National Board Review Darby Ch. 20 Community Oral Health

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You have been employed as a public health dental hygienist in a local health department to provide educational presentations for the participants in the WIC program in a non-fluoridated community. The natural fluoride concentration of the community water supply is 0.3 ppm. One of your first assignments is to present an educational program on basic oral health practices for culturally diverse pregnant teens in three alternative high schools that have day care facilities. How much additional fluoride is required to bring the fluoride concentration of the water supply to optimal level?

0.4 ppm

The administrator of a group home for mentally challenged adults has received multiple complaints from the attending caregivers regarding the residents' oral health. Limited manual dexterity abilities of the residents require that they receive assistance with oral hygiene routines; yet complaints of severe resistant halitosis and bleeding during normal oral hygiene routines have made the caregivers reluctant to provide assistance. Frustrated by a lack of staff compliance, the group home administrator contacts the local county public health dental hygienist, knowing that the county health department has a grant for oral care for this population. After gathering basic demographic information, the dental hygienist make a visit to the home to determine the actual oral health status of the residents. What know characteristics about this population can be utilized in a community profile?

Age Source of funding Population setting

The Human Resources director of an urban county hospital is alarmed by the rising cost of employee health insurance premiums related to tobacco-associated health conditions. The administrator charges the occupational health director, a dental hygienist, with addressing the issue of employee tobacco consumption. Employee demographics for the hospital are as follows: 40% Caucasian, 38% African American, 12% Hispanic, 10% Asian. The dental hygienist conducts an employee tobacco usage survey as part of the program planning process. Analysis of the survey reveals mean cigarette 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. Cigarette packs are known to contain 20 cigarettes. A computer-based educational program is planned for the initial intervention with the goal of reducing daily cigarette usage. Based on the survey results, which of the following is the highest-priority population to target with an intervention?

Allied health technicians

A local dental hygienists' association and a faith-based organization collaborate to target a school for a comprehensive oral disease prevention program. The school serves a population that consists of 50% Medicaid-eligible children, and 75% of them receive the school lunch program. The ethnic group representation is 15% Hispanic American, 5% African American, and 80% non-Hispanic white. The fluoride concentration of the community water is below the optimal level. A public health hygienist screens the children in preschool through grade 5 annually. Data for 2014 indicate a 22% urgent decay rate across all ages. Further assessment reveals that many of the children are not seeing a dentist routinely. A sealant program is conducted in grade 2 and 5. A fluoride varnish program is conducted with the preschoolers and grade K, including two applications annually; these children are screened for dental caries with a tongue blade and available light at the time of each application. An educational program is designed to meet the needs of the children in this school. Finally, the team explores the option of a fluoridation campaign to achieve water fluoridation in this community. What would have been BEST means of identifying the reported decay rate? A. Basic Screening Survey (BSS) B. Deft C. DMFT D. RCI

Basic Screening Survey (BSS)

The director of the Vintage Retirement Center contacts the local dental hygiene society to provide a seminar on oral health and conduct oral cancer screenings for the purpose of improving the oral health of the residents. The facility has a population of 100 well residents between ages 60-78 who have a middle SES; 80% of the residents are dentate, with varying numbers of teeth present. The oral health assessment results reveal a mean PII of 2.1, mean GI of 0.8, mean DMFT of 5.2, mean D of 2.0, RCI of 2.1, and untreated root caries of 1.5. Correlation analysis reveals a correlation coefficient of r=0.81 for the relationship between RCI and PII of this group. About 70% of the residents report having a dental home where they receive routine dental care. Over 50% of them report signs and symptoms of xerostomia. A SMART objective is established to improve the oral hygiene within 6 months by a six-member team of volunteer members of the Dental Hygienist Society delivering an oral hygiene educational program for residents and staff, providing oral hygiene supplies, and following up with reminders and motivational techniques to enhance the residents' daily effective oral hygiene. The Society has a budget for community oral health that can be used to support the program. What change in the DMFT scores would indicate that the needs are being met 5 yrs after implementation of a program? A. Decrease total DMFT B. Decrease D, no change M, increase F C. No change D, decrease M, increase F D. Decrease D, increase M, increase F E. Both B and D could be acceptable

Both B and D Decrease in D, no change in M, increase F Decrease in D, increase in M, increase F

A high dental caries rate has been reported by the school nurses in Head Start children in the county of the basis of the rate of toothaches and absences. Families are primarily Spanish-speaking Hispanic and East Indian migrant farm workers. They reside in predominantly rural settings with individual well-water supplies. At an informational meeting, the Head Start dental health coordinator introduces the goal of the program to the Head Start family advocates. A team of DH students from the local college is asked to design a comprehensive program to address the problem of dental caries in this population. They begin by collecting baseline date using the deft, OHI-S, and GI and identify a high level of S-ECC. Which would be MOST appropriate to explain during the informational session?

Cause of early childhood caries

DH students conduct a study to compare the effectiveness of two non alcohol mouthrinses, a 0.02%NaF rinsed (Listerine Zero) and a 0.07% CPC rinse (Crest Pro Health), in controlling plaque biofilm and gingivitis. A sample of 136 healthy adult volunteers is taken from the university dental hygiene clinic. ONly dentate adults with no to mild periodontitis are accepted to participate in the study. The study participants are qualified for inclusion in the study by their plaque biofilm forming potential and each participant. Study participants and examiners are unaware of the formula used by each participant. One group receives the 0.07% CPC mouthrinse, and the other group receives the 0.02% NaF mouthrinse. All other ingredients of both rinses are standardized. Two examiners are calibrated in the use of the PII and GI to measure plaque biofilm at baseline, 2 months, 4 months. The baseline PII scores are used during group assignment to ensure that the two groups have equivalent oral hygiene. What type of study is reflected by the methods of this reason study? Select four types of studies. A. Analytic study B. Clinical trial C. Double-bind study D. Experimental study E. Posttest only F. Retrospective study G. Time-series study

Clinical trial Double-blind study Experimental study Time-series study

DH students conduct a study to compare the effectiveness of two non alcohol mouthrinses, a 0.02%NaF rinsed (Listerine Zero) and a 0.07% CPC rinse (Crest Pro Health), in controlling plaque biofilm and gingivitis. A sample of 136 healthy adult volunteers is taken from the university dental hygiene clinic. ONly dentate adults with no to mild periodontitis are accepted to participate in the study. The study participants are qualified for inclusion in the study by their plaque biofilm forming potential and each participant. Study participants and examiners are unaware of the formula used by each participant. One group receives the 0.07% CPC mouthrinse, and the other group receives the 0.02% NaF mouthrinse. All other ingredients of both rinses are standardized. Two examiners are calibrated in the use of the PII and GI to measure plaque biofilm at baseline, 2 months, 4 months. The baseline PII scores are used during group assignment to ensure that the two groups have equivalent oral hygiene. The application of the PII in this study is an example of which step in the scientific method?

Collection, organization, analysis of data

A dental hygiene US Public Health Services (USPHS)- commissioned core officer is assigned to an Indian Health Service (IHS) Clinic to improve the oral care of pregnant women in an American Indian rural community with a population of 26,000. Approximately 20% of the pregnant women in this population develop gestational diabetes. When a woman first sees the physician in the clinic for prenatal care, she is referral to the dental clinic for a dental examination. Only 25% of the patients referred over the previous 6 months complied with dental referral, scheduled an appointment, and received treatment. The community is not classified a "dental manpower shortage area" because of the staffing of this clinic and the existence of this program. A survey of the pregnant women served by this clinic reveals that the women do not realize their risk for diabetes, are unaware of the relationship between oral health status and diabetes, and do not understand the benefits of an oral health assessment in relation to their overall health and the health of their babies. For the purpose of discussing the problem and possible solutions, the dental hygienist arranges a meeting of the medical clinic director, the dental clinic director,the medicine man of the Indian tribe, and dental clinic staff member who is a member of the tribe. This team sets a goal of doubling the rate of compliance with the dental referral to 30% within 6 months. Which theory of health promotion is exemplified by this program?

Community organization

A local dental hygienists' association and a faith-based organization collaborate to target a school for a comprehensive oral disease prevention program. The school serves a population that consists of 50% Medicaid-eligible children, and 75% of them receive the school lunch program. The ethnic group representation is 15% Hispanic American, 5% African American, and 80% non-Hispanic white. The fluoride concentration of the community water is below the optimal level. A public health hygienist screens the children in preschool through grade 5 annually. Data for 2014 indicate a 22% urgent decay rate across all ages. Further assessment reveals that many of the children are not seeing a dentist routinely. A sealant program is conducted in grade 2 and 5. A fluoride varnish program is conducted with the preschoolers and grade K, including two applications annually; these children are screened for dental caries with a tongue blade and available light at the time of each application. An educational program is designed to meet the needs of the children in this school. Finally, the team explores the option of a fluoridation campaign to achieve water fluoridation in this community. Which of the following should be done first in this program?

Contact key community leaders to obtain a broad base of support for fluoridation

DH students conduct a study to compare the effectiveness of two non alcohol mouthrinses, a 0.02%NaF rinsed (Listerine Zero) and a 0.07% CPC rinse (Crest Pro Health), in controlling plaque biofilm and gingivitis. A sample of 136 healthy adult volunteers is taken from the university dental hygiene clinic. ONly dentate adults with no to mild periodontitis are accepted to participate in the study. The study participants are qualified for inclusion in the study by their plaque biofilm forming potential and each participant. Study participants and examiners are unaware of the formula used by each participant. One group receives the 0.07% CPC mouthrinse, and the other group receives the 0.02% NaF mouthrinse. All other ingredients of both rinses are standardized. Two examiners are calibrated in the use of the PII and GI to measure plaque biofilm at baseline, 2 months, 4 months. The baseline PII scores are used during group assignment to ensure that the two groups have equivalent oral hygiene. What sampling technique is used for this study? A. Convenience sampling B. Judgmental or purposive sampling C. Random sampling D. Stratified random sampling E. Systematic sampling

Convenience sampling

The Human Resources director of an urban county hospital is alarmed by the rising cost of employee health insurance premiums related to tobacco-associated health conditions. The administrator charges the occupational health director, a dental hygienist, with addressing the issue of employee tobacco consumption. Employee demographics for the hospital are as follows: 40% Caucasian, 38% African American, 12% Hispanic, 10% Asian. The dental hygienist conducts an employee tobacco usage survey as part of the program planning process. Analysis of the survey reveals mean cigarette 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. Cigarette packs are known to contain 20 cigarettes. A computer-based educational program is planned for the initial intervention with the goal of reducing daily cigarette usage. Which step of program planning is BEST represented by the survey described in the scenario? A. Analysis of needs B. Collection of data C. Determination of priorities D. Implantation E. Program evaluation

Determination of priorities

You have been employed as a public health dental hygienist in a local health department to provide educational presentations for the participants in the WIC program in a non-fluoridated community. The natural fluoride concentration of the community water supply is 0.3 ppm. One of your first assignments is to present an educational program on basic oral health practices for culturally diverse pregnant teens in three alternative high schools that have day care facilities. Which of the following roles of the dental hygienist is illustrated by this activity?

Educator

DH students from a local program visit a geriatric day care called Camp Sunshine to implement a serve learning project. These older adults are functionally independent, although they are medically compromised. Under faculty supervision, the students screen the older adult clients to identify denture cleanliness and teach them how to clean their dentures daily. The goals are to improve their oral health by cleaning their dentures or partial dentures, increase their awareness of the need for daily oral care, and empower them to clean their dentures. The students compute the mean scores of the denture cleanliness measure for future evaluation of the program outcomes. The educational program consists of three weekly visits to teach and provide practice in various aspects of entire care. During the first weekly lesson, the students use motivational interviewing to identify the clients' current practices and intentions regarding daily denture cleaning. The students use this information to plan individualized instruction for each client. The student return in 6 months to measure denture cleanliness to evaluate the success of the program. Although the outcomes indicate improvement in cleanliness to evaluate the success of the program. Although the outcomes indicate improvement in cleanliness for the majority of the clients, the results are skewed as a result of a large number of them missing one of the weekly sessions because they came down with the flu that week. At the end of the program, the students prepare a final report in which they communicate the outcomes of the program to the facility director and propose funding of supplies by Camp Sunshine for future programs. Which of the following terms BEST describes the situation described related to the flu? A. Cluster B. Endemic C. Epidemic D. Occurrence E. Pandemic

Epidemic

A local dental hygienists' association and a faith-based organization collaborate to target a school for a comprehensive oral disease prevention program. The school serves a population that consists of 50% Medicaid-eligible children, and 75% of them receive the school lunch program. The ethnic group representation is 15% Hispanic American, 5% African American, and 80% non-Hispanic white. The fluoride concentration of the community water is below the optimal level. A public health hygienist screens the children in preschool through grade 5 annually. Data for 2014 indicate a 22% urgent decay rate across all ages. Further assessment reveals that many of the children are not seeing a dentist routinely. A sealant program is conducted in grade 2 and 5. A fluoride varnish program is conducted with the preschoolers and grade K, including two applications annually; these children are screened for dental caries with a tongue blade and available light at the time of each application. An educational program is designed to meet the needs of the children in this school. Finally, the team explores the option of a fluoridation campaign to achieve water fluoridation in this community. Which programs has the HIGHEST priority to further meet the needs of this population?

Establish dental homes and refer children for treatment

The Human Resources director of an urban county hospital is alarmed by the rising cost of employee health insurance premiums related to tobacco-associated health conditions. The administrator charges the occupational health director, a dental hygienist, with addressing the issue of employee tobacco consumption. Employee demographics for the hospital are as follows: 40% Caucasian, 38% African American, 12% Hispanic, 10% Asian. The dental hygienist conducts an employee tobacco usage survey as part of the program planning process. Analysis of the survey reveals mean cigarette 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. Cigarette packs are known to contain 20 cigarettes. A computer-based educational program is planned for the initial intervention with the goal of reducing daily cigarette usage. The data reported from the survey represent ordinal data. A pie chart is most appropriate graphic representation of these results.

FALSE

You have been employed as a public health dental hygienist in a local health department to provide educational presentations for the participants in the WIC program in a non-fluoridated community. The natural fluoride concentration of the community water supply is 0.3 ppm. One of your first assignments is to present an educational program on basic oral health practices for culturally diverse pregnant teens in three alternative high schools that have day care facilities. Which index would be appropriate to determine the rate of pregnancy gingivitis in this population? A. CPI B. CPITN C. GI D. PSR

GI

DH students from a local program visit a geriatric day care called Camp Sunshine to implement a serve learning project. These older adults are functionally independent, although they are medically compromised. Under faculty supervision, the students screen the older adult clients to identify denture cleanliness and teach them how to clean their dentures daily. The goals are to improve their oral health by cleaning their dentures or partial dentures, increase their awareness of the need for daily oral care, and empower them to clean their dentures. The students compute the mean scores of the denture cleanliness measure for future evaluation of the program outcomes. The educational program consists of three weekly visits to teach and provide practice in various aspects of entire care. During the first weekly lesson, the students use motivational interviewing to identify the clients' current practices and intentions regarding daily denture cleaning. The students use this information to plan individualized instruction for each client. The student return in 6 months to measure denture cleanliness to evaluate the success of the program. Although the outcomes indicate improvement in cleanliness to evaluate the success of the program. Although the outcomes indicate improvement in cleanliness for the majority of the clients, the results are skewed as a result of a large number of them missing one of the weekly sessions because they came down with the flu that week. At the end of the program, the students prepare a final report in which they communicate the outcomes of the program to the facility director and propose funding of supplies by Camp Sunshine for future programs. What is BEST teaching method for the psychomotor learning in this program? A. Demonstration B. Guided practice C. Lecture D. Video presentation

Guided practice

A dental hygiene US Public Health Services (USPHS)- commissioned core officer is assigned to an Indian Health Service (IHS) Clinic to improve the oral care of pregnant women in an American Indian rural community with a population of 26,000. Approximately 20% of the pregnant women in this population develop gestational diabetes. When a woman first sees the physician in the clinic for prenatal care, she is referral to the dental clinic for a dental examination. Only 25% of the patients referred over the previous 6 months complied with dental referral, scheduled an appointment, and received treatment. The community is not classified a "dental manpower shortage area" because of the staffing of this clinic and the existence of this program. A survey of the pregnant women served by this clinic reveals that the women do not realize their risk for diabetes, are unaware of the relationship between oral health status and diabetes, and do not understand the benefits of an oral health assessment in relation to their overall health and the health of their babies. For the purpose of discussing the problem and possible solutions, the dental hygienist arranges a meeting of the medical clinic director, the dental clinic director,the medicine man of the Indian tribe, and dental clinic staff member who is a member of the tribe. This team sets a goal of doubling the rate of compliance with the dental referral to 30% within 6 months. On the basis of the results of the survey, which health education theory is indicated as the foundation for an oral health education intervention to meet the goal? A. Health belief model B. Learning ladder C. Social cognitive theory D. Theory of reasoned action

Health belief model

The Human Resources director of an urban county hospital is alarmed by the rising cost of employee health insurance premiums related to tobacco-associated health conditions. The administrator charges the occupational health director, a dental hygienist, with addressing the issue of employee tobacco consumption. Employee demographics for the hospital are as follows: 40% Caucasian, 38% African American, 12% Hispanic, 10% Asian. The dental hygienist conducts an employee tobacco usage survey as part of the program planning process. Analysis of the survey reveals mean cigarette 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. Cigarette packs are known to contain 20 cigarettes. A computer-based educational program is planned for the initial intervention with the goal of reducing daily cigarette usage. What is the MOST important cultural factor to consider when planning an intervention for this population? A. Age B. Gender C. Educational level D. Ethnic background E. Health literacy

Health literacy

The director of the Vintage Retirement Center contacts the local dental hygiene society to provide a seminar on oral health and conduct oral cancer screenings for the purpose of improving the oral health of the residents. The facility has a population of 100 well residents between ages 60-78 who have a middle SES; 80% of the residents are dentate, with varying numbers of teeth present. The oral health assessment results reveal a mean PII of 2.1, mean GI of 0.8, mean DMFT of 5.2, mean D of 2.0, RCI of 2.1, and untreated root caries of 1.5. Correlation analysis reveals a correlation coefficient of r=0.81 for the relationship between RCI and PII of this group. About 70% of the residents report having a dental home where they receive routine dental care. Over 50% of them report signs and symptoms of xerostomia. A SMART objective is established to improve the oral hygiene within 6 months by a six-member team of volunteer members of the Dental Hygienist Society delivering an oral hygiene educational program for residents and staff, providing oral hygiene supplies, and following up with reminders and motivational techniques to enhance the residents' daily effective oral hygiene. The Society has a budget for community oral health that can be used to support the program. What is the BEST measure of success of this program?

Improved oral health indicators of the residents

The director of a local nursing home has contracted with a public health dental hygienist to design an oral health protocol for 300 residents. A registered nurse performs the intake oral examination. The majority of the residents are partially edentulous, have partial removal dentures, halitosis, trouble eating and frequently lose their removal partial dentures. The dental hygienist observes that the caregivers are neglecting daily oral hygiene care, are not conducting oral cancer screenings. The DH determines to carry out oral hygiene and oral cancer screening of all residents and introduce an educational component for the facility's caregivers and interested family members. Students from local DH educational program are recruited to assist with the educational program. These measures are compared to evaluate changes in knowledge. Caregivers' ability to conduct oral cancer screening is evaluated weekly for several weeks after the educational program. The success of the program will be evaluated by screening the residents again 1 yr later to identify any lesions that have not been found during the year. If the data reveal lesions that have not been identified, the DH plans to work with the director of the nursing to establish a new protocol for routine oral cancer screening by the registered nurses on staff. The DH secures funding from a local foundation for the equipment needed to screen the resident. Which term BEST describes the extent of oral cancer lesions found at the 1 yr evaluation? A. Count B. Incidence C. Prevalence D. Proportion E. Rate

Incidence

DH students from a local program visit a geriatric day care called Camp Sunshine to implement a serve learning project. These older adults are functionally independent, although they are medically compromised. Under faculty supervision, the students screen the older adult clients to identify denture cleanliness and teach them how to clean their dentures daily. The goals are to improve their oral health by cleaning their dentures or partial dentures, increase their awareness of the need for daily oral care, and empower them to clean their dentures. The students compute the mean scores of the denture cleanliness measure for future evaluation of the program outcomes. The educational program consists of three weekly visits to teach and provide practice in various aspects of entire care. During the first weekly lesson, the students use motivational interviewing to identify the clients' current practices and intentions regarding daily denture cleaning. The students use this information to plan individualized instruction for each client. The student return in 6 months to measure denture cleanliness to evaluate the success of the program. Although the outcomes indicate improvement in cleanliness to evaluate the success of the program. Although the outcomes indicate improvement in cleanliness for the majority of the clients, the results are skewed as a result of a large number of them missing one of the weekly sessions because they came down with the flu that week. At the end of the program, the students prepare a final report in which they communicate the outcomes of the program to the facility director and propose funding of supplies by Camp Sunshine for future programs. What is the BEST way for students to provide the final repost?

Include in the written proposal tables and graphs that summarize the pretest and posttest denture cleanliness data

DH students conduct a study to compare the effectiveness of two non alcohol mouthrinses, a 0.02%NaF rinsed (Listerine Zero) and a 0.07% CPC rinse (Crest Pro Health), in controlling plaque biofilm and gingivitis. A sample of 136 healthy adult volunteers is taken from the university dental hygiene clinic. ONly dentate adults with no to mild periodontitis are accepted to participate in the study. The study participants are qualified for inclusion in the study by their plaque biofilm forming potential and each participant. Study participants and examiners are unaware of the formula used by each participant. One group receives the 0.07% CPC mouthrinse, and the other group receives the 0.02% NaF mouthrinse. All other ingredients of both rinses are standardized. Two examiners are calibrated in the use of the PII and GI to measure plaque biofilm at baseline, 2 months, 4 months. The baseline PII scores are used during group assignment to ensure that the two groups have equivalent oral hygiene. Which is controlled by the procedures used with the examiners as they measure the plaque biofilm?

Inter-examiner reliability

A dental hygiene US Public Health Services (USPHS)- commissioned core officer is assigned to an Indian Health Service (IHS) Clinic to improve the oral care of pregnant women in an American Indian rural community with a population of 26,000. Approximately 20% of the pregnant women in this population develop gestational diabetes. When a woman first sees the physician in the clinic for prenatal care, she is referral to the dental clinic for a dental examination. Only 25% of the patients referred over the previous 6 months complied with dental referral, scheduled an appointment, and received treatment. The community is not classified a "dental manpower shortage area" because of the staffing of this clinic and the existence of this program. A survey of the pregnant women served by this clinic reveals that the women do not realize their risk for diabetes, are unaware of the relationship between oral health status and diabetes, and do not understand the benefits of an oral health assessment in relation to their overall health and the health of their babies. For the purpose of discussing the problem and possible solutions, the dental hygienist arranges a meeting of the medical clinic director, the dental clinic director,the medicine man of the Indian tribe, and dental clinic staff member who is a member of the tribe. This team sets a goal of doubling the rate of compliance with the dental referral to 30% within 6 months. Lack of compliance with the dental referral could be a result of which TWO of the following factors? A. Cost of dental care B. Lack of available appointments C. Lack of transportation to dental clinic D. Low dentist to population ratio E. Low health literacy

Lack of transportation to dental clinic Low health literacy

The director of a local nursing home has contracted with a public health dental hygienist to design an oral health protocol for 300 residents. A registered nurse performs the intake oral examination. The majority of the residents are partially edentulous, have partial removal dentures, halitosis, trouble eating and frequently lose their removal partial dentures. The dental hygienist observes that the caregivers are neglecting daily oral hygiene care, are not conducting oral cancer screenings. The DH determines to carry out oral hygiene and oral cancer screening of all residents and introduce an educational component for the facility's caregivers and interested family members. Students from local DH educational program are recruited to assist with the educational program. These measures are compared to evaluate changes in knowledge. Caregivers' ability to conduct oral cancer screening is evaluated weekly for several weeks after the educational program. The success of the program will be evaluated by screening the residents again 1 yr later to identify any lesions that have not been found during the year. If the data reveal lesions that have not been identified, the DH plans to work with the director of the nursing to establish a new protocol for routine oral cancer screening by the registered nurses on staff. The DH secures funding from a local foundation for the equipment needed to screen the resident. The stakeholder involved in this program represent what level of public health involvement?

Local

The director of the Vintage Retirement Center contacts the local dental hygiene society to provide a seminar on oral health and conduct oral cancer screenings for the purpose of improving the oral health of the residents. The facility has a population of 100 well residents between ages 60-78 who have a middle SES; 80% of the residents are dentate, with varying numbers of teeth present. The oral health assessment results reveal a mean PII of 2.1, mean GI of 0.8, mean DMFT of 5.2, mean D of 2.0, RCI of 2.1, and untreated root caries of 1.5. Correlation analysis reveals a correlation coefficient of r=0.81 for the relationship between RCI and PII of this group. About 70% of the residents report having a dental home where they receive routine dental care. Over 50% of them report signs and symptoms of xerostomia. A SMART objective is established to improve the oral hygiene within 6 months by a six-member team of volunteer members of the Dental Hygienist Society delivering an oral hygiene educational program for residents and staff, providing oral hygiene supplies, and following up with reminders and motivational techniques to enhance the residents' daily effective oral hygiene. The Society has a budget for community oral health that can be used to support the program. Which component of SMART objective is missing? A. Achievable B. Measurable C. Relevant D. Specific E. Time bound

Measurable

The administrator of a group home for mentally challenged adults has received multiple complaints from the attending caregivers regarding the residents' oral health. Limited manual dexterity abilities of the residents require that they receive assistance with oral hygiene routines; yet complaints of severe resistant halitosis and bleeding during normal oral hygiene routines have made the caregivers reluctant to provide assistance. Frustrated by a lack of staff compliance, the group home administrator contacts the local county public health dental hygienist, knowing that the county health department has a grant for oral care for this population. After gathering basic demographic information, the dental hygienist make a visit to the home to determine the actual oral health status of the residents. What is the BEST way for the DH to assess the actual oral hygiene routines in the group

Measure the plaque biofilm and gingivitis scores of residents over time

A high dental caries rate has been reported by the school nurses in Head Start children in the county of the basis of the rate of toothaches and absences. Families are primarily Spanish-speaking Hispanic and East Indian migrant farm workers. They reside in predominantly rural settings with individual well-water supplies. At an informational meeting, the Head Start dental health coordinator introduces the goal of the program to the Head Start family advocates. A team of DH students from the local college is asked to design a comprehensive program to address the problem of dental caries in this population. They begin by collecting baseline date using the deft, OHI-S, and GI and identify a high level of S-ECC. All the following would be an appropriate source of funding for this program EXCEPT: A. CHIP B. Head Start grant C. Medicare D. Medicaid E. Private funding

Medicare

You have been employed as a public health dental hygienist in a local health department to provide educational presentations for the participants in the WIC program in a non-fluoridated community. The natural fluoride concentration of the community water supply is 0.3 ppm. One of your first assignments is to present an educational program on basic oral health practices for culturally diverse pregnant teens in three alternative high schools that have day care facilities. What is the first step that should be accomplished to conduct this program? A. Develop a lesson plan B. Meet with people involved to determine program goals and objectives C. Plan an educational presentation for the day care children D. Request funding E. Select teaching strategies

Meet with the people involved to determine program goals and objectives

The director of the Vintage Retirement Center contacts the local dental hygiene society to provide a seminar on oral health and conduct oral cancer screenings for the purpose of improving the oral health of the residents. The facility has a population of 100 well residents between ages 60-78 who have a middle SES; 80% of the residents are dentate, with varying numbers of teeth present. The oral health assessment results reveal a mean PII of 2.1, mean GI of 0.8, mean DMFT of 5.2, mean D of 2.0, RCI of 2.1, and untreated root caries of 1.5. Correlation analysis reveals a correlation coefficient of r=0.81 for the relationship between RCI and PII of this group. About 70% of the residents report having a dental home where they receive routine dental care. Over 50% of them report signs and symptoms of xerostomia. A SMART objective is established to improve the oral hygiene within 6 months by a six-member team of volunteer members of the Dental Hygienist Society delivering an oral hygiene educational program for residents and staff, providing oral hygiene supplies, and following up with reminders and motivational techniques to enhance the residents' daily effective oral hygiene. The Society has a budget for community oral health that can be used to support the program. What level of oral hygiene is revealed by the mean PII? A. No plaque B. Slight plaque C. Moderate plaque D. Severe plaque

Moderate plaque present

A dental hygiene US Public Health Services (USPHS)- commissioned core officer is assigned to an Indian Health Service (IHS) Clinic to improve the oral care of pregnant women in an American Indian rural community with a population of 26,000. Approximately 20% of the pregnant women in this population develop gestational diabetes. When a woman first sees the physician in the clinic for prenatal care, she is referral to the dental clinic for a dental examination. Only 25% of the patients referred over the previous 6 months complied with dental referral, scheduled an appointment, and received treatment. The community is not classified a "dental manpower shortage area" because of the staffing of this clinic and the existence of this program. A survey of the pregnant women served by this clinic reveals that the women do not realize their risk for diabetes, are unaware of the relationship between oral health status and diabetes, and do not understand the benefits of an oral health assessment in relation to their overall health and the health of their babies. For the purpose of discussing the problem and possible solutions, the dental hygienist arranges a meeting of the medical clinic director, the dental clinic director,the medicine man of the Indian tribe, and dental clinic staff member who is a member of the tribe. This team sets a goal of doubling the rate of compliance with the dental referral to 30% within 6 months. The dental referral by the medical clinic is an example of which characteristic of public health?

Multi-disciplinary team approach to solving public health problems

A local dental hygienists' association and a faith-based organization collaborate to target a school for a comprehensive oral disease prevention program. The school serves a population that consists of 50% Medicaid-eligible children, and 75% of them receive the school lunch program. The ethnic group representation is 15% Hispanic American, 5% African American, and 80% non-Hispanic white. The fluoride concentration of the community water is below the optimal level. A public health hygienist screens the children in preschool through grade 5 annually. Data for 2014 indicate a 22% urgent decay rate across all ages. Further assessment reveals that many of the children are not seeing a dentist routinely. A sealant program is conducted in grade 2 and 5. A fluoride varnish program is conducted with the preschoolers and grade K, including two applications annually; these children are screened for dental caries with a tongue blade and available light at the time of each application. An educational program is designed to meet the needs of the children in this school. Finally, the team explores the option of a fluoridation campaign to achieve water fluoridation in this community. The same education materials can be used with participants in the other schools in the district because the cultural diversity of this population represents the cultural diversity of the general US population.

NEITHER the statement NOR the reason is correct

You have been employed as a public health dental hygienist in a local health department to provide educational presentations for the participants in the WIC program in a non-fluoridated community. The natural fluoride concentration of the community water supply is 0.3 ppm. One of your first assignments is to present an educational program on basic oral health practices for culturally diverse pregnant teens in three alternative high schools that have day care facilities. Which of the following agencies would be the BEST resource for program planning for this population? A. National Maternal and Child Oral Health Resource Center B. DHHS centers for Medicare and Medicaid C. Public Health Service D. DHHS Human Resources and Services Adminstration

National Maternal and Child Oral Health Resource Center

A high dental caries rate has been reported by the school nurses in Head Start children in the county of the basis of the rate of toothaches and absences. Families are primarily Spanish-speaking Hispanic and East Indian migrant farm workers. They reside in predominantly rural settings with individual well-water supplies. At an informational meeting, the Head Start dental health coordinator introduces the goal of the program to the Head Start family advocates. A team of DH students from the local college is asked to design a comprehensive program to address the problem of dental caries in this population. They begin by collecting baseline date using the deft, OHI-S, and GI and identify a high level of S-ECC. Which of the following describes the level of ECC for older age population?

Number of carious lesions is greater than five

A high dental caries rate has been reported by the school nurses in Head Start children in the county of the basis of the rate of toothaches and absences. Families are primarily Spanish-speaking Hispanic and East Indian migrant farm workers. They reside in predominantly rural settings with individual well-water supplies. At an informational meeting, the Head Start dental health coordinator introduces the goal of the program to the Head Start family advocates. A team of DH students from the local college is asked to design a comprehensive program to address the problem of dental caries in this population. They begin by collecting baseline date using the deft, OHI-S, and GI and identify a high level of S-ECC. Which index would be appropriate to evaluate the improvement in the children's oral hygiene resulting from strategies introduced in this program? A. OHI-S B PHP C. PII D. Turesky modification of the Quigley-Hein Plaque Index E. All the above

OHI-S

The administrator of a group home for mentally challenged adults has received multiple complaints from the attending caregivers regarding the residents' oral health. Limited manual dexterity abilities of the residents require that they receive assistance with oral hygiene routines; yet complaints of severe resistant halitosis and bleeding during normal oral hygiene routines have made the caregivers reluctant to provide assistance. Frustrated by a lack of staff compliance, the group home administrator contacts the local county public health dental hygienist, knowing that the county health department has a grant for oral care for this population. After gathering basic demographic information, the dental hygienist make a visit to the home to determine the actual oral health status of the residents. Which is an effective teaching strategy to raise the caregivers' compliance in this situation?

Provide training on how to maintain personal oral hygiene skills for themselves

The director of a local nursing home has contracted with a public health dental hygienist to design an oral health protocol for 300 residents. A registered nurse performs the intake oral examination. The majority of the residents are partially edentulous, have partial removal dentures, halitosis, trouble eating and frequently lose their removal partial dentures. The dental hygienist observes that the caregivers are neglecting daily oral hygiene care, are not conducting oral cancer screenings. The DH determines to carry out oral hygiene and oral cancer screening of all residents and introduce an educational component for the facility's caregivers and interested family members. Students from local DH educational program are recruited to assist with the educational program. These measures are compared to evaluate changes in knowledge. Caregivers' ability to conduct oral cancer screening is evaluated weekly for several weeks after the educational program. The success of the program will be evaluated by screening the residents again 1 yr later to identify any lesions that have not been found during the year. If the data reveal lesions that have not been identified, the DH plans to work with the director of the nursing to establish a new protocol for routine oral cancer screening by the registered nurses on staff. The DH secures funding from a local foundation for the equipment needed to screen the resident. What is the BEST method to use for the weekly evaluation of caregivers' ability to conduct oral cancer screening in this program?

Observe the caregivers conducting oral cancer screening

The Human Resources director of an urban county hospital is alarmed by the rising cost of employee health insurance premiums related to tobacco-associated health conditions. The administrator charges the occupational health director, a dental hygienist, with addressing the issue of employee tobacco consumption. Employee demographics for the hospital are as follows: 40% Caucasian, 38% African American, 12% Hispanic, 10% Asian. The dental hygienist conducts an employee tobacco usage survey as part of the program planning process. Analysis of the survey reveals mean cigarette 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. Cigarette packs are known to contain 20 cigarettes. A computer-based educational program is planned for the initial intervention with the goal of reducing daily cigarette usage. Which is the BEST instructional objective for this initiative?

On completion of the computer-based educational program, staff members will be able to correctly identify 80% of the harmful ingredients in tobacco.

The director of the Vintage Retirement Center contacts the local dental hygiene society to provide a seminar on oral health and conduct oral cancer screenings for the purpose of improving the oral health of the residents. The facility has a population of 100 well residents between ages 60-78 who have a middle SES; 80% of the residents are dentate, with varying numbers of teeth present. The oral health assessment results reveal a mean PII of 2.1, mean GI of 0.8, mean DMFT of 5.2, mean D of 2.0, RCI of 2.1, and untreated root caries of 1.5. Correlation analysis reveals a correlation coefficient of r=0.81 for the relationship between RCI and PII of this group. About 70% of the residents report having a dental home where they receive routine dental care. Over 50% of them report signs and symptoms of xerostomia. A SMART objective is established to improve the oral hygiene within 6 months by a six-member team of volunteer members of the Dental Hygienist Society delivering an oral hygiene educational program for residents and staff, providing oral hygiene supplies, and following up with reminders and motivational techniques to enhance the residents' daily effective oral hygiene. The Society has a budget for community oral health that can be used to support the program. Which of the following programs should be planned to address one fo the Healthy People 2020 Oral Health objectives for this target population? A. Denture marking B. Oral cancer screening and referral, as needed C. Referral to Medicaid D. Screening of periodontal condition E. Treatment with fluoride varnish to control dentinal hypersensitivity

Oral cancer screening and referral, as needed

A dental hygiene US Public Health Services (USPHS)- commissioned core officer is assigned to an Indian Health Service (IHS) Clinic to improve the oral care of pregnant women in an American Indian rural community with a population of 26,000. Approximately 20% of the pregnant women in this population develop gestational diabetes. When a woman first sees the physician in the clinic for prenatal care, she is referral to the dental clinic for a dental examination. Only 25% of the patients referred over the previous 6 months complied with dental referral, scheduled an appointment, and received treatment. The community is not classified a "dental manpower shortage area" because of the staffing of this clinic and the existence of this program. A survey of the pregnant women served by this clinic reveals that the women do not realize their risk for diabetes, are unaware of the relationship between oral health status and diabetes, and do not understand the benefits of an oral health assessment in relation to their overall health and the health of their babies. For the purpose of discussing the problem and possible solutions, the dental hygienist arranges a meeting of the medical clinic director, the dental clinic director,the medicine man of the Indian tribe, and dental clinic staff member who is a member of the tribe. This team sets a goal of doubling the rate of compliance with the dental referral to 30% within 6 months. Which of the following is the BEST intervention to implement first to meet the goal of the program?

Plan an educational presentation for the pregnant women on the relationship among oral health, systemic health and the risks and consequences of diabetes.

The director of a local nursing home has contracted with a public health dental hygienist to design an oral health protocol for 300 residents. A registered nurse performs the intake oral examination. The majority of the residents are partially edentulous, have partial removal dentures, halitosis, trouble eating and frequently lose their removal partial dentures. The dental hygienist observes that the caregivers are neglecting daily oral hygiene care, are not conducting oral cancer screenings. The DH determines to carry out oral hygiene and oral cancer screening of all residents and introduce an educational component for the facility's caregivers and interested family members. Students from local DH educational program are recruited to assist with the educational program. These measures are compared to evaluate changes in knowledge. Caregivers' ability to conduct oral cancer screening is evaluated weekly for several weeks after the educational program. The success of the program will be evaluated by screening the residents again 1 yr later to identify any lesions that have not been found during the year. If the data reveal lesions that have not been identified, the DH plans to work with the director of the nursing to establish a new protocol for routine oral cancer screening by the registered nurses on staff. The DH secures funding from a local foundation for the equipment needed to screen the resident. Which core public health function is exemplified by the potential future establishment of a new program protocol? A. Assessment B. Assurance C. Policy development D. Prevention

Policy development

The administrator of a group home for mentally challenged adults has received multiple complaints from the attending caregivers regarding the residents' oral health. Limited manual dexterity abilities of the residents require that they receive assistance with oral hygiene routines; yet complaints of severe resistant halitosis and bleeding during normal oral hygiene routines have made the caregivers reluctant to provide assistance. Frustrated by a lack of staff compliance, the group home administrator contacts the local county public health dental hygienist, knowing that the county health department has a grant for oral care for this population. After gathering basic demographic information, the dental hygienist make a visit to the home to determine the actual oral health status of the residents. Which is BEST use of the DH in this situation?

Present an in-service training program to the group home staff

The director of a local nursing home has contracted with a public health dental hygienist to design an oral health protocol for 300 residents. A registered nurse performs the intake oral examination. The majority of the residents are partially edentulous, have partial removal dentures, halitosis, trouble eating and frequently lose their removal partial dentures. The dental hygienist observes that the caregivers are neglecting daily oral hygiene care, are not conducting oral cancer screenings. The DH determines to carry out oral hygiene and oral cancer screening of all residents and introduce an educational component for the facility's caregivers and interested family members. Students from local DH educational program are recruited to assist with the educational program. These measures are compared to evaluate changes in knowledge. Caregivers' ability to conduct oral cancer screening is evaluated weekly for several weeks after the educational program. The success of the program will be evaluated by screening the residents again 1 yr later to identify any lesions that have not been found during the year. If the data reveal lesions that have not been identified, the DH plans to work with the director of the nursing to establish a new protocol for routine oral cancer screening by the registered nurses on staff. The DH secures funding from a local foundation for the equipment needed to screen the resident. What type of study is represented by evaluating the change of knowledge as a result of the educational component? A. Case-control B. Correlation also C. Crossover D. Protest/post test E. Time-series

Pretest/posttest

The director of a local nursing home has contracted with a public health dental hygienist to design an oral health protocol for 300 residents. A registered nurse performs the intake oral examination. The majority of the residents are partially edentulous, have partial removal dentures, halitosis, trouble eating and frequently lose their removal partial dentures. The dental hygienist observes that the caregivers are neglecting daily oral hygiene care, are not conducting oral cancer screenings. The DH determines to carry out oral hygiene and oral cancer screening of all residents and introduce an educational component for the facility's caregivers and interested family members. Students from local DH educational program are recruited to assist with the educational program. These measures are compared to evaluate changes in knowledge. Caregivers' ability to conduct oral cancer screening is evaluated weekly for several weeks after the educational program. The success of the program will be evaluated by screening the residents again 1 yr later to identify any lesions that have not been found during the year. If the data reveal lesions that have not been identified, the DH plans to work with the director of the nursing to establish a new protocol for routine oral cancer screening by the registered nurses on staff. The DH secures funding from a local foundation for the equipment needed to screen the resident. What type of data is being collected by the screening?

Qualitative and primary

The administrator of a group home for mentally challenged adults has received multiple complaints from the attending caregivers regarding the residents' oral health. Limited manual dexterity abilities of the residents require that they receive assistance with oral hygiene routines; yet complaints of severe resistant halitosis and bleeding during normal oral hygiene routines have made the caregivers reluctant to provide assistance. Frustrated by a lack of staff compliance, the group home administrator contacts the local county public health dental hygienist, knowing that the county health department has a grant for oral care for this population. After gathering basic demographic information, the dental hygienist make a visit to the home to determine the actual oral health status of the residents. From initial observations, what Healthy People 2020 objective is MOST applicable to this target group?

Reduced gingivitis and destructive periodontal disease in adults

DH students from a local program visit a geriatric day care called Camp Sunshine to implement a serve learning project. These older adults are functionally independent, although they are medically compromised. Under faculty supervision, the students screen the older adult clients to identify denture cleanliness and teach them how to clean their dentures daily. The goals are to improve their oral health by cleaning their dentures or partial dentures, increase their awareness of the need for daily oral care, and empower them to clean their dentures. The students compute the mean scores of the denture cleanliness measure for future evaluation of the program outcomes. The educational program consists of three weekly visits to teach and provide practice in various aspects of entire care. During the first weekly lesson, the students use motivational interviewing to identify the clients' current practices and intentions regarding daily denture cleaning. The students use this information to plan individualized instruction for each client. The student return in 6 months to measure denture cleanliness to evaluate the success of the program. Although the outcomes indicate improvement in cleanliness to evaluate the success of the program. Although the outcomes indicate improvement in cleanliness for the majority of the clients, the results are skewed as a result of a large number of them missing one of the weekly sessions because they came down with the flu that week. At the end of the program, the students prepare a final report in which they communicate the outcomes of the program to the facility director and propose funding of supplies by Camp Sunshine for future programs. Which is an ethical responsibility of the students and faculty who are implement this program?

Refer clients who have suspicious lesions identified during the program

A local dental hygienists' association and a faith-based organization collaborate to target a school for a comprehensive oral disease prevention program. The school serves a population that consists of 50% Medicaid-eligible children, and 75% of them receive the school lunch program. The ethnic group representation is 15% Hispanic American, 5% African American, and 80% non-Hispanic white. The fluoride concentration of the community water is below the optimal level. A public health hygienist screens the children in preschool through grade 5 annually. Data for 2014 indicate a 22% urgent decay rate across all ages. Further assessment reveals that many of the children are not seeing a dentist routinely. A sealant program is conducted in grade 2 and 5. A fluoride varnish program is conducted with the preschoolers and grade K, including two applications annually; these children are screened for dental caries with a tongue blade and available light at the time of each application. An educational program is designed to meet the needs of the children in this school. Finally, the team explores the option of a fluoridation campaign to achieve water fluoridation in this community. What is the basis for deciding to target this school with this program?

SES of the children in the school

A high dental caries rate has been reported by the school nurses in Head Start children in the county of the basis of the rate of toothaches and absences. Families are primarily Spanish-speaking Hispanic and East Indian migrant farm workers. They reside in predominantly rural settings with individual well-water supplies. At an informational meeting, the Head Start dental health coordinator introduces the goal of the program to the Head Start family advocates. A team of DH students from the local college is asked to design a comprehensive program to address the problem of dental caries in this population. They begin by collecting baseline date using the deft, OHI-S, and GI and identify a high level of S-ECC. Which preventive program is indicated for this target population?

School fluoride varnish program

The director of the Vintage Retirement Center contacts the local dental hygiene society to provide a seminar on oral health and conduct oral cancer screenings for the purpose of improving the oral health of the residents. The facility has a population of 100 well residents between ages 60-78 who have a middle SES; 80% of the residents are dentate, with varying numbers of teeth present. The oral health assessment results reveal a mean PII of 2.1, mean GI of 0.8, mean DMFT of 5.2, mean D of 2.0, RCI of 2.1, and untreated root caries of 1.5. Correlation analysis reveals a correlation coefficient of r=0.81 for the relationship between RCI and PII of this group. About 70% of the residents report having a dental home where they receive routine dental care. Over 50% of them report signs and symptoms of xerostomia. A SMART objective is established to improve the oral hygiene within 6 months by a six-member team of volunteer members of the Dental Hygienist Society delivering an oral hygiene educational program for residents and staff, providing oral hygiene supplies, and following up with reminders and motivational techniques to enhance the residents' daily effective oral hygiene. The Society has a budget for community oral health that can be used to support the program. The correlation between the RCI and PII demonstrates what relationship between root caries and plaque biofilm in this target population? A. Moderate positive B. Strong negative C. Strong positive D. Weak negative

Strong positive

DH students from a local program visit a geriatric day care called Camp Sunshine to implement a serve learning project. These older adults are functionally independent, although they are medically compromised. Under faculty supervision, the students screen the older adult clients to identify denture cleanliness and teach them how to clean their dentures daily. The goals are to improve their oral health by cleaning their dentures or partial dentures, increase their awareness of the need for daily oral care, and empower them to clean their dentures. The students compute the mean scores of the denture cleanliness measure for future evaluation of the program outcomes. The educational program consists of three weekly visits to teach and provide practice in various aspects of entire care. During the first weekly lesson, the students use motivational interviewing to identify the clients' current practices and intentions regarding daily denture cleaning. The students use this information to plan individualized instruction for each client. The student return in 6 months to measure denture cleanliness to evaluate the success of the program. Although the outcomes indicate improvement in cleanliness to evaluate the success of the program. Although the outcomes indicate improvement in cleanliness for the majority of the clients, the results are skewed as a result of a large number of them missing one of the weekly sessions because they came down with the flu that week. At the end of the program, the students prepare a final report in which they communicate the outcomes of the program to the facility director and propose funding of supplies by Camp Sunshine for future programs. Which statistic is BEST to determine the statistical significance of the improved denture cleanliness? A. Analysis of variance (ANOVA) B. Chi-square C. Correlation coefficient D. The t test

The t test

DH students conduct a study to compare the effectiveness of two non alcohol mouthrinses, a 0.02%NaF rinsed (Listerine Zero) and a 0.07% CPC rinse (Crest Pro Health), in controlling plaque biofilm and gingivitis. A sample of 136 healthy adult volunteers is taken from the university dental hygiene clinic. ONly dentate adults with no to mild periodontitis are accepted to participate in the study. The study participants are qualified for inclusion in the study by their plaque biofilm forming potential and each participant. Study participants and examiners are unaware of the formula used by each participant. One group receives the 0.07% CPC mouthrinse, and the other group receives the 0.02% NaF mouthrinse. All other ingredients of both rinses are standardized. Two examiners are calibrated in the use of the PII and GI to measure plaque biofilm at baseline, 2 months, 4 months. The baseline PII scores are used during group assignment to ensure that the two groups have equivalent oral hygiene. Which of the following statement of the null hypothesis for this study? A. Neither mouthrinse is effective in controlling plaque and gingivitis B. Plaque and gingivitis are strongly associated C. 0.02% Na F mouthrinse and the 0.007% CPC mouthrinse differ D. There is no difference between the ability of 0.02%NaF or 0.07% CPC to control plaque and gingivitis.

There is no difference between the ability of the 0.02% NaF mouthrinse and the 0.07% CPC mouthrinse to control plaque and gingivitis.

A high dental caries rate has been reported by the school nurses in Head Start children in the county of the basis of the rate of toothaches and absences. Families are primarily Spanish-speaking Hispanic and East Indian migrant farm workers. They reside in predominantly rural settings with individual well-water supplies. At an informational meeting, the Head Start dental health coordinator introduces the goal of the program to the Head Start family advocates. A team of DH students from the local college is asked to design a comprehensive program to address the problem of dental caries in this population. They begin by collecting baseline date using the deft, OHI-S, and GI and identify a high level of S-ECC. Which of the following is indicated by the second component of the caries index used in this program? A. Decayed surface B. Decayed tooth C. Tooth that needs to be extracted because of the severity of decay D. Tooth that has been extracted because of decay E. Tooth that has naturally exfoliated

Tooth that needs to be extracted because of the severity of decay

DH students from a local program visit a geriatric day care called Camp Sunshine to implement a serve learning project. These older adults are functionally independent, although they are medically compromised. Under faculty supervision, the students screen the older adult clients to identify denture cleanliness and teach them how to clean their dentures daily. The goals are to improve their oral health by cleaning their dentures or partial dentures, increase their awareness of the need for daily oral care, and empower them to clean their dentures. The students compute the mean scores of the denture cleanliness measure for future evaluation of the program outcomes. The educational program consists of three weekly visits to teach and provide practice in various aspects of entire care. During the first weekly lesson, the students use motivational interviewing to identify the clients' current practices and intentions regarding daily denture cleaning. The students use this information to plan individualized instruction for each client. The student return in 6 months to measure denture cleanliness to evaluate the success of the program. Although the outcomes indicate improvement in cleanliness to evaluate the success of the program. Although the outcomes indicate improvement in cleanliness for the majority of the clients, the results are skewed as a result of a large number of them missing one of the weekly sessions because they came down with the flu that week. At the end of the program, the students prepare a final report in which they communicate the outcomes of the program to the facility director and propose funding of supplies by Camp Sunshine for future programs. Which health education and health promotion theory is BEST reflected by the strategies used in the educational program? A. Health belief model B. Organizational change theory C. Social cognitive theory D. Trans-theoretical model (stages of change theory)

Trans-theoretical model (stages of change theory)

A local dental hygienists' association and a faith-based organization collaborate to target a school for a comprehensive oral disease prevention program. The school serves a population that consists of 50% Medicaid-eligible children, and 75% of them receive the school lunch program. The ethnic group representation is 15% Hispanic American, 5% African American, and 80% non-Hispanic white. The fluoride concentration of the community water is below the optimal level. A public health hygienist screens the children in preschool through grade 5 annually. Data for 2014 indicate a 22% urgent decay rate across all ages. Further assessment reveals that many of the children are not seeing a dentist routinely. A sealant program is conducted in grade 2 and 5. A fluoride varnish program is conducted with the preschoolers and grade K, including two applications annually; these children are screened for dental caries with a tongue blade and available light at the time of each application. An educational program is designed to meet the needs of the children in this school. Finally, the team explores the option of a fluoridation campaign to achieve water fluoridation in this community. What assessment classification is used with preschoolers and grade K in this program? A. Type 1, 11, 111, 1V

Type IV

The director of the Vintage Retirement Center contacts the local dental hygiene society to provide a seminar on oral health and conduct oral cancer screenings for the purpose of improving the oral health of the residents. The facility has a population of 100 well residents between ages 60-78 who have a middle SES; 80% of the residents are dentate, with varying numbers of teeth present. The oral health assessment results reveal a mean PII of 2.1, mean GI of 0.8, mean DMFT of 5.2, mean D of 2.0, RCI of 2.1, and untreated root caries of 1.5. Correlation analysis reveals a correlation coefficient of r=0.81 for the relationship between RCI and PII of this group. About 70% of the residents report having a dental home where they receive routine dental care. Over 50% of them report signs and symptoms of xerostomia. A SMART objective is established to improve the oral hygiene within 6 months by a six-member team of volunteer members of the Dental Hygienist Society delivering an oral hygiene educational program for residents and staff, providing oral hygiene supplies, and following up with reminders and motivational techniques to enhance the residents' daily effective oral hygiene. The Society has a budget for community oral health that can be used to support the program. All the following preventive programs are indicated by the assessment result EXCEPT one.? A. Educational presentation on basic oral hygiene B. Referral for restorative treatment C. Use of a 0.12% chlorhexidine rinse daily D. Daily use of a higher-concentration fluoride dentifrice

Use of a 0.12% chlorhexidine rinse daily

A local dental hygienists' association and a faith-based organization collaborate to target a school for a comprehensive oral disease prevention program. The school serves a population that consists of 50% Medicaid-eligible children, and 75% of them receive the school lunch program. The ethnic group representation is 15% Hispanic American, 5% African American, and 80% non-Hispanic white. The fluoride concentration of the community water is below the optimal level. A public health hygienist screens the children in preschool through grade 5 annually. Data for 2014 indicate a 22% urgent decay rate across all ages. Further assessment reveals that many of the children are not seeing a dentist routinely. A sealant program is conducted in grade 2 and 5. A fluoride varnish program is conducted with the preschoolers and grade K, including two applications annually; these children are screened for dental caries with a tongue blade and available light at the time of each application. An educational program is designed to meet the needs of the children in this school. Finally, the team explores the option of a fluoridation campaign to achieve water fluoridation in this community. Which is a required action for this program?

Written informed consent form signed by parents or legal guardians of all children who participate


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