Dental Public Health

Dental Public Health

Introduction
Topics
Historical Development Oral Epidemiology
Dental Care Delivery Research Methods
in the United States Biostatistics
around the world Evaluation of Literature
Financing Dental Care and Products
Legislative Initiatives Careers in the Government
Education and Promotion Entreprenurial Initiatives
Target Populations Board Review
Lesson Plan
Program Planning
Program Evaluation
The Prevention
Movement

Dental Hygienes Relation

to Dental Public Health
Historical Development
Dental Hygiene as
Forerunner to the
Prevention Movement
Dr. Alfred Fones
Founder of Dental
Hygiene School and
First Author of Dental
Hygiene College
Textbook
Historical Development
Continued
Practice Settings
Schools
Industry
Military
Hospitals
Professional
Organizations
 Preventive Modalities
Dental Hygiene Treatment
Fluoridation
Xylitol
Dental Sealants
Oral Cancer Exams and Tobacco
Cessation
Nutritional Counseling
Atraumatic Restorative Treatment (ART)
Mass Education/Media
Dental Care Delivery

In the United States

Dental Care Delivery

Vehicles of Dental Care

in the United States

FEDERAL NONGOVERNMENT STATE

Departments of the Private Practice Departments of State
Federal Government Institutions, Schools State Prisons
Insurance-Based Models Community Clinics, Schools
Dental Public Health

The oral health care and

education, with an emphasis
on the utilization of dental
hygiene sciences, delivered to
a target population
Factors Affecting Dental Health
Access to Care
Restriction of dental
hygiene services
Shortage of Medicaid
providers
Financial Situations
Insurance
Medicaid

Transportation
Factors Affecting Dental
Health, Continued
SES Relation to
Dental Health
Dental Hygiene
Sciences
Increase in the
Geriatric
Populations
Malpractice
Insurance Changes
 Federal Influence
Executive Branch System

Legislation Senate and House of

Representatives

Executive President and

Cabinet

Judicial Federal Court

Department of Health and
Human Services
Public Health
Service Operating
Division
Human Services
Operating Division
 Public Health Service
Operating Division
National Institutes Indian Health Services
of Health Health Resources and
Food and Drug Services
Administration
Administration
Agency for Health
Centers for Care Policy and
Disease Control Research
and Prevention Substance Abuse and
Agency for Toxic Mental Health Services
Substances and Administration
Disease Registry
Human Services Operating Division
Centers for Medicaid Administration for
and Medicare Children and Families
Medicaid Administration on Aging
Medicare
Public Health Service
PHS works toward
improving and
advancing the
health of our
nation.
U.S. Surgeon
General
Dental Hygienists
work as Public
Health Officers.
 Other Federal
Departments
Influencing Dental Care
Agriculture Labor
Defense State
Education Treasury
Justice Veterans Affairs
United States
Peace Corps
(which is an
executive branch
agency)
Individual State Influence
State Dental
Divisions
Medicaid
S-CHIPS
Prisons
Tribal Clinics
Institutions
Community Clinics
Dental Health Care Personnel
Need
Demand
Utilization
Supply
Dental Hygiene
Shortages
Dental Hygienist
to Dentist
Employment
Ratio = 1:2
 Dental Finance
Public and Private
Funding of Dental Care
Historical Funding of Dental Care
Patients Responsibility
The Advent of Dental
Insurance
Medicaid Coverage for
Dental Services
Todays Dental
Financing
 Payment Methods
Fee-for-Service
Capitation Plans
Encounter Fee Plans
Barter System
Fee-for-Service
A dental practice sets
a fee, and a patient
and/or third party pays
for the fee.
UCR: usual,
customary and
reasonable fee
Indemnity plans pay
fee-for-service.
Discounted coverage
available and sliding
scales for certain
patients in certain
clinics
 Capitation Method
Dental Managed Care
A certain amount is paid to a dental
practice for a certain number of
patients. Payment is received
whether treatment is provided or not.
Many times employees will state that
they are not paid for cleanings
provided; however, this is not an
accurate statement.
 Encounter and Barter
Encounters are for
an arrangement
paid for each visit.
Barter system is
used when the
dental provider
negotiates
payment by
exchanging goods
and services.
 Insurance Plans
Dental Service Corporations
Health Service Corporations
Preferred Providers Organizations
Individual Practice Associations
Capitation Programs
Dental Billing
Claim Form
ADA CDT
Payment Plans
Dental Credit Cards
Explanation of
Benefits
Government Role

Research
Disease Prevention
Disease Control
Program Planning and Operation
Funding for the Education of
Dental Professionals
Regulation
 Governments Role
U.S. PHS
Federal Block
Grants
State Governments
Local Governments
Medicaid
Title XIX
State/Federal
Program
Your States
Medicaid Program
Other States
Medicaid Program
Dental Care Delivery

Around the World

International Dental
Health Care
Dental Diseases
Historical Perspective
Demographics and the Dental
Hygienist
Global Education of the Dental
Hygienist
The Role of the Dental Hygienist
Access to Care in Other Countries
 International Dental
Health Care, Continued
Dental Public Health
Programs and
Campaigns
Oral Health Policies
Lobbying Groups
International Dental
Organizations
International Overview
Related Dental Portability of
Professionals Licensure
Regulation of Future of Dental
Dental Hygienists Hygiene
Independent
Practice
 Legislative Initiatives
Affecting Dental Hygiene
Practice
In the United States
Issues in the United States
Preceptorship/Alternative Education
On-the-Job Training for Supragingival
Scaling
Restrictive Supervision Laws Affecting
Access to Care
Advanced Dental Hygiene Practitioner
State Governments
Legislative
Executive
Judicial
Major Bodies of Law

Common Law
Statutory Law
Constitutional
Law
Administrative
Law
 Laws Pertaining to Dental
Hygiene
State Dental Hygiene Supervision Status
Practice Act,
sometimes referred to
as the statute
State Dental Board

Administrative Law
Governs Dental Hygienists and the
Practice of Dental Hygiene
Rules and Regulations
Self-Regulation
 Supervision Types
Unsupervised General Supervision
Independent Practice Indirect Supervision
Collaborative Practice Direct Supervision
International Overview
Related Dental Portability of
Professionals Licensure
Regulation of Future of Dental
Dental Hygienists Hygiene
Independent
Practice
 Dental Health
Education and Promotion
 Health Education
Principles
Five Dimensional
Health Model
Physical
Mental
Social
Spiritual
Emotional
 Dental Health Education
Goal: to prevent
dental diseases
utilizing appropriate
dental health
interventions
 Health Education
Principles
Health Education: the education of
health behaviors that bring an individual
to a state of health awareness
Health Promotion: the informing and
motivating of people to adopt health
behaviors
Health Behavior: an action that helps
prevent illness and promotes health for
a population
Goals of Dental Health Education
Provide Effective Dental Health Education.

Change Values Aimed at Improving
Health.
Healthy Behaviors
 Stages of Learning
Unawareness
Awareness
Self-Interest
Involvement
Action
Habit
Transtheoretical Model

Precontemplation
Contemplation
Preparation
Maintenance
Action
Theory of Reasoned Action
Attitude toward the behavior
Subjective norms
Perceived behavioral control
Intention
Behavior
 Social Cognitive Theory
Self-Efficacy Theory
Knowledge
Behavior
Environment
 Empowerment Models
Participant Oriented
Social Environments
Motivation

Motivation is the
will of the
individual to act.
Maslows Heirarchy of Needs
Self-Actualization
Need for Self-Esteem
Belongingness and
Love
Safety Needs
Physiological Needs
Behavioral Conditioning
Classical
Conditioning
Operant
Conditioning
Modeling
Lesson Plan

Development
Assessment Phase

Assess target populations

needs

interests

abilities

Assess resources
Dental Hygiene Diagnosis
Formulate Findings
from Assessment
into a Diagnosis.
Prioritize Goals.
 Planning
Broad Goal
Formulation
Specific
Objectives
Select Teaching
Methods.
Implementation
Be Prepared.
Effective Teacher
Characteristics
Evaluation

Qualitative Measurement
Quantitative Measurement
Information Provided to Appropriate
Parties
 Target
Populations
For the Practicing Hygienist
 Target Populations

A group of individuals with

similarities of some sort whether it be
age, race, educational background,
life situations, and/or health
conditions
Specific Target Populations
Family Caregivers Visual
Health Care Impairments
Workers School Teachers
Hospice Workers Social Workers
Persons with
Medical
Ages
Conditions/ Prenatal
Diseases Infancy

Children
Developmentally
Disabled Adults

Hearing Impaired Older Adults

Cultural Diversity

The social, ethnic, and

cultural elements that
compose a person.
Barriers to Dental Hygiene and
Dental Care
Age Language Habit
Culture No Finances Lack of Faith
Education MisunderstandingFear
Transportation Values Safety
Illiteracy Attitudes Denial of Disease
No providers Invulnerability Convenience
Social Issues Education LevelsProvider Conflicts
Program Planning
For the Dental Hygienist
What is a dental public health
program?

Educational, clinical,
and referral services to
a target population
 Preventive Programs
School Fluoride Mouthrinse Programs
School Dental Sealant Programs
Xylitol Programs
Mouthguard Programs
Dental Health Educational Programs
Tobacco Cessation Programs
Denture Identification Programs
 Dental Public Health
Programs
Healthy Smile
Program
Inner City Health
Center Dental
Program
Soroptomist Dental
Project
Matthew 25
Operation Smile
Dental Hygiene Program
Planning Paradigm
Assessment
Populations dental needs
Demographics

Facility

Personnel

Existing Resources

Funding
 Dental Hygiene Program
Planning Paradigm, Continued
Dental Hygiene Diagnosis
Prioritization of needs
Formulation of diagnosis to provide goals and
objectives for blueprint
Planning
Methods to measure goals
Blueprint
Address constraints and alternatives.
 Dental Hygiene Program
Planning Paradigm, Continued
Implementation
Program will begin operation.
Revision and changes identified and
employed
Evaluation
Measuring goals
Qualitative and quantitative evaluation
Ongoing revisions employed
Program Evaluation
Dental Public Health
Program Evaluation

Program Planning Objectives

Measurement of Objectives
Formative
Summative
Evaluation Techniques

Traditional Nonclinical Measurements

Interviews
Surveys
Clinical Methods
Basic
BSS
Dental Indexes
Governments Evaluation
Healthy People
2010 Objectives
and Evaluation
Mechanisms
NOHSS
Call to Action
Oral Epidemiology

Study of Oral Diseases

Multifactorial Nature of Disease
Terminology
Epidemic Prevalence
Endemic Incidence
Pandemic Etiology
Disease Rates Surveilance
Mortality Risk Factors
Morbidity Index
 Oral Epidemiology Reports
Morbidity and
Mortality (MMWR)
Healthy People
Reports
Surgeon Generals
Report
Call to Action
Global Oral Data
Bank
Epidemiology of Oral Diseases
Periodontal Diseases
Tooth Loss
Dental Caries
Oral Cancer
Cleft Lip/Palate
Injury
Toothaches
Research
In Dental Hygiene
Significance of Research
to Dental Hygiene
Dental public health is based
upon programs that have
demonstrated effectiveness in
achieving health for the
population.
Types of Research
Historical Epidemiological
Descriptive Longitudinal
Survey Cross-sectional
Observational Retroactive
Case Studies Experimental
Correlational (Prospective)
Quasi-experimental
Beginning Research
Research Question
Does Brand X toothpaste whiten teeth?
Positive Hypothesis
Brand X toothpaste does significantly
whiten teeth.
Null Hypothesis
There is no statistically significant
difference between Brand X and a placebo
when comparing the whitening of teeth.
 Research Design
Formulating a hypothesis
Review of the literature
Methods and materials
Statistical evaluation
Experimental Approaches
Two group pretest/post-test designs
Time series
Post-test only
Solomon three and four group
Factorial
Placebos
Control groups
Sampling Techniques

Randomization
Systematic
Convenience
Stratifying
 Informed Consent
Informed Consent is part of
examining the ethics of the research
project as a whole.
Dental Research

Biostatistics
 Categorizing Data
Discrete or Continuous
Nominal
Ordinal
Interval
Ratio
Descriptive Statistics
Measures of Central Tendency
Mean
Median
Mode
Measures of Dispersion
Range
Variance
Standard Deviation
The Normal Distribution
Gaussian Distribution
Bell-Shaped Curve
Skewed Data
 Graphing Data
Frequency
Distribution Table
Grouped Frequency 90
80

Table 70
60

Bar Graph
50 East

40 West
30 North
Histogram 20
10
Polygon 0
1st Qtr 2nd Qtr 3rd Qtr 4th Qtr
Correlation
Correlation
Coefficients
Positive Correlation
Negative
Correlation
Strong Correlation
Correlation

Pearson Product Movement Correlation

Coefficient
Spearman Rank-Order Correlation
Coefficient
 Statistical Decision Making
Probability
Type I Error
Type II Error
Degrees of Freedom
 Inferential Statistics
Parametric Inferential Statistics
Student t-test
Analysis of Variance

Nonparametric Inferential Statistics

Chi Square Test
Other Nonparametric Tests
 Interpretation of Data
Statistical
Significance
Clinical
Significance
 Research Results
Validity: Results of the study can
be inferred to the general
population.
Reliability: The study was
conducted in a controlled manner
and if repeated would lend the
same results; thus, the study is
reproducible.
 Evaluation of
Scientific Literature and
Dental Products
Regulation of Dental Care
Products
Food and Drug
Administration
American Dental
Association Seal
of Acceptance
Dental Hygienists Role
Criticalconsumer
Patient education
Awareness of
advertising
techniques
Evaluation of Scientific
Literature
Introduction Product Usage
Purpose Examiners
Research Design Statistical
Sample Selection Significance
Results
Careers in

Dental Public Health

 Positions for the RDH
U.S. PHS
VA Hospitals
Federal Prisons
Military Base
Clinics
Other Agencies
 United States RDH
Positions
Commissioned
Officer Positions
Civil Service
Positions
National Health
Service Corps
 Other Options
Independent Contractor
Employee of Dental Staffing Agency
Student Opportunities
COSTEP
 Strategies for Creating
Dental Hygiene Positions

In Dental Public Health

Settings
 Populations
Homebound
Institutionalized
Populations with Disabilities
Rural Area Residents
Population with Dental Phobias
Populations faced with Language or
Cultural Barriers
Patients without Financing
 Proposed Plan for Action

Dental Hygiene Program Planning Paradigm

Assessment
Dental Hygiene Diagnosis
Planning
Implementation
Evaluation
Practice Management Issues

Patient tracking
Appointment scheduling
Practice promotion
Collection of fees
 Proposal Development
and Presentation
Introduction
Significance of
Position
Blueprint of the
Operational
Program
Conclusion
Contracts
Teaching Strategies
Dental Public Health
Review
Community Health/Research
Principles
Promoting health and
preventing disease
within groups
Participating in
community programs
Analyzing scientific
information, utilizing
statistical concepts,
and applying research
results
 Dental Public Health:
Contemporary Practice
for the Dental Hygienist:
The Dental Hygienist is the
Premier Dental Public Health
Provider.