Community Dentistry

Health Education Definitions

Health Education

• Health education is a process that informs, motivates & helps people to adopt & maintain healthy practices & lifestyles, advocates environmental changes as needed to facilitate this goal & conducts professional training & research to the same end

Community Dentistry

• It is concerned with dental disease prevention & dental health care services to all the people of the community, the rich, the poor, the educated, the disadvantaged, middle class, urban & rural persons of every racial, religious & ethnic group

Propaganda

• It is a publicity campaign aimed at presenting a particular thing/ concept in a favorable light in such a way that the public may accept it without thinking about it analytically

Health Education Important Notes

1. Principles of health education

• Credibility:
• Interest
• Participation
• Motivation
• Comprehension:
• Reinforcement
• Learning by doing:
• Known to unknown
• Setting an example
• Good human relation
• Feedback
• Leaders

2. Soil, seed, sower

It forms the important components of any health education program All components are interdependent and result in dynamic interaction

3. Approaches to health education

1. Individual approach
   • Personal contact
   • Personal letters
   • Home visits
2. Group approach
   • Lecture
   • Demonstration
   • Discussion methods
   • Group discussion
   • Panel discussion
   • Workshop
   • Symposium
   • Seminars and conferences
   • Role-playing
3. Mass media
   • TV
   • Radio
   • Newspapers
   • Printed material
   • Direct mailing
   • Posters, billboards, signs
   • Health museums and exhibitions
   • Folk media
   • Internet
   • Mobile

Health Education Long Essays

Question 1. Define Health education. Write about principles. of health education, discuss the role of mass media in educating people at large (or) Define health education. Write in detail about the principles of health education (or) Define health education. Give your plan for educating the population of Andhra Pradesh on the prevention of dental diseases.
Answer:

Health Education Definition:

• Health education is a process that informs, motivates & helps people to adopt & maintain healthy practices & lifestyles, advocates environmental changes as needed to facilitate this goal & conducts professional training & research to the same end

Health education Principles:

Health education Credibility:

Health education Interest:

• The health educator should identify the felt needs of the people
• Health education should relate to the interest of the people

Health education Participation:

• The health educator should encourage people to participate in the program
• Group discussions, panel discussions, and workshops all provide opportunities for active learning

Health education Motivation:

Health education Definition: the fundamental desire for learning in an individual

Health education Types: primary & secondary

• Primary motive: inborn desires. Ex. Food, clothing, housing
• Secondary motives: desires resulting from outside forces. Ex. Gifts, love, word of praise, reward
• Health education can be facilitated by the motivation provided by the desire to achieve individual goals

Health education Comprehension:

• The health educator must know the level of understanding, education & literacy of people
• Words that are strange/ new to the people should not
• Teaching should be within the mental capacity of the audience

Health education Reinforcement:

• Repetition of new concepts done at regular intervals helps people to understand it

Health education Learning by Doing:

• If the learning process is accompanied by doing new things, it is better instilled in the minds of the people
• It is based on the famous Chinese proverb, “If I hear, I forget, if I see, I remember, if I do, I know”

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Health education Known to Unknown:

• Health education should start where the people are & with what they understand & then proceed to new knowledge

Health education Setting an Example:

• The health educator should set an example for other people to follow

Health education Good Human Relations:

• The health educator must be kind, sympathetic & should have good personal qualities

Health education Feedback:

• It is necessary to find out if any modifications are needed

Health education Leaders:

• If the leaders are convinced first about the program, then implementing the program will be easy as they are respected by the people of the community

Health education Soil. seed & Sower:

• The people are the soil
• Seeds: health facts- must be truthful
• Sower: transmitting media- should be attractive, pal- a table & acceptable

Health education Role of Mass Media:

Useful in transmitting messages to people even in remote areas

• It can reach a large number of people
• People of all socio-economic statuses irrespective of their caste, creed & religion have access to health education
• The effectiveness can give high returns for the time & money involved.

Question 2. Define community dentistry. What are the dif- be used different methods for mass communication? (or) Public health approach/mass approach
Answer:

Community dentistry Definition:

• It is concerned with dental disease prevention & dental health care services to all the people of the community, the rich, the poor, the educated, the disadvantaged, middle class, urban & rural persons of every racial, religious & ethnic group

1. Mass Approach:

• Most common & effective approach

community dentistry Advantage:

• Reaches a large number of people
• Useful for people irrespective of their socio-economic status, caste, creed, or religion.

community dentistry Disadvantage:

• One-way communication
• Media

Mass Communication:

Question 3. Define Health education. What are the different approaches in health education? Discuss the most common & effective approach used.
Answer:

Health Education Definition:

• Health education is a process that informs, motivates & helps people to adopt & maintain healthy practices & lifestyles, advocates environmental changes as needed to facilitate this goal & conducts professional training & research to the same end

Approaches In Health Education:

Individual Approach:

• It is used by public health personnel like public health Advantage: nurses, health visitors & health inspectors
• They interact with the individual & their families

Health education Advantage:

• Can be done in the dentist’s consultation room
• Can discuss, argue & persuade the individual to change the Disadvantages of his behavior
• Provide the opportunity for the individual for asking questions & clear doubts

Health education Disadvantage:

• The number we reach is small

Health Education Group Approach

• An effective way of educating the community
• Methods

Health Education Mass Approach

• Most common & effective approach

Health education Advantage

• Reaches a large number of people
• Useful for people irrespective of their socio-economic status, caste, creed, or religion.

Health education Disadvantage

• One-way communication

Media:

• Refer to the previous question

Health Education Short Essays

Question 1. Differentiating between health education & Health education should relate to the interest of the propaganda.
Answer:

Difference between Health education and propaganda

Question 2. Visual aids to health education.
Answer:

• It helps individuals to understand better

Classification:

Question 3. Barriers to communication/ health education.
Answer:

Psychological:

• Emotional disturbances, depression, or neurosis
• When interacting with individuals with these problems, special methods & utmost care should be adopted

Physiological:

• Include difficulties in self-expression, difficulties in hearing/seeing, difficulties in understanding
• While educating them specific media of communication should be selected

Environmental:

• Including excessive noise, difficulties in vision & congestion
• Overcome by making small groups

Cultural:

• It depends on levels of knowledge & understanding, customs, beliefs, attitudes

Question 4. Models of health education.
Answer:

Medical Model:

• It is concerned with the identification & treatment of diseases & technological advances to facilitate this process
• This medical information is provided to people
• But as it doesn’t give importance to the social, cultural & psychological factors it couldn’t succeed

Motivation Model:

• To make the health information effective, the individual is motivated to put it into action

Social Intervention Model:

• This model describes the importance of social environment besides focusing on an individual’s health

Question 5. Contents of health education.
Answer:

Human Biology:

• Children are taught about
• Parts of the human body & their functions
• Importance of good health
• Need for exercise, adequate rest & sleep
• Adverse habits like smoking, alcohol
• Methods of first aid

Nutrition:

• People should be taught about
• Nutritive value of foodstuffs
• Effect of nutrition on health
• Optimum & balanced diet

Hygiene:

• People are taught about
• The impotence of hygiene & methods of maintaining it

Aspects:

• Personal hygiene
• Environmental hygiene
  • Domestic hygiene
  • Community hygiene

Family Health Care:

• It is to strengthen & improve the family health espe- cially maternal oral health to improve the oral health of the child

Control Of Communicable & Non-Communicable Diseases:

• It is to provide knowledge about common signs & symp- Q. 1. Chalk and talk method. toms of disease & their prevention

Prevention Of Accidents:

• People are taught about basic safety rules & use of mouth guards while doing sports to prevent oro-facial trauma

Use Of Health Services:

Question 6. Educational aids.
Answer:

Educational aids

• Suitable for group
• Effective when used in a good environment with good light. Each speaker presents as aspect of the subject briefly ing, ventilation, temperature & comfortable seating

Auditory Aids:

• Based on the principles of sound, electricity & magnetism

Aids:

• Megaphones, gramophones, tape recorders, radio, sound amplifier
• Advantage
• Can reproduce any kind of spoken words
• Used for entertainment & mass communication

Visual Aids:

• It helps individuals to understand better
• Classification

Combination Of Audio-Visual Aids:

• It creates a better presentation as it combines both sound & sight
• It includes
  • Television
  • Tape & slide combination
  • Video cassette players & recorder
  • Motion pictures or cinemas

Health Education Short Question And Answers

Question 1. Chalk and talk methods
Answer:

Chalk and talk methods

• It is a method of group health education method
• Consists of an opening statement giving the theme of the lecture
• In it, the group should not exceed more than 30 people
• Duration should not exceed 15-20 minutes
• It should be based on the topic of people’s interest

Question 2. Symposium.
Answer:

Symposium

• It comprises a series of speeches on a selected topic
• Each speaker presents an aspect of the subject briefly
• No discussion occurs among speakers
• In the end, the audience may ask questions & at last, the chairman makes a summary of the topic

Question 3. Motivation.
Answer:

Motivation

• Definition: the fundamental desire for learning in an individual
• Types: primary & secondary
• Primary motive: inborn desires. Ex. Food, clothing, housing
• Secondary motives: desires resulting from outside forces. Ex. Gifts, love, word of praise, reward
• Health education can be facilitated by the motivation provided by the desire to achieve individual goals

Question 4. Audio-visual aids.
Answer:

Audio-visual aids

• It creates a better presentation as it combines both sound & sight
• It includes
  • Television
  • Tape & slide combination
  • Video cassette players & recorder
  • Motion pictures or cinemas

Health Education Viva Voce

1. A series of charts displayed one after the other before a group is a flip chart.
2. A series of speeches on a selected subject is a symposium.
3. A carefully prepared presentation to show how to perform a skill or procedure is called a demonstration
4. Mass media is an example of one-way communication
5. Health education failing as a result of illiteracy is due to cultural barrier
6. Health education differs from propaganda in develop- ing reflective behavior
7. The Chinese proverb ” If I hear, I forget, if I see I remember, if I do I know” illustrates learning by doing the principle of health education.
8. Education can be given only to people who come in contact with an individual approach is it limitation.

Nutrition In Health And Disease Definitions

Balanced diet

• A balanced diet contains a variety of foods in such quantities & proportions that the need for energy, amino acids, vitamins, minerals, fats, carbohydrates & other nutrients is adequately met for maintaining health, vitality & general well-being & also makes a small provision for extra nutrients to withstand the short duration of leanness

Nutrition:

• It is defined as the sum of the processes by which an individual takes in & utilizes food

Diet:

• It is defined as the types & amounts of food eaten daily by an individual

Malnutrition:

• It is the pathological state resulting from a relative/ absolute deficiency or excess of one/ more essential nutrients.

Nutrition In Health & Disease Important Notes

1. Fat-soluble vitamins

2. Water-soluble vitamins

Nutrition In Health & Disease Short Essays

Question 1. Trace elements.
Answer:

Trace elements

• WHO has recognized 14 trace elements
• They are
• Iron
• Zinc
• Copper
• Manganese
• Silicon
• Molybdenum
• Iodine
• Cobalt
• Tin
• Fluorine
• Chromium
• Nickel
• Selenium
• Vanadium

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Question 2. Fat-soluble vitamins.
Answer:

Fat-soluble vitamins

Nutrition In Health & Disease Short Question And Answers

Question 1. Molybdenum & dental caries.
Answer:

Molybdenum & dental caries

• Molybdenum is cariostatic
• Thus it reduces the acid solubility of calcified dental tissues

Question 2. Vitamin K.
Answer:

Vitamin K

Question 3. Balanced diet.
Answer:

Balanced diet

• A balanced diet contains a variety of foods in such quantities & proportions that the need for energy, amino acids, vitamins, minerals, fats, carbohydrates & other nutrients is adequately met for maintaining health, vitality & general well-being & also makes a small provision for extra nutrients to withstand the short duration of leanness
• It contains

Question 4. Vitamin D.
Answer:

Vitamin D

 

Question 5. Vitamin B complex.
Answer:

Vitamin B complex

Question 6. Enumerate nutritional problems in public health.
Answer:

Nutritional problems in public health

• Low birth weight
• Protein-energy malnutrition
• Xerophthalmia
• Nutritional anemia
• Iodine deficiency disorder
• Endemic fluorosis
• Lathyrism

Question 7. Define Diet, Nutrition, and Malnutrition.
Answer:

Diet:

• It is defined as the types & amounts of food eaten daily by an individual

Nutrition:

• It is defined as the sum of the processes by which an individual takes in & utilizes food

Malnutrition:

• It is a pathological state resulting from a relative/absolute deficiency or excess of one/ more essential nutrients.

Nutrition In Health & Disease Viva Voce

1. 14 trace elements are recognized
2. Vitamins A, D, E, and K are fat-soluble vitamins
3. Vitamins B and C are water-soluble vitamins
4. Vitamins and minerals are referred to as micronutrients
5. Vitamin A deficiency is the single most frequent cause of blindness among preschool children in developing countries
6. Milk and egg proteins have all essential amino acids so are considered biologically complete food.

Environment And Health Definitions

Garbage

• It means discarded vegetable matter from kitchens, canteens, etc.

Sullage – Refers to fluid waste from a kitchen unmixed with excrement

Water sewage – Refers to wastewater from households, industries, etc containing human excreta

Refuse – It is all solid and semi-solid waste matters of a community except excrement

Breakpoint chlorination

• The point where the addition of chlorine to water results in the appearance of free residual chlorine is called break-point chlorination

Environment & Health Important Notes

1. Biological wastes

Categories of biomedical wastes

Color coding

2. Methods of disposal of solid wastes

1. Dumping – Refuse is dumped in low-lying areas
2. Controlled tipping- Material is placed in a trench
3. Incineration- It is the best method for the disposal of healthcare
4. Composting- It is the process of nature where matter breaks down under bacterial action resulting in the formation of humus-like material called compost
5. Manure pits- Manure pits are dug by individual householders to dump the garbage
6. Burial – A trench is excavated and at the end of each day the trench is filled with earth and compacted

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3. Composting is a method wherein sludge is combined with solid wastes to produce manure-quality material

• There are two commercial methods of composting

1. Bangalore method

• It is a natural hot fermentation process in which trenches are dug and filled alternatively with refuse and excreta

2. Mechanical method

• It involves pulverization of raw materials and mixing with sludge.

4. Incineration

• It is a high-temperature dry oxidation process that reduces organic and combustible waste to inorganic, incom- combustible matter resulting in a significant reduction of waste volume and weight
• Types
  • Double-chamber pyrolytic incinerators
  • Single chamber furnaces
  • Rotary kilns
• Incineration is the choice of disposal for the following wastes
  • Human anatomical waste
  • Animal waste
  • Microbiology and biotechnology waste
  • Discarded medicines and cytotoxic drugs
  • Contaminated solid wastes
• Wastes that should never be incinerated are
  • Amalgams
  • Latex gloves
  • Lead wastes
  • PVC plastics

5. Loss of head

• As filtration proceeds, the suspended impurities and bacteria clog the filters and they soon become dirty and
• begin to lose their efficiency
• This is known as loss of head
• When the loss of the head approaches 7-8 feet, filtration is stopped and subjected to backwashing.

Environment & Health Long Essays

Question 1. Describe in detail the small-scale purification.
Answer:

Small-Scale Purification:

Environment & Health Short Essays

Question 1. Principles of chlorination.
Answer:

Principles of chlorination

• The water to be chlorinated should be clear & free from turbidity
• The chlorine demand of the water should be estimated
• The point at which the chlorine demand of the water is met is called the “breakpoint”
• If further chlorine is added, free chlorine begins to appear in the water
• The free residual chlorine should be present for a contest 1 hour to kill bacteria & viruses
• The minimum recommended concentration of free. It is defined as water that is chlorine is 0.5 mg/L for 1 hour
• The correct dose of chlorine to be applied = chlorine de- mand of water + free residual chlorine.

Question 2. Occupational hazards for dentists.
Answer:

Occupational hazards for dentists

Question 3. Potable water.
Answer:

Potable water

• It is defined as water that is
  • Free from pathogens
  • Free from harmful chemicals
  • Pleasant to taste
  • Usable for domestic needs
• Requirements:
  • Must be close to the people as its transportation may lead to pollution
  • The basic requirement at about 2 L/head/day
  • A daily supply of 150-200 L/capita is considered adequate to meet the domestic needs of the urban population
• Uses
  • Domestic purposes: drinking, cooking
  • Public purposes: cleaning streets & fire protection
  • Industrial purposes: factories
  • Agricultural purposes: irrigation

Question 4. Disposable of hospital waste.
Answer:

Hospital Waste Methods:

Hospital Waste Dumping:

• Waste/refuse is dumped in low-lying areas
• It is a suitable method for the reclamation of land
• As a result of bacterial action, refuse decreases consist of each day the erably in volume & is converted gradually into humus

Hospital waste Controlled Tipping:

• Here, the material is placed in a trench or other pared area, adequately compacted & covered with earth at the end of the working day

Hospital Waste Methods:

Hospital Waste Trench Method:

• A long trench is dug out 6-10 feet deep & 12-36 feet wide into which refuse is compacted & covered with caveated earth
• Ramp method
• Moderately sloping terrain is used Area method
• The refuse is deposited & sealed on its exposed face with a mud cover
• Changes occurring in refuse raise the temperature to 60 degrees C within 7 days & kill all the pathogens

Hospital Waste Incineration:

• By it, the refuse is reduced to 1/4th its original weight & the residue is called “clinker” and used for road making
• The incinerator consists of:
• A furnace
• A platform: for tipping refuse
• Baffle plate: to drive out all fumes

Hospital waste Types:

• Double cell Meldrum
• Single-cell destructor

Hospital waste Composting:

• It is a process of nature where matter breaks down under bacterial action resulting in the formation of relatively stable humus-like material called compose
• The compost formed contains few or no disease-producing agents
• The heat produced destroys all pathogens

Hospital waste Manure pits

• Dug by individual householders to dump garbage& other waste & covered with earth after each day’s dumping

Question 5. Rapid sand filtration.
Answer:

Rapid sand filtration

Types:

1. Gravity type
2. Pressure type

Steps:

Coagulation:

• Raw water is first treated with chemical coagulants such as alum

Rapid Mixing:

• The water is then violently agitated in a “mixing chamber” for a few minutes

Flocculation:

• It involves slow & gentle stirring of treated water in a “flocculation chamber” for 30 minutes

Sedimentation:

• The water is then led into sedimentation tanks & kept for 2-6 hours

Filtration:

• The water is then subjected to filtration

Question 6. Composting.
Answer:

Composting

Methods:

Bangalore/Anaerobic/ Hot Fermentation Process:

• Trenches are dug 3 feet deep, 5-8 feet broad, 15-30 feet long & located at least 800 m away from the city limits
• First, a layer of refuse is spread followed by nightsoil
• Similarly, alternate layers of refuse & nightsoil are added till the heap rises 1 foot above the ground level
• The top layer should be of refuse, at least 9 inches in thickness which is covered with excavated earth & compacted
• Within 7 days, considerable heat is generated which persists over 2-3 weeks
• Duration: 4-6 months
• Result
• The resulting material is a well-decomposed, odorless, nocuous material of high-manured value

Mechanical/ Aerobic Method:

• The refuse is first cleared of salvable material
• Then pulverized in pulverizing equipment
• The pulverized refuse is then mixed with sewage, sludge, or night soil in a rotating machine & incubated
• Duration: 4-6 weeks

Question 7. Elements of a slow sand filter.
Answer:

Supernatant Water:

• Depth: 1-1.5 m above the sand bed
• Purposes
  • Provides constant head of water
  • Provides a waiting period of some hours for the raw water

A Bed of Graded Sand:

• Thickness: about 1 m
• The sand bed is supported by a layer of graded gravel
• Water percolates through the sandbed very slowly
• Then it is subjected to mechanical straining, sediments bacterial action

Under Drainage System:

• Consist of porous/ perforated pipes
• Purpose
• Provides an outlet for filtered water
• Support filter medium above

Filter Control:

• It maintains a constant rate of filtration
• The venturi meter is used to measure the loss of head/ bed resistance
• When the resistance builds up the operator opens the regulating valve to maintain a steady rate of filtration

Question 8. Incineration
Answer:

Incineration

• It is a high-temperature dry oxidation process that duces organic and combustible waste to inorganic, combustible matter resulting in a significant reduction of waste volume and weight

Incineration Types

• Double-chamber pyrolytic incinerators
  • Single chamber furnaces
  • Rotary kilns
• Incineration is the choice of disposal for the following wastes
  • Human anatomical waste
  • Animal waste
  • Microbiology and biotechnology waste
  • Discarded medicines and cytotoxic drugs
  • Contaminated solid wastes
• Wastes that should never be incinerated are
  • Amalgams
  • Latex gloves
  • Lead wastes
  • PVC plastics

Environment & Health Short Question And Answers

Question 1. Compositing.
Answer:

Compositing

• It is a process of nature where matter breaks down un- der bacterial action resulting in the formation of relatively stable humus-like material called compose
• The compost formed contains few or no disease-producing agents
• The heat produced destroys all pathogens
• By-products: carbon dioxide, water, heat

Methods: Bangalore method, mechanical composting

Question 2. Backwashing.
Answer:

Backwashing

• Rapid sand filters need frequent washing daily/weekly depending upon the loss of head
• Washing is accomplished by reversing the flow of water through the sand bed-back washing
• Washing is stopped when the wash water is sufficiently clean
• Compressed air is used

Backwashing Effects:

• Dislodges the impurities
• Cleans the sand bed

Duration of Process: 15 minutes

Question 3. Loss of head.
Answer:

Loss of head

• When the filtration proceeds the suspended impurities & bacteria clog the filter
• This results in their reduced efficiency called “loss of head”

Effects:

• Filters soon become dirty
• When “loss of head” approaches 7-8 feet, filtration is stopped
• Filters are subjected to backwashing

Question 4. Vital layer.
Answer:

Vital layer Definition:

• It is the slimy growth covering the surface of the sand bed

Vital layer Synonym:

• Schmutzdecke, zoogleal layer, biological layer

Vital layer Components:

• Threadlike algae
  • Plankton
  • Diatoms
  • Bacteria

Vital layer Formation:

• The formation of the vital layer is known as the “ripening” of Disadvantages: filter
• It takes several days for the formation

Vital layer Significance:

• It is the heart of the slow sand filter
• Removes organic matter
• Holds back bacteria
• Oxidizes ammonical nitrogen into nitrates
• Purifies water

Question 5. Breakpoint chlorination.
Answer:

Breakpoint chlorination

• The fall in residual chlorine continues with a further increase in chlorine dose, until after a stage residual chlorine begins to increase in the proportion
• The point where the addition of chlorine to water results in the appearance of free residual chlorine is called breakpoint chlorination
• When the chlorine dose in the water is increased a reduction in the residual chlorine occurs

Question 6. The hardness of the water.
Answer:

The hardness of the water Definition:

• It is defined as the soap-destroying power of water

Hardness of the water Causes:

• Calcium bicarbonate
• Calcium sulfate
• Magnesium bicarbonate
• Magnesium sulfate

Classification of Hardness of the water:

• Carbonate/temporary hardness
• Non-carbonate/ permanent hardness

Expressed as: milliequivalent/L

The hardness of the water Removed as:

• Temporary hardness
  • Boiling
  • Addition of lime
  • Addition of sodium carbonate
  • Permutit process
• Permanent hardness
  • Addition of sodium carbonate
  • Base exchange process

Hardness of the water Disadvantages:

• Consumes more soap & detergent
• Causes furring of boilers
• Effects cooking
• Fabrics washed do not have a long life
• Results in economic losses
• Shortens the life of pipes & fixtures

Question 7. Sources of water.
Answer:

Sources of water

• Rain-main source
• Surface water
  • It ultimately flows into the sea
  • Impounding reservoirs- artificial lakes/ constructed dams
  • Rivers & streams: grossly polluted & unfit for drinking
  • Ponds & lakes: natural excavation
  • Sea water: contains 35% of salts in solution
• Groundwater: formed by percolated rainwater
  • Shallow wells: above the 1st impervious layer in the ground
  • Deep wells: below the 1st impervious layer in the ground
  • Tube wells: shallow/ deep, costly to construct & operate
  • Springs: shallow/deep, easily contaminated

Question 8. Controlled tipping.
Answer:

Controlled tipping

• Controlled Tipping
  • Here, the material is placed in a trench or other pared area, adequately compacted & covered with earth at the end of a working day
• Methods
• Trench Method
  • A long trench is dug out 6-10 feet deep & 12-36 feet wide into which refuse is compacted & covered with excavated earth
• Ramp method
  • Moderately sloping terrain is used
  • Area method
    • The refuse is deposited & sealed on its exposed surface with a mud cover
    • Changes occurring in refuse raise the temperature to 60 degrees C within 7 days & kill all the pathogens

Question 9. Waterborne diseases.
Answer:

Waterborne diseases

Question 10. Domestic refuse.
Answer:

Domestic refuse

• It consists of ash, rubbish & garbage
• Ash:
• It is the residue from the fire used for cooking & heating Rubbish:
• Comprises of wood bits, paper, clothing, metal, glass, dirt & dust
• Garbage:
• It consists of waste food, vegetable peeling & organic matter
• It needs quick removal & disposal because it ferments on storage

Environment & Health Viva Voce

1. The slimy growth covering the surface of the sand bed
2. Rapid sand filter is an earlier method of filtration where 99.9% of impurities are filtered out.
3. Clinical wastes are disposed of in yellow bags and non-clinical wastes are disposed of in black bags
4. Incinerators are used to burn all the combustibles at a temperature of 1300-1500 degrees C
5. Bangalore’s method of composting is anaerobic.
6. Occupational hazards to dentists result from accidental infection
7. Residual chlorine of water should be 0.5 mg/ltr after 1 hour
8. The temporary hardness of water is due to the presence of salts of calcium and phosphorous bicarbonates
9. Dumping is considered as most unsanitary method of waste disposal.
10. Waste sharps from hospitals should be discarded in
11. The heat produced over 60 degrees C in composting kills
12. Composting is a combined method of disposal of re-fuse and nightsoil.
13. Dumping is the most commonly used method of waste disposal posing a health hazard in India.
14. The hardness of water is expressed in terms of oil- equivalent per liter
15. The permanent hardness of water can be removed by base blue/white translucent bins. exchange process
16. Chlorination of water acts by killing pathogenic bacteria the pathogenic organisms.
17. Rainwater is the purest form of water

Practice Of Public Health Definitions

Public health:

It is the science & art of preventing disease, prolonging life & promoting physical & 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 & nursing services for the early diagnosis & preventive treatment of diseases.

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 & longevity- Winslow

Practice Of Public Health Important Notes

Procedural Steps in dental public health practice

• Survey
• Analysis
• Program planning
• Ethics
• Program operation

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• Financing
• Program appraisal

Practice Of Public Health Short Essays

Question 1. History of Public Health Dentistry
Answer:

History of Public Health Dentistry

Question 2. Procedural steps in dental public health.
Answer:

Dental Public Health Survey:

• It focuses on the population rather than the individual
• Surveys are methods for collection of data, analyzing & evaluating them to determine the number of disease problems in a community & also to identify cases that have not been identified
• It undergoes clinical assessments of the extent & severity of the disease

Dental Public Health  Analysis:

• It is done to define the characteristics of specific health problems in the community
• Here, the science of statistics is applied to achieve a correct diagnosis.
• Program Planning:
  • The public health professional would like to have the ideal program plan accepted with enthusiasm
  • It is the community that decides to accept- ing/reject the problem
  • Hence the community has to be well-informed about the program
• Program Operation:
  • The public health team constituting the professionals has to be employed to execute the program
• Financing:
  • It is a complicated mix of local, state & federal funds
  • Before starting the program public health personnel have to identify the source of funds & its management
• Program Appraisal:
  • It is made to assess the effectiveness of the public health program
  • The baseline data collected serves as an indicator of it
  • The dimensions used are efficiency, appropriateness, adequacy, possible side effects, etc.

Practice Of Public Health Short Question And Answers

Question 1. Medical indigence.
Answer:

Medical indigence

• It constitutes an inability to pay large bills for medical care
• This situation is chiefly found in the case of chronic diseases such as cancer as the treatment procedures are expensive
• As an aid to the medically indigent, the concept has arisen that health care is a right of citizenship & hence to be provided by the government to the extent available
• Public health dentistry makes oral health care available to every individual irrespective of their socio-economic status by obtaining governmental & non-governmental funding

Infection Definitions

Definition of Health: Health is a state of complete physical, mental & social well-being & not merely the absence of disease or infirmity

Agent Definition: It is defined as “an organism, a substance or a force, the presence or lack of which may initiate a disease process or may cause it to continue”

Host Definition: It is defined as “a person or an animal that affords subsistence or lodgement to an infectious agent under natural conditions

Sensitivity Definition: Defined as the ability of a test to identify correctly all those who have the disease i.e. true positive

Specificity Definition: Defined as the ability of a test to identify correctly those who do not have the disease i.e. true negative

Morbidity Definition: WHO has defined it as “any departure, subjective or objective, from a state of physiological well-being”

Mortality Definition: It is the condition of being mortal, or susceptible to death

Incubation Period Definition: It is the time interval between invasion by an infectious agent & appearance of the first sign or symptom of the disease in question

Risk Factor Definition: It is an attribute/ exposure that is significantly associated with the development of disease.

Latent Period Definition: It is a period between the disease initiation to the disease detection.

Disease Definition: Webster defined disease as “a condition in which the body’s health is impaired, a departure from a state of health, an alteration of the human body interrupting the performance of vital functions”.

Spectrum Of Disease Definition: It may be defined as the sequence of events that occur in the human host from the time of contact with the etio- logical agent upto the point of the ultimate outcome, which may be fatal in extreme cases

Carrier Definition: A carrier is defined as an infected person or animal that harbors a specific infectious agent in the absence of dis- credible clinical disease and serves as a potential source of infection for others.

Screening Definition: It is defined as the use of presumptive methods to identify unrecognized health risk factors or asymptomatic diseases in persons determined by prior studies to be potentially at elevated risk & able to benefit from interventions performed before overt symptoms develop.

Infection Important Notes

1. Screening for lung cancer includes two techniques: chest radiograph and sputum cytology
2. The main causes of maternal mortality rate are hemorrhage, sepsis, abortion, obstructed labor, and hypertensive disorders.
3. Modes of transmission of disease
   1. Direct Transmission
      • Direct contact
      • Droplet infection
      • Contact with soil
      • Inoculation into skin and mucosa
      • Transplacental
   2. Indirect Transmission
      • Vehicle borne
      • Vector-borne
      • Airborne
      • Fomite borne
      • Unclean hands and fingers

4. Various measures used to evaluate screening test

1. Sensitivity
2. Specificity
3. Positive predictive value
4. Negative predictive value

5. Positive predictive value indicates the probability of a patient with a positive result has the disease. Negative predictive- it is a test to correctly exclude the disease

6. Types of carriers:

1. Incubatory Carrier
   • These carriers shed infectious agents during the incubation period of the disease.
   • Examples: Measles, mumps, polio, pertussis
2. Convalescent Carriers
   • Shed the disease agent during the period of recovery from illness.
   • Examples: Typhoid, cholera, diphtheria
3. Healthy Carriers
   • Emerge from subclinical cases.
   • Examples: polio, cholera, diphtheria
4. Temporary Carriers
   • Shed the infectious agent for short periods of time.
   • Examples: incubatory, convalescent, and healthy carriers.
5. Chronic Carriers
   • Excretes the infectious agent for indefinite periods.
   • Examples: typhoid, hepatitis B, malaria, and gonorrhea.

Infection Long Essays

Question 1. Define Health. Enumerate the various environmental factors necessary for the maintenance of the general health of the individual.
Answer:

Health Definition: Health is a state of complete physical, mental & social well-being & not merely the absence of disease or infirmity

• The environment is the source of the agents of disease
  • It helps in the transmission of agents to the host
  • It may be favorable to the man & unfavorable to the agent or vice versa

Types Of Environments:

1. Internal Environment:

• It pertains to each & every component part, every tissue, organ & organ system & their harmonious functioning within the system
• Defect or deficiency in the functioning of one or more component parts results in disease of the individual

2. External Environment:

• It comprises all that is external to the individual human host
• It comprises of individual’s lifestyle
• When the individual is well-adjusted, he is in a state of health
• The imbalance of the body is responsible for disease

Components:

Physical Component: It comprises nonliving things & physical factors of man’s surroundings

3. Biological environment: It includes living things surrounding man including the man himself

4. Social environment:

• It comprises all human beings around man, their ac- activities & interactions
• It includes
  1. Social factors
     • It pertains to the society in which man lives
     • It affects the physical, mental & social state of man which he must adjust
  2. Economic factors
     • It determines the economic status of man
     • Low economic status means less diet, poor housing & fewer resources for medical aid

Infection Short Essays

Question 1. Epidemiological triad
Answer:

Epidemiological triad

1. The occurrence of any disease is determined by the interaction between the agent, host & environment con- stituting epidemiological triad

Agent:

• It is defined as “an organism, a substance or a force, the presence or lack of which may initiate a disease process or may cause it to continue”

1. It is classified as

• Biological agents: Example: bacteria, viruses, fungi
• Non-living agents
• Nutrient agents: Example: protein, fat, water

1. Chemical agents
   • External: lead, arsenic
   • Internal: urea, ketone
2. Physical agents: heat, cold, pressure
   • Mechanical agents: chronic friction
   • Social agents: smoking, poverty, isolation

Host:

• It is defined as “a person or an animal that affords subsistence or lodgement to an infectious agent under natural conditions

1. Host factors are classified as:

• Demographic characteristics: age, sex
• Biological characteristics: genetics, immunity
• Socio-economic characteristics: Education
• Lifestyles characteristics: living habits, food habits

Environment:

• It is a reservoir for the agent of diseases

Components: refer to the previous question

Question 2. Changing concepts of health.
Answer:

Changing concepts of health

1. Biomedical concept:

• According to it, health is viewed as an “absence of disease
• It is based on the Germ theory of disease
• This concept was found inadequate as it does not take into consideration environmental social & cul-subjective or cultural determinants of health

2. Ecological concept:

• According to it, health is viewed as a dynamic equilibrium between man & his environment & disease is a maladjustment of the human organism to the environment
• It focuses on imperfect man & imperfect environment

3. Psychosocial concept:

• According to it, health is influenced by social, psychological, cultural, economic & political factors

4. Holistic concept:

• It implies that all sectors of society have an effect on health
• Health implies a sound mind, a sound body, and a sound family, in a sound environment

Question 3. Sensitivity & specificity.
Answer:

Sensitivity:

• Introduced by Yerushalmy in the 1940s
• Defined as the ability of a test to identify correctly all those who have the disease i.e. true positive

Specificity:

• Defined as the ability of a test to identify correctly those who do not have the disease i.e. true negative

Inter-Relation

• Sensitivity may be increased only at the cost of specificity & vice versa

Significance:

• An ideal screening test should be 100% sensitive & 100% specific

Evaluation:

• Sensitivity(true positive) = a/(a+c)*100
• Specificity (true negative) = d/(b+d)*100
  • a = that individual found positive on the test who has the condition/disorder
  • b= those who have a positive test result but do not have the disease
  • c=hose with negative results but who have the disease
  • d = those with negative results but do not have the disease

Question 4. Morbidity & mortality. disease”
Answer:

Morbidity:

• WHO has defined it as “any departure, subjective or objective, from a state of physiological well-being”

1. It is based on

• Persons who are ill
• The illnesses/diseases these people experienced
• The duration of these illnesses/disease

2. Uses:

• Describe the extent & nature of the disease
• Provide more comprehensive, accurate & clinically relevant information on patient characteristics
• Serve as a starting point for etiological studies
• Monitor & evaluate disease control activities

3. Morbidity Rates:

• Incidence & prevalence
• Notification rates
• Attendance rates at the out-patient department
• Admission, readmission & discharge rates
• Duration of stay in hospital
• Spells of sickness/absence from work

Mortality:

• It is the condition of being mortal, or susceptible to death

1. Measures of Mortality:

• Crude death rate
  1. It is defined as “the number of deaths per 1000 people in a population in a given year”
     • Age-specific death rate
  2. It is the death rate specific to a given age group
     • Case fatality rate
  3. It represents the killing power of disease
     • Proportional mortality rate
  4. It is defined as “the number of deaths due to a particular cause per 100 or 1000 total deaths”

 

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Question5. Greek medicine.
Answer:

Greek medicine

• In Greek medicine, Hippocrates is called the “Father of medicine”
• He studied & classified diseases based on observation & reasoning
• The Hippocratic concept of health & disease stressed the relationship between man & the environment
• Greeks gave a new direction to medical thought
• They rejected the supernatural theory of disease & looked upon disease as a natural process, not a visitation from the God
• Hippocrates initiated the application of clinical methods in medicine

Question 6. Screening for oral diseases.
Answer:

Screening for oral diseases Definition:

• It is defined as the use of presumptive methods to identify unrecognized health risk factors or asymptomatic disease in persons determined by prior studies to be potentially at elevated risk & able to benefit from interventions performed before overt symptoms develop

Screening for oral diseases Criteria:

1. Acceptability:

• The screening test should be acceptable to the people at whom it is aimed
• Tests that are painful, discomforting, and embarrass- ing is not likely to be acceptable

2. Repeatability:

• The test must give consistent results when repeated more than once on the same individual/ material, under the same condition
• It depends upon observer variation, biological variation & errors relating to technical methods

3. Validity:

• It expresses the ability of the test to separate or dis- tinguish those who have disease from those who do not

Screening for oral diseases Uses:

• Case detection
• Control of diseases
• Research purposes
• It provides opportunities for public awareness

Question 7. Indicators of health.
Answer:

Indicators of health Uses:

• Measures the health status of a community
• Compare the health status of one country with that of another
• Assess the health care needs
• Allocate the scarce resources
• Monitor & evaluate health services
• Help to measure the extent of achievement of objectives of the programs

Indicators of health Characteristics:

• The ideal indicator should be
• Valid
• Reliable
• Sensitive
• Specific
• Feasible
• Relevant

Classification of Indicators of health:

• Mortality indicator
  • Crude death rate
  • Expectations of life
• Morbidity indicator
• Disability rates
  • Event-type indicator
  • Person-type indicator
• Nutritional status indicator
  • Anthropometric Measurement of preschool children
  • Heights of children at school entry
  • Prevalence of low birth weight
• Healthcare delivery indicator
  • Doctor-population ratio
  • Doctor-nurse ratio
  • Population-bed ratio
  • Population per health/subcentre
  • Population per traditional birth attendant
• Utilization rates
  • It is the proportion of people in need of a service who ac- actually receive it in a given period usually a year
• Indicators of social & mental health
• Environmental indicator
• Socio-economic indicator
  • Rate of population increase
  • Level of unemployment
  • Family size
• Health policy indicator
• Indicators of quality of life
  • Infant mortality
  • Life expectancy at age one
  • Literacy
• Other indicators
  • Social indicator
  • Basic needs indicator
  • Health for all indicator

Infection Short Question And Answers

Question 1. Determinants of health.
Answer:

The determinants of health include

1. Social and economic status:

• Higher income and social status are linked to better health
• The greater the gap between the richest and poor- est, the greater the differences in health

2. Education: Low education levels are linked with poor health, more stress, and lower self-confidence

3. Physical environment: Safe water and clean air, healthy workplaces, safe houses, and community and roads all contribute to good health

4. Personal behavior and coping skills: Balanced eating, keeping active, smoking, drinking, and how we deal with life’s stresses and challenges all affect health

Question 2. Risk factor.
Answer:

Risk factor

1. It means:

• An attribute/exposure that is significantly associated with the development of a disease
• The presence of a risk factor does not imply that the disease will occur & in its absence, the disease will not occur
• A combination of risk factors in the same individual may be purely additive/synergetic
• Risk factors may be truly causative or merely con- tributary or they may be predictive only in a statistical sense
• Some risk factors ex. Smoking can be modified while others like age, and sex cannot be modified

2. Significance:

• It will help in the prevention & intervention of disease
• It may characterize the individual, the family, the community & the environment

Question 3. A holistic view of health.
Answer:

A holistic view of health

• It implies that all sectors of society have an effect on health
• Health implies a sound mind, a sound body, and a sound family, in a sound environment

Question 4. Iceberg phenomenon.
Answer:

Iceberg phenomenon

According to the iceberg phenomenon, disease in a community may be compared to an iceberg

Tip Of Iceberg: Represents what the physician sees in the community i.e. clinical cases

1. Vast Submerged Portion:

• Represent latent, inapparent, presymptomatic & undiagnosed cases
• It is an important part as many inapparent infections can be transmitted & can produce disease in others

2. Water Line: It represents the demarcation between apparent & inapparent disease

Question 5. Sullivan index.
Answer:

Sullivan index

1. It is calculated by subtracting from the life expectancy the probable duration of bed disability & inability to perform major activities
2. It is based on cross-sectional data

Question 6. Incubation period.
Answer:

Incubation period

1. It is the time interval between invasion by an infectious agent & appearance of the first sign or symptom of the disease in question
2. An infection becomes apparent only after a certain incubation period
3. During the incubation period, the infectious agent undergoes multiplication in the host
4. When a sufficient density of the disease agent is built up in the host, the health equilibrium is disturbed & the disease becomes overt
5. It is the first stage of infectious disease
6. The incubation period of non-infectious disease may be months/years.

Question 7. True positive.
Answer:

True positive

1. It denotes those individuals found positive on the test, who have the condition/disease/ disorder being studied
2. It is denoted as ‘a in screening for diseases.

Question 8. Latent period.
Answer:

Latent period

1. It is defined as “the period from disease initiation to disease detection”
2. It is used in case of non-infectious disease as Incuba- the time period is used in case of infectious disease

Question 9. The germ theory of disease.
Answer:

The germ theory of disease

1. It proposes that the micro-organism are the cause of many diseases
2. Dr. John Snow contributed to the formation of it
3. It is generally referred to as the one-to-one relationship between causal agent & disease
   • Disease agent man→ disease
4. The emphasis had shifted from empirical causes to microbes as the sole cause of the disease

Question 10. A spectrum of disease.
Answer:

A spectrum of disease

1. It may be defined as the sequence of events that occur in the human host from the time of contact with the etiological agent upto the point of the ultimate out- come, which may be fatal in extreme cases
2. At one end of the disease spectrum are subclinical infections & at the other end are fatal illnesses
3. In the middle of the spectrum lie illnesses ranging in severity from mild to severe
4. The sequence of events in the spectrum of disease can be interrupted by early diagnosis & treatment or by preventive measures

Question 11. Define Health.
Answer:

Health

• Health is a state of complete physical, mental & social well-being & not merely the absence of disease or infirmity

Question 12. Define Disease.
Answer:

Disease

Webster defined disease as “a condition in which the body’s health is impaired, a departure from a state of health, an alteration of the human body interrupting the performance of vital functions”.

Question 13. World Health Day.
Answer:

World Health Day

• The Constitution of WHO came into force on 7th April 1948
• So it is celebrated as World health day
• Every year a theme is selected and global attention is focused on that particular theme
• World Health Day theme of 1994 focused on oral health as ” Oral health for a healthy Life”.

Infection Viva Voce

1. World health day is on 7th April.
2. Zoonotic describes a disease transmitted to man through animals.
3. The airborne source of infection is the most difficult to control.