Dental Public Health
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Dental Public Health Dental Public Health Introduction Topics Historical Development Dental Care Delivery in the United States around the world Financing Dental Care Legislative Initiatives Education and Promotion Target Populations Lesson Plan Program Planning Program Evaluation Oral Epidemiology Research Methods Biostatistics Evaluation of Literature and Products Careers in the Government Entreprenurial Initiatives Board Review The Prevention Movement Dental Hygiene s 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 Departments of the Federal Government NONGOVERNMENT Private Practice Institutions, Schools Insurance-Based Models STATE Departments of State State Prisons 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 President and Cabinet Federal Court Executive Judicial Department of Health and Human Services Public Health Service Operating Division Human Services Operating Division Public Health Service Operating Division National Institutes of Health Food and Drug Administration Centers for Disease Control and Prevention Agency for Toxic Substances and Disease Registry Indian Health Services Health Resources and Services Administration Agency for Health Care Policy and Research Substance Abuse and Mental Health Services Administration Human Services Operating Division Centers for Medicaid and Medicare Medicaid Medicare Administration for Children and Families Administration on Aging 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 Defense Education Justice Labor State Treasury Veteran s 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 Patient s Responsibility The Advent of Dental Insurance Medicaid Coverage for Dental Services Today s 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 Government s Role U.S.
PHS Federal Block Grants State Governments Local Governments Medicaid Title XIX State/Federal Program Your State s Medicaid Program Other State s 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 Professionals Regulation of Dental Hygienists Independent Practice Portability of Licensure Future of Dental Hygiene 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 Practice Act, sometimes referred to as the statute Supervision Status State Dental Board Administrative Law Governs Dental Hygienists and the Practice of Dental Hygiene Rules and Regulations Self-Regulation Supervision Types Unsupervised Independent Practice Collaborative Practice General Supervision Indirect Supervision Direct Supervision International Overview Related Dental Professionals Regulation of Dental Hygienists Independent Practice Portability of Licensure Future of Dental Hygiene 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. Maslow s 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 Health Care Workers Hospice Workers Persons with Medical Conditions/ Diseases Developmentally Disabled Hearing Impaired Visual Impairments School Teachers Social Workers Ages Prenatal Infancy Children Adults Older Adults Cultural Diversity The social, ethnic, and cultural elements that compose a person. Barriers to Dental Hygiene and Dental Care Age Culture Education Transportation Illiteracy No providers Social Issues Language No Finances Values Attitudes Invulnerability Education Levels Habit Lack of Faith Safety Denial of Disease Convenience Provider Conflicts Misunderstanding Fear 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 Population s 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 Methods to measure goals Blueprint Address constraints and alternatives. Planning Dental Hygiene Program Planning Paradigm, Continued Implementation Program will begin operation. Revision and changes identified and employed Measuring goals Qualitative and quantitative evaluation Ongoing revisions employed Evaluation Program Evaluation Dental Public Health Program Evaluation Program Planning ‘ Objectives Measurement of Objectives Formative Summative Evaluation Techniques Traditional Nonclinical Measurements Interviews Surveys Basic BSS Dental Indexes Clinical Methods Government s Evaluation Healthy People 2010 Objectives and Evaluation Mechanisms NOHSS Call to Action Oral Epidemiology Study of Oral Diseases Multifactorial Nature of Disease Terminology Epidemic Endemic Pandemic Disease Rates Mortality Morbidity Prevalence Incidence Etiology Surveilance Risk Factors Index Oral Epidemiology Reports Morbidity and Mortality (MMWR) Healthy People Reports Surgeon General s 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 Descriptive Epidemiological Survey Observational Case Studies Correlational Longitudinal Cross-sectional Retroactive Experimental (Prospective) Quasi-experimental Beginning Research Research Question Does Brand X toothpaste whiten teeth? Positive Hypothesis Brand X toothpaste does significantly whiten teeth. There is no statistically significant difference between Brand X and a placebo when comparing the whitening of teeth. Null Hypothesis 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 Table Bar Graph Histogram Polygon 90 80 70 60 50 40 30 20 10 0 1st Qtr 2nd Qtr 3rd Qtr 4th Qtr East West North 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 Hygienist s Role Critical consumer Patient education Awareness of advertising techniques Evaluation of Scientific Literature Introduction Purpose Research Design Sample Selection Product Usage Examiners Statistical 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.