Prevention Of Oral Diseases Question And Answers

Prevention Of Oral Diseases Definitions

Prevention

Prevention is defined as the efforts, which are made to maintain normal development of physiological function and to prevent disease of the mouth and adjacent parts

The primary level of prevention

The primary level of prevention is defined as the “action taken prior to the onset of the disease which removes the possibility that a disease will ever occur”

Prevention Of Oral Diseases

Prevention Of Oral Diseases Important Notes

1. Prevention of oral cancer
(or) Prevention of periodontal disease
(or) Prevention of dental caries

Prevention Of Oral Diseases Provention of oral cancer

Prevention Of Oral Diseases Long Essays

Question 1. Define prevention. Discuss the measures taken at the primary level of prevention of caries.
Answer:

Prevention Definition:

Prevention is defined as the efforts, which are made to maintain normal development of physiological function and to prevent disease of the mouth and adjacent parts

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Primary Level Of Prevention Of Caries:

  • The primary Level Of Prevention Of Caries is defined as the “action taken prior to the onset of the disease which removes the possibility that a disease will ever occur”
  • Primary Level Of Prevention Of Caries is applied to the prevention of chronic disease based on the elimination or modification of risk factors of disease
  • It includes
  • Primordial prevention
    • In it, efforts are directed toward discouraging children from adopting harmful lifestyles
    • The main approaches are individual and mass education
  • Population strategy
    • Population strategy is directed at the whole population
  • High-risk strategy
    • High-risk strategy aims to bring preventive care to individuals at special risk
    • A high-risk strategy requires the detection of individuals at high risk
  • Services
    • Health promotion
      • Health promotion enables people to increase control over and improve their health
      • Health promotion is intended to strengthen the host through a variety of approaches to health education
  • Specific protection
  • Interventions used are
    • Immunization
    • Chemoprophylaxis
    • Protection against occupational hazards
    • Use of specific nutrients

Prevention Of Oral Diseases Level of prevention

Oral Health Prevention Tips

Question 2. Write about various levels of prevention of oral diseases. Describe in detail various preventive services rendered by dentists for the prevention of dental caries at various levels.
(or) Community measures of prevention of periodontal diseases.

Answer:

Levels Of Prevention

Levels Of Prevention Primary Level of Prevention:

  • The primary Level of Prevention is defined as the “action taken prior to the onset of the disease which removes the possibility that a disease will ever occur”
  • Primary Level of Prevention is applied to the prevention of chronic disease based on the elimination or modification of risk factors of disease
  • Primary Level of Prevention includes
    • Primordial prevention
    • Population strategy
    • High-risk strategy

Levels Of Prevention Secondary Level of Prevention:

The primary Level of Prevention employs routine treatment methods

1. Secondary Level of Prevention Uses:

  • Terminate a disease process
  • Restores tissues to as near normal as possible

Prevention Of Oral Diseases

2. Secondary Level of Prevention Services:

  • Early diagnosis and treatment
    • They are the main intervention in disease control
    • The earlier a disease is diagnosed the better it is treated
    • Further, it prevents the occurrence of further cases

Secondary Levels Of Prevention Tertiary Level of Prevention:

  • The primary Level of Prevention replaces lost tissues
  • The primary Level of Prevention rehabilitates patients to the point that function as near normal as possible

Secondary Levels Of Prevention  Services:

  • Disability limitation
  • Primary Level of Prevention prevents the transition of the disease process from impairment to handicap
  • Rehabilitation
  • Primary Level of Prevention is defined as the combined and coordinated use of medical, social, educational, and vocational measures for training and retraining the individual to the highest possible level of functional ability

Preventive Services Undertaken By Dentist:

Prevention Of Oral Diseases Preventive services undertaken by dentist

Common Oral Diseases And Prevention

Prevention Of Oral Diseases Short Essays

Question 1. The primary level of oral cancer.
Answer:

The primary level of oral cancer

Prevention Of Oral Diseases Preventive services

Question 2. Tertiary prevention of oral disease.
Answer:

Tertiary prevention of oral disease

  • Tertiary prevention of oral disease replaces lost tissues
  • Tertiary prevention of oral disease rehabilitates patients to the point that function as near normal as possible

prevention of oral disease Services:

  • Disability limitation
  • Tertiary prevention of oral disease prevents the transition of the disease process from impairment to handicap
  • Rehabilitation
  • Tertiary prevention of oral disease is defined as the combined and coordinated use of medical, social, educational, and vocational measures for training and retraining the individual to the highest possible level of functional ability

Prevention of oral disease Services provided by an individual:

Use of dental services

prevention of oral disease Services provided by the dental community:

Provision of dental services

prevention of oral disease Services provided by dentists:

  • Complex restorative treatment
  • Pulpotomy
  • Root canal treatment
  • Extraction
  • Removable and fixed prosthesis
  • Minor tooth movements
  • Implants

How To Prevent Gum Disease

Question 3. Secondary level of prevention.
Answer:

Secondary level of prevention

The secondary level of prevention employs routine treatment methods

1. Services provided by the community:

  • Periodic screening and referral
  • Use of dental services

2. Services provided by a dentist:

  • Complete examination
  • Early treatment of early lesions
  • Preventive treatment
  • Simple restorative treatment
  • Pulp capping

Question 4. Tools of Dental Public Health
Answer:

1. Epidemiology:

Public health Definition:

Public health is defined as the study of the distribution and determinants of health-related states or events in specified populations and the application of this study to the control of health problems

public health Aims:

  • To minimize or eradicate the disease
  • Promote well-being of the society

2. Biostatistics:

public health Definition:

Public health is that branch of statistics concerned with mathematical facts and data related to biological events

public health Uses:

  • To define normalcy
  • To test the difference between two populations
  • To study the association between two/more attributes
  • To evaluate the efficacy of vaccines, sera by control studies
  • To locate, define, and measure the extent of morbidity and mortality in the community
  • To evaluate the achievements of public health programs
  • To fix priorities

3. Social sciences:

Includes sociology, cultural anthropology

4. Principles of administration:

  • Administrative work is divided into
    • Organization
      • Deals with the structure of the agency
  • Management
    • Concerned with the handling of personnel

5. Preventive dentistry:

Levels of prevention

Causes And Prevention Of Tooth Decay

Public Health Primary Level Of Prevention:

  • Public Health Primary Level Of Prevention is defined as the “action taken before the onset of the disease which removes the possibility that a disease will ever occur”
  • Public Health Primary Level Of Prevention is applied to the prevention of chronic disease based on the elimination or modification of risk factors of disease
  • Public Health’s Primary Level Of Prevention includes
  • Primordial prevention ° Population strategy e High-risk strategy

Public Health Secondary Level Of Prevention:

Secondary Level Of Prevention employs routine treatment methods

Public Health Tertiary Level Of Prevention:

  • Tertiary Level Of Prevention replaces lost tissues
  • Tertiary Level Of Prevention rehabilitates patients to the point that function as near normal as possible

Public health Services:

  • Disability limitation
  • Public health Services prevent the transition of the disease process from impairment to handicap
  • Rehabilitation
  • Public health Services is defined as the combined and coordinated use of medical, social, educational, and vocational measures for training and retraining the individual to the highest possible level of functional ability

Prevention Of Oral Diseases Viva Voce

  1. Prevention of the emergence or development of risk factors in population groups falls in the category of primordial prevention
  2. The knowledge of the pathogenesis phase of disease embracing the agent, host, and environment is required for primary prevention
  3. Early diagnosis and prompt treatment are the modes of intervention under secondary prevention
  4. Disability limitation is an intervention under tertiary prevention

Dentist Act And Association Question And Answers

Dentist Act And Association Important Notes

1. Dentist Act

  • Chapter 1: Introductory
  • Chapter 2: Dental Council of India
  • Chapter 3- State Dental Council
  • Chapter 4: Registration
  • Chapter 5-Miscellaneous

2. IDA Members

  1. Honorary members – Persons of high scientific or literary attainment
  2. Life members – dental practitioners
  3. Annual members – by paying an annual subscription
  4. Direct members – persons eligible for membership but not residing/ practicing in the area of the local branch
  5. Student members
  6. Affiliate members – Nonresidential foreign dental practitioners having dental qualification

Dentist Act And Association Short Essays

Question 1. Functions of DCI.
Answer:

Functions Of DCI

  • Basic principles for the maintenance of minimum education standard for BDS degree
  • Minimum physical requirement of a dental college
  • Minimum staff pattern for undergraduate dental studies in colleges with 40,60 and 100 admissions
  • Basic qualifications and teaching experience required to teach BDS and MDS students
  • General establishment of dental facilities. Its duration, of course, selection of students
  • Migration and transfer rules for students
  • Regulations of the scheme of exams for BDS and MDS
  • Dental curriculum: time and subject specification to clinical program and field program, syllabus, etc.

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Question 2. IDA.
Answer:

IDA

  • IDA was formed in the year 1949
  • IDA was registered in Delhi in 1967 with register number S/265

IDA Objectives:

  • Promotion, encouragement and advancement of dental and allied sciences
  • Encourage the members to undertake measures for the improvement of public health and education in India
  • The maintenance of honor and dignity and the upholding of interests of the dental profession and cooperation between the members thereof

IDA Functions:

  • Holding periodic meetings and conferences
  • Publishing and circulating as a journal
  • Encouraging the opening of libraries
  • Publishing the papers from time to time
  • Encouraging research in dental and allied sciences
  • Conducting an educational campaign
  • Consider and express its views on all questions about the Indian legislation
  • Protects the public from unethical treatment from unqualified practitioners
  • Trying to set exemption from custom duty for essential dental materials and instruments

IDA Structure:

  • Local branches- within the district
  • State branches- within the state

IDA Membership:

  • Honorary members
  • Life members
  • Annual members
  • Direct members
  • Student members
  • Affiliate members

IDA Office Bearers:

  • One President
  • One President-Elect
  • Three Vice-President
  • One Honorary General Secretary
  • One Honorary Joint Secretary
  • One Honorary Assistant Secretary
  • One Honorary Treasurer
  • One Editor of The Journal
  • One Chairman of The Council
  • One Honorary Secretary of The Council

Dentist Act Questions And Answers

Question 3. Dentist Act of India 1948.
Answer:

Dentist Act of India 1948

Chapter 1: Introductory:

  • Short title and extent
  • Interpretation
  • Construction of reference to laws not in force in Jammu and Kashmir

Chapter 2: Dental Council Of India:

  • Constitution and composition of the council
    • Incorporation of council
    • Mode of elections
    • Term of office and casual vacancies
    • President and Vice President of Council
    • Staff, remuneration, and allowances
    • The executive committee
    • Recognition of dental qualification

Dentist Act And Association

    • Qualification of dental hygienist
    • Qualification of dental mechanics
    • Effect of recognition
    • Power to acquire information as to courses of study and training and examination
    • Inspection
  • Appointment of visitors
    • Withdrawal of recognition
    • Withdrawal of recognition of recognized dental qualification
    • Mode of declaration
    • Professional Conduct
    • The Indian Register
    • Information to be furnished
    • Power to make regulations

Chapter 3: State Dental Council:

  • Constitution and Composition of the State Council
  • Inter-state agreements
  • Composition of the Joint State Council
  • Incorporation of the State Council
  • President and vice president of the state council
  • Mode of election
  • Term of office and casual vacancies
  • Staff, remuneration, and allowances
  • Executive committee
  • Information to be furnished

Dentist Act 1948 Summary

Chapter 4: Registration:

  • Preparation and maintenance of the register
    • First preparation of the register
    • Qualification for entry on first preparation of the register
    • Qualification for subsequent registration
    • Scrutiny of application for registration
    • Special provision for amending the register of the dentist
    • Register of dental hygienist and dental mechanics
    • Qualification for registration as a dental hygienist
    • Qualification for registration as a dental mechanics
    • Renewal fees
    • Entry of additional qualification
    • Removal from register
    • Restoration to register
    • Bar of jurisdiction
    • Issue of duplicate certificate
    • Printing of register
    • Effect of registration
    • Transfer of registration

Chapter 5- Miscellaneous:

  • Penalty for falsely claiming to be registered
  • Misuse of titles
  • Practice by unregistered persons
  • Failure to surrender certification of registration
  • Companies not to engage in dentistry
  • Cognizance of offenses
  • Payment of part of fees to the council
  • Accounts and audit
  • Appointment of Commission of Inquiry
  • Power to make rules

Dental Council Of India

Question 4. Functions of IDA.
Answer:

Functions Of IDA

  • Holding periodic meetings and conferences
  • Publishing and circulating as a journal
  • Encouraging the opening of libraries
  • Publishing the papers from time to time
  • Encouraging research in dental and allied sciences
  • Conducting an educational campaign
  • Consider and express its views on all questions about the Indian legislation
  • Protects the public from unethical treatment from unqualified practitioners
  • Trying to set exemption from custom duty for essential dental materials and instruments

Question 5. Constitution and components of the dental council. (or) Functions Of DCI of India
Answer:

Dental Council

  • Once registered dentist possessing a recognized dental qualification elected by the dentists registered in part A of each state register
  • One member elected from amongst themselves by the members of the Medical Council of India
  • Not more than 4 members are elected from among themselves by
  • Principals, Deans, Directors, and Vice Principals of Dental colleges in the states training students for recognized dental qualification provided that not more than one member shall elect from the same dental college
  • Heads of dental wings of medical colleges in the states training students for recognized dental qualification
  • One member from each university established by law in the state which grants a recognized dental qualification to be elected by the members of the Senate of the University
  • One member to represent each state nominated by the government of each such state from among persons registered either in a medical or dental register of the state
  • Six members nominated by the Central Government of whom at least one shall be a registered dentist possessing a recognized dental qualification and practicing or holding an appointment in an institution for the training of dentist and at least two shall be dentists registered in part B of a state register
  • The Director General of Health Services (ex-officio)

Functions Of Dci:

  • Basic principles for the maintenance of minimum education standard for BDS degree
  • Minimum physical requirement of a dental college
  • Minimum staff pattern for undergraduate dental studies in colleges with 40, 60, and 100 admissions
  • Basic qualifications and teaching experience required to teach BDS and MDS students
  • General establishment of dental facilities. Its duration, of course, selection of students
  • Migration and transfer rules for students
  • Regulations of the scheme of exams for BDS and MDS
  • Dental curriculum: time and subject specification to clinical program and field program, syllabus, etc.

Dental Associations In India

Dentist Act And Association Viva Voce

  1. Indian Dental Association was formed in the year 1948.
  2. Indian Dental Association was registered in Delhi in 1967
  3. 10 members of the Central Council are to propose a person to be elected as an honorary member of the IDA.
  4. For the proper management of the IDA, the office bearer’s functions include one president, one president-elect, and three Vice presidents.
  5. The office bearer of IDA who need not reside in the city of head office is the editor of the journal
  6. The general management of the IDA shall be vested in the central council
  7. Those people practicing dentistry as a sole means of living hood without qualification are registered under part B
  8. The Dental Council of India was formed on 12th April 1949
  9. The Consumer Protection Act came into force on 15th April 1987
  10. The Consumer Protection Act was amended in 1993.

Dental Ethical Issues Question And Answers

Ethical Issues Definitions

Ethics

Ethics is defined as the science of the ideal human character and behavior in situations where distinction must be made between right and wrong, duty must be followed and good interpersonal relations maintained

Ethical Issues Important Notes

1. Ethical Principles

  • To do no harm
  • To do good
  • Respect for persons
  • Truthfulness
  • Confidentiality

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2. Informed Consent

  • Informed consent is voluntary, comprehending, and confidential
  • Informed consent is an essential component of a patient’s right to autonomy

Ethical Issues Long Essays

Question 1. Discuss in detail the principles of ethics to be followed by a dentist. Add a note on unethical practices by a dentist
Answer:

Principles Of Ethics To Be Followed By A Dentist:

To Do No Harm (Non-Maleficence):

  • Non-maleficence is the foundation of social morality
  • The dentist in cases where pain cannot be avoided can make attempts to minimize it or an alternative can be presented to the patient

To Do Good (Beneficence):

  • Beneficence should be the role of any health provider to benefit patients, as well as not to inflict harm
  • In the process of treating a patient what has to be weighed are the consequences of treatment versus no treatment
  • The expectation of the patient is that the care provider will initiate beneficial action

Respect For Persons: It involves

1. Autonomy:

That dictates health providers respect the patient’s right to make decisions concerning the treatment plan

2. Informed Consent:

  • Informed Consent is both a legal and an ethical concept
  • Informed Consent is an essential component of a patient’s right to autonomy

Justice:

  • It is described as fairness/ equal treatment giving each his/ her right/due
  • Dentists can provide some free/ discounted care to the needy or provide financial support/donate to low-income patients

Truthfulness:

Lying fails to show respect for persons and their autonomy

Dental Ethical Issues Questions And Answers 

Confidentiality:

  • Patients have the right to expect that his/her treatment talks and works are treated as confidential
  • Confidentiality can be breached only if it would benefit the patient
  • Confidentiality must be maintained at all times.

Unethical Practices:

  • Practice by unregistered persons employed by the dentist
  • Dentist signed under his name and authority issuing any certificate that is untrue, misleading, or improper
  • Dentist advertising whether directly or indirectly for the purpose of obtaining patients or promoting his own professional advantage
  • Use of bogus diplomas
  • Allowing commission
  • Paying or accepting the commission of charges in order to solicit patients
  • If the planned treatment is beyond the dentist’s skill, the patient is not referred to a consultant
  • In case of an emergency consultation during the temporary absence of the patient’s dentist, temporary service is provided and the patient is not sent back
  • If consulted, the dentist accepts charge of the case without a request of the referring dentist
  • Any contravention of the drugs
  • Immorally involving abuse of the professional relationship
  • Involving in any kind of illegal practice
  • Employing secret methods of treatment
  • Using sign boards greater than 0.9 m  0.6 m and use of words like teeth, painless extraction
  • Insertion of any paragraphs and notices in the press
  • Allowing the dentist’s name for commercial articles like toothpaste, toothbrush, tooth powder
  • Mentioning any abbreviations after the dentist’s name other than dental qualification

Commuinty Dental Ethical Issues

Ethical Issues Short Essays

Question 1. Ethical rules for dentists.
Answer:

Duties Of Dentists Towards The Patient:

  • Every dentist should be courteous, sympathetic, friendly and helpful
  • He should observe punctuality in fulfilling appointments
  • He should establish a well-merited reputation for professional ability
  • The welfare of the patient should be conserved
  • A dentist should not permit differentiating in terms of religion, nationality, race, party politics, or social standings
  • Should keep patient’s information confidential

Duties Of Dentists Towards Colleagues:

  • Cherish proper pride in his colleague
  • Should not do anything harmful to the interest of the members of the fraternity
  • Honor mutual arrangements made regarding remuneration
  • Retire in favor of a regular dentist, after the emergency is over.
  • Institute correct treatment at once
  • Regard it as a pleasure and privilege to render gratuitous service to another dentist

Duties Of Dentist To The Public:

The dentist has to assume a leadership role in the community on matters related to dental health

Ethical Issues In Dentistry 

Question 2. Consent.
Answer:

Consent

  • Consent is a both legal and ethical concept
  • Consent is the largest principle of the Nuremberg code

1. Consent Attributes:

  • Voluntary
  • Legally competent
  • Informed
  • Comprehending

2. Consent Process:

  • Consent Process is a two-step process
    • Information is presented to the patient by the doctor
    • The patient satisfies himself/herself that he/she understands

It consists of

  • Description of the proposed treatment
  • Material/foreseeable risks
  • Benefits and prognosis of proposed treatment
  • Alternative to the proposed treatment
  • Risks, benefits, and prognosis of alternative treatment
  • A statement that the patient has understood and is willing to the treatment
  • The signature of the patient and of a witness

Ethical Issues Short Question And Answers

Question 1. Tort.
Answer:

Tort

Tort is a civil wrong or injury, independent of a contract, that results from a breach of a duty

Types of Tort :

  • An unintentional tort
  • In it, harm is not caused by intentional
  • An intentional tort
  • Contains intentional harm

Question 2. Ethical principles.
Answer:

Ethical Principles

  • Ethical principles are
    • To do no harm
    • To do good
    • Respect for persons
    • Justice
    • Veracity or truthfulness
    • Confidentiality

Common Ethical Dilemmas In Dentistry

Question 3. Consent.
Answer:

Consent

  • Consent is a both legal and ethical concept
  • Consent is the largest principle of the Nuremberg code
  • Consent consists of
    • Description of the proposed treatment
    • Material/foreseeable risks
    • Benefits and prognosis of proposed treatment
    • Alternative to the proposed treatment
    • Risks, benefits, and prognosis of alternative treatment
    • A statement that the patient has understood and is willing to the treatment
    • The signature of the patient and of a witness

Principles Of Dental Ethics

Ethical Issues Viva Voce

  1. Informed consent was proposed by the Nuremberg code
  2. In earlier days, the remedy for medical negligence was under the law of tort
  3. Consent considered by the fact that a patient comes to a doctor for an ailment that he agrees to examination is Tacit consent
  4. Components of informed consent include information. Voluntariness and capacity
  5. The informed consent should be in the local language
  6. A dentist is criminally liable if he commits tort intentionally
  7. Ethical principles guiding the conduct of the population based on research and practice are macro ethics
  8. Informed consent is obtained after participation is involuntary
  9. Duties of dentists to the public include not disclosing the professional secrets of patients in public
  10. Informed consent is to protect the investigator’s interest and defend them against any liability.

Dental Auxiliaries Question And Answers

Dental Auxiliaries Definition

Dental Auxiliary

A dental auxiliary is a person who is given responsibility by a dentist so that he or she can help the dentist render dental care but who is not himself/ herself qualified with a dental degree

Denturist

Denturist is a term applied to those dental laboratory technicians who are permitted to fabricate dentures directly for patients without a dentist’s prescription

Expanded Function Dental Auxiliary

An expanded function dental auxiliary is a dental assistant or a dental hygienist in some cases who has received further training in duties related to the direct treatment of patients though still working under the direct supervision of a dentist.

Dental Auxiliaries

Dental Auxiliaries Important Notes

1. Classification Of Dental Auxiliaries

  • Non operating
  • Dental assistant
  • Receptionist
  • Dental laboratory technician or denturist
  • Dental health educator
  • Operating
  • Dental nurse
  • Dental Therapist
  • Dental hygienist

2. Duties Of School Dental Nurse

  • Oral examination and oral prophylaxis
  • Topical fluoride application and administration of dietary fluoride supplements
  • Administration of LA and extraction of teeth
  • Dental health education
  • Pulp capping and placement of amalgam filling
  • Individual patient instruction in tooth brushing
  • Patient referral

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3. Four-Handed Dentistry

Four-handed dentistry is the term given to the art of seating both the dentist and the dental assistant in such a way that both are within easy reach of the patient’s mouth

Four-Handed Dentistry Process:

  • The patient is in a fully supine position
  • The assistant will hand the dentist the particular instrument he wants
  • Assistant can also perform functions like retraction or aspiration

Dental Auxiliaries Questions And Answers

Dental Auxiliaries Long Essays

Question 1. Define dental auxiliary. Give classification and functions of dental auxiliaries.
Answer:

Dental Auxiliary Definition:

A dental auxiliary is a person who is given responsibility by a dentist so that he or she can help the dentist render dental care but who is not himself/ herself qualified with a dental degree

Classification Of Dental Auxiliary:

Dental Auxiliary Non-operating:

  • Clinical
    • Assists the dentist in his clinical work
    • Doesn’t carry out any procedures independently
  • Laboratory
    • Assists dentist to carry out certain technical laboratory procedures
  • Operating auxiliary
    • Permit to carry out treatment procedures in the mouth under the direction and supervision of a dentist

Revised Classification:

Dental Auxiliaries Revised classification

Functions Of Dental Auxillary:

Dental Auxiliaries Function of dental auxillary

Question 2. Write about the functions of a school dental nurse.
Answer:

School Dental Nurse:

  • This is an operating auxiliary who is allowed to diagnose and carry out certain treatment procedures usually in school children

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  • She is employed by the government to provide regular dental care to between 450-700 children at nearly 6 monthly intervals
  • She is accepted as a member of the school

School Dental Nurse Functions:

  • Permitted to diagnose dental diseases
  • Plan and carry out specific preventive and treatment measures

School Dental Nurse Duties:

  • Oral examination
    • Prophylaxis
    • Topical fluoride application
    • Advice on dietary fluoride supplements
    • Administration of local anesthesia
    • Cavity preparation and placement of amalgam filling
    • Pulp capping
    • Extraction of primary teeth
    • Oral hygiene instruction
    • Health education
    • Referral of patients for complex services

Types Of Dental Auxiliaries

Question 3. Explain the New Zealand school dental nurse.
Answer:

New Zealand Dental Nurse:

  • The dental nurse scheme was established in Wellington, New Zealand in 1921 due to extensive dental disease
  • The man who influenced its formation was T.A.Hunter, a pioneer in the establishment of a dental school in New Zealand

Dental Auxiliaries Short Essays

Question 1. Denturist.
Answer:

Denturist

Denturist is a term applied to those dental laboratory technicians who are permitted to fabricate dentures directly for patients without a dentist’s prescription

Dental Auxiliaries Denturist

The desire for autonomy among dental laboratory technicians led to the formation of denturists

Denturist Opposition:

Dental Auxiliaries Apposition

Question 2. Expanded dental auxiliary.
Answer:

Expanded Dental Auxiliary

  • Expanded function dental auxiliary is a dental assistant or a dental hygienist in some cases who has received further training in duties related to the direct treatment of patients though still working under the direct supervision of a dentist
  • They are allowed to carry out reversible procedures
  • They do not prepare cavities

Expanded Dental Auxiliary Duties:

  • Placing and removing rubber dams
  • Placing and removing temporary restoration
  • Placing and removing matrix bands
  • Condensing and carving amalgam restoration
  • Placing of acrylic restoration
  • Applying the final finish and  polish

Expanded Dental Auxiliary Procedure:

  • The auxiliary seats a patient
  • Performs initial inspection
  • Carry out x-ray
  • Examines the patient
  • Diagnose and carry out a treatment plan
  • Gives local anesthesia
  • Prepare cavity and insert pulp protective agents

Expanded Dental Auxiliary Functions:

Allowed to carry out reversible procedures

Classification Of Dental Auxiliaries

Question 3. Needs and development of dental personnel.
Answer:

Needs And Development Of Dental Personnel

  • With increasing health consciousness the demand for dental care increases among the public
  • There was a necessity to make it affordable and available to all
  • In order to provide cost-effective services and satisfy demand utilization of some of the paraprofessionals in this field become inevitable
  • This personnel receive less training of a shorter duration
  • They provide certain limited preventive treatment
  • The types of dental personnel in a society are a part of the structure
  • It encompasses the various providers of dental care who have different rules, functions, and periods of training and who combine to treat patients
  • They assist the dentist in treating the patients

Dental Auxiliaries Short Question And Answers

Question 1. Dental hygienist.
Answer:

Dental Hygienist

  • He is a person, not a dentist or a medical practitioner, who does oral prophylaxis, gives instructions in oral hygiene and preventive dentistry, assists the dental surgeon in chairside work, and manages the office
  • He shall work under the supervision of the dental surgeon
  • The duration of his training is 1-2 years

Dental Hygienist Functions:

  • Cleaning of mouth and teeth
  • Topical application of fluoride
  • Screening
  • Oral hygiene instructions
  • Resource work

Dental Assistants vs. Dental Hygienists

Question 2. Dental surgery assistant.
Answer:

Dental Surgery Assistant

A dental surgery assistant is a non-operating auxiliary who assists the dentist/ dental hygienist in treating patients but who is not legally permitted to treat patients independently

Dental Surgery Assistant Functions:

  • Reception of the patient
  • Preparation of the patient for any treatment
  • Preparation and provision of all necessary facilities
  • Preparation of instruments
  • Preparation and mixing of restorative materials
  • Care of the patient after treatment
  • Preparation of surgery for the next patient
  • Presentation of documents
  • Assistance with x-ray work
  • Instructions of the patient
  • Aftercare of persons

Question 3. Expanded dental auxiliary.
Answer:

Expanded Dental Auxiliary

  • Expanded function dental auxiliary is a dental assistant or a dental hygienist in some cases who has received further training in duties related to the direct treatment of patients though still working under the direct supervision of a dentist
  • They are allowed to carry out reversible procedures
  • They do not prepare cavities

Expanded Dental Auxiliary Duties:

  • Placing and removing rubber dams
  • Placing and removing temporary restoration
  • Placing and removing matrix bands
  • Condensing and carving amalgam restoration
  • Placing of acrylic restoration
  • Applying the final finish and polish

Dental Hygienist Responsibilities

Dental Auxiliaries Viva Voce

  1. The dental laboratory technician is a nonoperating auxiliary
  2. Dr. Edmund Kells hired the first dental surgery assistant
  3. The formal training period for dental laboratory technicians is 1 year
  4. A certified dental assistant gets trained for a period of 8 months
  5. Mrs. Irene Newman was the first dental hygienist
  6. The expanded function dental auxiliary in Philadelphia was called technotherapists

School Dental Health Question And Answers

School Dental Health Definitions

Comprehensive care

  • Comprehensive care is the meeting of accumulated dental needs at the time a population group is taken into the program and the detection and correction of new increments of dental diseases on a semiannual/another periodic basis

Incremental dental care

  • Incremental dental care is defined as periodic care so spaced that increments of dental disease are treated at the earliest time consistent with proper diagnosis and operating efficiency in such a way that there is no accumulation of dental needs beyond the minimum

School Dental Health

School Dental Health Short Essays

Question 1. Tattle tooth program.
Answer:

Tattle tooth program

  • Developed in 1974-76 as a cooperative effort between
  • Texas dental health professional organization
  • Texas Department of Health and
  • Texas education agency

Tattle tooth program Features:

  • 3 videotapes were produced as part of the teacher training package
  • First- familiarises teachers with lesson format
  • 2nd- trains the teacher and educate students
  • 3rd- prepares teachers to teach the lesson

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  • Materials for program implementation consist of
  • Brochure providing an overview of the program
  • A school nurse’s brochure

Tattle tooth program Cost:

  • Less than $ 1.00 per child

Tattle tooth program Goals:

  • Relates dental health of the individuals and focuses on a total person
  • Reduces dental diseases and develops dental habits to last a lifetime

Program Implementation:

  • The hygienist instructs the teacher
  • Health promotion activities are encouraged to invite a dental professional
  • A field trip to the dental office is recommended

Tattle tooth program Evaluation:

  • Field testing
  • Statewide continuous monitoring

School Dental Health Short Question And Answers

Question 1. Comprehensive care.
Answer:

Comprehensive care Definition:

  • Comprehensive care is the meeting of accumulated dental needs at the time a population group is taken into the program and the detection and correction of new increments of dental diseases on a semiannual/other periodic bases

Comprehensive care Services Provided:

  • Eliminate pain and infection
  • Restore serviceable teeth
  • Replace missing teeth
  • Provide maintenance care for the control of early lesions
  • Provide preventive and educational measures

Comprehensive care Advantages:

  • Inexpensive
  • Less interruption
  • Better psychological

Comprehensive care Disadvantage:

  • Disease has already occurred
  • The initial cost of controlling disease is high
  • Time-consuming

Dental Hygiene Tips For Students 

Question 2. Incremental dental care.
Answer:

Incremental dental care Definition:

  • It is defined as periodic care so spaced that increments of dental disease are treated at the earliest time consistent with proper diagnosis and operating efficiency in such a way that there is no accumulation of dental needs beyond the minimum

Incremental dental care  Advantages:

  • Aims at prevention and maintenance
  • Less initial cost
  • Fewer man hours
  • Treatment of early lesions
  • Maintains topical and other preventive measures
  • Bills are equalized and regularly spaced
  • A child develops the habit of visiting the dentist regularly
  • Establish a positive impression of dentists in the community
  • Periodontal disease is interrupted at/near the beginning
  • Confines dental disease to small early increments

Dental Health Education 

Incremental dental care  Disadvantages:

  • Time-consuming
  • Attention to deciduous teeth
  • Interruption in Children’s Dental Health Program
  • Exhaustion of financial resources

School Dental Health

Planning Survey And Evaluation Question And Answers

Planning Survey And Evaluation Definitions

Planning

  • Planning is a systemic approach to defining the problem, setting priorities, developing specific goals and objectives, and determining alternative strategies and methods of implementation.

Survey

  • Survey is a non-experimental type of research that attempts to gather information about the status quo for a large number of cases by describing present conditions without directly analyzing their causes

Evaluation

  • Evaluation measures the degree to which objectives and targets are fulfilled and the quality of the results obtained

Planning Survey And Evaluation Mcqs 

Planning Survey And Evaluation Important Notes

1. Types of survey

Planning, Survey & EvaluatioN Types of survey

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2. Pathfinder survey

  • Pathfinder survey was put forth by WHO
  • In this survey, 0.1%-1% of the population is assessed by 4 specific groups of different ages
  • Age groups:

Planning, Survey & Evaluation Age groups

Planning Survey And Evaluation Long Essays

Question 1. Define survey. How do you conduct an oral health survey of a town having a 3 lac population?
Answer:

Definition Of Survey:

  • Survey is a non-experimental type of research that attempts to gather information about the status quo for a large number of cases by describing present conditions without directly analyzing their causes

Survey Steps

  • Establishing the objectives
    • The objective must be clear before the start of the study
    • The objectives can be stated in the form of a null hypothesis or by describing what is to be measured
  • Designing the investigation
    • Protocol: it should contain
      • Main objective and purpose of the survey
      • Type of the study to be used- descriptive or analytic
      • Type of information to be collected and methods to be used- case-control or cohort
      • Sampling method used
      • Personnel and physical arrangement
      • Statistical methods to be used
    • Budget
    • Schedule of the activities
    • Selection of control group or cohort
  • Selecting the sample
    • Selecting the sample is done as it is impossible to study every individual in the study population
    • Along with this, it saves resources in terms of time, money, and manpower
    • Sample i.e. reference population is selected using any of the sampling methods
  • Conducting the examination
    • Organize the survey as follows
    • Before the examination obtain approval from the authorities
    • The budget is made according to the resources required
    • Schedule the program as the time required for oral examination
    • Prepare a list of emergency care and referral services
    • The diagnostic method used should be valid and reliable
    • Organize the personnel such as clerks to manage the patients
  • Instruments and supplies needed
    • Plain mouth mirror- 30/ examiner
    • Periodontal probe-30/examiner
    • Several pairs of tweezer
    • Container and concentrated sterilizing solution
    • A wash basin
    • Cloth/ paper hand towels
    • Gauze
  • Infection control
    • Including the use of protective barriers, sterilization, waste disposal
  • Examination area- includes
    • An adjustable chair
    • A source of illumination
    • A recorder to receive information from the examiner
  • Precautions
    • Minimize the number of examiners
    • Use of a similar design to the explorer
    • Minimum divergences of opinion
    • Discuss the interpretation of borderline cases
    • Circulate rules among examiners
    • Supervises should recheck an occasional case
  • Analyzing the data
    • The data is analyzed manually or mechanically
    • Tabulation and graphical presentation are done for an easy conclusion
  • Drawing the conclusion
    • Drawing the conclusion is related to the investigation
    • No exploration of the population as a whole is made
  • Publishing the report
    • Publishing the report should be clear and simple
    • Publishing the report should contain
  • Purpose of the survey
  • Materials and methods used
  • Diagrammatic presentation of the result
  • Discussion and conclusion
  • Summary/abstract

Planning Survey And Evaluation

Health Survey And Evaluation Questions

Question 2. What do you mean by planning? Write about the stages of planning
Answer:

Definition Of Planning:

  • Planning is a systemic approach to defining the problem, setting priorities, developing specific goals and objectives, and determining alternative strategies and methods of implementation.

Planning Steps:

Identify The Problem:

  • It includes

Planning, Survey & Evaluation Conducting need assessment

Determining Priorities:

  • A health advisory committee is established for it
  • Priorities are determine
    • To allow the most efficient allocation of resources
  • For ranking solutions to the problem
  • Factors considered are
  • Severity of disease
  • Who needs care most
  • Percentage of people affected
  • High-risk group

Development of Program Goals, Objectives, and Activities:

  • Goal: it is defined as the ultimate desired state towards which objectives and resources are directed
  • Objective: it should be precise
  • It should specify
    • Nature of situation/ condition
    • The extent of the situation/ condition
    • Desired population
    • Desired geographic area
    • The desired time of the situation is intended to exist
  • Types: outcome and process
  • Activities include
    • What is going to be done
    • Who will be doing it
    • When will it be done

Resources Identification:

  • Resources should be
    • Appropriate
    • Adequate
    • Effective
    • Efficient

Identifying Constraints:

  • Constraints that commonly occur are
    • Lack of funding
    • Lack of inadequate facilities
    • Lack of time
    • Inadequate transport
    • Labor shortage
    • Negative community attitudes

Identify Alternative Strategies:

  • To overcome the existing constraints and available resources

Develop Implementation Strategies:

  • Includes
    • Why? – objective of the study
    • What?- activities required
    • Who?- Individuals responsible
    • When?- Sequence of activities
    • How?- Materials and method used
    • How much?- Cost and time spent

Implementation:

  • Implementation is the process of putting the plan into operation
  • Implementation involves individuals, organizations, and the community

Monitoring, Evaluating, and Revising The Program:

  • Monitoring refers to the maintenance of an ongoing watch over the activities of a health service
  • It is the basis for the continual modification of goals, plans, or activities
  • The program requires continuous surveillance of all activities

Program Planning And Evaluation Quiz

Planning Survey And Evaluation Short Essays

Question 1. Calibration of examiners in surveys.
Answer:

Objectives

  • To ensure uniform interpretation, understanding and application by all examiners of the codes and criteria for various diseases and conditions to be observed
  • To ensure that each examiner can examine consistently

Features:

  • To measure intra-examiner variability each examiner should carry out reproducibility
  • One of many examiners must be carefully standardized
  • To measure inter-examiner variability examiner should undergo a training and calibration exercise

Precautions:

  • Minimize the number of examiners
  • Use of a similar design to the explorer
  • Minimum divergences of opinion
  • Discuss the interpretation of borderline cases
  • Circulate rules among examiners
  • Supervises should recheck an occasional case

Question 2. Importance of pilot survey/ Pilot survey.
Answer:

Importance of pilot survey

  • The pilot survey includes only the most important subgroups in the population
  • Provide the minimum amount of data needed for planning
  • Includes only one or two index ages out of which one is 12 years
  • Additional data should then be collected for the implementation and monitoring of services

Question 3. Evaluation.
Answer:

Evaluation Definition:

  • Evaluation measures the degree to which objectives and targets are fulfilled and the quality of the results obtained
  • It measures the productivity of available resources in achieving clearly defined objectives
  • It measures how much output or cost-effectiveness is achieved
  • It makes possible the reallocation of priorities and of resources on the basis of changing health needs- WHO

Evaluation Purpose:

  • Determine the value of the program
  • Provide information for decision-making
  • Measure the effect
  • Modification can be done
  • Measure the progress of each activity

Evaluation Criteria:

  • Effectiveness
  • Efficiency
  • Appropriateness
  • Adequacy

Evaluation Types:

  • Formative
  • It refers to the internal evaluation of a program
  • Evaluation is an examination of the process/ activities of a program as they are taking place
  • Evaluation aids in the development of a program in its early phases
  • Evaluation concerns whether various components of a program are workable or whether changes should be made
  • Summative
  • Evaluation judges the worth of a program
  • Evaluation is aimed at program decision-makers

Evaluation Elements:

  • Relevance
    • Adequacy
    • Accessibility
    • Acceptability
    • Effectiveness
    • Efficiency
    • Impact

Evaluation Steps:

  • Determine what is to be evaluated
    • Establishment of standard criteria
    • Planning of methodology
    • Gathering information
    • Analysis of results
    • Taking action
    • Revaluation

Health Program Evaluation Questions 

Planning Survey And Evaluation Short Question And Answers

Question 1. Evaluation.
Answer:

Evaluation Definition:

  • Evaluation measures the degree to which objectives and targets are fulfilled and the quality of the results obtained
  • Evaluation measures the productivity of available resources in achieving clearly defined objectives
  • Evaluation measures how much output or cost-effectiveness is achieved
  • Evaluation makes possible the reallocation of priorities and resources based on changing health needs- WHO

Evaluation Purpose:

  • Determine the value of the program
  • Provide information for decision-making
  • Measure the effect
  • Modification can be done
  • Measure the progress of each activity

Evaluation Criteria:

  • Effectiveness
    • Efficiency
    • Appropriateness
    • Adequacy

Evaluation Types:

  • Formative
  • Summative

Question 2. Plan.
Answer:

  • A plan is a decision about a course of action

Question 3. Pathfinder survey.
Answer:

Pathfinder survey

  • It is a stratified cluster sampling technique that aims to include the most important population subgroups likely to have differing disease levels
  • It is a practical and economical method
  • It provides the following information
  • Prevalence of oral diseases
  • The severity of oral diseases
  • Need for treatment
  • Progression of oral diseases

Classification:

  • Pilot survey
  • National pathfinder survey

Monitoring And Evaluation In Public Health

Question 4. Formative evaluation.
Answer:

Formative evaluation

  • Formative evaluation refers to the internal evaluation of a program
  • Formative evaluation is an examination of the process/ activities of a program as they are taking place
  • Formative evaluation aids in the development of a program in its early phases
  • Formative evaluation concerns whether various components of a program are workable or whether changes should be made

Question 5. Uses of the survey.
Answer:

Monitoring Trends In Oral Health and Disease:

  • When surveys are repeated over time they give information about how oral health varies by geographic area, social class, race, or ethnic group

Policy Development:

  • A survey can be used to establish oral health strategies and develop an oral health policy

Program Evaluation

  • Survey data are often used to evaluate program
  • However, inferences in a survey need to be made with caution

Assessment Of Dental Needs

  • The survey can be used for the assessment of needs with differences in criteria used in the survey and for individual patient care

Provide Visibility To Dental Issues From A

National Survey:

Question 6. Summative evaluation
Answer:

Summative evaluation

  • Summative evaluation judges the worth of a program
  • Summative evaluation is aimed at program decision-makers
  • Summative evaluation provides information on program effectiveness
  • Conducted after the completion of the program design

Summative evaluation Uses:

  • To help decide whether to continue or end a program
  • To help determine whether a program should be expanded to other locations

Planning, Survey, And EvaluatioN Viva Voce

  1. The analytical survey is conducted to assess the determinants of the diseases
  2. The Pathfinder survey employs a stratified cluster sampling technique
  3. 15 The age group is considered a global age index age to monitor oral health
  4. 15 years index age is important to assess periodontal disease indicators in adolescent
  5. 35-44 years index group is used to assess the full effect of dental caries and the severity of periodontal involvement
  6. 25-50 subjects in each index age group are to be examined in the Pathfinder survey
  7. Calibration is done to ensure uniform interpretation of codes and criteria for various diseases and conditions
  8. 5-10 minutes are taken for a basic oral health examination of the child
  9. 15-20 minutes is taken for a basic oral health examination of adults
  10. The validator in a survey is an experienced epidemiologist
  11. The recording clerk is instructed to record data on the assessment form in a survey
  12. The pilot survey includes the most important subgroups and one or more index ages
  13. Children are examined at 5 years of age in the Pathfinder survey to estimate the level of dental caries in primary dentition

Dental Public Health Question And Answers

Introduction To Dental Public Health Definitions

Public Health Dentistry

  • Public health dentistry is the science and art of preventing and controlling dental diseases and promoting dental health through organized community efforts

Public Health

  • Public health is the science and art of preventing disease, prolonging life, and promoting physical and mental efficiency through organized community efforts for the sanitation of the environment, the control of communicable infections, the education of the individual in personal hygiene, the organization of medical and nursing services for the early diagnosis and preventive treatment of diseases and the development of the social machinery to insure everyone a standard of living adequate for the maintenance of health, so organizing these benefits as to enable every citizen to realize his birthright of health and longevity- Winslow

Dental Public Health Questions And Answers

Introduction To Dental Public Health Long Essays

Question 1. Define public health dentistry. What are the similarities and dissimilarities between clinical dentists and public health dentists?
Answer:

Public Health Dentistry:

  • Public health dentistry is the science and art of preventing and controlling dental diseases and promoting dental health through organized community efforts
  • Public health dentistry is that form of dental practice that serves the community as a patient rather than the individual
  • Public health dentistry is concerned with the dental health education of the public, with applied dental research and the administration of group dental care programs as well as the prevention and control of dental diseases on a community basis

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Similarities Between Clinical Dentists And Public Health Dentists:

Examination/Survey:

  • The survey with a health and personal history and then goes on to clinical assessment
  • Survey assesses the extent and severity of disease in a population

Diagnosis/ Analysis:

  • Following the examination, the next step is a diagnosis in private practice/ analysis of the survey in public health
  • A statistician may be employed to process and analyze the survey

Treatment Planning/ Program Planning:

  • Treatment Planning is a complex procedure involving the patient’s interest, cost of treatment, patient’s reluctant to treatment, alternative of treatment, and outcome
  • While in program planning, it is the community that decides to accept/reject the program

Dental Public Health

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Treatment/ Program Operation:

  • Clinicians/ public health providers arrange a schedule to carry out the treatment

Payment/ Program Funding:

  • Payment for dental services is arranged between the patient and the dentist
  • Financing in public health programs is usually through the funds provided by the government/ by local/ state authorities

Principles Of Dental Public Health

Evaluation/ Program Appraisal:

  • Program Appraisal begins during treatment and is repeated at each visit
  • The effectiveness of the program is assessed
  • The dimensions used are efficiency, appropriateness, adequacy, possible side effects, etc

Clinical Dentists And Public Health Dentists Dissimilarities

Introduction To Dental Public Health Dissimilarities

Introduction To Dental Public Health Short Questions and Answers

Question 1. Characteristics of an ideal public health work.
Answer:

Characteristics Of An Ideal Public Health Work

  • Recognition of group responsibility
  • Public health work must be done in areas where group responsibility is recognized
  • Team effort
    • Large groups of people can be handled must easier as a team with systemic allocation
  • Prevention
    • Objectives
      • Ethical
      • Teamwork
      • Cost efficient
  • Concept of Medical Indigence
    • The concept of Medical Indigence constitutes an inability to pay large bills for medical care
    • The concept of Medical Indigence is found in chronic diseases
  • Multi factorial problem
    • The multifactorial problem deals with all sorts of problems involving the host population and the environment
  • Dependence on the biostatistician method
    • As changes occur in the prevalence of disease, it is observed over several years
  • The worker deals with the healthy as well as the healthy people
    • Its to attain prevents disease
  • Adaptation of the program to community culture
    • Care should be brought as close as possible to where the people are normally concentrated

Community Dentistry Vs Dental Public Health

Question 2. Public health-definition.
Answer:

Public Health-Definition

Public health is the science and art of preventing disease, prolonging life, and promoting physical and mental efficiency through organized community efforts for the sanitation of the environment, the control of communicable infections, the education of the individual in personal hygiene, the organization of medical and nursing services for the early diagnosis and preventive treatment of diseases and the development of the social machinery to insure everyone a standard of living adequate for the maintenance of health, so organizing these benefits as to enable every citizen to realize his birthright of health and longevity- Winslow.

Examination Procedures Short Question And Answers

Question 1. CPITN probe.

Answer:

CPITN Probe:

  • Described first by WHO (TRS 621-1978)
  • Reported in detail by Emslie in 1980

CPITN Probe Purposes:

  • Measurement of pocket depth
  • Detection of subgingival calculus

Dental Public Health Programs

CPITN Probe Features:

  • Thin in the handle
  • Very lightweight (15 gms)
  • Designed for gentle manipulation of sensitive soft tissues
  • Color band of 2 mm from 3.5-5.5 mm
  • 0.5 mm diameter ball tip present

CPITN Probe Modification:

  • Additional lines present at 8.5 mm and 11.5 mm

CPITN Probe Probing Force:

  • 15-25 gram

Infection Control And Sterilization Question And Answers

Infection Control And Sterilization Important Notes

For disinfecting large bodies of water, chlorine is applied as

  • Chlorine gas
  • Chloramine
  • Perchloron

DPT vaccine

  • By it, immunization against 3 diseases can be done
  • They are: Diphtheria, Pertussis and Tetanus
  • Types: plain and adsorbed
  • Adsorption is usually carried out by the addition of aluminum phosphate or aluminum hydroxide
  • The adsorption process increases the immunological effectiveness of the vaccine
  • It should not be repeated if a severe reaction occurred after a previous dose

Meningococcal vaccine

  • Meningococcal vaccine is offered only to travelers at significant risk of infection
  • The vaccines are purified, heat-stable, lyophilized capsular polysaccharides from meningococci

Types of polio vaccine

  • Inactivated Salk polio vaccine
  • Oral Sabin polio vaccine containing live attenuated virus

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Herpetic whitlow

  • Herpetic whitlow is a painful infection of herpes simplex and typically affects the fingers and thumb
  • Herpetic whitlow can be caused by HSV-1 or HSV-2
  • Herpetic whitlow lesions are commonly seen in dental workers and medical workers exposed to oral secretion
  • Also observed in children with thumb-sucking habits and with primary HSV-1 oral infection.

Sterilization And Disinfection Questions

Infection Control And Sterilization Short Essays

Question 1. Infection control in the dental office.
Answer:

Personal Barriers:

  • Washing and care of the hands
    • The dentist should wash their hands before and after treating each patient and after touching inanimate objects
    • For surgical procedures, an antimicrobial surgical hand scrub should be used
    • When gloves are torn, cut, or punctured they should be removed
  • Gloves
    • Nonsterile- used for examination and other non-surgical procedures
    • Sterile- used for surgical procedures
    • Gloves should not be washed before use and should not be reused
  • Gowns
    • Protective clothing such as reusable/disposable gowns, laboratory coats, or uniforms should be worn when clothing is likely to be soiled with blood or other body fluids
    • Reusable protective clothing should be used
  • Masks/ protective eyewear
    • Chin-length plastic face shields or surgical masks protect
      tive eyewear should be worn when splashing or spattering of blood or other body fluids is likely to occur
  • Rubber dam
    • Rubber dam minimizes the formation of droplets, spatter, and aerosols during patient treatment

Use and Care Of Sharp Instruments:

  • Used needles should never be recapped
  • Sharp items should be placed in appropriate puncture-resistant containers
  • Bending or breaking of needles is not recommended

Sterilization Or Disinfection Of Instruments

Sterilization Methods:

  • Physical
  • Steam under pressure
  • Diyheat
  • Hydrogen peroxide
  • Gas plasma
  • Boiling water
  • Ionizing radiation
  • Chemical methods
  • Acids
  • Alkalis
  • Aldehyde
  • Chlorine

Sterilization Cleaning:

  • Sterilization Cleaning is the removal of visible soil from objects
  • Accomplished manually or mechanically using water with detergents or enzymatic products

Cleaning and Disinfection Of Dental Unit and Environmental Surfaces:

  • Aluminum foil or plastic cover should be used to protect items and surfaces that may become contaminated
  • After treatment of each patient and after completion of daily work countertops and dental unit surfaces should be cleaned with disposable toweling, using appropriate cleaning agent and water

Infection Control In Dental Practice

Question 2. Hepatitis B.
Answer:

Hepatitis B

  • Described in 1965

Hepatitis B Signs and Symptoms:

  • Mild flu with illness to fulminant
  • Fatal liver failure
  • Prodromal phase involves
    • Anorexia
    • Malaise
    • Nausea
    • Vomiting
    • Fever
    • Urticaria
    • Arthralgia
  • After 3-10 days
    • Dark urine
    • Jaundice
  • After 1-2 weeks
    • Jaundice fades and recovery begins in 2-4 weeks
  • Incubation period- 45-160 days
  • Sequel
    • Cirrhosis
    • Acute hepatitis
    • Primary liver cancer
    • Death

Hepatitis B Mode Of Transmission:

  • Major is a blood-borne infection
  • Other involve saliva and crevicular fluid

Hepatitis B Treatment:

  • Effective treatment not available
  • Subcutaneous administration of interferon alfa 2b was effective in inducing loss of replication of virus

Infection Control And Sterilization

Question 3. Transmissible infection in dentistry.
Answer:

Herpes Virus Infections:

Infection Control and Sterilization Herpes virus infections

Acute Viral Hepatitis:

Infection Control and Sterilization Acute viral hepatitis

Sterilization In Dentistry Mcqs

Acquired Immunodeficiency Syndrome:

  • Human immunodeficiency virus leads to it
  • Route of transmission
  • Blood and other body fluids
  • Signs and symptoms
    • Unexplained diarrhea
    • Fatigue
    • Malaise
    • Loss of body weight
    • Fever
    • Night sweat
    • Oral thrush
    • Generalized lymphadenopathy
    • Enlarged spleen
    • Opportunistic infections

Tuberculosis:

  • Mycobacterium tuberculosis organism causes it
  • Symptoms
    • Cough of more than 3 weeks
    • Sputum possibly tinged with blood
    • Unexplained weight loss
    • Night sweats

Epidemiology Of Oral Diseases Question And Answers

Epidemiology Of Oral Diseases Definitions

Epidemiology

  • Epidemiology is defined as the study of the distribution and determinants of health-related states or events in specified populations and the application of this study to the control of health problems

Dental caries

  • Dental caries is defined as an infectious, microbiologic disease of the teeth that results in localized dissolution and destruction of the calcified tissues

Epidemiology Of Oral Diseases Important Notes

1. Diet studies related to dental caries

  • Vipeholm study
  • Hopewood House study
  • Turku sugar study
  • Hereditary fructose intolerance
  • Tristan da Cunha’s study

2. Vipeholm study

  • Described by Gustaffson et al in 1954 and summarized by Davies in 1955

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Vipeholm Method:

  • The institutional diet was nutritious but contained little sugar with no provision for between meals
  • 4 meals were eaten daily
  • 7 groups were obtained
    • Control group
    • Sucrose group
    • Bread group
    • Chocolate Group
    • Caramel Group
    • 8 toffee group
    • 24 toffee group

Vipeholm Conclusion:

  • An increase in carbohydrate intake increases dental caries
  • Retentive sugar items cause an increase in dental caries
  • Sugar consumed in between meals causes dental caries
  • Increase in caries activity varies between individuals
  • Withdrawal of sugar items causes the disappearance of increased caries activity
  • A high concentration of sugar in solution & its prolonged retention leads to increased caries activity
  • An increase in clearance time of sugar increases caries activity

Epidemiology Of Oral Diseases Questions And Answers

3. Hopewood house study

  • Investigators are Harris and Sullivan
  • The dental status of children between 7-14 years of age residing at Hopewood House, Bowral, New South Wales was studied longitudinally for 10 years
  • The absence of meat and the rigid restriction of refined carbohydrates are two important features of the study

Hopewood house Result:

  • At the end of 10 years

Epidemiology Of Oral Diseases Hopewood house study

Hopewood House Conclusion:

  • In institutionalized children dental caries can be reduced by a restricted carbohydrate diet even in the presence of unfavourable oral hygiene

4. Turku sugar study

  • Investigators are Scheinin and Makinen et al
  • Investigated the effect of sucrose, fructose and xylitol on caries development

Turku sugar Conclusion:

  • Sucrose – highly cariogenic
  • Fructose – cariogenic as sucrose for the first 12 hours but less at the end of 24 hours
  • Xylitol – anti-cariogenic with 85% reduction in dental caries

5. Tristan

  • Investigator is Fisher
  • He carried dental examinations in 1932,1937, and 1953 on the island and again in England in 1962 and 1966 in the island when the people of Tristan de Cunha returned to their island from England

Tristan Results:

  • In 1932 and 1937 – 0% of caries
  • In 1962-50%
  • In 1966-80%

6. Hereditary fructose intolerance

  • It is due to reduced levels of enzyme fructose-l-phosphate aldolase required for the metabolism of sucrose or fructose
  • Persons affected by it avoid food containing fructose or sucrose because ingestion of these foods causes nausea, vomiting, excessive sweating and even coma.

7. Predictors of high caries risk are

  • Multiple new lesions
  • Multiple restorations
  • History of premature extraction for caries
  • Anterior teeth caries or restoration
  • History of frequent replacement of restoration

8. Frequent intake of sucrose for at least 60-100 minutes/day is associated with the formation of rampant caries

Oral Diseases Epidemiology

Epidemiology Of Oral Diseases Long Essays

Question 1. Define epidemiology. Describe the epidemiological factors of oral cancer.
Answer:

Epidemiology Definition:

It is defined as the study of the distribution & determinants of health-related states or events in specified populations and the application of this study to the control of health problems

Epidemiological Factors Of Oral Cancer:

Host:

  • Age:
    • Older people show an incidence of carcinoma
    • Younger people show an incidence of sarcoma
  • Race:
    • Whites develop lip melanoma more frequently
  • Sex
    • Carcinoma of the lip common in women
    • Cancer of the tongue & buccal mucosa common in males
  • Genetic factors
    • Oncogenes involved in the initiation & progression of malignancy
  • Occupation
    • Textile workers show an increased incidence of oral cancer

Epidemiological Of Oral Diseases

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  • Immunity
    • Kaposi sarcoma common in AIDS patient
  • Social class
    • Low-income group shows an increase in cancer of the oral cavity
  • Customs & Habits
    • Smoking increases the incidence of cancer

Agent:

  • Biological
    • Virus
    • Fungi
  • Chemical
    • Arsenic
    • Dyes
    • Nickel
    • Aromatic amines
  • Mechanical
    • Sharp tooth
    • fitting dentures
    • Jagged teeth
  • Nutritional agents
    • Precarcinogens
    • Increased consumption of fat
    • Deficiency of folic acid
    • Protein deficiency
    • Increased consumption of red chilli powder
    • Decrease in copper, zinc, vegetable, vitamin C, E

Environmental:

  • Water contaminants
    • Includes some organic pollutants like chloroform
  • Air pollution
    • Caused by the release of several gases from automobiles & factories
  • Geographic variation
    • In the Netherlands: buccal mucosa is most affected
    • In Switzerland: the lip & tongue are most affected
    • In Canadian Eskimos: cancer of the salivary gland is more common
    • In Srikakulam & Vishakapatnam: palatal cancer is the most common
  • Solar heat
    • Prolonged exposure to sunlight causes melanoma
  • Industrialization
    • The release of various toxins by the industries contaminates water & lead to cancer

Epidemiology Of Dental Caries

Question 2. Epidemiology of periodontal disease.
Answer:

Epidemiology of periodontal disease Agent:

Dental plaque:

  • Dental plaque is a primary etiological factor for periodontal disease
  • Dental plaque is defined as a structured, resilient, yellow-greyish substance that adheres tenaciously to the intraoral hard surfaces, including removable & fixed restoration
  • Dental plaque is composed of bacteria in a matrix of salivary glycoprotein & extracellular polysaccharides
  • Dental plaque is because of this matrix, it cannot be removed by rinsing
  • Classified into
    • Supragingival plaque: at or coronal to marginal gingiva
      • It is responsible for gingivitis
    • Subgingival plaque: apical to gingival margin
      • It is responsible for calculus & root caries
    • Accumulation of plaque is found more on the gingival l/3rd of the tooth surfaces, cracks, pits & fissures, overhanging restoration & around malaligned teeth

Calculus:

  • Calculus is a hard deposit that forms by mineralization of dental plaque & is usually covered by a layer of unmineralized plaque
  • Calculus is classified into
    • Supragingival calculus
    • Located coronal to the gingival margin
    • Calculus is white or whitish-yellow
    • Calculus has a hard, clay-like consistency
    • Calculus can be easily detached from the tooth
  • Subgingival calculus
    • Subgingival calculus is located below the crest of the marginal gingiva
    • Subgingival calculus is a dark brown or greenish black
    • Subgingival calculus is hard & dense
    • Subgingival calculus is firmly attached to the tooth structure
  • Calculus provides a fixed nidus for the continued accumulation of plaque

Host Factors:

  • Age
    • The prevalence of periodontal disease increases with age due to the cumulative progression of the lesions over time
  • Gender
    • Based on epidemiological studies, the prevalence & severity is higher in males than in females
  • Socio economic status
    • Lower socioeconomic status results in poor diet, poor oral hygiene & a general lack of dental awareness
    • Whereas those who are well-educated, wealthier & live in better circumstances visit dentists frequently
    • Thus periodontal disease prevalence increases in low socioeconomic status
  • Diet & Nutrition
    • Sticky foods adhere to the teeth & are difficult to remove thus interfering with the natural cleansing mechanism and leading to periodontal disease
    • The nutrients associated with periodontal tissues are vitamin A, B complex, C, D, calcium & phosphorous
    • Prevalence & severity of periodontal disease increases in protein malnutrition & vitamin A deficiency
  • Anatomy
    • The normal contour of the tooth protects the underlying tissues
    • Tooth
      • Sharp cusps, uneven marginal ridges, lack of contact between teeth & crowding can cause food impaction
  • Soft tissue
    • When the frenum is inserted close to the marginal gingival, the pull of attachment may cause recession of the papilla along with interfering with the proper use of the toothbrush
  • Habits
    • Thread biting, holding nails between teeth, bruxism, lip, cheek & nail biting can cause traumatic effects on the periodontium
  • Local irritants
    • Mechanical
      • Faulty tooth brushing causes abrasion or recession of the gingival tissues
      • Faulty restoration impinges on gingival & irritates them
      • Faulty orthodontic treatment results in root resorption as well as alveolar bone loss & Mobility
  • Chemical
    • Alcohol, tobacco & condiments lower tissue resistance & increase susceptibility to gingivitis & periodontitis
    • Atmospheric lowers the tissue resistance
  • Systemic factors
    • Systemic diseases act locally to reduce the resistance to periodontal destruction & the local periodontal pathogens act systemically to produce an impact on the general health

Epidemiology of periodontal disease Environmental Factor

Geographic variation:

Epidemiology Of Oral Diseases Geographic variation

  • Nutrition:
    • Avitaminosis C, Niacin deficiency shows an increased prevalence of periodontal disease
    • Increased prevalence of periodontal disease was found in areas with protein malnutrition & vitamin A Deficiency
  • Degree of urbanization
    • Rural areas may have an increased prevalence than urban areas
    • It can be due to oral hygiene practices, diet & socioeconomic status
  • Psychological & cultural factors
    • Stress predisposes to ANUG
    • Certain cultures view dental problems & loss of teeth solely as an ageing process

Periodontal Disease Epidemiology

Question 3. What is an epidemiological triad? Discuss the role of components of an epidemiological triad in dental caries.
Answer:

Epidemiological Triad:

  • The occurrence of any disease is determined by the interaction between the agent, host and environment constituting an epidemiological triad

Components In Dental Caries:

1. Host factor:

  • Tooth

Composition:

Epidemiology Of Oral Diseases Composition

Morphology:

  • That predisposes to dental caries are deep, narrow, occlusal fissures, buccal & lingual pits
  • Disturbed clarification

Position:

  • Malaligned & rotated predispose to caries

Saliva:

  • Removes bacteria & food debris through its flushing action

Epidemiology Of Oral Diseases Saliva

pH:

  • Saliva is slightly acidic
  • As the flow rate increases pH also increases

Viscosity:

  • As viscosity increases caries activity increases

Sex:

  • Caries are more common in females

Race:

  • Caries are more common in whites

Age:

  • Root caries common in older individuals
  1. Familial hereditary
    • Inheritance of a characteristic tooth structure
  2. Developmental disturbances
    • The presence of deep pits and fissures, enamel hypoplasia and enamel defects more prone to caries
  3. Economic status
    • In young individuals, caries decreases with an increase in income
    • In adults, as income decreases, dental caries decreases
  4. Concomitant disease
    • Fewer caries in controlled diabetes
  5. Oral hygiene habits
    • Fewer caries in those who maintain good oral hygiene

2. Microflora:

  • Streptococcus mutans are responsible for early carious lesions
  • Lactobacilli are associated with dentinal caries and
  • actinomyces strains with root surface caries

3. Local substrate diet:

  • It depends on
  1. Physical Properties of Food and Cariogenicity
    • Physical properties that improve the cleansing action reduce the retention of food within the oral cavity and increase saliva flow are caries-preventive
  2. Sucrose
    • It is responsible for caries development
  3. Vitamin K
    • Has the possible anticaries agent
  4. Vitamin B complex
    • Alters oral flora by promoting the growth of non-cariogenic organisms
  5. Calcium and phosphorous dietary intake
    • Disturbance in calcium and phosphorous metabolism during the period of tooth formation may result in severe enamel hypoplasia and defects of the dentin
  6. Fluoride in diet
    • Fluoride prevents dental caries

Oral Cancer Epidemiology

Epidemiology Of Oral Diseases Short Essays

Question 1. Role of tobacco in oral health.
Answer:

Role of tobacco in oral health

  • Tobacco is a major contributor to oral disease
  • Tobacco use
    • Slows wound healing after dental surgery
    • It promotes periodontal disease
    • Halitosis
    • Oral infections
    • Causes cancer of the oral cavity & tongue, larynx, pharynx, oesophagus, stomach, lung
  • Smokeless tobacco causes oral cancer
  • Chewing of paan is a major cause of oral & oesophageal cancer
  • Smoking is a known cause of cardiovascular disease
  • Exposure to non-smokers causes respiratory disease, worsening of asthma
  • Tuberculosis is more common in smokers
  • Mortality increases
  • Pregnant women exposed to passive smoking may deliver lower birth-weight babies
  • Its consequence may be babies with cleft lip & palate
  • Men who smoke or use smokeless tobacco may develop reduced fertility & sexual impotence

Question 2. Prevention of oral cancer.
Answer:

Prevention of oral cancer

  • Prevention of oral cancer mainly focuses on modifying habits associated with the use of tobacco
  • There are 3 well-known approaches
    • Regulatory approach
      • Print warning on cigarette packets
      • In 2003, prohibition was made on advertisement of & to provide for the regulation of production, supply & distribution of cigarettes & other tobacco production
  • Service approach
    • The active search for disease among apparently healthy people
  • Educational approach
    • Dentists help patients to quit tobacco by promoting tobacco prevention & control strategies

Counselling For Tobacco Cessation (5a’s):

  • Ask:
    • Ask the patient about tobacco use at every visit
  • Advice
    • Non-smokers to never use tobacco smokers to quit
  • Assess
    • The level of dependence
  • Assist
    • Quitting by setting a firm quit date
  • Arrange
    • For follow-up/recall visits

Use Of Pharmacotherapy:

  • Nicotine replacement therapies
    • Nicotine gum
    • Nicotine patch
    • Nicotine inhaler
    • Nicotine nasal spray
    • Nicotine lozenges
  • Anti .depressants
  • First line therapies
  • Buproprion SR
  • Selegiline
  • Second line therapies
  • Clonidine
  • Nortriptyline

Counselling Those Unwilling To Quit (5r’s):

  • Relevance of quitting
  • Risks of continuing tobacco use
  • Rewards of quitting
  • Roadbacks to quitting
  • Repeat these at each level

Common Oral Diseases And Prevention

Question 3. Oral submucous fibrosis.
Answer:

Oral submucous fibrosis

  • Oral submucous fibrosis is a pre-cancerous condition
  • Oral submucous fibrosis is characterized by juxta epithelial inflammatory reaction in the oral mucosa followed by a fibro elastic transformation of the lamina propria leading to mucosal atrophy, rigidity & trismus

Aetiology:

  • Consumption of red chillies
    • Consumption of areca nuts
    • Nutritional deficiencies
    • Immunological factors
    • Genetic factors

Features:

  • Burning sensation
    • Difficulty in mastication
    • Referred pain in the ear
    • Depapillation of tongue
    • Restricted movement of the floor of the mouth
    • Shrunken uvula
    • Fibrous bands
    • Restricted mouth opening
    • Stiffness of buccal mucosa

Management:

  • Quit the habit
    • Antioxidant- Oxyace-1 capsule/ day
    • Multivitamin therapy
    • Steroid- Betnovate 0.12%
    • Tumeric application
    • Intralesional injection of Hyaluronidase- 1500 U
    • Physiotherapy
    • Splitting of fibrous bands
    • Laser

Question 4. Antibacterial property of saliva.
Answer:

Antibacterial properties of saliva

Epidemiology Of Oral Diseases Antibacterial property of saliva

Epidemiology Of Oral Diseases Short Question And Answers

Question 1. Stephen’s curve.
Answer:

Stephen’s curve

  • Stephan showed that within 2-4 minutes of rinsing with a solution of glucose/ sucrose, plaque pH is reduced from 6.5-5
  • Stephen’s curve gradually returns to the original value within approximately 40 minutes
  • Graphical presentation of it gives Stephan a curve

Epidemiology Of Oral Health

Question 2. Sugar substitutes.
Answer:

Sugar substitutes

Epidemiology Of Oral Diseases Sugar substitutes

Question 3. Constituents of Cigarette smoke
Answer:

Constituents of Cigarette smoke

Epidemiology Of Oral Diseases Constituentsw of cigratte smoke

Question 4. Reverse smoking.
Answer:

Reverse smoking.

Cigarette

  • Tobacco is smoked with a lighted end inside the mouth
  • Air reaches the burning side through the unlighted end
  • Smoke is expelled through the cigarette/ mouth

Chutta

  • The smoker lights the chute
  • Draws a few puffs conventionally
  • Chutta is rarely taken out

Places

Epidemiology Of Oral Diseases Places

Side Effects:

  • The temperature of the palatal mucosa increases to 58 degrees C
  • Palatal patches exhibiting malignancy

Question 5. Smoking form of tobacco.
Answer:

Smoking form of tobacco

1. Bidis

  • About 0.2-0.3 gms of sundried tobacco flakes are hand-rolled in a rectangular piece of tempura or tendu leaf and tied with a thread

2. Chillum

  • It is a straight, 10-14 cm long conical clay pipe

3. Chutta

  • It is a cylindrical coarsely prepared cheroot

4. Cigarettes

  • About 1 gm of tobacco cured in the sun or artificial heat is covered with papers

5. Dhumti – conical carrots

  • Hookah – water pipe
  • Hookli
  • Clay pipe of about 7-10 cm with mouthpiece and bowl

Risk Factors For Oral Diseases

Epidemiology Of Oral Diseases Viva Voce

  1. Miller proposed the chemical-parasitic theory of dental caries
  2. Clark observed a higher number of Streptococcus mu- tans are found at various site
  3. The two most important risk factors associated with oral cancer are tobacco and alcohol
  4. Hookah is also called water pipe or hubble-bubble
  5. No tobacco day is observed on 31st May.
  6. Anticancer drug busulfan is an alkylating agent
  7. Dhumti is used for reverse smoking in women
  8. Masheri is used to clean the teeth

Epidemiological Methods Question And Answers

Epidemiological Methods Definitions

Epidemiology

  • Epidemiology is defined as the study of the distribution & determinants of health-related states or events in specified populations and the application of this study to the control of health problems

Incidence

  • Incidence is defined as the number of new cases of a specific disease occurring in a defined population during a specified time

Prevalence

  • The total number of all individuals who have an attribute or disease at a particular time divided by the population at risk of having the attribute or disease at this point in time or midway through the period

Matching

  • Matching is defined as the process by which we select controls in such a way that they are similar to cases with regard to certain pertinent selection variables which is known to influence the outcome of the disease and which if not adequately matched for comparability could distort or confound the results.

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Cohort

  • A cohortis defined as a group of people who share a common characteristic or experience within a defined time period

Epidemic

  • It is an unusual occurrence in a community or region of disease, specific health-related behavior, or other health-related events clearly in excess of excepted occurrence.

Epidemiological Methods Questions And Answers 

Pandemic

  • A pandemicis an epidemic usually affecting a large proportion of the population and occurring over a wide geographic area such as a nation, a continent, or a world

Attributable risk

  • Attributable risk is the difference in incidence rates of disease between an exposed group and a nonexposed group

Endemic

  • Endemic is the constant presence of a disease or infectious agent within a given geographic area or population group without importation from outside.

Epidemiological Methods Important Notes

1. Classification of epidemiology:

  • Descriptive
  • Analytical
    • Ecological study
    • Cross-sectional
    • Case-control
    • Cohort study
  • Experimental

2. Types of study

Epidemiological Methods Types of study

3. Odds ratio

  • Odds ratio is an indirect method of estimating the relative risk
  • Odds ration = \(\frac{\begin{array}{c}\text { Exposed with disease } \times \\\text { unexposed without disease }\end{array}}{\begin{array}{c}\text { Exposed without disease } \times \\\text { unexposed with disease }\end{array}}\)
  • The odds ratio is used for case-control studies
  • The odds ratio takes a value between zero to infinity.
  • Derived from case-control studies
  • An odds ratio of 2.25 means that the risk of oral cancer is 2.25 times higher in people who smoke than those who do not smoke

4. Blinding is done to reduce bias

  • Blinding is done to reduce bias can be done in 3 ways
  1. Single-blind trial
    • Single-blind trial is so planned that the participants are not aware whether they belong to the study group or control group
  2. Double-blind trial
    • Double-blind trial is so planned that neither the doctor nor the participants know to which group of patients are given drugs and which group is given a placebo
    • Double-blind trial is the most frequently used method of blinding.
  3. Triple blind trial
    • In this, the participant, investigator, and the person analyzing the data are all blind

5. Tools of measurement in epidemiology

  • Rates – It is the frequency of a disease expressed per unit size of a population or group in which it is observed.
  • Ratio – Denotes the relation in size between two random quantities
  • Proportions – it is a ratio that expresses the relation in the magnitude of art of the whole. Expressed in percentage.

6. Principles of epidemiology

  • Exact observation
  • Correct interpretation
  • Rational explanation
  • Scientific construction

7. Basic measurements in epidemiology

  • Measurement of mortality
  • Measurement of morbidity

8. Epidemiological methods

  • Descriptive epidemiology
  • Analytical epidemiology
  • Experimental epidemiology

9. Attributable risk

  • Derived from a cohort study
  • Expressed as percentage
  • Indicates to what extent the disease under study can be attributed to exposure.

Observational Studies In Epidemiology

10. Relative risk

  • Relative risk is the ratio between incidence among exposed and incidence among non-exposed
  • Relative risk is a direct measure of the strength of the association.

11. Various terms

Epidemiological Methods Various terms

Epidemiological Methods Long Essays

Question 1. Define epidemiology. Write about its principles. Discuss briefly the agent and host factor in periodontal disease.
Answer:

Epidemiology Definition:

Epidemiology is defined as the study of the distribution & determinants of health-related states or events in specified populations and the application of this study to the control of health problems

Epidemiology Principles:

  • Exact observation- strict, vigorous, accurate, precise
  • Correct interpretation- free from error
  • Rationale explanation- intelligent, sensible
  • Scientific construction- by expert knowledge & technical skill

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Epidemiology Of Periodontal Disease:

Epidemiology Agent:

  • Dental plaque
    • Dental plaque is a primary etiological factor for periodontal disease
    • Dental plaque is defined as a structured, resilient, yellow-grayish substance that adheres tenaciously to the intraoral hard surfaces, including removable and fixed restoration
    • Dental plaque is composed of bacteria in a matrix of salivary glyphosate in and extracellular polysaccharides
    • Dental plaque is because of this matrix, that it cannot be removed by rinsing
  • Classified into
    • Supragingival plaque: at or coronal to marginal gingiva
    • The agent is responsible for gingivitis
    • Subgingival plaque: apical to gingival margin
      • The agent is responsible for calculus & root caries
  • Accumulation of plaque is found more on the gingival 1/3rd of the tooth surfaces, cracks, pits, and fissures, over-hanging restoration & around malaligned teeth
  • Calculus
    • Calculus is a hard-to deposit that forms by mineralization of dental plaque and is usually covered by a layer of unmineralized plaque
    • Calculus is classified into
  • Supragingival calculus
    • Located coronal to the gingival margin
    • Supragingival calculus is white or whitish-yellow
    • Supragingival calculus has a hard, clay-like consistency
    • Supragingival calculus can be easily detached from the tooth
  • Subgingival calculus
    • Supragingival calculus is located below the crest of the marginal gingiva
    • Supragingival calculus is a dark brown or greenish black
    • Supragingival calculus is hard and dense
    • Supragingival calculus is firmly attached to the tooth structure
  • Calculus provides a fixed nidus for the continued accumulation of plaque

Epidemiological Methods

Epidemiology Host Factors:

Age:

  • The prevalence of periodontal disease increases with age due to the cumulative progression of the lesions over time

Gender:

  • Based on epidemiological studies, the prevalence and severity are higher in males than in females

Race:

  • Blacks are more affected than the whites

Epidemiology Socioeconomic Status:

  • Lower socioeconomic status results in poor diet, poor oral hygiene, and a general lack of dental awareness
  • Whereas those who are well-educated, wealthier, and live in better circumstances visit dentists frequently
  • Thus periodontal disease prevalence increases in low socioeconomic status

Epidemiology Diet And Nutrition:

  • Sticky foods adhere to the teeth and are difficult to remove thus interfering with the natural cleansing mechanism and leading to periodontal disease
  • The nutrients associated with periodontal tissues are vitamin A, B complex, C, D, calcium, and phosphorous
  • Prevalence and severity of periodontal disease increases in protein malnutrition and vitamin A deficient

Epidemiology Anatomy:

  • The normal contour of the tooth protects the underlying tissues

Epidemiology Tooth:

  • Sharp cusps, uneven marginal ridges, lack of contact between teeth, and crowding can cause food impaction

Epidemiology Soft Tissue:

  • When the frenum is inserted close to the marginal gingival, the pull of attachment may cause recession of the papilla along with interfering with the proper use of a toothbrush

Epidemiology Habits:

  • Thread biting, holding nails between teeth, bruxism, lip, cheek, and nail-biting can cause traumatic effects on the periodontium

Epidemiology Mechanical:

  • Faulty toothbrushing causes abrasion or recession of the gingival tissues
  • Faulty restoration impinges on gingival and irritates them
  • Faulty orthodontic treatment results in root resorption as well as alveolar bone loss and Mobility

Epidemiology Chemical:

  • Alcohol, tobacco, and condiments lower tissue resistance and increase susceptibility to gingivitis and periodontitis

Epidemiology Atmospheric:

  • Because of obstruction in the nasal passage patient breath from the mouth leading to dehydration of the mucous membrane
  • Atmospheric lowers tissue resistance

Epidemiology Systemic factors:

  • Systemic diseases act locally to reduce the resistance to periodontal destruction and the local periodontal pathogens act systemically to produce an impact on the general health

Descriptive And Analytical Epidemiology

Question 2. Describe in brief the types of epidemiology studies.
Answer:

Types Of Epidemiological Studies:

Descriptive Epidemiology:

  • Descriptive Epidemiology is usually the first step in an epidemiological study
  • Descriptive Epidemiology is concerned with the observation of the distribution of the disease or any health-related events in the human population and the identification of the characteristics with which the disease or condition under study seems to be associated
  • Descriptive Epidemiology is used for the quantification of the disease status of the community
  • The steps involved in it are
    • Defining the population to be studied
    • Defining the disease under study
    • Describing the disease in terms of
      • Time
      • Place
      • Person
  • Measurement of the disease
  • Compared with known indices
  • Formulating an etiological hypothesis

Analytical Epidemiology:

  • The focus here is the individual within the population
  • Analytical Epidemiology is designed primarily to establish the causes of disease by investigating the association between exposure to a risk factor and the occurrence of disease
  • The objective is to test the hypothesis
  • Types
    • Case-control study
    • Cohort study

Experimental Epidemiology:

  • Experimental Epidemiology is carried out under the direct control of the investigator
  • Experimental Epidemiology involves some actions, interventions,s or manipulation in the experimental group while making no change in the control group
  • Next, compare the outcome of the experiment in both groups
  • Types
  • Randomized controlled trials
  • Non-randomized trials

Question 3. Describe the uses of epidemiology.
Answer:

Uses Of epidemiology:

  • Community Diagnosis
    • This consists of the collection, description, and analysis of information on the occurrence and distribution of disease in the population about characteristics of the agent, host, and environment
    • The importance of the disease is usually determined by the extent of the incidence, prevalence, and mortality by age, sex, race, nativity, marital status, geographic area, temporal variation, and socioeconomic status
  • Rise and fall of the disease
    • It is done through repeated evaluation of the health care related matters
    • Due to this, some diseases pale out in history while new ones emerge
    • The seasonal nature of the disease may be revealed
  • Planning and Evaluation
    • Planning is essential for a rational allocation of limited resources
    • Evaluation is done to find out whether the measures undertaken to prevent disease are effective in reducing the frequency of the disease
  • Evaluation of individual risk
    • The purpose of this is to estimate the probable chances that certain types of individuals will, under certain conditions, suffer from specific illnesses, de- fects, or accidents
    • It is also an estimate of the probabilities of life and death expectancy

Question 4. Describe steps in descriptive epidemiology.
Answer:

Steps In Descriptive Epidemiology:

Defining The Population to Be Studied:

  • The population has to be defined in terms of the total number and the composition of the individuals within the population in terms of characteristics such as age, sex, occupation, culture, socio-economic status
  • The defined population can either be the total population in a geographic area or a representative sample taken from the population
  • The defined population provides a denominator for calculating rates
  • The population of the community selected for the study should always remain stable, without any migration into or out of the area

Defining The Disease Under Study:

  • It should be precise and valid to enable the investigator to identify those who have the disease from those who do not
  • The disease needs to be defined with an operational definition which is a definition with which the disease or condition can be identified and measured in the fined population with a degree of accuracy
  • The diagnostic methods adopted for the study should be acceptable and applicable to the population to be studied

Describing the Disease Under Study:

This step is used to describe the occurrence and distribution of the disease by the time of its occurrence, the place of occurrence, and the persons who are affected by the disease

1. Time Distribution:

  • Time may be measured in terms of hours, days, weeks, months, years, etc.

Time Distribution Types:

  • Short-term fluctuation ex. Epidemic
  • Common source epidemic
    • A single exposure or point source epidemic. Ex. Food poisoning
  • Continuous or multiple exposure. Ex. Contaminated water
    • Propagated epidemic
  • Person-to-person transmission
  • Arthropod vector
  • Animal reservoir
    • Periodic fluctuation
      • Seasonal trends: example: Measles and varicella
      • Cyclic trends.
  • Certain diseases appear in cycles, which may spread over short periods like days, weeks, months, or years
  • Example: Automobile accidents
  • Long term fluctuation
  • Implies changes in disease occurrence over a long period, generally several years.
    Example: Lung cancer

2. Place Distribution:

  • Variation in the frequency of different diseases from place to place has long been identified
  • International variation
    • There exist differences in the incidence of various diseases in different parts of the world
    • Example: Stomach cancer is very common in Japan and unusual in the USA
    • National variation
      • Distribution of endemic goiter, fluorosis, leprosy, and malaria have shown variation in their distribution in India
  • Urban and rural variation
    • Chronic bronchitis, lung cancer, and CVS disorder are more common in urban than rural areas Local distribution
  • Inner and outer city variations in disease frequency are well-known

3. Person Distribution:

  • The factors that influence the disease pattern in an individual are
  • Age: certain diseases are more frequent in certain age groups
  • Sex: obesity is common in females while lung cancer in males
  • Ethnicity
  • Marital status
  • Occupation
  • Social class
  • Behavior
  • Stress
  • Migration

Measurement Of Disease:

  • The measurement of disease is done in terms of mortality and morbidity indicators
  • The morbidity is expressed in terms of incidence and prevalence

Comparing With Known Indices:

  • It helps to conclude about the disease etiology
  • Identify groups and subgroups which are potentially at high risk for the development of certain diseases

Formulation Of An Etiological Hypothesis:

  • Formulation Of An Etiological Hypothesis is defined as ” a supposition arrived at by observation or by reflection”
  • The formulation Of An Etiological Hypothesis can be tested using the techniques of analytical epi- epidemiology after which it may be accepted or rejected
  • Formulation Of An Etiological Hypothesis should specify the population, specific cause, ex-expected outcome, dose-response relationship, and time response relationship

Cohort Study Vs Case-Control Study

Question 5. What are the aims of epidemiology? Explain. It is defined as the process by which we select control case-control studies in detail.
Answer:

Aims Of Epidemiology:

  • To describe the size and distribution of the disease problems in the human population
  • To provide the data essential for the planning, implementation, and evaluation of health services for the pre-prevention, control, and treatment of diseases and for setting up priorities among those services
  • To identify etiological factors in the pathogenesis of disease

Epidemiology Features:

  • Both exposure and outcome occurred before the start of the disease
  • The study proceeds from effect to cause
  • Epidemiology uses a control or comparison group to support to refuse a hypothesis

Epidemiology  Steps:

Epidemiology  Selection Of Cases And Controls:

  • Selection of cases
  • Definition of a case
    • Diagnostic criteria: the diagnostic criteria of the disease Epidemiology and the stage of the disease to be included in the study must be specified before the study is under- taken
    • Eligibility criteria: only newly diagnosed cases within a specified period are eligible than old cases or cases in advanced stages of disease
  • Sources of cases
    • Hospitals
    • General population
  • Selection of controls
  • The control must be free from disease under study
  • They must be as similar to the case as possible
  • Sources of control
    • Hospital
    • Relatives
    • Neighborhood
    • General population
  • Number of control
    • If many cases are available and a large study is contemplated, one tends to use one control for each
    • case
    • If the study group is small, 2,3 or even 4 controls can be selected for each study subject

Epidemiology Matching:

  • In such a way that they are similar to cases about certain pertinent selection variables which is known to influence the outcome of the disease and which if not adequately matched for comparability could distort or confound the results
  • While matching it should be borne in mind that the suspected etiological factor or the variable we wish to measure should not be a match

Epidemiology Types:

  • Group matching
  • Pair matching

Epidemiology Measurement Of Exposure:

  • Obtained by
  • Interviews
  • Questionnaires
  • Records
  • Clinical or laboratory examination

Epidemiology Analysis:

  • Final step
  • It is to find out
  • Exposure rates among cases and controls to suspected factor
  • Estimation of disease risk associated with exposure

Epidemiology Advantages:

  • Easy to carry out
  • Rapid and Inexpensive
  • Few subjects are required
  • Rare diseases can be studied
  • No risk to subjects
  • Allows study of several etiological factors
  • Risk factors can be identified
  • No attrition problems
  • Minimal ethical problems

Epidemiology Disadvantages:

  • Problem of bias
  • Selection of appropriate control group
  • Incidence cannot be measured
  • Not distinguishing between causes and associated factors
  • Not suited to the evaluation of therapy
  • The concern is the representativeness of cases and controls

Epidemiological Study Designs

Epidemiological Methods Short Essays

Question 1. Uses of epidemiology.
Answer:

Epidemiology Community Diagnosis:

  • This consists of the collection, description, and analysis of information on the occurrence and distribution of disease in the population about characteristics of the agent, host, and environment
  • The importance of the disease is usually determined by the extent of the incidence, prevalence, and mortality by age, sex, race, nativity, marital status, geographic area, temporal variation, and socio-economic status

Epidemiology Rise And Fall Of The Disease:

  • The rise and fall of the disease is done through repeated evaluation of the health. It occurs when other factors that are associated with care-related matters
  • Due to this, some diseases pale out in history while new ones emerge
  • The seasonal nature of the disease may be revealed

Epidemiology Planning And Evaluation:

  • Planning is essential for a rational allocation of the differences in admission rates and resources
  • Evaluation is done to find out whether the measures undertaken to prevent a disease are effective in reducing the frequency of the disease

Evaluation Of Individual Risk:

  • The purpose of this is to estimate the probable chances that certain types of individuals will, under certain conditions, suffer from specific illnesses, defects, or accidents
  • Individual risk is also an estimate of the probabilities of life and death expectancy

Question 2. Bias in case-control studies.
Answer:

Selection Bias:

  • Selection Bias occurs when a group studied does not reflect the same characteristics like age, sex, occupation, race, etc as in the general population
  • Selection Bias can be reduced by careful selection of individuals for inclusion in the study
  • The selection bias can be best controlled by the prevention

Information Bias:

  • Information Bias occurs when there is an error in the classification of individuals concerning the outcome variable

Confounding Bias:

  • The outcome and exposure variables do not have the same distribution in the exposed and unexposed groups
  • Confounding Bias can be removed by matching

Berkesonian Bias:

  • Of people in hospitals with different diseases

Interviewer’s Bias:

  • Interviewer’s Bias occurs when the interviewer knows the hypothesis and also knows who the cases are

Memory Bias:

  • When the cases and controls are asked questions about their history it may be more likely for the cases to recall the existence of certain events or factors than the controls who are healthy persons

Telescopic Bias:

  • If a question refers to the recent past, episodes that occurred longer ago may also be reported

Prevalence-Incidence Bias:

  • If the exposure occurred years before, then mild cases that improved or severe cases that died would have been missed and not counted among the cases

Question 3. Comparison of case-control and cohort studies.
Answer:

Comparison Of Case-control And Cohort Studies

Epidemiological Methods Compariswon of case control

Question 4. Incidence and prevalence.
Answer:

Incidence:

  • Incidence is defined as the number of new cases of a specific disease occurring in a defined population during a specified period
  • Incidence can range from zero to infinity
  • Incidence can be represented by the formula
  • Number of new cases of specific disease during a given period x 1000

The Population At Risk:

Incidence Types:

  • Episode incidence
    • Episode incidence is the rate of occurrence of new episodes of a disease Identify the potential high-risk population
  • Cumulative incidence
    • Similar to incidence the time interval is expressed as a fixed period.

Incidence Uses:

  • Provide a clue for the etiology and pathogenesis of the disease
  • Study the distribution of the study
  • Control the disease
  • Evaluate the efficacy of preventive and therapeutic measures.

Incidence Significance:

  • Indicative of failure or preventive program
  • Suggest the need for a new disease control program
  • Suggest a change in the etiology of the disease

Prevalence:

  • The total number of all individuals who have an attribute or disease at a particular time divided by the population at risk of having the attribute or disease at this point or midway through the period

Prevalence Types:

  • Point prevalence
    • It is the number of all current cases of a specific disease at one point in time with a defined population
  • Period prevalence
    • It is defined as the total number of existing cases of a specific disease during a defined period ex- pressed concerning a defined population

Prevalence Uses:

  • Estimate the magnitude of disease or health problems in the community
  • the disease under investigation
  • Useful in administrative and planning purposes like assessing manpower needs in health services, etc

Relation Between Incidence and Prevalence:

  • Prevalence is dependent on the incidence and duration of the disease
  • Prevalence = incidence x Mean duration
  • (P=IxD)
  • Relation Between Incidence and Prevalence reveals that as the duration of the disease increases, the greater will be its prevalence
  • Changes in prevalence from one time to another can result from changes in incidence, changes in duration of disease or both

Experimental Studies In Epidemiology

Question 5. Cohort studies.
Answer:

Cohort Studies

  • Prospective study
  • Longitudinal study
  • Incidence study
  • Forward-looking study

Cohort Studies Features:

  • The cohorts are identified before the appearance of
  • The study groups are observed over some time to determine the frequency of the disease among them
  • The disease proceeds forward from cause to effect

Cohort Studies Indications:

  • When a good association occurs between exposure and disease
  • When exposure is rare
  • When attrition of the study population can be minimized
  • When ample funds are available

Cohort Studies Types:

  • Prospective
  • Retrospective
  • Combination

Cohort Studies Elements:

  • Selection of study subjects
    • Obtaining data on exposure
    • Selection of comparison group in terms of
      • Internal comparison
      • External comparison
  • Comparison with general population rates
    • Follow up
    • Analysis

Question 6. Blinding.
Answer:

Blinding

  • In order to reduce the problem of bias a technique called blinding is adopted
  • It can be done in three ways
  • Single-blind trial
  • The trial is so planned that the participant is unaware of whether he belongs to the study group or the control group
  • Double-blind trial
  • The trial is so planned that neither the investigator nor the participant is aware of the group allocation and the treatment received
  • The most frequently used method
  • Triple blind trial
  • The participant, the investigator, and the person analyzing the data are all blind
  • Ideally used method

Question 7. Case-control studies
Answer:

Case-Control Studies

Case-Control Studies Features:

  • Both exposure and outcome occurred before the start of the disease
  • The study proceeds from effect to cause
  • It uses a control or comparison group to support to re-fuse a hypothesis

Selection Of Cases And Controls:

  • Selection of cases
  • Definition of a case
    • Diagnostic criteria: the diagnostic criteria of the disease and the stage of the disease to be included in the study must be specified before the study is under- taken
    • Eligibility criteria: only newly diagnosed cases within a specified period of time are eligible than old cases or cases in advanced stages of disease
  • Sources of cases
    • Hospitals
    • General population
  • Selection of controls
    • The control must be free from disease under study
    • They must be as similar to the case as possible
  • Sources of control
    • Hospital
    • Relatives
    • Neighbourhood
    • General population
  • Number of control
    • If many cases are available and a large study is contemplated, one tends to use one control for each case
    • If the study group is small, 2,3 or even 4 controls can be selected for each study subject

Case-Control Studies Matching:

  • Case-control studies Matching is defined as the process by which we select controls in such a way that they are similar to cases with regard to certain pertinent selection variables which is known to influence the outcome of the disease and which if not adequately matched for comparability could distort or confound the results
  • While matching it should be borne in mind that the suspected etiological factor or the variable we wish to measure should not be a match

Case-Control Studies Types:

  • Group matching
  • Pair matching

Case-Control Studies Measurement Of Exposure:

  • Obtained
  • Interviews
  • Questionnaires
  • Past records
  • Clinical or laboratory examination

Case-Control Studies Analysis:

  • Final step
  • Case-control studies Analysis is to find out
  • Exposure rates among cases and controls to suspected factor
  • Estimation of disease risk associated with exposure

Case-Control Studies Advantages:

  • Easy to carry out
  • Rapid and Inexpensive
  • Few subjects are required
  • Rare diseases can be studied
  • No risk to subjects
  • Allows study of several etiological factors
  • Risk factors can be identified
  • No attrition problems
  • Minimal ethical problems

Case-Control Studies Disadvantages:

  • Problem of bias
  • Selection of appropriate control group
  • Incidence cannot be measured
  • Not distinguishing between causes and associated factors
  • Not suited to the evaluation of therapy
  • The concern is the representativeness of cases and controls

Types Of Epidemiological Studies

Question 8. Descriptive epidemiology.
Answer:

Descriptive Epidemiology Steps:

Defining The Population To Be Studied:

  • The population has to be defined in terms of the total number and the composition of the individuals within the population in terms of characteristics such as age, sex, occupation, culture, socio-economic status
  • The defined population can either be the total population in a geographic area or a representative sample taken from the population
  • The defined population provides a denominator for calculating rates
  • The population of the community selected for the study should always remain stable, without migration into or out of the area

Defining The Disease Under Study:

  • The Disease should be precise and valid to enable the investigator to identify those who have the disease from those who do not
  • The disease needs to be defined with an operational definition which is a definition with which the disease or condition can be identified and measured in the fined population with a degree of accuracy
  • The diagnostic methods adopted for the study should be acceptable and applicable to the population to be studied

Describing The Disease Under Study

  • This step is used to describe the occurrence and distribution of the disease by the time of its occurrence, the place of occurrence, and the persons who are affected by the disease

Time Distribution:

  • Time may be measured in terms of hours, days, weeks, months, years, etc.
  • Types
    • Short-term fluctuation ex. Epidemic
      • Common source epidemic
      • A single exposure or point source epidemic. Example: Food poisoning
    • Continuous or multiple exposure. Example: Contaminated water
  • Propagated epidemic
    • Person-to-person transmission
    • Arthropod vector
  • Animal reservoir
    • Periodic fluctuation
    • Seasonal trends: ex. Measles and varicella
    • Cyclic trends.
    • Certain diseases appear in cycles, which may spread over short periods of time like days, weeks, months, or years Example: Automobile accidents
  • Long term fluctuation
    • Implies changes in the occurrence of disease over a long period of time, generally several years.
    • Example: Lung cancer

Place Distribution:

  • Variation in the frequency of different diseases from place to place has long been identified
    • There exist differences in the incidence of various diseases in different parts of the world
    • Example: Stomach cancer is very common in Japan and usual in the USA
  • National variation
    • Distribution of endemic goiter, fluorosis, leprosy, and malaria have shown variation in their distribution in India
  • Urban and rural variation
    • Chronic bronchitis, lung cancer, and CVS disorder are more common in urban than rural areas
  • Local distribution
    • Inner and outer city variations in disease frequency are well-known

Person Distribution:

  • The factors that influence the disease pattern in an individual are
    • Age:
    • certain diseases are more frequent in certain age groups
    • Sex: obesity is common in females while lung cancer in males
    • Ethnicity
    • Marital status
    • Occupation
    • Social class
    • Behavior
    • Stress
    • Migration

Measurement Of Disease:

  • The measurement of disease is done in terms of mortality and morbidity indicators
  • The morbidity is expressed in terms of incidence and prevalence

Comparing With Known Indices:

  • Comparing With Known Indices helps to conclude the disease. The total number of all individuals who have an attrib- etiology
  • Identify groups and subgroups which are potentially at high risk for the development of certain diseases

Formulation Of An Etiological Hypothesis:

  • Formulation Of An Etiological Hypothesis is defined as “a supposition arrived at by observation or by reflection”
  • The formulation Of An Etiological Hypothesis can be tested using the techniques of analytical epi- epidemiology after which it may be accepted or rejected
  • V should specify the population, specific cause, and example. pected outcome, dose-response relationship and
  • time response relationship

Principles Of Epidemiological Methods

Question 9. Case-control studies
Answer:

Case-Control Studies

  • In it, the same individuals are examined on repeated occasions over a prolonged period using follow-up examination

Case-Control Studies Uses:

  • Study the natural history of the disease & its outcome
  • Identify the risk factor associated with the disease
  • Calculate the incidence rates of the disease

Case-Control Studies Disadvantage:

  • Difficult to organize
  • More time consuming

Epidemiological Methods Short Question And Answers

Question 1. Attributable risk (AR).
Answer:

Attributable risk (AR)

  • Attributable risk is often expressed as a percent
  • Attributable risk indicates to what extent the disease under study can be attributed to the exposure
  • AR= Incidence of disease rate among exposed Inci- dence of disease rate among non-exposed/Incidence rate among exposed

Question 2. Cohort Studies.
Answer:

Cohort Studies Features:

  • The cohorts are identified prior to the appearance of the disease under investigation
  • The study groups are observed over a period of time to determine the frequency of the disease among them
  • The disease proceeds forward from cause to effect

Cohort Studies Indications:

  • When a good association occurs between exposure & disease
  • When exposure is rare
  • When attrition of the study population can be minimized
  • When ample funds are available

Cohort Studies Types:

  • Prospective
    • Retrospective
    • Combination

Question 3. Cohort.
Answer:

Cohort

  • Thus a group of people born on the same day or in the same period of time form a “birth cohort”
  • which the cohort is derived or it may be another cohort. It can be represented by the formula little or no exposure to the substance in question

Question 4. Single-blind trial.
Answer:

Single-Blind Trial

  • In order to reduce the problem of bias a technique called blinding is adopted
  • Single-blind trial
  • The trial is so planned that the participant is unaware of whether he belongs to the study group or the control group

Question 5. Long-term/secular trends.
Answer:

Long-Term/Secular Trends

  • It refers to changes in disease frequency that occur gradually over a long period of time generally several years or decades
  • Examples: Coronary heart disease, lung cancer & diabetes
  • Oral cancer has shown a consistent upward trend during the last 50 years in developed countries

Question. 6. Prevalence.
Answer:

Prevalence

The total number of all individuals who have an attribute or disease at a particular time divided by the population at risk of having the attribute or disease at this point in time or midway through the period

Prevalence Types:

  • Point prevalence
    • It is the number of all current cases of a specific disease at one point in time in relation to a defined population
  • Period prevalence
    • It is defined as the total number of existing cases of a specific disease during a defined period of time expressed in relation to a defined population

Prevalence Uses:

  • Estimate the magnitude of disease or health problems in the community
  • Identify the potential high-risk population
  • Useful in administrative & planning purposes like assessing manpower needs in health services, etc

Question 7. Parkinsonian Bias.
Answer:

Parkinsonian Bias

  • Parkinsonian Bias is named after Dr. Joseph Berkson
  • Parkinsonian Bias arises when there are differences in admission rates of people in hospitals with different diseases
  • The causes of bias include the burden of symptoms, ac- TELESCOPIC BIAS: cess to care & popularity of certain institutions
  • It is more common in observational studies, particularly in case-control studies

Question 8. Bias.
Answer:

Selection Bias:

  • Selection Bias occurs when a group studied does not reflect the same characteristics like age, sex, occupation, race, etc as in the general population

Interviewer’s Bias:

  • Interviewer’s Bias occurs when there is an error in the classification of individuals with respect to the outcome variable

Confounding Bias:

  • Confounding Bias occurs when other factors that are associated with the outcome & exposure variables do not have the same distribution in the exposed & unexposed groups
  • Confounding Bias can be removed by matching

Berkesonian Bias:

  • Berkesonian Bias arises when there are differences in admission rates of people in hospitals with different diseases

Information Bias:

  • Information Bias occurs when the interviewer knows the hypothesis & also knows who the cases are

Memory Bias:

  • When the cases & controls are asked questions about their history it may be more likely for the cases to recall the existence of certain events or factors than the controls who are healthy persons

Telescopic Bias:

  • If a question refers to the recent past, episodes that occurred longer ago may also be reported

Prevalence-Incidence Bias:

  • If the exposure occurred years before, then mild cases that improved or severe cases that died would have been missed & not counted among the cases

Uses Of Epidemiological Methods

Question 9. Double-blind trial.
Answer:

Double-Blind Trial

  • In order to reduce the problem of bias a technique called blinding is adopted
  • Triple blind trial
  • The participant, the investigator & the person analyzing the data are all blind
  • Ideally used method

Question 10. Randomized trial.
Answer:

Randomized Trial Steps:

  • Drawing up a protocol
  • Selecting reference & experimental population
  • Randomization
  • Manipulation or intervention
  • Follow up
  • Assessment of outcome

Randomized Trial Types:

  • Clinical trials
    • Prophylactic trials
    • Therapeutic trial
    • Safety trial
    • Risk-factor trial
  • Preventive trial
  • Risk factor trials
  • Cessation experiments
  • Trial of etiological agents
  • Evaluation of health services
  • Community intervention trial

Question 11. Confounding factor.
Answer:

Confounding Factor

  • A confounding factor is defined as one that is associated both with the exposure & disease & is unequally distributed in study & control groups
  • A confounding factor is one that although associated with exposure under investigation is itself independent of any such association, a risk factor for the disease
  • Example: role of alcohol in the etiology of esophageal cancer
  • Smoking is a confounding factor because
  • A confounding factor is associated with the consumption of alcohol
  • A confounding factor is an independent risk factor for esophageal cancer

Epidemiological Methods Viva Voce

  1. Prevalence incidence mean duration
  2. The epidemic is the best example of short-term fluctuations
  3. Cohort studies are also called longitudinal studies
  4. A confounding factor is associated with both exposure and disease
  5. Carriers of avirulent organisms are called pseudo-carriers
  6. The science of the health of travelers is called emporia tics
  7. John Snow is the father of epidemiology
  8. Case-control study begins with the identification of jects with a specific disease and studies for risk factors
  9. Case-control studies proceed backward from effect to cause. So it is also known as a retrospective study
  10. In a cohort study, a group of the population who has been exposed to a risk factor is identified and followed over an extended period
  11. A cohort study proceeds from cause to effect so it is known as a prospective study.
  12. Panel study is another name for cohort study. Total number of cases of disease at a given time Estimated total population
  13. Prevalence =\(\frac{\begin{array}{c}\text { Total number of cases } \\\text { of disease at given time }\end{array}}{\begin{array}{c}\text { Estimated total population } \\\text { at same time }\end{array}} \times 100\)
  14. Incidence =\(\frac{\begin{array}{c}\text { Number of new cases of } \\\text { specific disease at given time }\end{array}}{\text { Population at risk }} \times 100\)
  15. Cross-sectional study measures the disease to assess the association between risk factors and disease
  16. The case-control study measures the prevalence of the disease
  17. In cross-sectional studies, different individuals of a particular group are studied only once
  18. In longitudinal studies, the same individual is studied at different ages
  19. Berkonsian bias occurs due to different rates of admission to hospitals for people with different diseases
  20. Confounding bias is reduced by matching
  21. Selection bias is controlled by the prevention
  22. The interviewer’s bias is eliminated by double-blinding
  23. Cross-sectional studies are useful for chronic diseases
  24. Hippocrates is the Father of medicine
  25. Alfred Fones is the Father of dental hygiene.