NBDHE Community Oral Health Planning and Practice - 20

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TESTLET A You have been employed as a public health DH 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 F. 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 would be required to bring the F concentration of the water supply to the optimal level? a. 0.4 ppm F b. 0.7 ppm F c. 1 ppm F d. 0.4 to 0.9 ppm F

0.4 ppm F (the new recommendation for the optimal level of F in the community water is 0.7 mg F per liter (ppm F), adopted by DHHS in 2011. The natural concentration of F in this community water supply is 0.3 ppm F. An adjustment of 0.4 ppm F added to the water would bring the concentration to the optimal level.)

GI (the GI is used to assess gingivitis.)

TESTLET G A local DH association and local faith based organization collaborated to targe a school in a non-fluoridated area for a comprehensive oral disease prevention program. The school serves a population that consists of 50% Medicaid-eligible children, and 75% are on the lunch school program. 15% Hispanics, % African American, and 80% are non-Hispanic. The water supply contains 0.3 ppm F. Children in grades 2-6 are screened 2x a yr. with a mirror, an explorer, and dental light. Preschool and grade K are screened 2x a yr. with a tongue blade and light at the time of each application. An educational program is designed to meet the needs of the children in the school. Finally the team explores the option of fluoridization 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 U.S. population. a. Both the statement and the reason are correct and related. b. Both the statement and the reason are correct but NOT related. c. The statement is CORRECT, but the reason is NOT correct. d. The statement is NOT correct, but the reason is CORRECT. e. NEITHER the statement NOR the reason is correct.

NEITHER the statement NOR the reason is correct (educational materials should be designed for or adapted to the needs and culture of the target audience, and the needs of children in other schools may differ. The cultural diversity of this target group does not match the general population, which in 2014 was 74% non-Hispanic white, 15% Hispanic, and 12% African American.)

TESTLET A You have been employed as a public health DH 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 F. 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 Administration

National Maternal and Child Oral Health Resource Center (the website of the National Maternal & Child Oral Health Resource Center has available a variety of resources to help communities develop oral health programs for young children, including publications, "how-to" guides, tool boxes, and grants.)

TESTLET E A high dental caries rate has been reported by the school nurses in Kern County head start children on the basis of the rate of toothaches and absences. The families are primarily Spanish speaking Hispanic and east Indian migrant farm workers. they reside in predominantly rural settings with individual well water supplies. A team of DH students has been asked to design a comprehensive program to address the problem of the dental cries in the population. they being by collecting baseline data using the deft, OHI-S, and GI. 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. P1I d. Turesky modification of the Quigley-Hein Plaque index e. Any of the above would be appropriate

OHI-S (a condition must be measured at baseline and post-test using the same criteria to allow for comparison to evaluate any change in the condition. Because the OHI-S is used at baseline plaque biofilm scores, this same index should be used for evaluation purposes.)

TESTLET G A local DH association and local faith based organization collaborated to targe a school in a non-fluoridated area for a comprehensive oral disease prevention program. The school serves a population that consists of 50% Medicaid-eligible children, and 75% are on the lunch school program. 15% Hispanics, % African American, and 80% are non-Hispanic. The water supply contains 0.3 ppm F. Children in grades 2-6 are screened 2x a yr. with a mirror, an explorer, and dental light. Preschool and grade K are screened 2x a yr. with a tongue blade and light at the time of each application. An educational program is designed to meet the needs of the children in the school. Finally the team explores the option of fluoridization campaign to achieve water fluoridation in this community. What is the basis for deciding to target this school with this program? a. Convenience b. Cultural diversity of the school c. Random selection of the school d. SES of the children in the school

SES of the children in the school (the SES in this school was reported as low. This is the basis for targeting school oral health programs because of the higher levels of oral disease and lower access to care in a low SES population.)

Testlet J: The administer 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 residence require that they receive assistance with oral hygiene routines; yet complains of severe resident halitosis and bleeding during normal oral hygiene, making the caregivers reluctant to provide assistance. Frustrated by a lack of staff compliance, the group home administrator contact the local county public health dental hygienist, knowing that the county health department has a grant for the oral care for this population. After gathering basic demographic information, the hygienist makes a visit to the home to determine the actual oral health status of the residents. What known characteristics about this population can be utilized in a community profile? Select THREE characteristics from the following list. a. Age b. Ethnicity c. Source of funding d. Gender e. Geographic location f. Literacy level g. Population setting

a, c and g (according to the scenario described, the population is comprised of adults (age) residing in a group home (population setting), and the county health department has a grant for oral care for this population (source of funding).)

TESTLET C The human director of an urban country hospital is alarmed by the rising cost of employee health insurance premiums related to tobacco associated health conditions. The administer 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, and 10% Asian. The dental hygienist conducts 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 the administrators, 19.6 for 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? a. Allied health technicians b. Clerical support staff c. Hospital administrators d. Hospital patients e. Nurses f. Physicians g. All the groups are equally important and should be targeted at the same time

allied health technicians (programs are targeted based on need. When assessment and evaluation tools are chosen to measure the unique attributes of the chosen sample, stronger data outcomes will result. In this case, mean cigarette usage each day can be used to prioritize need for an intervention. Allied health technicians had the highest mean cigarette average; when factoring in the standard deviation, 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. If the data follow a normal bell curve, given an adequate sample size, 68% of the scores will fall within ±1 SD of the mean. Consequently, the dental hygienist can conclude that 68% of the allied health technicians smoke 17.6 to 22 cigarettes each day.)

TESTLET I: DHG students conduct a study to compare the effectiveness of two non-alcohol mouth rinses, a .02% NaF rinse (Listerine zero) and a .07% CPC rents (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 Gentile adults with no mild. Donis are excepted to participate in the study. The study participants are qualified for inclusion in the study by their plaque bio film forming potential in presence of mild gingivitis. Two groups are formed, and an unmarked bottle of mouth rents is given to each participant. Study participants and examiners are unaware of the formula used by each participant. One group receives the .0% CPC mouth rents, and the other Group receives the .02 NaF mouth rents. All other ingredients of both rinses are standardize. Two examiners are collaborated in the use of the PII and G.I. to measure plaque biofilm at baseline, two months, and four 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 research study? Select FOUR types of studies from the following list. a. Analytic study b. Clinical trial c. Double-blind study d. Experimental study e. Posttest only study f. Retrospective study g. Time-series study

b, c, d and g (clinical trials are well-controlled experimental studies conducted with human participants. Procedures in this study that limit bias and assure validity are delimited selection of study participants and regulation of other mouthrinse ingredients to control extraneous variables, randomization and equivalency of groups, use of standardized instruments to measure the dependent variable, calibration of examiners, and use of double blind procedures. In a double-blind study, study participants and examiners are unaware of group assignment. The procedure whereby examiners measure the dependent variable without knowing the group assignment helps to control bias. The study participants' lack of awareness of group assignment controls for the Hawthorne effect. In this study, examiners are unaware of which mouthrinse the participants are using, and the study participants are unaware of which mouthrinse they are given in the unmarked bottle. An experimental study is a carefully designed study used to determine the effectiveness of altering some factor or factors to establish cause-and-effect relationships; there is a deliberate application or withholding of the supposed cause or controlling agent of a condition and observation of results. In this study the two mouthrinses (the independent variable) are applied and their effect on plaque biofilm and gingivitis is compared. A cause-and-effect relationship is determined between the mouthrinse and plaque biofilm and gingivitis. In a time series study, the dependent variable is measured several times over a specific period to determine if the effect holds over time. In this study, plaque biofilm and gingivitis are measured at 2 months and again at 4 months.)

TESTLET E A high dental caries rate has been reported by the school nurses in Kern County head start children on the basis of the rate of toothaches and absences. The families are primarily Spanish speaking Hispanic and east Indian migrant farm workers. they reside in predominantly rural settings with individual well water supplies. A team of DH students has been asked to design a comprehensive program to address the problem of the dental cries in the population. they being by collecting baseline data using the deft, OHI-S, and GI. Which of the following would be MOST appropriate to explain during the informational session? a. Benefits of community water fluoridation b. Cause of early childhood caries c. Effectiveness of daily brushing d. Value of healthy food choices

cause of early childhood caries (the goal is to reduce early childhood caries; the advocates must understand the nature and causes of the disease to be able to support the programs that will be planned to solve the problem.)

TESTLET G A local DH association and local faith based organization collaborated to targe a school in a non-fluoridated area for a comprehensive oral disease prevention program. The school serves a population that consists of 50% Medicaid-eligible children, and 75% are on the lunch school program. 15% Hispanics, % African American, and 80% are non-Hispanic. The water supply contains 0.3 ppm F. Children in grades 2-6 are screened 2x a yr. with a mirror, an explorer, and dental light. Preschool and grade K are screened 2x a yr. with a tongue blade and light at the time of each application. An educational program is designed to meet the needs of the children in the school. Finally the team explores the option of fluoridization campaign to achieve water fluoridation in this community. What would have been the BEST means of identifying the reported decay rate? a. Basic Screening Survey (BSS) b. Deft c. DMFT d. RCI

basic screening survey (the Basic Screening Survey (BSS) is a simple, efficient survey method that can be used to assess dental caries in all ages with a dichotomous measure of the absence or presence of untreated dental caries and dental caries experience, categorizing the need and referral as none (routine care recommended), early (early dental care recommended), and urgent (emergency dental care recommended).)

TESTLET B The director of the Vintage retirement center contacts the local DH society to provide a seminar on oral health. The facility has a population of 100 residents between 60-78 yrs old who have a middle SES. 20% is edentulous, 80% have some remaining teeth. The oral health assessment 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. Coefficient analysis revealed a correlation coefficient of r=+0.81 for the relationship of RCI and PlI. 70% of the residents have a dental home and report having regular dental care. <10% report mild signs and symptoms of xerostomia. What change in the DMFT scores would indicate that the needs are being met 5 years after implementation of a program? a. Decrease in the total DMFT score b. Decrease in D, no change in M, and increase in F c. No change in D, decrease in M, and increase in F d. Decrease in D, increase in M, and increase in F e. Both B and D could be acceptable indicators of success

both B and D could be acceptable indicators of success (a decrease in D (decayed), increase in F (filled), and either no change or an increase in M (missing as a result of caries) indicate a reduction in caries via provision of treatment. Although no change in M would be the most desirable outcome in that it would indicate treatment in the form of restoration rather than extraction, in a senior adult population treatment with an extraction might be warranted because of the potential for fractured teeth and recurrent caries in teeth that have been restored multiple times in the past.)

TESTLET C The human director of an urban country hospital is alarmed by the rising cost of employee health insurance premiums related to tobacco associated health conditions. The administer 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, and 10% Asian. The dental hygienist conducts 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 the administrators, 19.6 for 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 the most appropriate graphic representation of these results. a. Both statements are TRUE. b. Both statements are FALSE. c. The first statement is TRUE; the second statement is FALSE. d. The first statement is FALSE; the second statement is TRUE.

both statements are FALSE (the type of data collected (number of cigarettes smoked per day) is considered to be ratio data, information that represents whole numbers on a scale with an absolute zero point. Ratio data are considered the strongest form of data, and are best represented graphically by a histogram or frequency polygon. Ordinal data possess attributes that can be ranked, much like a Likert scale, and nominal data are purely categorical, for example, male/female gender information and SES categories. Nominal data are best displayed via a frequency table, or with bar graphs (also called bar charts) and pie charts. Pie charts clearly represent parts of a whole. Bar graphs and pie charts are also used to illustrate discrete data that are ordinal or ratio. The difference between a histogram and a bar graph is that the bars of the histogram touch because continuous data are represented, and the bars of the bar chart do not touch because discrete data are represented. Continuous data have points all along a continuum with points between whole numbers; thus, continuous data can be expressed meaningfully with a fraction. Discrete data are expressed only with whole numbers (no fractions). A histogram best conveys the information in this case (number of cigarettes smoked per day) because the data are ratio scaled and reflect the nature of data found along a continuum.)

c and e (the scenario does not describe any special arrangements for transportation. In a rural community of this size, transportation could be an issue. It is a frequently cited barrier in low SES populations, and Native American Indians on reservations are among the poorest populations in the United States. Also, the survey results indicate low health literacy (they 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).)

TESTLET I: DHG students conduct a study to compare the effectiveness of two non-alcohol mouth rinses, a .02% NaF rinse (Listerine zero) and a .07% CPC rents (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 Gentile adults with no mild. Donis are excepted to participate in the study. The study participants are qualified for inclusion in the study by their plaque bio film forming potential in presence of mild gingivitis. Two groups are formed, and an unmarked bottle of mouth rents is given to each participant. Study participants and examiners are unaware of the formula used by each participant. One group receives the .0% CPC mouth rents, and the other Group receives the .02 NaF mouth rents. All other ingredients of both rinses are standardize. Two examiners are collaborated in the use of the PII and G.I. to measure plaque biofilm at baseline, two months, and four months. The baseline PII scores are used during Group assignment to ensure that the two groups have equivalent oral hygiene. The application of the P1I in this study is an example of which step in the scientific method? a. Collection, organization and analysis of data b. Formulation of a hypothesis c. Identification and statement of the problem d. Verification, rejection, or modification of the hypothesis

collection, organization and analysis of data (collection, organization, and analysis of data is the step in the scientific method in which data are collected and analyzed. In this study, the PlI is used to document and organize the data (plaque biofilm scores) for analysis of a difference in groups.)

community organization (the scenario describes a meeting of the dental hygienist with community leaders who can influence the community for the purpose of discussing the problem and possible solutions. This exemplifies the application of the community organization theory that involves community groups identifying common problems or goals, mobilizing resources, and implementing strategies to reach the goals. Involving key leaders of the community in this process is an essential component of this theory.)

TESTLET G A local DH association and local faith based organization collaborated to targe a school in a non-fluoridated area for a comprehensive oral disease prevention program. The school serves a population that consists of 50% Medicaid-eligible children, and 75% are on the lunch school program. 15% Hispanics, % African American, and 80% are non-Hispanic. The water supply contains 0.3 ppm F. Children in grades 2-6 are screened 2x a yr. with a mirror, an explorer, and dental light. Preschool and grade K are screened 2x a yr. with a tongue blade and light at the time of each application. An educational program is designed to meet the needs of the children in the school. Finally the team explores the option of fluoridization campaign to achieve water fluoridation in this community. Which of the following should be done FIRST in this program? a. Contact key community leaders to obtain a broad base of support for fluoridation. b. Determine the fluoride level of the community water supply. c. Organize a massive community educational program about the benefits and safety of fluoridation. d. Schedule a referendum to allow the citizens to express their opinion about fluoridation. e. Testify before the city council to convince them to fluoridate the water.

contact key community leaders to obtain a broad base of support for fluoridation (because the team is considering the option of a fluoridation campaign, obtaining support from key community leaders is the first step to obtain community buy-in. A referendum or city governmental decision to fluoridate cannot pass without the support of the community.)

TESTLET I: DHG students conduct a study to compare the effectiveness of two non-alcohol mouth rinses, a .02% NaF rinse (Listerine zero) and a .07% CPC rents (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 Gentile adults with no mild. Donis are excepted to participate in the study. The study participants are qualified for inclusion in the study by their plaque bio film forming potential in presence of mild gingivitis. Two groups are formed, and an unmarked bottle of mouth rents is given to each participant. Study participants and examiners are unaware of the formula used by each participant. One group receives the .0% CPC mouth rents, and the other Group receives the .02 NaF mouth rents. All other ingredients of both rinses are standardize. Two examiners are collaborated in the use of the PII and G.I. to measure plaque biofilm at baseline, two months, and four 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 (study participants were chosen on the basis of availability. This sampling technique is convenience sampling and commonly used for clinical trials when access to the total population is not feasible for random sample selection. It introduces bias and reduces validity of the sample; therefore, replication studies are required to develop the evidence.)

TESTLET C The human director of an urban country hospital is alarmed by the rising cost of employee health insurance premiums related to tobacco associated health conditions. The administer 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, and 10% Asian. The dental hygienist conducts 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 the administrators, 19.6 for 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. Implementation and strategy development e. Program evaluation

determination of priorities (the purpose of collecting survey data in this case is to determine the priorities of the tobacco cessation program: who to target and the influential factors related to their tobacco consumption. Program priorities lay the foundation for establishing program goals and objectives.)

educator (the role of the educator role involves teaching oral health to individuals and community groups for the purpose of health promotion. The dental hygienist in this case was hired to provide educational presentations for the participants in the WIC program.)

epidemic (an epidemic is a significantly greater prevalence of a disease or condition than normal, that is, more than the expected number of cases.)

TESTLET G A local DH association and local faith based organization collaborated to targe a school in a non-fluoridated area for a comprehensive oral disease prevention program. The school serves a population that consists of 50% Medicaid-eligible children, and 75% are on the lunch school program. 15% Hispanics, % African American, and 80% are non-Hispanic. The water supply contains 0.3 ppm F. Children in grades 2-6 are screened 2x a yr. with a mirror, an explorer, and dental light. Preschool and grade K are screened 2x a yr. with a tongue blade and light at the time of each application. An educational program is designed to meet the needs of the children in the school. Finally the team explores the option of fluoridization campaign to achieve water fluoridation in this community. Which of the following programs has the HIGHEST priority to further meet the needs of this population? a. Conduct a daily classroom fluoride rinse program. b. Establish dental homes and refer children for treatment. c. Make plans to implement school water fluoridation. d. Plan a health fair for children and their families.

establish dental homes and refer children for treatment (establishment of dental homes and referral of children for treatment would be important for this Medicaid-eligible target group that is not receiving adequate dental care.)

guided practice (guided practice builds on demonstration and provides the students opportunities to correct any misunderstanding of the procedures or to adapt them if necessary. This is important in order to empower clients to provide adequate self-care.)

TESTLET H A DH public health service commissioned core officer is assigned to an indian health service clinic to improve oral care of pregnant women in an American indian rural community. 20% of the pregnant women in this population develop gestational diabetes. When a women first sees a physician she is referred to a dentist. Only 25% referred complied with the dental referral. As a result the community is not classified a dental manpower shortage area. A survey pregnant women served by this clinic reveals poor oral health literacy. Cont. 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 e. Transtheoretical model (stages of change theory)

health belief model (the health belief model (HBM) is a cognitive approach to address risks, seriousness, benefits, and overcoming barriers, which are indicated by the reported results of the survey. An educational program, use of written educational materials, and individual counseling at the pre-natal visits can be designed around the HBM.)

TESTLET C The human director of an urban country hospital is alarmed by the rising cost of employee health insurance premiums related to tobacco associated health conditions. The administer 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, and 10% Asian. The dental hygienist conducts 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 the administrators, 19.6 for 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 (health literacy is the degree to which individuals are capable of obtaining, processing, and understanding basic health information and services needed to make appropriate health decisions. It is influenced by communication, knowledge, culture, demands of the health care and public health systems, and demands of the situation/context. It affects one's ability to navigate the health care system, fill out complex forms, locate providers and services, share personal health information with providers, engage in self-care and chronic-disease management, and understand concepts such as probability and risk. Health literacy level is the best cultural consideration to target due to the established link between health literacy and health actions, behaviors, and outcomes.)

TESTLET B The director of the Vintage retirement center contacts the local DH society to provide a seminar on oral health. The facility has a population of 100 residents between 60-78 yrs old who have a middle SES. 20% is edentulous, 80% have some remaining teeth. The oral health assessment 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. Coefficient analysis revealed a correlation coefficient of r=+0.81 for the relationship of RCI and PlI. 70% of the residents have a dental home and report having regular dental care. <10% report mild signs and symptoms of xerostomia. What is the BEST measure of the success of this program? a. Administrative support for the program b. Improved oral health indicators of the residents c. Improved oral hygiene of the residents d. Increased availability of oral hygiene supplies for use by the residents e. Increased oral health knowledge of the staff

improved oral health indicators of the residents (the success of a program is measured by the outcome of the objectives, which in this case relate to improvement of oral health.)

Teslet D: The director of local nursing home has contracted with a public health dental hygienist to design an oral health protocol for the 300 residence. Currently a registered nurse performs the intake oral examination. The majority of the residents are partially dentulous, have removable partial dentures, and requires assistance with daily hygiene practices. The caregivers state the residents have severe halitosis, trouble eating, and frequently lose their partial dentures. The hygienist observed that the caregivers are neglecting daily oral hygiene care and are not conducting oral health screenings. On the basis of these observations the Thai is determines the Carrio oral hygiene and oral cancer screening of all the residents and introduce an educational component for the facilities caregivers in interested family members. Students from the local dental hygiene program are recruited to assist with the educational program. The caregivers knowledge is measured prior to and a week following the educational program. The success of the program will be evaluated by screening the residents again one year later to identify any lesions that have not been found during the year. If the data reveals lesions that have not been identified, the hygienist plans to work with the director of nursing to establish a new protocol for routine oral cancer screening by the register nurses on staff. The hygienist secures funding from a local foundation for the equipment needed to screen the residence. Which term BEST describes the extent of oral cancer lesions found at the 1-year evaluation screening? a. Count b. Incidence c. Prevalence d. Proportion e. Rate

incidence (incidence is the rate of new disease during a period.)

TESTLET F DH students from a local program visit a geriatric day care, to implement a service learning project. These campers are functionally independent, although they are medically compromised. Under staff 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 by cleaning their dentures/partials, increase 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. What is the BEST way for the students to provide the final report? a. Discuss the results at a meeting with the administrators in which they provide a written proposal of the funding request. b. Include in the written proposal a list of the clients with their baseline and posttest cleanliness scores. c. Include in the written proposal tables and graphs that summarize the pretest and posttest denture cleanliness data. d. Write a few paragraphs in the proposal that describe the statistical analysis of the pretest and posttest denture cleanliness data.

include in the written proposal tables and graphs that summarize the pretest and posttest denture cleanliness data (tables and graphs are the format for presentation of data that are the easiest to understand and interpret; they would provide a reference during a presentation and a written form for the director's future review. Also, by summarizing the data in the tables and graphs, the individual clients' identities are protected.)

TESTLET I: DHG students conduct a study to compare the effectiveness of two non-alcohol mouth rinses, a .02% NaF rinse (Listerine zero) and a .07% CPC rents (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 Gentile adults with no mild. Donis are excepted to participate in the study. The study participants are qualified for inclusion in the study by their plaque bio film forming potential in presence of mild gingivitis. Two groups are formed, and an unmarked bottle of mouth rents is given to each participant. Study participants and examiners are unaware of the formula used by each participant. One group receives the .0% CPC mouth rents, and the other Group receives the .02 NaF mouth rents. All other ingredients of both rinses are standardize. Two examiners are collaborated in the use of the PII and G.I. to measure plaque biofilm at baseline, two months, and four months. The baseline PII scores are used during Group assignment to ensure that the two groups have equivalent oral hygiene. Which of the following is controlled by the procedures used with the examiners as they measure the plaque biofilm? a. Inter-examiner reliability b. Intra-examiner reliability c. Inter-examiner variability d. Intra-examiner variability

inter-examiner reliability (inter-examiner reliability is the agreement among two or more examiners as they apply an index or instrument to measure a disease or condition. Calibration and repeated practice applying the criteria are required to assure this consistency.)

Teslet D: The director of local nursing home has contracted with a public health dental hygienist to design an oral health protocol for the 300 residence. Currently a registered nurse performs the intake oral examination. The majority of the residents are partially dentulous, have removable partial dentures, and requires assistance with daily hygiene practices. The caregivers state the residents have severe halitosis, trouble eating, and frequently lose their partial dentures. The hygienist observed that the caregivers are neglecting daily oral hygiene care and are not conducting oral health screenings. On the basis of these observations the Thai is determines the Carrio oral hygiene and oral cancer screening of all the residents and introduce an educational component for the facilities caregivers in interested family members. Students from the local dental hygiene program are recruited to assist with the educational program. The caregivers knowledge is measured prior to and a week following the educational program. The success of the program will be evaluated by screening the residents again one year later to identify any lesions that have not been found during the year. If the data reveals lesions that have not been identified, the hygienist plans to work with the director of nursing to establish a new protocol for routine oral cancer screening by the register nurses on staff. The hygienist secures funding from a local foundation for the equipment needed to screen the residence. The stakeholders involved in this program represterm-61ent what level of public health involvement? a. Local b. State c. National d. A combination of two or more levels

local (this program involves direct administration of educational, preventive, and patient care programs in the local community. It is delivered through the collaboration of a local facility, a contracted oral health care provider, and a local dental hygiene educational program, with local funding. All of this represents a local program.)

measurable (SMART objectives meet the criteria represented by the letters of the acronym: specific, measurable, achievable, relevant, and time bound. The SMART objective for this program is not measurable, which refers to the ability to quantify the activity or results. It is necessary to convey "how much" change is expected, indicate a means of measuring the amount of change expected, and provide a reference point by which the change can be measured, none of which are communicated by this objective. If the objective stated that the PlI of 2.1 would be reduced by 50%, it would be measurable.)

Testlet J: The administer 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 residence require that they receive assistance with oral hygiene routines; yet complains of severe resident halitosis and bleeding during normal oral hygiene, making the caregivers reluctant to provide assistance. Frustrated by a lack of staff compliance, the group home administrator contact the local county public health dental hygienist, knowing that the county health department has a grant for the oral care for this population. After gathering basic demographic information, the hygienist makes a visit to the home to determine the actual oral health status of the residents. What is the BEST way for the dental hygienist to assess the actual oral hygiene routines in the group home? a. Assess the values of caregivers by conducting focus groups. b. Measure the plaque biofilm and gingivitis scores of residents over time. c. Observe the residents' ability to brush correctly. d. Observe the caregivers' ability to brush correctly. e. Survey the beliefs and attitudes of caregivers with a questionnaire.

measure the plaque biofilm and gingivitis scores of residents over time (the only real measure of actual oral hygiene routines, and their subsequent effectiveness, is to measure the residents' oral health conditions using various dental indices over time. Staff members may comply with correct routines when under observation. Thus, repeatedly assessing the results of oral hygiene, for example, plaque biofilm and gingivitis, provides a more valid and objective evaluation of the staff members' daily compliance assisting the residents with their oral hygiene routines.)

TESTLET E A high dental caries rate has been reported by the school nurses in Kern County head start children on the basis of the rate of toothaches and absences. The families are primarily Spanish speaking Hispanic and east Indian migrant farm workers. they reside in predominantly rural settings with individual well water supplies. A team of DH students has been asked to design a comprehensive program to address the problem of the dental cries in the population. they being by collecting baseline data using the deft, OHI-S, and GI. 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 from a local foundation.

medicare (medicare is a federal insurance program for seniors, not for children.)

TESTLET A You have been employed as a public health DH 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 F. 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 for the educational session for the pregnant teens. b. Meet with the people involved to determine program goals and objectives. c. Plan an educational presentation for the day care children. d. Request funding for oral hygiene supplies from the local health department. e. Select teaching strategies for the educational program.

meet with the people involved to determine program goals and objectives (after the need is established, the first step of developing a lesson plan is to establish goals and objectives. Doing this in consultation with the people involved is a principle of public health (involvement of the community of interest in planning).)

TESTLET B The director of the Vintage retirement center contacts the local DH society to provide a seminar on oral health. The facility has a population of 100 residents between 60-78 yrs old who have a middle SES. 20% is edentulous, 80% have some remaining teeth. The oral health assessment 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. Coefficient analysis revealed a correlation coefficient of r=+0.81 for the relationship of RCI and PlI. 70% of the residents have a dental home and report having regular dental care. <10% report mild signs and symptoms of xerostomia. What level of oral hygiene is revealed by the mean P1I? a. No plaque present b. Slight plaque present c. Moderate plaque present d. Severe plaque present e. Cannot be determined from the information provided

moderate plaque present (the range of possible PlI (plaque index) scores is 0 to 3: 0 is no plaque present, 1 is slight plaque, 2 is moderate plaque, and 3 is severe plaque. The average PlI score for the residents is 2.1, which is closer to 2, moderate plaque.)

TESTLET H A DH public health service commissioned core officer is assigned to an indian health service clinic to improve oral care of pregnant women in an American indian rural community. 20% of the pregnant women in this population develop gestational diabetes. When a women first sees a physician she is referred to a dentist. Only 25% referred complied with the dental referral. As a result the community is not classified a dental manpower shortage area. A survey pregnant women served by this clinic reveals poor oral health literacy. Cont. The dental referral by the medical clinic is an example of which characteristic of public health? a. Application of biostatistics to analyse population health problems b. Community rather than the individual as the client c. Multidisciplinary team approach to solving public health problems d. Social responsibility for oral health

multidisciplinary team approach to solving public health problems (the collaboration of the referring medical practitioner with the dental clinic staff is an interdisciplinary team effort to solve this public health problem.)

Teslet D: The director of local nursing home has contracted with a public health dental hygienist to design an oral health protocol for the 300 residence. Currently a registered nurse performs the intake oral examination. The majority of the residents are partially dentulous, have removable partial dentures, and requires assistance with daily hygiene practices. The caregivers state the residents have severe halitosis, trouble eating, and frequently lose their partial dentures. The hygienist observed that the caregivers are neglecting daily oral hygiene care and are not conducting oral health screenings. On the basis of these observations the Thai is determines the Carrio oral hygiene and oral cancer screening of all the residents and introduce an educational component for the facilities caregivers in interested family members. Students from the local dental hygiene program are recruited to assist with the educational program. The caregivers knowledge is measured prior to and a week following the educational program. The success of the program will be evaluated by screening the residents again one year later to identify any lesions that have not been found during the year. If the data reveals lesions that have not been identified, the hygienist plans to work with the director of nursing to establish a new protocol for routine oral cancer screening by the register nurses on staff. The hygienist secures funding from a local foundation for the equipment needed to screen the residence. What is the BEST method to use for the weekly evaluation of the caregivers' ability to conduct oral cancer screening in this program? a. Administer a weekly written test over the cancer screening procedure. b. Interview the residents about the caregivers' technique. c. Observe the caregivers conducting oral cancer screening. d. Survey the family members about the caregivers' technique.

observe the caregivers conducting oral cancer screening (observation is the best means of evaluating a skill.)

TESTLET C The human director of an urban country hospital is alarmed by the rising cost of employee health insurance premiums related to tobacco associated health conditions. The administer 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, and 10% Asian. The dental hygienist conducts 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 the administrators, 19.6 for 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 of the following is the BEST instructional objective for this initiative? a. After completing the educational program, participants will understand the harmful effects of tobacco and how they contribute to oral and systemic diseases and conditions. b. Participants will be able to list recommended methods to control cravings that can lead to failure. c. Ninety percent of the staff will voluntarily participate in the program during the first month of availability. d. On completion of the computer-based educational program, staff members will be able to correctly identify 80% of the harmful ingredients in tobacco.

on completion of the computer-based educational program, staff members will be able to correctly identify 80% of the harmful ingredients in tobacco (a well-written instructional objective is specific and measurable, and includes four critical components: (a) the action verb that describes what the learner will be able to do or perform after learning has occurred, (2) the conditions under which performance is to occur, (3) the criterion of acceptable performance that communicates how well the learner must perform in order for the performance to be considered acceptable, and (4) the audience or who will perform the action described by the verb. All of these components are present in this instructional objective: (a) the action is "identify," (b) the conditions are "upon completion of the computer-based educational program," (c) the criterion is "80%," and (d) the audience is "staff members." It is a specific, measurable, well-written instructional objective.)

TESTLET B The director of the Vintage retirement center contacts the local DH society to provide a seminar on oral health. The facility has a population of 100 residents between 60-78 yrs old who have a middle SES. 20% is edentulous, 80% have some remaining teeth. The oral health assessment 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. Coefficient analysis revealed a correlation coefficient of r=+0.81 for the relationship of RCI and PlI. 70% of the residents have a dental home and report having regular dental care. <10% report mild signs and symptoms of xerostomia. 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 educational presentation on denture care b. Oral cancer screening and referral, as needed c. Referral to a Medicaid provider for dental treatment d. Screening of periodontal condition and referral, as needed e. Treatment with fluoride varnish to control dentinal hypersensitivity

oral cancer screening and referral, as needed (several Healthy People 2020 oral health objectives relate to conducting an oral cancer screening program in the older adult population: (1) increase the proportion of oral and pharyngeal cancers detected at the earliest stage, (2) increase the proportion of adults who, in the past 12 months, report having had an examination to detect oral and pharyngeal cancer, and (3) reduce the oropharyngeal cancer death rate. Although a high proportion of these residents have a dental home and see the dentist regularly, studies have reported a low frequency of routine performance of oral cancer examinations in dental offices. Therefore, this group would benefit from an oral cancer screening and referral program.)

TESTLET H A DH public health service commissioned core officer is assigned to an indian health service clinic to improve oral care of pregnant women in an American indian rural community. 20% of the pregnant women in this population develop gestational diabetes. When a women first sees a physician she is referred to a dentist. Only 25% referred complied with the dental referral. As a result the community is not classified a dental manpower shortage area. A survey pregnant women served by this clinic reveals poor oral health literacy. Cont. Which of the following is the BEST intervention to implement first to meet the goal of the program? a. Conduct a mailing program to remind pregnant women to schedule an appointment for a dental examination. b. Develop an oral health screening program to be implemented during prenatal care visits. c. Develop written educational materials for distribution during prenatal visits. d. Document the oral condition of the women who have complied and received a dental examination. e. Plan an educational presentation for the pregnant women on the relationship among oral health, systemic health, and the risks and consequences of diabetes.

plan an educational presentation for the pregnant women on the relationship among oral health, systemic health, and the risks and consequences of diabetes (the goal of the program is to increase the referral rate. An educational presentation for this group is important to help them understand the relationship of oral health and systemic health and the risks and consequences of diabetes. Even the clients who have already complied would benefit long term from this program.)

Teslet D: The director of local nursing home has contracted with a public health dental hygienist to design an oral health protocol for the 300 residence. Currently a registered nurse performs the intake oral examination. The majority of the residents are partially dentulous, have removable partial dentures, and requires assistance with daily hygiene practices. The caregivers state the residents have severe halitosis, trouble eating, and frequently lose their partial dentures. The hygienist observed that the caregivers are neglecting daily oral hygiene care and are not conducting oral health screenings. On the basis of these observations the Thai is determines the Carrio oral hygiene and oral cancer screening of all the residents and introduce an educational component for the facilities caregivers in interested family members. Students from the local dental hygiene program are recruited to assist with the educational program. The caregivers knowledge is measured prior to and a week following the educational program. The success of the program will be evaluated by screening the residents again one year later to identify any lesions that have not been found during the year. If the data reveals lesions that have not been identified, the hygienist plans to work with the director of nursing to establish a new protocol for routine oral cancer screening by the register nurses on staff. The hygienist secures funding from a local foundation for the equipment needed to screen the residence. 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 three core functions of public health are assessment, assurance, and policy development. Policy development is the establishment of comprehensive public health policies based on scientific evidence. Creation of this new protocol is an example of a policy that would address national oral health objectives based on the scientific evidence that early detection of lesions leads to reduced risk of mortality.)

Testlet J: The administer 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 residence require that they receive assistance with oral hygiene routines; yet complains of severe resident halitosis and bleeding during normal oral hygiene, making the caregivers reluctant to provide assistance. Frustrated by a lack of staff compliance, the group home administrator contact the local county public health dental hygienist, knowing that the county health department has a grant for the oral care for this population. After gathering basic demographic information, the hygienist makes a visit to the home to determine the actual oral health status of the residents. Which of the following is the BEST use of the dental hygienist in this situation? a. Conduct an educational program on daily oral hygiene care for the residents b. Make available dental hygiene services for the residents using portable equipment c. Present a in-service training program to the group home staff d. Provide daily oral hygiene care for the residents

present a in-service training program to the group home staff (because the caregivers are failing to assist residents with daily oral hygiene care as expected, the best use of the dental hygienist's time and effort is to provide training of the care staff. A principle of the role of the dental hygienist in public health is to maximize the effect by educating and training others who can provide education or services directly to the population.)

Teslet D: The director of local nursing home has contracted with a public health dental hygienist to design an oral health protocol for the 300 residence. Currently a registered nurse performs the intake oral examination. The majority of the residents are partially dentulous, have removable partial dentures, and requires assistance with daily hygiene practices. The caregivers state the residents have severe halitosis, trouble eating, and frequently lose their partial dentures. The hygienist observed that the caregivers are neglecting daily oral hygiene care and are not conducting oral health screenings. On the basis of these observations the Thai is determines the Carrio oral hygiene and oral cancer screening of all the residents and introduce an educational component for the facilities caregivers in interested family members. Students from the local dental hygiene program are recruited to assist with the educational program. The caregivers knowledge is measured prior to and a week following the educational program. The success of the program will be evaluated by screening the residents again one year later to identify any lesions that have not been found during the year. If the data reveals lesions that have not been identified, the hygienist plans to work with the director of nursing to establish a new protocol for routine oral cancer screening by the register nurses on staff. The hygienist secures funding from a local foundation for the equipment needed to screen the residence. What type of study is represented by evaluating the change of knowledge as a result of the educational component? a. Case-control b. Correlational c. Crossover d. Pretest/posttest e. Time-series

pretest/posttest (evaluation of change requires a pretest measure (before the intervention) and a post-test measure (after the intervention) for comparison, with the intervention in-between. It is a prospective approach to determine if change occurs over time and to evaluate if the change can be attributed to the intervention. Because of a lack of a control group for comparison, it is considered a quasi-experimental study rather than an experimental study, but it is still a pretest/post-test approach.)

Testlet J: The administer 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 residence require that they receive assistance with oral hygiene routines; yet complains of severe resident halitosis and bleeding during normal oral hygiene, making the caregivers reluctant to provide assistance. Frustrated by a lack of staff compliance, the group home administrator contact the local county public health dental hygienist, knowing that the county health department has a grant for the oral care for this population. After gathering basic demographic information, the hygienist makes a visit to the home to determine the actual oral health status of the residents. Which of the following is an effective teaching strategy to raise the caregivers' compliance in this situation? a. Demonstrate to them the proper oral hygiene procedures. b. Provide a lecture for them on the importance of oral hygiene. c. Show them pictures of good oral health versus oral disease. d. Provide training on how to maintain personal oral hygiene skills for themselves.

provide training on how to maintain personal oral hygiene skills for themselves (according to learning theories, change in values is important in achieving compliance, and values can be changed by providing new experiences. Training in personal oral hygiene will provide an opportunity to experience the benefits of good oral hygiene. Once the caregivers develop this value, they will be more likely to assist residents with their daily oral hygiene. This training will also increase their confidence in their ability to improve the residents' oral health (self-efficacy), which is also an important factor in compliance.)

Teslet D: The director of local nursing home has contracted with a public health dental hygienist to design an oral health protocol for the 300 residence. Currently a registered nurse performs the intake oral examination. The majority of the residents are partially dentulous, have removable partial dentures, and requires assistance with daily hygiene practices. The caregivers state the residents have severe halitosis, trouble eating, and frequently lose their partial dentures. The hygienist observed that the caregivers are neglecting daily oral hygiene care and are not conducting oral health screenings. On the basis of these observations the Thai is determines the Carrio oral hygiene and oral cancer screening of all the residents and introduce an educational component for the facilities caregivers in interested family members. Students from the local dental hygiene program are recruited to assist with the educational program. The caregivers knowledge is measured prior to and a week following the educational program. The success of the program will be evaluated by screening the residents again one year later to identify any lesions that have not been found during the year. If the data reveals lesions that have not been identified, the hygienist plans to work with the director of nursing to establish a new protocol for routine oral cancer screening by the register nurses on staff. The hygienist secures funding from a local foundation for the equipment needed to screen the residence. What type of data is being collected by the screening? a. Qualitative and primary b. Qualitative and secondary c. Quantitative and primary d. Quantitative and secondary

qualitative and primary (new data are called primary data. Qualitative data are descriptive as opposed to numeric data. Oral hygiene and oral lesions are both described rather than numerically measured. Even if an index were used to evaluate oral hygiene, the numbers of the index represent descriptions of categories rather than actual quantities of plaque biofilm or calculus.)

Testlet J: The administer 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 residence require that they receive assistance with oral hygiene routines; yet complains of severe resident halitosis and bleeding during normal oral hygiene, making the caregivers reluctant to provide assistance. Frustrated by a lack of staff compliance, the group home administrator contact the local county public health dental hygienist, knowing that the county health department has a grant for the oral care for this population. After gathering basic demographic information, the hygienist makes 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? a. Reduce untreated dental decay in children and adults. b. Reduce gingivitis and destructive periodontal disease in adults. c. Increase detection of oral cancer lesions at stage I. d. Increase annual use of dental services by residents of long-term care facilities.

reduce gingivitis and destructive periodontal disease in adults (caregiver observations of halitosis and bleeding during oral hygiene routines correlate with the presence of periodontal disease, suggesting that the HP 2020 objective of reducing gingivitis and destructive periodontal disease in adults is most applicable to this population. It is well known and supported by evidence that mentally challenged individuals have higher rates of periodontal disease. Therefore, the dental hygienist automatically knows that the residents of this group home are at a higher risk status for gingivitis and periodontitis. From the information provided, one can best apply the HP 2020 objective of reducing gingivitis and periodontitis to this population.)

TESTLET F DH students from a local program visit a geriatric day care, to implement a service learning project. These campers are functionally independent, although they are medically compromised. Under staff 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 by cleaning their dentures/partials, increase 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. 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 findings to submit to the health department. c. Refer clients who have suspicious lesions identified during the program. d. Take the dentures back to the dental hygiene clinic to clean them more thoroughly.

refer clients who have suspicious lesions identified during the program (failure to refer a client with a suspicious lesion would go against the ethical principle of beneficence.)

TESTLET E A high dental caries rate has been reported by the school nurses in Kern County head start children on the basis of the rate of toothaches and absences. The families are primarily Spanish speaking Hispanic and east Indian migrant farm workers. they reside in predominantly rural settings with individual well water supplies. A team of DH students has been asked to design a comprehensive program to address the problem of the dental cries in the population. they being by collecting baseline data using the deft, OHI-S, and GI. Which preventative program is indicated for this target population? a. Distribution of fluoridated dentifrice b. Professional fluoride applications every 6 months c. School fluoride varnish program d. School sealant program e. Water fluoridation

school fluoride varnish program (fluoride varnish is a recommended public health caries prevention program for young children. The best means of reaching this population is with a school program.)

TESTLET B The director of the Vintage retirement center contacts the local DH society to provide a seminar on oral health. The facility has a population of 100 residents between 60-78 yrs old who have a middle SES. 20% is edentulous, 80% have some remaining teeth. The oral health assessment 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. Coefficient analysis revealed a correlation coefficient of r=+0.81 for the relationship of RCI and PlI. 70% of the residents have a dental home and report having regular dental care. <10% report mild signs and symptoms of xerostomia. The correlation between the RCI and P1I 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 e. Little if any

strong positive (correlation coefficient is the statistic used to demonstrate a relationship or association between two variables. The sign of the coefficient (negative or positive; below or above 0) indicates the direction of the relationship. The value of the coefficient indicates the strength of the relationship: 0.9 to 1.0 is very strong, 0.70 to 0.89 is strong, 0.50 to 0.69 is moderate, 0.26 to 0.49 is weak, and 0.25 and below is little if any relationship. The value of r for this target group is 0.81, which demonstrates a strong (value between 0.70 and 0.89) and positive (above 0) association between root caries and plaque biofilm in this target group.)

TESTLET E A high dental caries rate has been reported by the school nurses in Kern County head start children on the basis of the rate of toothaches and absences. The families are primarily Spanish speaking Hispanic and east Indian migrant farm workers. they reside in predominantly rural settings with individual well water supplies. A team of DH students has been asked to design a comprehensive program to address the problem of the dental cries in the population. they being by collecting baseline data using the deft, OHI-S, and GI. Which of the following describes the level of ECC for the older age of this population? a. No smooth-surface caries is present. b. No cavitated lesions are present on anterior teeth. c. Number of carious lesions is less than four. d. The number of carious lesions is greater than five.

the number of carious lesions is greater than five (head start programs are targeted at ages 3 and 4 years; the older children are 4 years old. According to the criteria for classifying ECC, in children age 4 years, S-ECC includes one or more cavitated dmfs in maxillary anterior teeth or five or more dmfs.)

the t-test (the t-test is used to compare two mean scores.)

TESTLET G A local DH association and local faith based organization collaborated to targe a school in a non-fluoridated area for a comprehensive oral disease prevention program. The school serves a population that consists of 50% Medicaid-eligible children, and 75% are on the lunch school program. 15% Hispanics, % African American, and 80% are non-Hispanic. The water supply contains 0.3 ppm F. Children in grades 2-6 are screened 2x a yr. with a mirror, an explorer, and dental light. Preschool and grade K are screened 2x a yr. with a tongue blade and light at the time of each application. An educational program is designed to meet the needs of the children in the school. Finally the team explores the option of fluoridization campaign to achieve water fluoridation in this community. Which of the following is a required action for this program? a. Phone call to each family to describe the program b. Presence if a dentist while the fluoride varnish is placed by hygienists c. Radiographs before placing sealants d. Written informed consent form signed by parents or legal guardians of all children who participate

written informed consent form signed by parents or legal guardians of all children who participate (written informed consent by the parents is required for children to participate in screening, sealant, and fluoride programs.)

TESTLET I: DHG students conduct a study to compare the effectiveness of two non-alcohol mouth rinses, a .02% NaF rinse (Listerine zero) and a .07% CPC rents (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 Gentile adults with no mild. Donis are excepted to participate in the study. The study participants are qualified for inclusion in the study by their plaque bio film forming potential in presence of mild gingivitis. Two groups are formed, and an unmarked bottle of mouth rents is given to each participant. Study participants and examiners are unaware of the formula used by each participant. One group receives the .0% CPC mouth rents, and the other Group receives the .02 NaF mouth rents. All other ingredients of both rinses are standardize. Two examiners are collaborated in the use of the PII and G.I. to measure plaque biofilm at baseline, two months, and four months. The baseline PII scores are used during Group assignment to ensure that the two groups have equivalent oral hygiene. Which of the following is a 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. The 0.02% NaF mouthrinse and the 0.07% CPC mouthrinse differ in their ability to control plaque and gingivitis. d. There is no difference between the ability of the 0.02% NaF mouthrinse and the 0.07% CPC mouthrinse to control plaque and gingivitis. e. Which controls plaque and gingivitis better, the 0.02% NaF mouthrinse or the 0.07% CPC mouthrinse?

there is no difference between the ability of the 0.02% NaF mouthrinse and the 0.07% CPC mouthrinse to control plaque and gingivitis (the null hypothesis is stated negatively and assumes the absence of statistically significant differences between the sample groups.)

TESTLET E A high dental caries rate has been reported by the school nurses in Kern County head start children on the basis of the rate of toothaches and absences. The families are primarily Spanish speaking Hispanic and east Indian migrant farm workers. they reside in predominantly rural settings with individual well water supplies. A team of DH students has been asked to design a comprehensive program to address the problem of the dental cries in the population. they being by collecting baseline data using the deft, OHI-S, and GI. 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 (the caries index used in this program is the deft. The second component, "e," signifies that the tooth needs to be extracted (is indicated for extraction) because of the severity of decay.)

TESTLET F DH students from a local program visit a geriatric day care, to implement a service learning project. These campers are functionally independent, although they are medically compromised. Under staff 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 by cleaning their dentures/partials, increase 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. 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 (the transtheoretical model (stages of change theory) is reflected in this scenario. The students' use of the data collected in the interviews to plan individualized instruction for each client is an example of individualizing instruction according to the client's current stage (precontemplation, contemplation, preparation, action, maintenance, and termination) to encourage movement to the next stage.)

TESTLET G A local DH association and local faith based organization collaborated to targe a school in a non-fluoridated area for a comprehensive oral disease prevention program. The school serves a population that consists of 50% Medicaid-eligible children, and 75% are on the lunch school program. 15% Hispanics, % African American, and 80% are non-Hispanic. The water supply contains 0.3 ppm F. Children in grades 2-6 are screened 2x a yr. with a mirror, an explorer, and dental light. Preschool and grade K are screened 2x a yr. with a tongue blade and light at the time of each application. An educational program is designed to meet the needs of the children in the school. Finally the team explores the option of fluoridization campaign to achieve water fluoridation in this community. What assessment classification is used with preschoolers and grade K in this program? a. Type I b. Type II c. Type III d. Type IV

type IV (type IV is used to screen with a tongue depressor and available illumination to identify glaring needs for assessment in program planning.)

TESTLET B The director of the Vintage retirement center contacts the local DH society to provide a seminar on oral health. The facility has a population of 100 residents between 60-78 yrs old who have a middle SES. 20% is edentulous, 80% have some remaining teeth. The oral health assessment 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. Coefficient analysis revealed a correlation coefficient of r=+0.81 for the relationship of RCI and PlI. 70% of the residents have a dental home and report having regular dental care. <10% report mild signs and symptoms of xerostomia. All the following preventative programs are indicated by the assessment results EXCEPT one. Which one is the exception? 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 (this is the recommended dosage and duration for use of 0.12% chlorhexidine gluconate to control gingivitis, which is not indicated by the reported mean GI of 0.8. The range of possible Gingival index scores is 0 to 3: 0 is no gingivitis, 1 is mild gingivitis, 2 is moderate gingivitis, and 3 is severe gingivitis. This target group needs programming to address dental caries. For caries management, the recommended off-label procedure is to rinse with 0.12% chlorhexidine gluconate for one minute daily for one week each month.)

NBDHE Community Oral Health Planning and Practice - 20

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