1. Algonquin College - Jan Ladas1 Community Dental Health Review

2. Algonquin College - Jan Ladas2 Dental Hygienist’s Key Responsibilities 1. Health Promotion: Awareness/Improvement/Responsibility 2. Education: Teaching/Learning/Behavior Modification 3. Clinical Therapy: Care/Treatment

3. Algonquin College - Jan Ladas3 Dental Hygienist’s Key Responsibilities 4. Research: Scientific Investigation/Study/Reporting 5. Change Agent: Catalyst for process of change 6. Administration: Policy Development/Management Processes * All responsibilities mean a commitment to Lifelong Learning to maintain competence.

4. Algonquin College - Jan Ladas4 Dental Hygienist’s Key Responsibilities In Private Practice Health Promoter:  Enabling clients to increase awareness, responsibility and improvement of their health  Practice prevention Educator:  Teaching / learning from clients  Motivating and modifying behaviour of clients

5. Algonquin College - Jan Ladas5 Clinician:  Preventive, therapeutic and ongoing care procedures  Technology used appropriately Researcher:  Investigating, studying and keeping current with knowledge that validates D.H. practice Dental Hygienist’s Key Responsibilities In Private Practice

6. Algonquin College - Jan Ladas6 Dental Hygienist’s Key Responsibilities In Private Practice Change Agent:  Managing the process of change  catalyst, solution giver, resource link/process helper  advocator for rights and well-being Administrator:  Management process and policy development  Record keeping  Office policy  Cost Effectiveness

7. Algonquin College - Jan Ladas7 Dental Hygienist’s Key Responsibilities In Community Health Health Promoter:  Increase awareness, personal responsibility and improvement of oral health in the community  Resource person for other health professionals Educator / Program Planner:  In response to needs and resources in the community  Dental health advisor

8. Algonquin College - Jan Ladas8 Dental Hygienist’s Key Responsibilities In Community Health Clinician:  Screening surveys  Preventive care, referrals and client follow-ups Researcher:  Keeping current

9. Algonquin College - Jan Ladas9 Dental Hygienist’s Key Responsibilities In Community Health Change Agent:  For health policies – rights and well-being  Catalyst, solution-giver, resource link  Process helper Administrator:  Maintains records, data input, analysis and dissemination  Policy and procedure management  Ensures cost-effectiveness

10. Algonquin College - Jan Ladas10 Phases Of Process Of Care Private Practice Assessment of: - Client’s medical and dental history - Socio-cultural history - Oral exam Diagnosis of: - Patient’s oral hygiene status Public Health Assessment of: - Needs of the community and the target population - Analyzes assessment Diagnosis of: - Community dental hygiene status

11. Algonquin College - Jan Ladas11 Phases Of Process Of Care Private Practice Planning of: - Treatment needs and priorities - Method of payment Public Health Planning of: - Program based on data, priority and resources - Funding sources

12. Algonquin College - Jan Ladas12 Phases Of Process Of Care Private Practice Implementation of:  Treatment plan and co-ordination of treatment with other professionals  Changing when necessary Public Health Implementation of:  Varied personnel are involved  Changing plan when necessary

13. Algonquin College - Jan Ladas13 Phases Of Process Of Care Private Practice Evaluation  During treatment, specific intervals or on completion of treatment Public Health Evaluation  Ongoing in terms of: - effectiveness - efficiency - appropriateness - adequacy

14. Algonquin College - Jan Ladas14 Role Of Dental Hygienist In Community Health School dental health program  Screening, referrals, follow ups  Resource person in dental health to staff  Providing clinical services where appropriate  Maintaining records and data input  Assisting in developing education materials

15. Algonquin College - Jan Ladas15 Role Of Dental Hygienist In Community Health Dental indices surveys  Organizing and implementing Dental health advisor in the community  Multidisciplinary Dental health programs  Plan, organize, implement In-service trainer to the community  On request Special dental health activities  Dental hygiene week, dental health month, health fairs

16. Algonquin College - Jan Ladas16 Role Of Dental Hygienist In Community Health As well as:  Be familiar with all current legislation and regulations  Compile records, reports and statistics for dissemination  Role model for dental services on committees and programs as assigned  Function as a “team” member in all activities

17. Algonquin College - Jan Ladas17 Target Populations  Family caregivers (parents, relatives, etc.)  School teachers / staff  Health care workers – providers of direct patient care  Hospice workers – for terminally ill  Persons with medical conditions  Developmentally disabled  Hearing impaired / deaf  Visually impaired / blind

18. Algonquin College - Jan Ladas18 Target Populations Things to consider:  Age specific competencies  Cultural diversity  Beliefs, values, attitudes, perceptions, expectations and needs  Barriers to dental care: age, language, disabilities, finances, transportation, access to care, fear, misunderstanding, trust, illiteracy, denial of disease, social issues and habits

19. Algonquin College - Jan Ladas19 Criteria For Public Health Decisions 1. Disease or other threat to health is widespread 2. Knowledge exists on how to prevent or cure the condition 3. Such knowledge is not being applied W.H.O. Definition of health “A state of complete physical / mental and social well- being and not merely the absence of disease”

20. Algonquin College - Jan Ladas20 Community Prevention Programs Prevention – primary goal  Primary prevention - Most effective - Prevents disease before it occurs – fluoridization / immunization, diet, physical activity

21. Algonquin College - Jan Ladas21 Community Prevention Programs Prevention – primary goal  Secondary prevention - Treats disease after it occurs - Promptly - Reduce prevalence - Shorten duration - Screening / referrals - Early & accurate diagnosis

22. Algonquin College - Jan Ladas22 Community Prevention Programs Prevention – primary goal Tertiary prevention - Limits or rehabilitates a disability from disease – e.g. - Prostheses provided - Reduce complications * Community prevention programs used only when shown to be effective by well-designed clinical studies and evidence-based research

23. Algonquin College - Jan Ladas23 World Health Organization Activities  Maintains country profile development (information on oral disease and services, tobacco use, sugar consumption, fluoride/fluoridization)  Implements and evaluates community preventive programs (affordable oral care)  Public education / health promotion

24. Algonquin College - Jan Ladas24 World Health Organization ACTIVITIES  Advocacy and legislation promotion  Information dissemination (41 W.H.O. centers worldwide)

25. Algonquin College - Jan Ladas25 Current Dental Public Health Practice 1. Water Fluoridization 2. Prevention of oral cancer 3. Reduction of dental problems 4. Education 5. Nutrition 6. Injury prevention 7. Research and development

26. Algonquin College - Jan Ladas26 1. Water FLUORIDIZATION 1901-08Dr. Fredrick McKay observed “Colorado Brown Stain” (Motteling and brown opacities of the teeth – less caries) 1920Common link – shared water source – water analysis showed nothing 1925McKay advised using water from outside source – resulted in less motteling

27. Algonquin College - Jan Ladas27 1. Water FLUORIDIZATION 1930Improved water analysis method showed correlation between increased fluoride resulted in more motteling then termed “Dental Fluorosis” 1931Dr. H. Trendley Dean Goal: to define the minimal level of fluoride to inhibit caries without Fluorosis - developed Fluorosis index Result: caries rate down at F. Level up to 1.0 p.p.m.

28. Algonquin College - Jan Ladas28 2. Prevention Of Oral Cancer W.H.O. – A Global Concern Tobacco Cessation How to reduce oral cancer: 1. Train health care workers to look for early signs 2. Education of the public – advertising (causes and signs) 3. Involve other educators (teachers) 4. Public policy – taxes / bans 5. Individual counseling 6. Prevention / cessation programs 7. Social acceptance changes

29. Algonquin College - Jan Ladas29 3. Reduction Of Dental Problems  Technology / research & development  Fluoride – variety of sources  Improved access to care  Early interventions / injury prevention campaigns  Improved oral health education / promotion  Improved nutrition awareness

30. Algonquin College - Jan Ladas30 Preventive Properties Of Fluoride CLASSICAL EPIDEMIOLOGICAL STUDY – SIX PRINCIPALS 1.Studied groups not individuals “Colorado Springs Community” 2.Examined “well” and “ill” people – long term residents more affected 3.Looked at relative prevalence surrounding areas studied

31. Algonquin College - Jan Ladas31 Preventive Properties Of Fluoride CLASSICAL EPIDEMIOLOGICAL STUDY – SIX PRINCIPALS 4.Broad goal established, e.g. association between prevalence of fluorosis or caries and fluoridated and non-fluoridated areas 5.Required 2 demonstrations - association itself is dependable and predictable from population to population - other factors could not be responsible

32. Algonquin College - Jan Ladas32 Preventive Properties Of Fluoride CLASSICAL EPIDEMIOLOGICAL STUDY – SIX PRINCIPALS 6.Support for association between fluoride and dental health is gained through additional studies FINAL CONCLUSION Water can be fluoridated to optimal level to reduce caries without increasing fluorosis

33. Algonquin College - Jan Ladas33 Ministry Of Health Program Children In Need Of Treatment C.I.N.O.T.  Dental Screening Program– 3 Hygienists High/Moderate Risk Elementary Schools - screening of selected students and data recording - intensive follow-ups and referrals - take home notice - phone contact/consultation - follow up school screening - provision of preventive services - exam, prophylaxis, sealants, fluorides

34. Algonquin College - Jan Ladas34 Ministry Of Health Program Children In Need Of Treatment C.I.N.O.T.  Dental Screening Program– 3 Hygienists High/Moderate Risk Elementary Schools - Dental Health Education and Promotion - clients, caregivers, school staff - resource person - for students / caregivers - in the community - for other health care providers Year 2000: - 60 schools screened - 1500 CINOT referrals - 480 clinic services

35. Algonquin College - Jan Ladas35 Terminology EPIDEMIOLOGY: The study of the amount, distribution, determinants and control of diseases and health conditions among given populations. Endemic: A relatively low, but constant level of occurrence of a disease or health condition in a population.

36. Algonquin College - Jan Ladas36 Terminology Epidemic: A disease or condition occuring among many individuals in a community or region at the same time and usually spreading rapidly. Often called an “outbreak” of disease. Widespread outbreaks across a region or continent may be termed pandemic in extent. Disease rates: The number of cases or deaths among a population or target group during a given time period, expressed as a ratio. Rates are often statistically “adjusted” to make valid comparisons across different populations or to detect trends within the same population.

37. Algonquin College - Jan Ladas37 Terminology Mortality: The ratio of the number of deaths from a given disease or health problem to the total number of cases reported. Morbidity: The ratio of “sick” (affected) individuals to well individuals in a community. It often measures the level of nonfatal health consequences (severity) of a disease or condition.

38. Algonquin College - Jan Ladas38 Terminology Prevalence: A numerical expression of the number of all existing cases of a disease or problem in a population measured at a given point or period of time. Case rate: Frequency of occurrence of a condition. Incidence: The number of new cases of a disease in a population over a given period of time.

39. Algonquin College - Jan Ladas39 Terminology Etiology: The theory of causation for a disease or condition. Risk factors: Characteristics of an individual or population, which may increase the likelihood of experiencing a given health problem (e.G., Age, gender, educational level, socioeconomic status).

40. Algonquin College - Jan Ladas40 Terminology Index: A standardized method used to describe the status of an individual or group with respect to a given condition. Indexes usually involve a graduated scale for measuring the extent of the health problem. Surveillance: Methods or systems used to monitor disease and morbidity in a population periodically or on an ongoing basis. It is an important function of the centers for disease control (CDC) and health departments, etc.