Introduction to dental public

health

Dr. Rabaa Mahmoud

 Objectives
• BY THE END OF THIS LECTURE, STUDENTS SHOULD BE ABLE
TO:
1. Define public health and dental public health and know
the difference between them
2. Identify the public health problems
3. Recognize the role of dental practitioners in the private
practice and community health dentistry
4. Recognize Different functions and roles of dental public
health
5. Understand different tools of dental public health

2
• Definition of Health (1948)
• WHO defines health as a state of complete physical, mental and
social well being and not merely the absence of disease or
infirmity.

• Definition of public health {Winslow (1920)}

• The art and science of preventing disease, prolonging life and
promoting physical and mental efficiency, through organized
community efforts.
• Notice:
• 1. Public health focus on populations rather than individual
patients, and on prevention rather than diagnosis and
treatment.
• 2. The main goal of public health is to improve the general
health of the population.
 Role of Public Health

• Prevent epidemics and the spread of disease

• Protects against environmental hazards
• Prevents injuries
• Promotes and encourages healthy behaviors
• Responds to disasters and assists communities in recovery
• Assures the quality and accessibility of health services.

• Notice:

Epidemic: The unusual occurrence of disease, specific health – related behavior

(smoking) or other health related events (traffic accidents) in excess of expected
occurrence in a community or region .
 Differences between personal or private
practitioner and a community health dentist.
Community health dentist Private practitioners
Work in a team Work more or less alone 1

Focus on community Focus on individual patient 2

Decision taken by governing body Independent decision maker 3

or advisory council regarding line of treatment
Salaried with fringe benefits like Higher take home pay but less fringe 4
pension plan(‫اش‬9‫لمع‬99‫)ا‬ benefits ‫ضافات‬
( ‫ال‬99‫)ا‬
Community participation Patient consent and cooperation 5
required
Payment by government authorities Payment for treatment by individual 6

Emphasis on promotive and Emphasis on curative and restorative 7

preventive care care
 PUBLIC HEALTH PROBLEM

• It is well recognized now that demands on health care system will

always be greater than the resources available to meet these needs.

This creates a need to direct the available resources to particular

problem areas or the most important problem.

 Criteria for a Public Health Problem

• 1. Prevalence of the condition - what percentage of population affected?

• 2. Impact of the condition on an individual level- how serious are effects

of disease to the patient?

• 3. Impact on wider society.

• 4. If the condition is preventable and effective treatments are available.

 IMPACT OF ORAL DISEASE
• Oral health is an integral part of general health. Oral diseases directly affect
quality of life by having a serious impact on an individual's well being and
the ability to fulfill desired function as:.

I. Appropriate nutritional intake can also be influenced by incapacity to

masticate or persisting pain due to oral diseases.

II. The consequences of conditions like oro-pharyngeal cancer on the

individual are even worse. They can be life-threatening and often result
in lifelong functional impairment or disfigurement.

III. Oral appearance affects self-esteem and the willingness to interact with
others.

IV. The economic costs of oral diseases are also considerable.

 Public health importance of oral diseases:.
• Why oral diseases are public health problems?
because of:
1. High prevalence
2. High cost of treatment
3. Considerable impact on individuals
5. Causes are known - diet and dirt
6. Easy and cheap to prevent
7. Diagnosis is easy
8. Easy to evaluate treatment
9. Treatment relatively unsuccessful
• So as oral diseases considered as a public health problem

• There is a shift from public health concept to dental public

health as a separate entity.
 Definition of Dental Public Health

• Dental public health is the science and art of preventing and controlling
dental diseases and promoting dental health through organized
community efforts. It is that form of dental practice that serves the
community as a patient rather than the individual.
 AIMS OF DENTAL PUBLIC HEALTH

1. To develop programs aims at the prevention of oral diseases and the

improvement of general and oral health.

2. To promote the delivery of best possible oral health care.

3. To permit an exchange of knowledge and experience in all aspects of oral

health and oral health care.

4. To provide a comprehensive information and communication system for

making relevant information available to members, the media and
governments.
 FUNCTIONS OF PUBLIC HEALTH DENTISTRY

• Services provided to the community by public health

dentist include:
1. Preventive Services
ex. Application of topical fluorides and pit and fissure sealants.
2. Public Health Training
ex. School teacher training program.
3. School Dental Health Program
ex. Teaching of oral hygiene methods and importance of dental health to
children.
4. Dental Public Health Program
ex. Screening program for oral cancer.
5. Dental Health Education
ex. Education about dental health and its importance to community,
industrial workers and social organizations.
TOOLS OF DENTAL PUBLIC HEALTH

1. Epidemiology

2. Biostatistics

3 . Social sciences

4. Principles of administration

5. Preventive dentistry
 1. Epidemiology

• Defined as 'the study of the distribution and determinants of health

related states or events in specified populations and the application of
this study to control health problems'.
• Uses

1. Concerned with course and outcome [natural history] of disease in

individuals and groups.

2. Causation of disease.

3. Used to describe the health status of the population.

4. Helps in evaluating effectiveness and efficiency of health services

 2. Biostatistics

• It is the method of collection, organizing, analyzing, tabulating and

interpretation of data related to living organisms and human beings.
Uses

1. To test whether the difference between two populations,

regarding a particular attribute is real or a chance occurrence.

2. To evaluate the progress of public health programs.

3. To define and measure the extent of morbidity and mortality in

the community.
 3. Social Science

• It includes:

a. Sociology,

b. Cultural anthropology ((‫النسان‬99‫ ا‬9‫علم‬

(Cultural anthropology is a branch of anthropology focused on

the study of cultural variation among humans).

c. And psychology.
 4. Principles of administration

• Administration is defined as "the art and science of guidance,

leadership, and control of the efforts of a group of individuals
towards some common goals".

• Management is the operational part of administration. It is defined

as: “a set of interactive processes through which the utilization of
resources results in the accomplishment of organization objectives.“

It is through "management" that the objectives of the health care

organization are achieved by gathering and positioning of resources.
 5. Preventive dentistry

• Prevention is defined as "actions aimed at eradicating,

eliminating or minimizing the impact of diseases and
disability.

• Levels of prevention:

i. Primary-primary prevention.

ii. Primary prevention.

iii. Secondary prevention .

iv. Tertiary prevention.

Procedural steps in dental public health
1. Survey
2. Analysis
3. Program planning
4. Ethics and planning approval
5. Program operation
6. Financing
7. Program appraisal
 Similarities and differences between clinical and
public health practice
Public health practice Individual care
Survey Examination 1
Assessment of disease rate Patient interview
Community support Medical history
Available services Clinical examination
Barriers to services Diagnostic tests
Analysis Diagnosis 2
Interpretation of statistics Based on examination information
Program planning Treatment planning 3
Community desire, cost, availability of intervention Professional judgment, patient interest, cost of treatment

Ethics and planning approval Informed consent 4

Program operation Treatment 5

A varied group of disciplines may be needed for Schedule for care designated
implementation Referral may be necessary for complex procedures
Funding Payment 6
May be federal, state, local or funded by grants Self pay, third party

Program appraisal and review Evaluation 7

Data collected at initial assessment serves as a At subsequent visits (follow up)
baseline for the appraisal
 Summary
• TOOLS OF DENTAL PUBLIC HEALTH:

Preventive
dentistry

Epidemiology Principles of
administratio
n

Social
Biostatistics
sciences
23
 References
• A Textbook of Public Health Dentistry, CM

Marya, Jaypee Brothers Medical Publishers, 1st

ED; 2011 (Chapter 25 Page 273-276)

24
 QUIZ
1. The main goal of public health is to:
1. Improve general health of the population.
2. Render restorative care for individuals
3. Concern with esthetics
4. None of the above

2. The role of public health is to:

5. Prevent spread of disease
6. Prevent injuries
7. Promote and encourage healthy behaviors
8. All of the above

25
Thank You