CHAPTER 17 Community Oral Health
Use of dental services is defined as the proportion of the population who receive dental care services within given period. Factors that affect frequency include age, gender, economics, ethnicity, geographical location, general health status, acquisition of dental insurance. Factors influence and affect each other, interrelationship makes it difficult to determine exact influence of each component.
Dental services are paid for by several means, including fee-for-service; third-party plans; usual, customary, reasonable (UCR) fees; capitation plans; dental service corporation plans (e.g., Delta Dental); indemnity plans; direct reimbursement; managed care plans; public financing.
Philosophy of U.S. government gives responsibility for seeking and receiving oral healthcare services to each individual. MOST health-related programs administered by federal government are conducted through Department of Health and Human Services (HHS). Federal government developed two programs for express purpose of improving nation’s capacity to provide oral health protection and oral healthcare services.
Scenario: A junior high school counselor contacted local dental and medical professionals regarding a perceived increase in the number of girls with eating disorders in her school. Several local dental hygienists decided to develop a program for raising the awareness of the dangers of eating disorders for this population of students. To determine the current level of awareness, the dental hygienists developed a pretest that elicited information regarding facts and fallacies related to eating disorders; it also asked students whether they had an eating disorder and whether they knew of a classmate with an eating disorder.
The pretest was voluntarily taken by 410 girls in grades 7 through 9. One week later, the participants gathered in an auditorium, where they listened to information about different eating disorders, their treatment, and the dental and medical effects of the disorders. The participants subsequently watched a 20-minute video of personal accounts of battles against anorexia and bulimia. One week after the presentation, the 410 participants were given a posttest that covered the information on the pretest. Participants scored significantly higher on the facts and fallacies section of the posttest than they did on the pretest.
Epidemiology is the study of disease prevalence. It is conducted through systematic observation and is used in medicine, social and computer science, biology, and statistics. Epidemiological methods can be applied in dentistry to evaluate the specific disease patterns and needs of a community. Comparisons can be made between groups of a defined population.
A 2005 report, “The Centers for Disease Control Surveillance for Dental Caries, Dental Sealants, Tooth Retention, Edentulism, and Enamel Fluorosis—United States, 1988-1994 and 1999-2002,” used the National Health and Nutrition Examination Survey (NHANES), ongoing survey of representative samples of population.
The American Academy of Periodontology (AAP) Research, Science and Therapy Committee (2005) reviewed evidence concerning periodontal disease and formed conclusions. National prevalence of moderate and severe periodontal diseases among dentate adults aged 20 years and older was estimated from the 1999-2004 National Health and Nutrition Examination Survey conducted by NHANES.