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Chapter 06: Oral Health Programs in the Community
Beatty: Community Oral Health Practice for the Dental Hygienist, 4th Edition
MULTIPLE CHOICE
1. Which of the following set of terms describes dental caries?

a. Transmissible, acute, and preventable
b. Transmissible, chronic, and not preventable
c. Transmissible, chronic, and preventable
d. Transmissible, acute, and not preventable
ANS: C
Dental caries is a transmissible chronic disease that can be prevented.
DIF: Recall REF: p. 142 OBJ: 1

TOP: COMMUNITY HEALTH/RESEARCH PRINCIPLES 2.0 Participating in Community
Programs, 2.2 Designing, Implementing, and Evaluating Programs
2. School-based pit and fissure sealant programs reduced dental caries as much as what
percentage?
a. 50%
b. 60%
c. 70%
d. 80%
ANS: B
School-based pit and fissure sealant programs reduced dental caries as much as 60%.

3. Which of the following helps define a best-practice approach to oral health programs?
a. Practices that seem to be true over time
b. Practices seen in clinical practice
c. Practices that are supported by evidence for impact and effectiveness
d. The consensus of what clinicians believe is true
ANS: C
The Association of State and Territorial Dental Directors (ASTDD), Centers for Disease
Control and Prevention (CDC), and other organizations/agencies recognize best-practice
approaches to oral health programs in order to promote health equity and quality of life,
eliminate oral health disparities, and achieve improved oral health and consequently overall
health for all populations. The ASTDD defines a best-practice approach as a public health
strategy that is supported by evidence for its impact and effectiveness.
DIF: Comprehension REF: p. 143 OBJ: 2

4. Which of the following is the federal government’s principal agency for protecting the health
of all Americans?
a. Department of Health and Human Services (DHHS)
b. Food and Drug Administration (FDA)
c. National Institutes of Health (NIH)
d. Health Resources and Services Administration (HRSA)
ANS: A
DHHS is the federal government’s principal agency for protecting the health of all Americans.
DHHS is the largest grant-making agency in the federal government. DHHS works with state
and local governments and funds services at the local level through state or county agencies or
through private sector grantees. The rest of the choices are public health service operating
divisions of the DHHS.
DIF: Recall REF: p. 143 OBJ: 1|8

5. Approximately what percentage of the states have full-time dental directors who provide
leadership and guidance in the planning, funding, and implementation of oral health
promotion programs for the residents of the states they serve?
a. 50%
b. 66%
c. 88%
d. 95%
ANS: B
State dental directors provide leadership and guidance for the state oral health programs
(SOHP). Approximately 88% of state dental directors are full time, representing a significant
increase in the number of states with full-time dental directors in the last decade. In addition
to the state dental directors, SOHPs employ regional dental directors, public health educators,
clinical dentists, dental hygienists, and dental assistants who provide oral health services to
underserved populations.

6. Many individual county and city health departments have federally funded clinics that offer
services on a sliding scale fee schedule and accept clients who receive public assistance
through which of the following?
a. Medicare
b. Medicaid
c. The U.S. Department of Agriculture (USDA)
d. Workforce development
ANS: B
Many of these clinics are federally funded, offering services on a sliding scale fee schedule
and accepting clients who receive public assistance through Medicaid. Hours of clinic
operation are tailored to best meet the needs of the population they serve. The clinics provide
diagnostic, preventive, and restorative oral health services to older adults, the indigent
population, and the working poor. In addition, some of these clinics operate sealant, oral
health education, and other preventive programs in local schools.
DIF: Recall REF: p. 1 45 OBJ: 1|8

7. Which of the following is true of essential public health services for oral health?
a. Describes the roles of a community initiative
b. Developed by the environmental protection agency (EPA)
c. Used in the development and evaluation of public health activities at the state level
ANS: C
The core public health functions (assessment, policy development, and assurance) and the
essential public health services to promote oral health developed by ASTDD shape the basic
practice of dental public health. These guidelines describe the roles of state oral health
programs and have been used in the development and evaluation of public health activities at
the state level.

8. An oral health coalition is which of the following?

a. A division of the Department of Labor
b. A cooperative effort on the part of many individuals and organizations to build
systems and develop programs that improve community health
c. A collaboration between dental schools and dental hygiene programs
d. A yearly event that provides care for low-income individuals with no out-of-pocket
expense
ANS: B
An oral health coalition is a cooperative effort on the part of many individuals and
organizations to build systems and develop programs that improve community health.. SOHP
depend on oral health coalitions and community advocates to implement and promote
comprehensive oral health services in the state and local communities to improve the oral
health and overall health for people of all ages.

9. The community is viewed as the patient in public health, and which of the following can be
compared with the evaluation of the patient’s treatment?
a. Assessment
b. Planning
c. Implementation
d. Evaluation
ANS: D
Evaluation and review of the program can be compared with the evaluation of the patient’s
treatment. The community survey is comparable to the patient’s examination for assessment.
The program plan and implementation are similar to the treatment plan and the treatment of
the patient.

10. Which of the following is true of implementation?

a. An organized and systematic approach to identify a target group and to define the
extent and severity of oral health needs present
b. An organized response to reduce or eliminate one or more problems
c. Includes the process of putting the plan into action and monitoring the plan’s
activities, personnel, equipment, resources, and supplies
d. Provides the method of measuring results of the program against objectives
developed during the early planning stages
ANS: C
Implementation includes the process of putting the plan into action and monitoring the plan’s
activities, personnel, equipment, resources, and supplies. This step should include feedback
from personnel and participants as well as ongoing evaluation mechanisms.

11. Which of the following is true of formative evaluation?

a. It involves judging the merit or worth of a program prior to the initiation.
b. It is an attempt to determine whether a fully operational program is meeting the
goals for which it was developed.
c. It is an examination of the processes or activities of a program as they are taking
place.
d. It measures outcomes and objectives.
ANS: C
Formative evaluation, or the internal evaluation of a program, is an examination of the
processes or activities of a program as they are taking place. The purpose of formative
evaluation is to identify problems and solutions to assist in revising the program as needed
even as it is being conducted. Implementation, like planning, involves individuals, agencies,
and the community working together.

12. If a community’s perception of needs is adhered to exclusively, actual clinical health

problems may go untreated because of which of the following?
a. Funding is limited
b. People are not knowledgeable about many areas of health care
c. There are differences between wants and needs
d. Desires are endless
ANS: B
People are not knowledgeable about many areas of health care. The solution to this dilemma
involves striking a delicate balance between negligence and overzealousness. Although it is
unethical to impose one’s own perceptions on a community, it is the professional’s
responsibility to inform people of existing problems and their consequences.

13. Developing goals and objectives during the development of an oral health program in the
community is part of which of the following processes?
a. Assessment
b. Planning
c. Implementation
d. Evaluation
ANS: B
Developing goals, objectives, and program activities is part of the planning process. During
this stage, it is essential to have community involvement and participation. The formulation of
program goals and objectives is an active process, offering specific proposals for changes to
be made in the community.

14. Which of the following is the key to a measurable objective?

a. The time frame
b. The performance verb
c. The condition
d. A specific goal
ANS: B
The performance verb is the key to a measurable objective; it is an action word, such as
“write,” “demonstrate,” or “recite.” The performance verb is essential in writing a measurable
objective. The inclusion of a condition and a criterion makes the objective more specific and
useful to the learner.

15. Which area of program planning describes how the objectives will be accomplished?
a. Program goals
b. Program objectives
c. Program activities (interventions)
d. Program implementation
ANS: C
Program activities describe how the objectives will be accomplished. In planning these
program activities, one must carefully consider the type of resources available as well as
program restraints.

16. The “WHAT” in the implementation strategy development should address which of the
following?
a. The organization responsible for each action step
b. The activities required to achieve the objectives
c. The chronologic sequence of the action steps
d. What materials, methods, media are needed
ANS: B
The implementation phase of a program includes the ongoing process of putting the plan into
action and monitoring the plan’s activities, personnel, equipment, resources, and supplies. The
“WHAT” addressed the activities required to achieve the objectives. The organization
responsible for each action step addresses the “who”; the chronologic sequence of the action
steps answers the “when”; what materials, methods, media are needed answers the “how.”

17. Using a smaller population for a community oral health program with the intent to expand
later on is called:
a. test marketing.
b. pilot testing.
c. a stratified sample.
d. testing the waters.
ANS: B
For ease in addressing these questions, many community oral health programs begin on a
small scale; it is called pilot testing. This implementation strategy allows an opportunity for
formative evaluation of the program operation and provides ease in control and monitoring of
the program activities. A pilot program provides useful information and enables decisions to
be made about the future of the program.
DIF: Recall REF: pp. 150-151 OBJ: 3

18. Which of the following is the first step in evaluation of a community oral health program?
a. Examine the specific measurable objectives.
b. Evaluate the measurable outcomes.
c. Perform pilot testing.
d. Review the program goals.
ANS: D
The first step in evaluation is to review the program goals and then examine the specific
measurable objectives. The data that are obtained through measuring the objectives are called
the measurable outcomes. Each objective should be reviewed to determine how well it is
meeting the program goals.

19. Which of the following is true for evaluation of a community oral health program?
a. Evaluation determines whether the program accomplishes what it was designed to
accomplish.
b. A summary of what went well and what did not is adequate.
c. A negative outcome means that the program has been a failure.
d. Drawing conclusions based on intuition is adequate.
ANS: A
Evaluation determines whether or not a program has accomplished what it was designed to
accomplish. The objectives themselves must be specifically addressed. Summarizing what
went well and what did not or drawing conclusions based on intuition is not appropriate or
adequate. A negative outcome does not mean that the program has been a failure.

20. If the objectives of a community health program are not met, it does not mean a program is a
failure for which of the following reasons?
a. The workers were reimbursed for their time.
b. If a program is evaluated properly, in some sense it has been a success.
c. Some form of care was delivered to the public.
d. At least the implementers tried.
ANS: B
Inherent in program evaluation is the possibility of attaining a negative outcome, that is, the
conclusion that the objectives have not been met. At the same time, however, this does not
mean that the program has been a failure. If a program is evaluated properly so that negative
outcomes become learning experiences and indicators of future programming and research, in
some sense it has been a success.

21. Which of the following has been recognized as one of the top 10 public health measures of the
twentieth century?
a. Cosmetic bonding
b. Fluoridation of water
c. Silver dental amalgam
d. Porcelain fused to metal crowns
ANS: B
Fluoridation has been recognized as one of the top 10 public health measures of the twentieth
century. As a result of the general availability of public water sources to most people, the
adjustment of the natural fluoride content found in the water to levels optimal for combating
oral disease has proven to be a successful public health measure.

22. The average number of decayed, missing (because of caries), or filled permanent teeth
(DMFT) steadily declined from 1967 to 1992 in the United States because of:
a. improved oral hygiene.
b. populations residing in fluoridated water communities.
c. improvements in the design of toothbrushes.
d. the use of dental floss.
ANS: B
The average number of DMFT steadily declined from 1967 to 1992 because of populations
residing in fluoridated water communities.

Programs, 2.1 Assessing Populations and Defining Objectives, 2.2 Designing, Implementing, and
Evaluating Programs
23. The total population receiving community water fluoridation in 2012 was approximately
which of the following?
a. 41.5%
b. 51.5%
c. 61.5%
d. 74.6%
ANS: D
In 2012, approximately 282.5 million people or 74.6% on public water systems had access to
optimally fluoridated water. The Healthy People 2020 objective for water fluoridation is to
increase the proportion of the population served by community water systems with optimally
fluoridated water to the target goal of 79.6% of the population by 2020.
DIF: Recall REF: pp. 153-154 OBJ: 4

Evaluating Programs
24. The mean annual per capita cost is lower in community water fluoridation systems for larger
populations than it is for smaller populations. The optimal level for water fluoridation is 7.0
ml F per liter of water regardless of climatic conditions.
a. Both statements are true.
b. Both statements are false.
c. The first statement is true; the second statement is false.
d. The first statement is false; the second statement is true.
ANS: A
Community water fluoridation is cost saving, even for small communities. An economic
evaluation published in 2001 estimated an annual per person cost savings ranging from $16 in
very small communities of 5000 or less to nearly $19 for larger communities of 20,000 or
more. In 1962, the DHHS recommended levels for water fluoridation ranging from 0.7 to 1.2
ppm F, depending on the average daily temperature for the area. The range was based on the
hypothesis that water consumption increased with increasing climatic temperature. This
recommendation remained in place until 2015, when the Public Health Service issued the final
recommendation that the optimal fluoride level be changed to 0.7 ml F per liter of water
regardless of climatic conditions.

25. Reasons for the 2015 PHS recommendation that the optimal fluoride level be changed to 0.7
ml F per liter of water regardless of climatic conditions include which of the following?
a. A trend of increasing prevalence of fluorosis where multiple sources of fluoride
are available.
b. The controlled climate results in similar water intake across the United States
c. Increase in access to multiple fluoride sources.
d. A trend of increasing prevalence of fluorosis where multiple sources of fluoride
are available. The controlled climate results in similar water intake across the
United States. Increase in access to multiple fluoride sources.
ANS: D
The recommended levels for water fluoridation no longer depend on daily temperature for that
area. The reasons for the recommended change were (1) an increase in access to multiple
sources of fluoride today, (2) a trend of increasing prevalence of fluorosis in the population
attributed to the multiple sources of fluoride, and (3) the controlled climatic environment with
air conditioning, resulting in similar water intake across the nation regardless of climatic
conditions.

26. Which of the following offers the benefits of fluoride in a structured environment in
communities where a public water source is not available or where community water
fluoridation is undesired for various reasons?
a. Fluoridated salt
b. Fluoride supplemented sports drinks
c. School-based fluoride mouth rinse programs
d. Fluoridated chewing gum
ANS: C
School-based fluoride mouth rinse programs offer the benefits of fluoride in a structured
environment. The mouth rinse program is administered by school personnel or volunteers on a
weekly basis to participating children. The protocol includes a 60-second rinse with 10 mL of
0.2% sodium fluoride.
Programs, 2.1 Assessing Populations and Defining Objectives
27. Advantages of community water fluoridation over a community-based fluoride supplement

program include:
a. reduced need for compliance.
b. lower installation and startup costs.
c. decay prevention and oral health benefits for the entire population.
d. reduced need for compliance and decay prevention and oral health benefits for the
entire population.
ANS: D
The need for compliance over an extended period of time is a major procedural and economic
disadvantage of community-based fluoride supplement programs. Although the total costs of
the purchase of supplements and administration of a program are small compared with the
installation and start-up costs associated with fluoridation equipment, the overall cost of
supplements per child is much greater than the per capita cost of community water
fluoridation. Community water fluoridation provides decay prevention and oral health benefits
for the entire population regardless of age, socioeconomic status, educational attainment, or
other social variables.

28. Which of the following is true of a fluoride varnish?

a. It is self-applied by the patient at home.
b. It is intended to be permanent, much like dental sealant.
c. Offers ease of application for people with severe gag reflexes who cannot tolerate
tray application.
d. It is self-applied by the patient at home. Offers ease of application for people with
severe gag reflexes that cannot tolerate tray application.
ANS: C
The varnish is applied by an operator, with a recommended twice-yearly reapplication for
optimal benefit. The varnish is not intended to be permanent, like a sealant, but to hold the
fluoride in contact with the tooth for a period of time. Varnish offers easy applicability of
fluoride for infants, toddlers, and young children; disabled individuals; hospitalized patients;
and people with severe gag reflexes who cannot tolerate tray application of gels and foams.

29. Which of the following is the most cost-effective, most practical, and safest means of
preventing tooth decay?
a. Dental sealants
b. Regular dental visits
c. Community water fluoridation
d. Fluoride varnish
ANS: C
Even though other sources of fluoride are available and despite the increased risk of fluorosis,
community water fluoridation remains the most cost-effective, the most practical, and the
safest means of preventing tooth decay. Additionally, community water fluoridation provides
dental caries prevention for the entire population regardless of age, socioeconomic status,
educational attainment, or other social variables.
DIF: Application REF: p. 156 OBJ: 4

30. Which of the following is true regarding antifluoridationists?

a. They provide inaccurate and false information to the public.
b. Their arguments against fluoridation do have some merit based on scientific
knowledge.
c. They attempt to link adverse health effects with fluoridation.
d. They provide inaccurate and false information to the public and attempt to link
adverse health effects with fluoridation.
ANS: D
Antifluoridationists provide inaccurate and false information to the public and to elected
officials and attempt to link adverse health effects with fluoridation. Their arguments against
fluoridation do not have any merit based on scientific knowledge. The economic and health
benefits of fluoridation for millions of Americans have been confirmed in numerous studies
by renowned scientists.

31. Which of the following is true of dental sealants?

a. Little increase of sealant application has occurred among school-aged children in
low-income populations.
b. One goal of Healthy People 2010 was to have 90% of children receiving dental
sealants on their permanent molars.
c. According to the 1988-1994 baseline data, about 51% of 14-year-old adolescents
had dental sealants on their permanent molars.
d. Dental insurance will not reimburse for sealants.
ANS: A
Although the percentage of school-age children with sealants has risen in recent years as the
public and private sectors have been using the procedure, as dental insurance has paid for
sealants, and as parents have requested sealants for their children, little increase has occurred
among children in low-income populations. One goal of Healthy People 2020 is to increase
the number of children with dental sealants on their primary and permanent molars. The focus
on sealing primary teeth is a new subobjective in this latest version of Healthy People oral
health objectives and is based on the need to address the rise in early childhood caries in the
last decade.

32. To reach the Healthy People 2020 goal of increasing the proportion of children who have
received dental sealants on their molar teeth, many states have instituted:
a. reimbursement through dental insurance programs.
b. expansion of dental assisting and dental hygiene educational programs.
c. school-based sealant programs (SBSP).
d. educational grants for sealant placement in public health programs.
ANS: C
Many states have instituted SBSP. In some programs, mobile dental vans are sent to schools,
and the sealants are applied in the van. In other programs, portable equipment is transported
from school to school and is set up in available space.

Evaluating Programs
33. Which of the following is true of an effective health education program?

a. The intent of oral health education is to effectively train on-the-job personnel to
provide oral self-care instruction to children.
b. The participant must be actively involved in the learning process.
c. The focus should be on skill acquisition.
d. The participant must be actively involved in the learning process, and the focus
should be on skill acquisition.
ANS: B
To be effective, a health education program must have participants actively involved in the
learning process. Oral health education is the process of teaching people about oral health
directed at helping them prevent oral disease. The intent of oral health education is to assist
people in making decisions about their oral health and to choose behaviors conducive to
maintaining this health. Oral health education should focus on intervention and stress skill
acquisition and adoption of evidence-based risk-reducing behaviors.
DIF: Comprehension REF: pp. 159-160 OBJ: 3

34. Most dental educational programs have been implemented for which of the following groups?
a. Children
b. Adolescents
c. Adults
d. The elderly
ANS: A
Many large-scale oral health education programs have been focused on children, with the
thought that they are the future of society. The school setting is ideal to reach children and,
through them, their families, community members, and organizations.

Evaluating Programs
35. The type of teaching method that encourages active participation is which of the following?
a. Discussion
b. Discovery learning
c. Collaborative and cooperative learning activities
d. Discussion, discovery learning, and collaborative and cooperative learning
ANS: D
Discussion, discovery learning, and collaborative and cooperative learning activities all
encourage active participation.
DIF: Recall REF: p. 161|Box 6-11 OBJ: 3

36. Approximately what percentage of adults (aged 18 to 24) visit a dental office yearly?
a. 28%
b. 45%
c. 62%
d. 83%
ANS: C
Approximately 62% of U.S. adults (aged 18 to 24) visit a dental office yearly. Various
barriers are responsible for people failing to seek dental care or seeking it only in
emergencies, including cost, limited geographic access, low oral health literacy, language,
cultural barriers, fear, and the belief that dental care is only important when in pain.

37. At what age should a dental home be established?

a. No later than 12 months
b. At age 3, when all primary teeth have erupted
c. At age 6, when all the first permanent molars are erupting
d. No later than age 12, when most permanent teeth are in place
ANS: A
According to the American Academy of Pediatric Dentistry, a dental home should be
established no later than 12 months of age and include referral to dental specialists when
appropriate.

38. The population in need of both primary and secondary prevention and tertiary care is which of
the following?
a. Children
b. Adolescents
c. Young adults
d. Older adults
ANS: D
An expanding population in need of both primary prevention and secondary and tertiary care
is the older adult population. It is estimated that by the year 2050, the number of Americans
aged 65 and older will reach 89 million, twice as many as recorded in 2010. The growth of
this population is expected to impact every facet of American society.

39. Which of the following federal initiatives that provide funding to states administers the Head
Start program?
a. Special Supplemental Nutrition Program for Women, Infants, and Children (WIC)
b. Administration for Children and Families (ACF)
c. Children’s Health Insurance Plan Reauthorization Act (CHIPRA)
d. Medicaid (Title XIX)
ANS: B
Administration for ACF, an agency of the Department of Health and Human Services, is
responsible for 60 programs that provide assistance to needy children and families, including
the administration of the Head Start program. HS was founded in 1965 as part of President
Johnson’s War on Poverty. Congress passed the most recent HS Reauthorization Act in 2007,
set to run through 2012. Congressional funding has continued since 2012 even though the
program has not yet been re-authorized by Congress.

40. A federally qualified health center (FQHC) has been designated by the federal government by
adhering to regulations pertaining to the scope and quality of health services provided to
which of the following segment of the population?
a. Those individuals with a substance abuse problem
b. Anyone, regardless of ability to pay
c. Only those older than 18 years of age
d. Military and ex-military personnel
ANS: B
An FQHC has been designated by the federal government by adhering to regulations
pertaining to the scope and quality of health services provided to anyone, regardless of ability
to pay.

41. From 1965 until the most recent Head Start Reauthorization in December 2007, eligibility for
Head Start services was at or below what percentage of the federal poverty level (FPL)?
a. 40%
b. 60%
c. 80%
d. 100%
ANS: D
Eligibility was at or below 100% of the FPL. The 2010 FPL for a family of four is $22,050.

42. The 2007 Reauthorization of Head Start allows Head Start programs to serve up to what
percentage of children whose family income is up to 130% of the federal poverty level (FPL)?
a. 20%
b. 35%
c. 50%
d. 65%
ANS: B
It allows Head Start programs to serve up to 35% of children whose family income is up to
130% of the FPL. For a family of four, this is $28,665.

43. Head Start primarily serves children of what age?

a. 4 years
b. 6 years
c. 8 years
d. 10 years
ANS: A
Head Start primarily serves 4-year-old children.

44. The Early Head Start program was established in fiscal year 1995 to serve children from birth
to what age?
a. 1 year
b. 2 years
c. 3 years
d. 4 years
ANS: C
It was established to serve children from birth to age 3 years. Sixty-eight Early Head Start
programs were awarded funds in 1995. In 2009, the American Recovery and Reinvestment
Act increased funding for Early Head Start by $1.1 billion, which will result in Early Head
Start being able to serve 55,000 more pregnant women, infants, and toddlers and their
families.
45. Which of the following agencies receives the most Head Start funding?
a. Tribal governments or consortia
b. Private and public nonprofit agencies
c. Government agencies
d. Community action agencies
ANS: B
Private and public nonprofit agencies (37%) received the most, followed by community action
agencies (32%), public and private schools (17%), government agencies (7%), and tribal
governments or consortia (7%).
DIF: Application REF: pp. 163-164 OBJ: 6

46. Which of the following is the most common health defect in Head Start children?
a. Asthma
b. Dental decay
c. Juvenile diabetes
d. Obesity
ANS: B
In 1972, the Office of Head Start (OHS) published a series of training and technical assistance
educational materials known as the Rainbow Series. The guide on Dental Services discusses
the importance of dental care for the preschool child and states that “Dental decay is the single
most common health defect in Head Start children.”

47. During much of the 1990s, which of the following was the number one health issue affecting
Head Start programs nationwide?
a. Lack of funding
b. Lack of motivation
c. Poor access to oral health services
d. Poor compliance
ANS: C
Poor access to oral health services was the number one health issue affecting Head Start
programs nationwide as reported by Head Start directors, training and technical assistance
providers, and Administration for Children and Families Regional Office Head Start program
specialists.

48. The United States’ youngest and poorest children aged 2-4 years old and living below poverty
level have nearly _____ times the number of dental caries as children of higher-income
families.
a. two
b. three
c. four
d. five
ANS: B
These children have nearly three times the number of dental caries as children of
higher-income families. A comprehensive goal of a Head Start community oral health project
would be to improve the oral health of Head Start children and families through oral health
education, disease prevention, and referrals to dental homes for treatment.

49. Dental hygienists and dental hygiene students interested in working with Head Start programs
should contact their ______________________ to determine the level of services presently
being offered and how best to organize efforts and get involved.
a. component dental hygiene organization
b. state senator or representative
c. State Dental Hygienists’ Association
d. A and C
ANS: D
They should contact their State Dental Hygienists’Association and their component dental
hygiene organization. Dental hygienists also can locate a Head Start center directly by visiting
the website www.adah.org/publichealth/index.html and following the link entitled “Find a
Head Start Center Near You.”

50. The overall mission of Head Start is to __________________.

a. teach parents to help their children learn
b. ensure that children eat a nutritious breakfast
c. prepare children for school
d. provide transportation for children if needed
ANS: C
All of the above are goals or facets of Head Start; however, the overall mission is to prepare
children for school. Head Start programs promote school readiness by enhancing the social
and cognitive development of children through the provision of educational, health,
nutritional, social, and other services to enrolled children and their families.

51. Head Start agencies receive grant funding directly from the Administration for Children and
Families (ACF), and most of these agencies________________.
a. delegate operations
b. directly operate Head Start programs
c. directly operate the program and delegate service delivery
d. maintain central staff only and operate no program directly
ANS: B
Most directly operate Head Start programs (72%) or delegate operations (23%), or may
directly operate the program and delegate service delivery (4%) or maintain central staff only
and operate no program directly (1%).

52. Head Start and Early Head Start programs are monitored every ________ years to ensure
compliance with federal Program Performance Standards.
a. 3
b. 4
c. 5
d. 9
ANS: A
They are monitored every 3 years to ensure compliance.

MULTIPLE RESPONSE
1. All Head Start and Early Head Start programs must follow a set of federal program
performance standards in which of the following service areas? (Select all that apply.)
a. Child development and health
b. Family and community partnerships
c. Program design and management
ANS: A, B, C
All Head Start and Early Head Start programs must follow a set of federal program
performance standards in each of the following service areas: child development and health,
family and community partnerships, and program design and management.

Another random document with
no related content on Scribd:
Apple Bread Pudding
Cover the bottom of a well-buttered baking dish to one-third its
depth with Apple Sauce, arrange stale bread spread generously with
soft butter, crusts removed and bread cut in small pieces and fit
closely together over Apple Sauce. Sprinkle generously with sugar
mixed with one-half teaspoon cinnamon; dot over top with two
tablespoons butter. Bake thirty-five minutes in a moderate oven.
Serve with Hard Sauce or sugar and cream.
Croustades of Bread
Shape stale bread cut in two
and one-half inch slices into
boxes, using a biscuit cutter; with
a smaller cutter stamp out centre,
being careful not to cut through.
The wall of boxes should be one-
Croustades of Bread third inch thick. Place boxes on a
plate and baste them with egg diluted with cold milk, using two
tablespoons milk to each egg. Season egg with salt, and when each
box is well-soaked, drain, lift carefully with a spatula, place in a
croquette basket and fry in deep, hot fat. Drain on brown paper and
fill with creamed chicken, sweetbreads, mushrooms, brains, etc.
Pudding Sauces
Creamy Sauce
2 cups whipped cream.
Confectioner’s sugar.
Brandy, sherry wine and a few grains nutmeg or vanilla extract.
Process: Sweeten cream to taste (will require about two-thirds

cup sugar), add flavoring desired, constantly beating mixture very
slowly with a wire whisk.
Vanilla Sauce
½ cup sugar.
1 tablespoon cornstarch.
⅛ teaspoon salt.
1 cup boiling water.
2 tablespoons butter.
1 teaspoon vanilla.
Process: Sift together sugar, cornstarch and salt. Add, gradually,

boiling water, beating continually; cook six minutes. Remove from
range and beat in butter, adding it in small bits. Add vanilla, beat
thoroughly; keep hot over hot water. Lemon and Orange Sauce are
made same as foregoing, using one teaspoon of lemon or orange
extract in place of vanilla. A few grains of nutmeg may be added to
Lemon Sauce.
Peach Canapes
Saute circles of stale sponge cake in butter until delicately
browned. Rub the left-over canned peaches drained from their liquor
through a sieve, sweeten with powdered sugar, add a few drops
lemon juice and a slight grating nutmeg. Pile peach pulp on circles of
cake, mask with whipped cream sweetened and flavored, delicately,
with peach extract. Serve as dessert.
Hard Sauce
⅓ cup butter.
1 cup Confectioner’s sugar.
½ teaspoon vanilla.
½ teaspoon lemon.
Process: Cream butter, add sugar gradually, while stirring

constantly. Add extracts, drop by drop, while beating. Brandy may be
used instead of extracts. Force mixture through a pastry bag and
star tube on to a cold plate, sprinkle with nutmeg.
Coffee Jelly
2 tablespoons granulated gelatin.
⅓ cup cold water.
1 cup boiling water.
6 tablespoons sugar.
2 cups left-over coffee.
½ teaspoon vanilla.
Process: Soak gelatin thirty minutes in cold water, dissolve in

boiling water, strain through sieve, add to sugar and coffee, add
vanilla. Turn into a ring mold and chill. Unmold on a cold glass platter
and fill centre of mold with whipped cream, sweetened and flavored,
delicately, with vanilla.
Coffee Jelly
Candied Orange Peel

Save the left-over peel from four large thinned-skin oranges cut in
quarters or halves. Cover with cold salted water, let stand over night.
In the morning drain and rinse thoroughly. Put peel in a sauce-pan
and cover with cold water, bring to boiling point, let boil five minutes,
pour off water and cover with fresh boiling water; repeat three times.
Then add boiling water and let cook until tender. Drain and remove
the white portion, using a teaspoon. Cut peel in narrow shreds, using
the shears. Prepare a syrup of two cups sugar and one-half cup
water, skim syrup if necessary, and let cook until it spins a thread
when dropped from the tip of a wooden spoon. Simmer shreds of
orange peel in syrup until they have absorbed nearly all the syrup;
then boil rapidly, stirring until each shread is well coated with sugar.
Drain and coat with fine granulated sugar. Let dry in a warm oven.
Then store in tin left over crystalized ginger or marshmallow boxes.
In Conclusion—Let Nothing Be Wasted
That small piece of ham left from breakfast, finely minced, will
doubtless make one tablespoonful, when finely minced, for your
omelet.
The half-cup of creamed onions left from dinner, if rubbed through

a sieve, added to thin white sauce and served with “hard boiled”
eggs, will furnish a delicious dish for luncheon or supper.
The small bits of jelly added to a berry pie will materially improve
the richness of its juice, or it may be added to the mince meat, but
should never be thrown away. The tablespoonful of apple and other
sauces left-over may be used in a similar way.
The leaves and roots of celery, as well as the outer stocks, may
all be used either for making cream of celery soup or for flavoring the
soup stock.
Broken crackers that cannot be served on the table, may be

crushed moderately and used for stuffing, or may be rolled fine and
used for crumbing oysters, scallops or fish, croquettes, etc.
There need be no waste of stale bread in the kitchen. For stale
bread can be used in an infinite variety of ways. Only the thin brown
crust may be removed and this makes good food for the chickens.
Smalls bits of bread should be dried in the warming oven, covered
with a piece of cheese cloth to protect it from dust, then passed
through the meat chopper and sifted. The fine crumbs are used for
crumbing purposes, and the coarse crumbs for the top of Au Gratin
dishes.
The onion from which a slice has been cut, should be turned “cut
side” down on a saucer, and covered with a cup or small bowl, and
set aside in a cool place for future use.
When using garlic, break off one section, called “a clove of garlic,”
in cooking parlance. The remainder of bulb will keep some time if
kept dry.
The outer leaves of lettuce, if not wilted and torn, may be cut in
shreds or ribbons and used to garnish salad or cold meat dishes.
Stale cheese has many possibilities, as shown in the chapter on

“How to Use Stale Cheese.” If kept in a cool place, in a covered dish,
it may be grated and ready for future use.
The stale rye bread makes delicious stuffing, and is also used for
making puddings.
Brown bread may be dried, then crumbed and used in ice cream
or bisque, and will take the place of macaroons very palatably.
Transcriber’s Note
Words may have multiple spelling variations or inconsistent
hyphenation in the text. Obsolete and alternative spellings were left
unchanged. Misspelled words were not corrected. Final stops
missing at the end of sentences and abbreviations were added.
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1. Which of the following set of terms describes dental caries?

DIF: Recall REF: p. 142 OBJ: 1

DIF: Recall REF: p. 142 OBJ: 5

DIF: Comprehension REF: p. 143 OBJ: 2

DIF: Recall REF: p. 143 OBJ: 1|8

DIF: Recall REF: p. 143 OBJ: 1

DIF: Recall REF: p. 1 45 OBJ: 1|8

DIF: Comprehension REF: p. 144 OBJ: 2

8. An oral health coalition is which of the following?

DIF: Recall REF: p. 144 OBJ: 2

DIF: Recall REF: p. 146 OBJ: 2

10. Which of the following is true of implementation?

DIF: Comprehension REF: p. 150 OBJ: 3

11. Which of the following is true of formative evaluation?

DIF: Comprehension REF: p. 150 OBJ: 3

12. If a community’s perception of needs is adhered to exclusively, actual clinical health

DIF: Comprehension REF: p. 147 OBJ: 3

DIF: Recall REF: p. 148 OBJ: 3

14. Which of the following is the key to a measurable objective?

DIF: Recall REF: p. 148 OBJ: 3

DIF: Recall REF: p. 148 OBJ: 3

DIF: Comprehension REF: p. 150 OBJ: 3

DIF: Recall REF: pp. 150-151 OBJ: 3

DIF: Recall REF: p. 150 OBJ: 3

DIF: Comprehension REF: p. 151 OBJ: 3

DIF: Comprehension REF: p. 151 OBJ: 3

DIF: Recall REF: p. 152 OBJ: 4

DIF: Recall REF: p. 152 OBJ: 1

DIF: Recall REF: pp. 153-154 OBJ: 4

DIF: Comprehension REF: p. 154 OBJ: 4

DIF: Recall REF: p. 154 OBJ: 4

27. Advantages of community water fluoridation over a community-based fluoride supplement

DIF: Comprehension REF: p. 158 OBJ: 4

28. Which of the following is true of a fluoride varnish?

DIF: Recall REF: p. 156 OBJ: 4

DIF: Application REF: p. 156 OBJ: 4

30. Which of the following is true regarding antifluoridationists?

DIF: Comprehension REF: p. 155 OBJ: 4

31. Which of the following is true of dental sealants?

DIF: Comprehension REF: p. 158 OBJ: 5

DIF: Recall REF: p. 158 OBJ: 5

33. Which of the following is true of an effective health education program?

DIF: Comprehension REF: pp. 159-160 OBJ: 3

DIF: Recall REF: p. 159 OBJ: 3

DIF: Recall REF: p. 161|Box 6-11 OBJ: 3

DIF: Recall REF: p. 165 OBJ: 1

37. At what age should a dental home be established?

DIF: Recall REF: p. 166 OBJ: 7

DIF: Recall REF: p. 167 OBJ: 7