aid in planning other studies Limits: -No control of extraneous variables -Decreased internal validity Example: Use of a sleep apnea device

GI Index

Assesses severity of gingivitis F, L, M, D Based on color, consistency, and bleeding

Which of the following is the highest priority population? A: Physicians B: Allied health technicians C: Nurses D: Clerical support staff

B: Allied health technicians

The research design is an example of what type of epidemiological study? A: Longitudinal B: Cross-sectional C: Prospective cohort D: Case-control

B: Cross-sectional

The type of research utilized in this study is A: Historical B: Descriptive C: Experimental D: Ex post factor

B: Descriptive

What are the four general components of the epidemiology triangle? A: Environment, Time, Agent, Education B: Environment, Time, Agent, Host C: Education, Time, Age, Health Status D: Education, Time, Agent, Age

B: Environment, Time, Agent, Host

The program had to be rescheduled due to a sudden increase in absences from the camp due to the flu. Which of the terms best describes this flu situation? A: Endemic B: Epidemic C: Pandemic D: Incidence

B: Epidemic

What is the best teaching method for this program? A: Demonstration B: Guided practice C: Lecture D: Video presentation

B: Guided practice Guided practice builds on the demonstration and provides an opportunity to correct any misunderstandings.

How can you determine the caregivers' compliance with providing daily oral hygiene care for the residents? A: Assess a change in the values of the caregivers by conducting focus groups B: Measure the plaque and gingivitis scores of residents over time C: Assess the caregivers' knowledge with a post-test D: Observe the caregivers' ability to brush correctly at the last session

B: Measure the plaque and gingivitis scores of residents over time

What is the best method of evaluating the caregivers' ability to conduct oral cancer screenings? A: Administer a post-test after the training B: Observe the caregiver conducting oral cancer screenings C: Interviewing the residents about the caregivers technique D: Survey the family members

B: Observe the caregiver conducting oral cancer screenings

To further ascertain the dental needs of the prisoners, which of the following should be utilized? A: Access to care regarding clinic hours, payment, and prisoner schedules B: Pre-index scores for plaque and gingival and periodontal conditions C: A survey regarding prisoners' dental knowledge, values, and attitudes D: The level of prisoners' demand for dental care

B: Pre-index scores for plaque and gingival and periodontal conditions

All are true of the US Surgeon General's 2003 Call to Action except one. Which one is the EXCEPTION? A: Requested an increase in the diversity of the oral health workforce B: Requested a stabilization in the capacity of the oral health workforce C: Requested an increase in the flexibility of the oral health workforce D: The ADHP helps move the dental hygiene profession closer to meeting the Surgeon General's requests

B: Requested a stabilization in the capacity of the oral health workforce? THE ANSWER IS NOT D FOR SURE

Which of the following is not a role of a dental hygiene change agent? A: Resource linker B: Stakeholder C: Catalyst D: Solution giver

B: Stakeholder

Which of the following is characteristic of the type of sampling used in these data? A: Stratified B: Systematic C: Simple random D: Convenience

B: Systematic

What is the purpose of the screening for denture cleanliness? A: To motivate patients/clients B: To individualize the education provided C: To collect data requested by Camp Sunshine D: To give dental hygiene students practice with screening techniques

B: To individualize the education provided

Which of the following would be an effective teaching strategy to raise the caregivers' value of oral hygiene? A: Demonstrate proper oral hygiene procedures B: Train them in personal oral hygiene skills C: Lecture on the importance of oral hygiene D: Show pictures of oral cancer

B: Train them in personal oral hygiene skills

Hypotheses are usually stated in the null form. Which of the following is an example of a null hypothesis? A: Brand X significantly reduces periodontal pocket depths B: Ultrasonic instrumentation is not significantly more effective than hand scaling during periodontal debridement C: Ultrasonic instrumentation is significantly more effective than hand scaling during periodontal debridement D: All of the above

B: Ultrasonic instrumentation is not significantly more effective than hand scaling during periodontal debridement

All of the following preventive programs are indicated by the assessment results EXCEPT one. Which one is the EXCEPTION? A: Daily use of a higher concentration of fluoride dentifrice (5000 ppm) B: Use of a 0.12% chlorhexidine rinse daily C: Referral for restorative treatment D: Educational presentation on basic oral hygiene

B: Use of a 0.12% chlorhexidine rinse daily

T/F (1) Incidence is the number of existing cases of disease in population at a given time. (2) Prevalence number or rate of new cases of disease over a given period

Both statements are false

T/F (1) Indirect supervision means the dentist must be in the treatment operatory during the dental hygiene treatment. (2) Direct supervision means dental hygiene practice without a dentist physically present.

Both statements are false

T/F Incidence is the number of existing cases of a disease in a given population at a given time. Prevalence is the number of new cases of a disease during or over a given time period.

Both statements are false

T/F (1) A Cohort Study is a Prospective study. (2) A Cohort Study involves a well-defined group of people who have had a common exposure.

Both statements are true

T/F (1) A coalition is an alliance of distinct organizations or persons to take a joint action. (2) A coalition can increase the potential for success in creating policy change.

Both statements are true

T/F (1) Interprofessional education involves learners within the same profession learning from one another. (2) Intraprofessional education is when two or more professions learn from each other.

Both statements are true

T/F (1)The epidemiology triangle (triad) includes host factors, a pathogen (agent), and environmental circumstances. (2) The agent factors can include biologic, chemical, physical or mechanical agents.

Both statements are true

T/F (1)The legislative branch of government makes the laws in each state. (2) The judicial branch interprets the laws, but does not make them.

Both statements are true

T/F Descriptive research is characterized as the attempt to identify and describe the topic being researched. Analytic research attempts to establish why something is the way it is and how it came to be that way.

Both statements are true

T/F External validity means that the results of the study can be inferred to the general population and depends on how well the sample represents the population. Internal validity means that the study measured what it was supposed to measure.

Both statements are true

State agencies such as dental boards fall within which type of law? A: Statutory B: Common C: Administrative D: Constitutional

C: Administrative

Three state public health dental hygienists are identifying oral health needs of persons residing in state-subsidized drug and alcohol rehabilitation centers. One study compared oral lesions in persons who smoke cigarettes to those who do not smoke. This study was performed in three state rehabilitation centers, and patient selection was done in alphabetical order by choosing every third individual from the patient list. The two dental hygienists who worked jointly for one day at each of the three sites calibrated the index. The research design is an example of what type of epidemiological study? A: Case-control B: Prospective cohort C: Cross-sectional D: Longitudinal

C: Cross-sectional

All of the following are established potential risk factors for root caries in this population EXCEPT one. Which one is the EXCEPTION? A: Medications B: Smoking C: Diabetes and heart disease D: Plaque biofilm E: Xerostomia

C: Diabetes and heart disease

What is the most important cultural factor to consider when planning an intervention for the population? A: Ethnic background B: Educational level C: Health literacy D: Age

C: Health literacy

What would be the best measure of the success of the program? A: Increased oral health knowledge of the staff B: Increased availability of oral hygiene supplies C: Improved oral health indicators of the residents D: Administrative support for the program

C: Improved oral health indicators of the residents

Which of the following is not a characteristic of a change agent? A: Individual or group with a common concern B: Joins efforts to educate, promote, or lobby others C: Is not concerned with the availability of resources D: An individual who intentionally or unintentionally causes social, cultural, or behavioral change

C: Is not concerned with the availability of resources

All are true of administrative law except one. Which one is the EXCEPTION? A: Created by government administrative agencies B: Includes state dental board rules and regulations C: Is the legislative-enacted law which serves to promote justice D: Delegated legislative power to an administrative agency

C: Is the legislative-enacted law which serves to promote justice

Which branch of government makes laws for the state? A: Judicial B: Administrative C: Legislative D: Executive

C: Legislative

What level of oral hygiene is revealed by the mean PlI? A: No plaque present B: Slight plaque present C: Moderate plaque present D: Severe plaque present

C: Moderate plaque present

The extent of disease, injury, or disability in a population is called: A: Internal validity B: Mortality C: Morbidity D: External validity

C: Morbidity

All indices might be utilized by the dental hygienist for assessing gingival bleeding on this population EXCEPT one. Which one is the EXCEPTION? A: EIBI B: SBI C: OHI-S D: GBI

C: OHI-S

Which of the following programs should be planned to address one of the Healthy People 2020 oral health objectives for this target population? A: Denture marking and denture care B: Referral to Medicaid provider C: Oral cancer screening and referral, as needed D: Screening for periodontal condition and referral, as needed

C: Oral cancer screening and referral, as needed

As a consultant to the community-funded Women, Infant, and Children's (WIC) clinic your main assignment is to collaborate with the nearby community college to include dental hygiene students in oral health assessments of the women participating in WIC's clinical activities. After studying the health histories of the women utilizing WIC's services, you note that bleeding gums and toothaches are frequently reported. While consulting with the dental hygiene program director she indicates that you will also be assigned to statistically analyze data from several board exams and professional journals.Which of the following indices would BEST meet the goals of determining plaque status and providing an opportunity for the women to observe plaque biofilm? A: DI-S and PLI B: GI and PLI C: PLI and PHP D: OHI-S and PHP

C: PLI and PHP

If the data reveal lesions that have not been identified previously, the dental hygienist plans to work with the director of nursing to establish a new protocol for routine oral cancer screening by the registered nurses on staff. What core public health function would this exemplify? A: Assessment B: Assurance C: Policy development D: Tertiary prevention

C: Policy development

The Surgeon General is nominated by: A: House of Representatives B: Senate C: President D: Governor

C: President

What type of data would be collected with the screening? A: Quantitative and primary B: Quantitative and secondary C: Qualitative and primary D: Qualitative and secondary

C: Qualitative and primary

All are examples of Descriptive research EXCEPT one. Which one is the EXCEPTION? A: Cohort Study B: Case Study C: Randomized Clinical Trial Study D: Cross-sectional Study

C: Randomized Clinical Trial Study

Which of the following is an ethical responsibility of the students and faculty who are implementing this program? A: Communicate oral findings to the staff of the facility B: Prepare a formal report of the findings for the health department C: Refer patients who have suspicious lesions identified during the program D: Take the dentures back to the clinic to clean more thoroughly

C: Refer patients who have suspicious lesions identified during the program

When the dental hygienists selects the most effective index to measure oral lesions, which of the following is a necessary criterion? A: Flexibility in measurement B: Predictability of outcome C: Reliability in calibration D: All of the above

C: Reliability in calibration

Which three components make up a research proposal/protocol? A: Research question, survey, and the research study design B: Research question, data collection, and study objectives C: Research question, review of the literature, and the research study design D: None of the above

C: Research question, review of the literature, and the research study design

What relationship does the correlation between the RCI and PlI demonstrate between root caries and plaque biofilm in this target population? A: Weak positive B: Moderate positive C: Strong positive D: Weak negative E: Strong negative

C: Strong positive

The statistics regarding brushing, flossing, and emergency dental care visits imply that: A: The need and the demand for dental care are equal B: The need for dental care is lower than the demand for dental care C: The need for dental care is higher than the demand for dental care D: None of the above

C: The need for dental care is higher than the demand for dental care

For Testlet #1 Which of the following would be an effective teaching strategy to raise the caregivers' value of oral hygiene? A: show them pictures of oral cancer B: lecture on the importance of oral hygiene C: train them in personal oral hygiene skills D: demonstrate proper oral hygiene procedures

C: train them in personal oral hygiene skills

WHO: World Health Organization induced the

CPI: Community periodontal index also called CPITN (community periodontal index of treatment needs)

Historical Approach

Can lead to new insights and recommendations for future studies by using past events through records and literature reviews, or interviews Limits: -Biased reports -Distortion of events -No ability for replication -Locating accurate data -Gaps in knowledge Example: water fluoridation

Qualitative Data

Cannot be measured numerically Expressed as outcomes, themes or categories Examples: -Lists or ranks client's responses to what they liked most or least about their dental hygiene treatment

Type 1 Caries Exam

Comprehensive Includes radiographs surveys and all tests like vitality tests

What are the roles identified for the dental hygiene change agent? A: Catalyst B: Solution giver C: Resource linker D: All of the above

D: All of the above

Which statement(s) are true? A: A research study should be reliable as well as valid B: Reliability refers to the degree to which the study would yield the same results within the same population each time the study is repeated C: The purpose of inferential statistics is to generalize between the sample being studied D: All of the above E: None of the above

D: All of the above

Which is not considered a major body of law? A: Common law B: Statutory law C: Administrative law D: Judicial law

D: Judicial law

All are part of the SMART model for writing objectives EXCEPT one, which one is the EXCEPTION? A: Time Bound B: Measurable C: Attainable D: Recurrent E: Specific

D: Recurrent

The overall goal of this plaque control program is to: A: Decrease overall expenses of dental care in the clinic B: Increase the number of prisoners seeking dental treatment C: Increase the amount of practicing dentists in the clinic D: Reduce the amount of gingival and periodontal disease

D: Reduce the amount of gingival and periodontal disease

Why does biostatistics matter to dental hygienists? A: A hygienist determines correct therapy for a patient's condition from statistically significant research results B: A healthcare professional recommends safe and effective products by correctly understanding biostatistics C: Biostatistics is of minor importance to dental hygienists, since it has little to do with dental hygiene clinical treatments D: a & b E: a, b, & c

D: a & b

For Testlet #1 When residents are screened a year later, new lesions are found. What will the examiners be describing? A: risk factors B: prevalence C: mortality D: incidence

D: incidence

For Testlet #1 What is the BEST method of evaluating the caregivers' ability to conduct oral cancer screening on completion of the educational program? A: interview the residents about the caregivers' technique B: survey the family members about the caregivers' technique C: administer a post-test over the cancer screening procedure D: observe the caregivers conducting oral cancer screening

D: observe the caregivers conducting oral cancer screening

Testlet #3

Dental hygiene students from a local program visit a geriatric day care called Camp Sunshine to implement a service learning project. These campers are functionally independent, although they are medically compromised. Under faculty supervision, the students screen the seniors to identify denture cleanliness and teach them how to clean their dentures daily. The goals are to improve their oral health and increase their awareness of the need for daily oral care. the students compute the mean scores of the denture cleanliness for future evaluation of program outcomes.

Standard Deviation

Example: -1000 Students took an exam -The mean was 76 -The standard deviation was 4 -What does this mean? --68% of the scores were between 72 and 80 (most of the scores) --76 (+4/-4) which is the distribution of usage --95% of the scores were between 68 and 84 --99% of the between 64 and 88 -"Walking up the hill" = Negative -"Sliding down the hill" = Positive

T/F Information that reflects the quality or nature of variables that cannot be measured numerically is referred to as quantitative data.

False

T/F Because federal laws regulate dental hygiene practice, federal senators are involved in state regulation

False

T/F Epidemiology is used to describe the health status of individuals, identify multiple factors associated with disease and conditions to explain their etiology, predict the occurrence of disease and conditions, and control the distribution of diseases and conditions at an individual level.

False Not at an individual level

T/F (1) Epidemiology attempts to understand the causes of disease and health conditions in a population. (2) An insignificant aspect of epidemiology is determinants, which is defined as a factor or event that can bring about a change in health (oral or otherwise).

First statement is true and the second is false

Epidemiology Accounts for:

Host factors Causes Physical Environment Lifestyle

Multifactorial approach to epidemiology (also called the epidemiology triangle)

Host: -Refers to an individual's genetic or social factors -Example: age, sex, race, genetic profile, previous disease, immune status, religion, customs, occupation, marital status, and familiy background Agent: -Biologic, chemical, physical, nutrional, or mechanical cause of a disease or condition -Example: S. mutans to dental caries or brushing with a hard toothbrush to abrasion Environment: -Physical, social, economic circumstances required for the disease to survive, thrive or spread (example: climate; geography; culture; water sources) -Example: smoking in relation to oral cancer; low social economic statue in relation to dental caries

Community health process of care

Individuals Steps: -Patient profile: patient age, address, preferred name, spoken language; guardian if applicable -Assessment: HH, exam, radiographs, restorative charting, periodontal charting, and diet intake -Dental hygiene diagnosis: patient's primary problems and risk level; contributing factors; constraints -Dental hygiene treatment plan: desired therapy outcome; sequence of services; cost, time and referral -Informed consent: discuss treatment plan, risks and benefits and alternative treatment plans with patients obtain patient signatures -Therapy implementation: appropriate personnel provides care - dentist; dental hygienist, and dental assistant -Therapy Evaluation Group Steps: -Population profile -Needs assessment -Needs analysis -Community oral health program plan -Community approval -Program implementation -Program evaluation

Type 3 Caries Exam

Inspection Performed with mouth mirror, explorer, and adequate illumination

Validity: Accuracy of a measurement; measures what is is supposed to measure

Internal validity: study design/ the degree to which a study is free from bias and/or controls errors External validity: the degree to which results of a study may apply, be relevant, or be generalized to populations or groups that did not participate in the study

Which branch of government makes laws for the state?

Legislative

Comparison of State and Federal Governments

Legislative: -Federal: Congress -State: State legislature Executive: -Federal: President -State: Governor Judicial: -Federal: Federal courts -State: State courts

Type 2 Caries Exam

Limited Performed with mouth mirror, explorer, adequate illumination and posterior bite-wing radiographs and selected periapicals

What is it called when an advocate is attempting to influence or sway others for action/support?

Lobbying

Quantitative Data

Numerical: -Counts -Percentages -Means Examples: -Pocket depths -Number of teeth with sealants -Number of communities with water fluoridation

Experimental (Prospective)

Often known as a clinical trial. It studies an experimental treatment/intervention using dependent & independent variables. -Dependent Variable-the variable that is being tested -Independent Variable-the variable being manipulated Uses a placebo and control groups Best experimental studies are double-blind Limits: -Appear artificial due to amount of control -Decreased external validity Example: Instrumentation with piezo scaler vs. ultrasonic scaler

Water Fluoridation

Old recommended level of water fluoridation: -1962 US public health service was 0.7-1.2 ppm or mg/L New recommended level of water fluoridation: -2011 US department of health and human services recommends 0.7 ppm or mg/L Air temperature can affect fluoride concentrations in water

Prevalence vs. Incidence

Prevalence -Total number of cases at a point in time Incidence -How many NEW cases or the rate of new cases

OHI-S Index

Purpose: To assess oral cleanliness by estimating the tooth surfaces covered by debris and/or calculus. Uses probe or explorer OHI-S (Combines DI-S and CI-S) -EXCELLENT: 0 -GOOD: 0.1-1.2 -FAIR: 1.3-3.0 -POOR: 3.1-6.0

Type 4 Caries Exam

Screening The least valid uses a tongue depressor and available illumination and produces the greatest number of false negatives

Correlation Coefficient (R-value)

Signifies the relationship between variables and direction positive or negative -Helps you to understand how strong the relationship is between the two variables -R= stands for the absolute value (the closer to +/- 1 the stronger the correlation) -Positive correlation +1 -Negative correlation -1 -Example: As one variable increases so does the other (or decreases) -Example: Periodontal disease and diabetes Interpretation of correlation coefficient -0.9 to 1.0 is very strong or very high -0.70 to 0.89 is strong or high -0.50 to 0.69 is moderate -0.26 to 0.49 is weak -0.25 and below is little if any relationship -R = 0.0 IS NO CORRELATION

S.M.A.R.T.

Specific Measurable Attainable Relevant Time-based

Laws which explain what services dental hygienists can provide are found in state dental practice acts

State dental practice act

Tests used in inferential statistics (methods for using data from sample populations to draw conclusions about a larger or entire population)

T-test: test the hypothesis between two mean scores -Ex: pre and post test ANOVA: compares the difference between 3 or more mean scores -Hint to help remember: 3 vowels = 3 mean scores P-value: probability value -Used when testing a hypothesis -Probability that a condition/circumstances would happen by chance without intervention -Standard acceptability is 1 out of 20 or p-value of less than or equal to 0.05 -(Greater than 0.05 will negatively affect the results)

Testlet #1

The director of a local nursing home has approached a public health dental hygienist to design an oral health protocol for the 250 residents. Currently, a registered nurse is performing the intake oral examination, and the nursing home has an "on call" dentist. The majority of residents are partially edentulous, have partial removable dentures, and require assistance with daily hygiene practices. The caregivers state that the residents have severe halitosis, trouble eating, and frequently lose their removable partial dentures. The dental hygienist observes that the caregivers are neglecting daily oral hygiene care and are not expected to conduct oral cancer screenings. On the basis of these observations, the dental hygienist determines to carry out oral hygiene and oral cancer screening of all residents and introduce an educational component to be used by the facility's caregivers and interested family members. Flashlights, disposable mouth mirrors, masks, gloves, protective eyewear, and 2x2 gauze are required for the screening. The educational component will consist of six weekly 1-hour sessions and will focus on knowledge of the risk of oral cancer, the benefits of periodic oral screenings, recognition of signs and symptoms of common oral lesions, daily oral hygiene care, and other oral health procedures to meet the needs of the residents. A pretest and post-test will be used to evaluate change in knowledge.

Testlet #2

The director of a local nursing home has approached a public health dental hygienist to design an oral health protocol for the 300 residents. The nursing home has an on-call dentist. The majority of the residents require assistance with daily hygiene practices. The caregivers state that the residents have severe halitosis, trouble eating, and frequently lose their removable partial dentures. The dental hygienist observes that the caregivers are neglecting daily oral hygiene care for the residents and are not expected to conduct oral cancer screenings. The dental hygienist conducts oral hygiene and oral cancer screening of all the residents, and introduces an educational component to be used by the caregivers and interested family members. The educational component with consist of six weekly 1-hour sessions. A pretest and post-test will be used to evaluate change in knowledge.

Testlet #5

The director of the Vintage Retirement Center contacts the local dental hygienists' society to provide a seminar on oral health. The facility has a population of 100 well residents between the ages of 60 and 78 years who have a middle SES. Twenty percent of the residents are edentulous, and the remaining 80% have varying numbers of teeth present. The oral health assessment results revealed a mean PlI of 2.1, mean DMFT of 5.2, mean D of 0, RCI of 2.1, and untreated root caries of 1.5. Correlation analysis revealed a correlation coefficient of r=+0.81 for the relationship between the RCI and PlI in this group. Seventy percent of the residents have a dental home and report having regular dental care. Less than 10% of them report mild signs and symptoms of xerostomia.

T/F While working in private dental practice you volunteered extensively at a small state-funded dental clinic in a rural county whose primary employer is a large tobacco-growing operation. Community water sources are fluoridated, but a significant portion of the population relies on well water. Recently you were hired by a nonprofit organization through a state-funded grant to develop tobacco-cessation strategies and provide dental hygiene care for underserved local adults. Before you initiate services, the grant mandates that you assess the oral health status and needs of the population. An epidemiologist is available for you to consult, as is an environmental health specialist. (1)Four components necessary to address and develop before the initiation of an oral health program are assessment, planning, implementation, and evaluation. (2)A community oral health assessment is a narrowly constructed process designed to extend data collected in private dental offices to wider segments of the population.

The first statement is true and the second is false

T/F (1) A Case-control study is a descriptive study that is prospective. (2) A Case-control study compares two groups, a case group and a control group.

The first statement is true and the second is false.?

Testlet #6

The human resources director of an urban county hospital is alarmed by the rising cost of employee health insurance premiums related to tobacco use. The administrator charges a dental hygienist with addressing the issue of tobacco use. The dental hygienist conducts a survey as part of program planning. Analysis of the survey revealed usage per day of 4.6 for administrators, 19.6 for clerical support staff, 10.6 for nurses, 6.2 for physicians, and 19.8 for allied health technicians. Standard deviation is 2.2 cigarettes for all groups. There are 20 cigarettes per pack. The distribution of usage is 17.6 to 22.0 cigarettes per day (19.8 ± 2.2). The mean represents the average of scores and the standard deviation (SD) represents the distribution or spread of scores around the mean. The data follow a normal bell curve.

Definition of epidemiology

The study of the nature, cause, control, and determinants of the frequency and distribution of disease, disability, and death in human populations, NOT individuals

Testlet #4

Three state public health dental hygienists are identifying oral health needs of persons residing in state-subsidized drug and alcohol rehabilitation centers. One study compared oral lesions in persons who smoke cigarettes to those who do not smoke. This study was performed in three state rehabilitation centers, and patient selection was done in alphabetical order by choosing every third individual from the patient list. The two dental hygienists who worked jointly for one day at each of the three sites calibrated the index.

T/F Although not every dental hygienist will conduct research studies or evaluate community programs, each and every dental hygienist must understand the research process, including data analysis and interpretation, to be able to critically analyze the results of published studies and understand the epidemiology of disease. This is essential for the dental hygienist to be able to practice therapies and implement programs that are based on scientific evidence.

True

T/F Based on the analysis, the dental hygienist can conclude that 95% of the allied health technicians smoke 15.4 to 24.2 cigarettes per day.

True

T/F Conducting another screening a year later to identify any new lesions is an example of incidence.

True

T/F Epidemiology can be defined as the study of the nature, cause, control, and determinants of the frequency and distribution of disease, disability, and death in human populations

True

T/F If the data follow a normal bell curve, 68% of the population will fall within + or - 1 standard deviation.

True

T/F The competent change agent has refined abilities of vision, collaboration, communication, and negotiation.

True

T/F The following is an appropriate instructional objective: On completion of the computer-based educational program, staff members will be able to correctly identify 80% of the harmful ingredients in tobacco.

True

T/F To be able to generalize research results to the entire population, the researcher must be sure the sample population is a representative subset of the entire population.

True

T/F Judges do not make the laws, but they interpret them

True

Descriptive Approach

Used to describe and identify current events or situations Conducted with: Surveys: -Gathers broad information & uses a large sample via questionnaires & interviews -Limit: Lack of Depth -Ex. Frequency of dental visits Case-studies: -A comprehensive report on one individual or event -Limits: Possible bias, replication not possible -Ex. Complex orthodontic treatment Cross-sectional studies: -Studies a cross-section of a population or group in a limited period of time Also called prevalence studies Cohort/longitudinal studies: -Same population over time -Limits: Time-consuming, costly & subject loss -Ex. Changes in oral health over time Prospective, incidence of new disease Content analysis: -Analyze documents themselves -Limit: Subjectivity in evaluation -Ex. Evaluation of dental journal articles Trends: -Uses both descriptive & historical research to establish patterns in the past in order to predict future events/occurrences -Limit: Long-range prediction is less valid & reliable -Ex. Use of artificial sweeteners in carbonated beverages Correlational studies: -Measures the relationship between variables (two sets of data) -Limit: No indication correlation indicates cause-effect relationship between variables -Ex. Frequency of flossing and periodontal disease Retrospective studies: -Investigates existing differences to determine possible causes -Limits: Can't determine causal relationship, only determines functional relationship, and independent variable cannot be manipulated -Ex. Study of 25-30-year old's with or without periodontal disease

Working with patients with Dementia or Alzheimer's disease

Who oversees their oral health? Who must value oral health? Who would you be educating to deliver appropriate oral health? Would these people need to value their own oral health?

Inter-rater reliability

agreement among TWO or more examiners as they apply a test or index

Change Agent

an individual who intentionally or unintentionally causes social, cultural, or behavioral change

Intra-rater reliability

consistency of a SINGLE examiner in the application of a test or index