Community Weiner

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1

COMMUNITY

terminology
Health:

Public Health;

Astate of complete physical, mental and social
well being, including the absence of disease
The science of preventing disease, prolonging

life, and promotion physical health through
organized community efforts

Dental Public Health:

The concern for the improvement of and the

promotion of dental health for an entire
population,

• 4. f
It serves a community as a patient, not an
individual as a patient.

Community:

Includes geographic boundaries as large as a
region of a state, or as small as a nursing
home facility, including its residents,
administrators, staff &caretakers.

Epidemiology:

Compares groups or specific populations

Measures the circumstances under which a
disease occurs among groups

0 Epidemic:

Prevalence of a disease is greater than
normal ***

The disease spreads rapidly and there are
more than the expected number of incidents
Endemic:

The normal prevalence of disease

It includes the expected number of cases and

usually they are indigenous to a specific area
or people ***

Pandemic:

Worldwide

Mortality:

Death rate = # of deaths

Morbidity:

Extent of disease - amount ofdisease

Dental Hygiene National Board Review
Jane Weiner, RDH, Board Reviews. Inc.

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Rate:

2

Numerical ratio

The # of people who have the disease is the
numerator and the # of possible occurrences is
the denominator

r # of people with the diseased

[ # of people in a community]
The rate or# of new cases at a given time

Incidence:

The percent of the population affected
*** "The total # of cases of a specific disease or
condition in existence in a given population at a certain

9 Prevalence:

time"

(Wilkins 8"^ ed. Page 294 )
P =

Cases

x100%

population

Most dental surveys (DMF) counts measure

the prevalence of dental disease within a given
population

« Reliability:

Reproducible***
Measures consistently at different times
Measurement must have stability
Important in evaluating (Board info)

o Validity :

Examiner measures what they are supposed
to measure ***

i

Internal validity: when the independent variable
alone brings about a change In the dependent
Variable

Extemal validity: when the survey reflects
accurately things that would occur in reality

• ***Why must there be evidence of validity and reliability ofa research design?***
To give accurate results
Calibration:

Examiners evaluate what is found in common

(x), compare results and come to an agreement
Index:

Assess reversible & irreversible diseases or a
combination

Dental Hygiene National Board Review

Jane Weiner, RDH, Board Reviews, Inc.

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Index Selection:

Determined by

Type of condition to be assessed
B.
C.

Types of indices:

3

Age ofthe group to be studied
The purpose ofthe research

Cumulative index

Measures all the evidence of a condition past
and present
Ex: DMFT

Simple index

Measures the presence or absence ofa
condition

Ex: One that measures the presence ofbiofilm
without evaluating its effect on the gingiva

« jnt[-arater reliability:

1nterrater reliability:

The same examiner remains consistent in
scoring
Standardized with self***

Consistency occurs between examiners

(Board info: when 2 or more people view a
subject the same way, a higher interrater
reliability exists) ***

Which would increase interrater reliability***

Utilizing the same tool for measurement
Keeping the subjects the same
Monitor the same independent variable
Be sure that the examiners are calibrated
Variable:

• Independent variable:

g Dependent variable:

Condition or concept which can vary

Condition manipulated orcontrolled by the
investigator ***

Condition thought to have changed due to the
absence, presence, or manipulation of the
independent variable ***

Data:

Numbers that are collected from numbers or
amounts

Statistics:

Analyzes &uses numerical data
Measure values based on sample data, either

descriptive or inferential (experimental)
Dental Hygiene National Board Review
Jane Weiner, RDH, Board Reviews, Inc.

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Descriptive statistics;

4

Nunnerically describe &summarize data
collected

No attempt made to find out anything beyond
the immediate sample
ANOVA

Analysis of variance

Analyzes effects of two or more independent
variables at the same time in the same

research design
Tests for differences among three or more
means

• *Measure of central

tendency:


*Mean:

Describes what is typical in a sample
group based on accumulated data
Ratio statistic

Sum of values divided by # of items
Affected by extreme scores
''Median:

Midpoint or middle (50% yes - 50% no)
[If total score is odd, median is the middle
score]
[If total score is even, take the two middle
scores, add them & divide by 2]
Not affected by extreme scores

'Mode:

Variance:

Most frequently occurring score
Ranks people by numbers (nominal status)
The sum of the squared deviations from the
mean divided by N

Square root of the variance gives us the
standard deviation

'Standard deviation:

Analyzes the dispersion of scores from the
mean

The smaller the SD, the more homogeneous a
group

Measures variability

[Board example: If the mean is 8 and the standard deviation is one, the scores
represented are:

5-9
6-10
7-9

Dental Hygiene National Board Review
Jane Weiner, RDH, Board Reviews, Inc.

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Determines the strengtli of the linear

Correlation:

relationship between two variables

Ranges from -1.0 to +1.0 (perfect)
Strongest correlation closest to -1 or +1

(Board example: -.95 —Is it strong or weak
correlation? Strong)

Positive : closer to +1 , both variable's values
increase

Negative : closer to -1, one variable value
increases while the other decreases
Null: no difference

Infers findings form the sample to the general

Inferential statistics:

population

Used to generalize results

Value inferred from a statistic (assumptions)

Parameter:

Inferential statistical procedures which yield

Non-Parameter

fewer, ifany, assumptions

Scales

" Ranks in empirical order

^ Ordinal:

\1rk*

[students according to grades] (Bd.-related)
Observations fitted into categories

Nominal:
Inten/al:

***

[good oral hygiene - poor oral hygiene]

'

^Measurement characterized by equal intervals
having no zero [Fahrenheit thermometer]

Ratio:

Characterized by presence of absolute 0

Skewed:

Not an even bell shape (lopsided )

[age, height orweight]
Positive skew is skewed right
More scores are in lower range

Negative skew is skewed left
More scores are in higher range

Tables and graphs lose details but make ^
results easierto calculate and to identify trends

and give a more concise presentation of facts.
Histograph; measures things over a long time

Dental Hygiene National Board Review
Jane Weiner, RDH, BoardReviews, Inc.

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Dispersion;

Variability of spread of scores

Significance Level:

Odds for detemnining the operation of chance

6

factors in producing the obtained result
(Probability level, or p-value)
p-Value:

The probability of observing a value equal to or
more extreme than its table value

[p < 0.05 = results statistically significant]
95% chance what is found is
due to tx.

0.5% chance due to sampling error

[p > 0.05 =

result not statistically
significant]

[p = 0.05 =

observed difference occurs by
chance

t-Test:

Test for significance between 2 means ( groups)

Chi square test (x2):

Analyzes discrete and nominally scaled data
Determines significant differences between

observed & expected frequencies
Divide the square of the observed number

minus the expected number by the expected
number

Third party

Applies to groups
Ex. #1:
Dental prepayment plan,
usually sponsored by dental

payment plan:

Ex. #2:

association
Commercial insurance

companies have no obligation
to dental health of a

community

Most commonly used data base in

Index to Dental
Literature:

research

The best reference to use in locating infomnation on dentists' utilization of
auxiliary personnel over the past five years is;
a.

index Medicus

b.

Dental abstracts

c.

American Dental Directory

d.

Index to Dental Literature

Dental Hygiene National Board Review
Jane Weiner, RBH, Board Reviews, Inc.

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Computer References:
0 Pilot testing:

7

Medline, PubMed, BRFSS (CDC government data
base)

Initial testing during research design ^
Uses fewer people and is used to prepare a
larger experiment

Assessment:

Prioritize problem/analyze data

Plan:

Define problem/set goals &objectives

Implementation:

Action taken

Evaluation:

Measures success

0 Need:

Professional judgment about the type of health
services required by an individual to attain a
standard level of health ***

9 Perceived need:

• Demand:

Subjective of felt need ***
Determined by the patient or public

Type of health care individual desires, usually
at some level of price ***

Potential demand:

Desire for care &inability to obtain it

Effective demand:

Desire for care &ability to obtain it

Utilization:

Amount and type of dental sen/ices consumed
by a proportion of a population over a time
period

Host factor:

r Age, race, ethnic background, etc.
\ Trends: *caries inc. with age, females,
'

and Afro Americans

*perio inc. with age and lower
economics, no difference with sex
or race

Agent:

^Chemical or bacterial irritants, viral or parasitic

Dental Hygiene National Board Review
Jane Weiner, RDH, Board Reviews, Inc.

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Socioeconomic conditions, ciimate or physical

Environment:

environment; food sources

Determined by education before income

Masiow's Hierarchy

Explains the motivationarprocess
Classified in a pyramid ranking importance

Of Needs

Lower levels must be met first and once a

f

Level is achieved, It no longer serves to
Motivate.

1.
2.
3.
4.
5.

Physiologic(food water, oxygen, sex)
Security (shelter, income, stability)
Social (love, social acceptance, friendship)
Esteem - ego (achievement, status)
Self-actualization (drive to be best) •

TYPES OF STUDIES OR SURVEYS

7

> Longitudinal study;

A long-term study *** (histograph)

"^Case control study:

When one group is compared to another
Group having disease is compared to matching
group not having the disease

Necessary tools: questionnaires & medical
histories to review past events and exposures
- Relatively inexpensive (Board-related
information) ***
Double Blind Study:.

When neither the examiners or the

Single Blind Study;.,

Participants know which group is control
and which is experimental.
Only one group knows

Convenience study :

Used when access to the total population is not
feasible

If the survey is performed in an assisted living facility, what type of survey is It?
longitudinal

' (ib. .'convenience
c.

case control

d.

random sampling

Dental Hygiene National Board Review
Jane Weiner, RBH, Board Reviews, Inc.

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4 Random sample:

9

Composed of subjects chosen independently
of one another

4 Increases the external validity ***

^

decreases chance for examiner's bias)***

Which of the following is the primary advantage of using a random sample?
broad increase in sample size

«r

elimination of extraneous variables

elimination of researchers' bias in sample selection
accurate measurement ofthe dependent variable
ft Systematic Random
Sample;

-m/
\ .r

Members are numbered consecutively &table
of random sample numbers is used for
Experimental and controlled group
Assignments.***

Non-Random sample:

Intact groups

Not randomly selected from a given populous
Threat to external validity

Experimental group;

Group receiving the independent variable

Control group:

Group receiving a placebo or no tx. at all
Hawthorne Effect: Particpants in a productivity

study showed increased results even when no
intervention was made
-c Stratified sampling:

Random choosing *** Usually from a
previously subdivided group

Pilot Study:

Used to get ready to do a larger experiment.
This type of study uses fewer people.

Experimental Study:

Epidemiology study under controlled conditions
Identifies whether there is an association between an
exposure and a disease
Variables can be manipulated

Control groups are used
Treatment groups are used
Must be double blind

Two types of trials: Clinical trials test preventive agents

Community trials test community not

the individual

Dental Hygiene National Board Review
Jane Weiner, RBH, Board Reviews, Inc.

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Formative Study:

Examination of process or aspects of the program as it
occurs

^

Used to augment the implementation process
Retrospective Study:

Studies those diagnosed with the disease and those who

do not have the disease (past exposure to risk factors)
Common factors: environmental, familial, behavioral
Prospective Study:

Observes future outcomes after exposure to risk factors

If it involves people who share some demographic
characteristic then it is usually a" cohort" study.

rs
Dental Hygiene National Board Review
Jane Weiner, RDH, Board Reviews, Inc.

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PROCESS IN FORMULATING AND PERFORMING SURVEYS

STEPS IN PRIVATE SECTOR

STEPS IN PUBLIC HEALTH

1.

Exam (Dental office)

Survey (Health Clinic orCenter)

2.

Diagnosis (Dental exam)

Analysis (Community Survey)

3.

Treatment Plan

Program Plan

4.

Treatment

Program

5.

Payment

Finance

6.

Evaluation

Appraisal

7.

One dentist

Work as a team

8.

One individual or patient

Group study

RESEARCH
1.
2.
3.
4.

Observe problem
Review literature

Define problem
Hypothesis

5.

Research design

6.

Develop measuring techniques

7.

Collect data

8.

Analyze data

9.

Conclusion

STEPS IN DEVELOPING A PROGRAM
1.

Identify needs

a.

b.

^

use surveys, epidemiology, DMF indices, screenings

screenings always have a follow-up referral

2.

Analyze data

3.

Put in priority order

4.
5.

Identify goals
Develop objectives

6.

Budget or identify resources

7.

Plan program

Dental Hygiene National Board Review
Jane Weiner, RX>H, Board Reviews, Inc.

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RESEARCH STEPS VS. DENTAL COMMUNITY PROFILE
RESEARCH STEPS

r\

DENTAL COMMUNITY PROFILE

Collect infomiation to provide a
comprehensive overview of a
community
'Rationale for development for a profile
in order to understand the target
population's environment
Size, location &type of the
community
Analysis of data

Problem identification

Hypothesis formulation

Data collection
4.

Analysis/interpretation

5.

Conclusion

Conclusion

(DENTAL INDICES

KnowTtfielfoITowlng:
What is it measuring
Is it reversible or irreversible
How is it scored

What instruments are used, anything special?

(^ptai^aries In^ipes J

A. ^^^MFn^inft for >7and <11/12 )***
T.

Measures past &present caries of people with permanent
teeth

LL

*Not including: third molars, unerupted teeth,

I

congenitally missing teeth, teeth removed for ortho,

teeth restored due to trauma, and primary retained teeth
2.
3.

Irreversible index ***
D = carious tooth

4.

M = tooth missing due to carles

5.
6.

F = filled tooth
T = teeth

Dental Hygiene National Board Review
Jane Weiner, RDH, Board Reviews, Inc.

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Formula
a.
FNM

7.

Indicates treatment
received for decay

F

(filling needs met)

Total DMFT

b.

Percent of decayed teeth =

D

Total DMFT

Indicates treatment needed for unmet filling needs
Unmet treatment needs
d.

Mean of decayed teeth

Mean of decayed &filled
Percent of missing teeth =

M

Total DMFT

Indicates number of teeth lost by decay
e.

Average D, M, or F per individual =
D or M or F

Number of People Examined
Total DMFT

DMFT count =

Number of People Examined

Indicates number ofteeth with history of decay

deft *** {dft, dfs the " d" +the "e" are combined)
1.

Used for under age 7

2.

Measures caries seen in primary teeth

3.

e = need for extraction

4.
5.

Does not take into account teeth missing due to canes
deft count =
Total deft

Number of children examined

Indicates observable caries experience

In a preschool survey using 3and 4year olds which survey
would be indicated?
Dmft
dmft
-deft
Gi

Dental Hygiene National Board Review
Jane Weiner, RDH. Board Reviews, Inc.

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Determines

a.
2.

Prevalence &severity of gingivitis

Uses

a.

Epidemiology surveys

b.

Individual situations

; a ^9<j^

C&r7UxX-<^

Scoring

4.

a.

0.1 -1.0 = miid gingivitis

b.

1.1 - 2.0 = moderate gingivitis

c.

2.1 - 3.0 = severe gingivitis

5.

Difficultto reproduce

6.

P-M-A (papillary, marginal &attached gingival)

PI 1
1.

2.

3.

i

Reversible index

•r

f'

>:3 •

Detemnines

a.

The thickness of the biofilm and soft deposits

b.

Measures differences in the thickness of debris at the
gingival margin

***

Uses

a.

Trials and longitudinal studies

b.

In conjunction with the gingival index

rs

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Scoring

a.
b..

Mesial, distal, facial ( buccal), and lingual
Range of 0 - 3 in scoring
0 = no plaque

1 = Rim of plaque to free ging. margin and adjacent
area of tooth or plaque noticed only by running a

> A

j

probe across tooth surface

1^

2 = Moderate amt of soft deposits within gingival
margin &/or adjacent tooth surface
Can be seen by naked eye
3 = Abundance of soft material within gingival
pocket &/ or gingival margin and adjacent tooth surface

H-

d
c.

Add the scores for each tooth and divide by
the number ofteeth examined (for an individual)
Add the scores for each person and divide by the
number of people (for a group survey)

Dental Hygiene National Board Review

Jane Weiner, RDH, Board Reviews, Inc.

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4.

Examination tools
a.
Mouth mirror

b.

Explorer or probe (the probe is used when no plaque
is visible)

c.

Air

d

Disclosing solution if warranted, but rf using

this with the Gl the Gl must be perfonned first as the

disclosing solution will cover the gingival condition

eT^ Plaque control record:

Records presence of biofilm on individual surfaces

1.

Allows patient to visualize progress while leaming biofilm

2.

control
Measurements:

3.

a. All teeth included

b. Four surfaces are recorded (F, L, M, D)

c. Six areas can be recorded as well (MF, ML, etc.)
Special measuring device: Disclosing tablet

4.

F;/'plaque Free Score;

^

,

1. Determines location, number and %of biofilm free surfaces
2. Used as a motivator and for instructioin
3. Interdental bleeding can be documented
4. Measurements:

All erupted teeth included

F, L, M, Dsurfaces are scored or recorded

5. Special measuring device: Disclosing tablet
SBI

1.

Sulcus bleeding index

2.

Uses

a.

to detect early symptoms of gingivitis

b.

short-term clinical trials

a.
b.
4.

I.

I

1 '

"J

***

c.
Reversible
Calibration

3.

I

. . .

examiners' calibrations most important
report results by frequency ofscore

Criteria

maxillary &mandibular anterior teeth
papillary &marginal bleeding
scored on scale of 0-5

1)

healthiest = 0

2)

worst = bleeding on probing

Dental Hygiene National Board Review
Jane Weiner, RDH, Board Reviews, Inc.

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ingival Bleeding Index:
1. Determines;

J

a. absence or presence of gingival inflammation by bleeding from IP
gingival suici
2. Examination tool unwaxed dental floss

3. Scoring: no scoring of severity...
Healthy: no bleeding
Unhealtliy: bleeding

EIBI: Eastman Interdental Bleeding Index

^

1. Detemnines:

Presence ofinflammation In interdental area by presence or absence of—^

^

Bleeding
2. Examination tool: Triangular wooden interdental cleaner-^

3. Recording:

Record bleeding within 15 seconds for each area

Cn'

J-

(Russell's periodontal index)
Periodontal disease Index
Reversible & irreversible ***
Assesses

a.

t

gingivitis through occlusal & attrition mobility & lack of
contact on six teeth

c
b.
c.
4.

'1)

#3, 9, 12, 19, 25. 28 \

'(Ramfjord's teeth)***J *

gingiva & gingival crevice
measures periodontal patient's progress

Criteria

a.

scale of 0 to 8

1 = mild gingivitis

2 = gingivitis where inflamed area totally
circumscribes the tooth

6 = Gingivitis with pocket formation
8 = Advanced destojction with loss of

masticatory function
5.

Formula

a.

total scores of the teeth & divide by number of teeth

b.

for groups: total # of individual scores and divide by #

examined

of people examined

t
Dental Hygiene National Board Review
Jane Weiner, RDH, Board Reviews, Inc.

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f Kj

OHI-S
1.
Simplified Oral Hygiene Index
a.
b.
c.

0.0 -1.2 = good oral hygiene
1.3- 3.0 = fair oral hygiene
3.1 - 6.0 = poor oral hygiene

2.

Reversible ***

3.

Measures oral hygiene status ***

4.

Assesses

debris &calculus separately ***
1)

Dl-S

a)

0 = no debris to 3 =soft debns covers

2)

Cl-S

morethan 2/3 exposed tooth surface
. . ,

,
1
L

^

^

^

'

b.

a)

six teeth

,

2)
3)
r-O

PHP

V_/

1,

2.

0 = no calculus to 3=supragingival

covers more than 2/3 exposed tooth
surface or continuous heavy band of
sub around cervical portion oftooth
.

first erupted tooth distal to the second
premolar in each quadrant
maxillary right central
mandibular left central

•Patient hygiene performance



Assesses individual's performance to remove debns in
toothbrushing

3.

_

(i)

Uses:

Clinical Trials

Criteria (prev. bd. question) ***

fa)

^

six teeth

1)
2)

#3.8,14.19.24,30
know that it is first molars and incisors

5.

Formula

6.

Special Tool: Disclosing tablet

a.

total five subdivision scores per tooth surface &
divide by the number of tooth surfaces examined

I
Dental Hygiene National Board Review
Jane Weiner, RDH, BoardReviews, Inc.

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r>

CPITN

1.

Community periodontal index of treatment needs
Age 7 - 19 = children
Age 20and over = adults

2.

Uses

a.
3.

oral healthy surveys by World Health Organization

Indicators

a.

absence or presence of ginglval bleeding

b.

supra or subginglval calculus
periodontal pockets divided Into 4-5 mm. & 6 mm. or

c.

more

d.

Uses specialized WHO Probe
1.
Lightweight

2,

.5 mm ball tip ( black band between 3.5-5.5 mm)

Periodontal Screening & Recording (PSR)
1.
Purpose is to assess the state of periodontal health in a
patient in the most quick and efficient way.
2.
Color-coded probe at intervals from the tip of 3.5, 2.0, 3.0,
and 3.0mm.

3.

Total mm on probe 11.5 mm.

4.

When a code 4 is found, there is no need to probe remaining
teeth ( a comprehensive periodontal assessment is
indicated)

5.

Only one score is marked for each sextant, with a 3 or 4 indicating

6.

the need for a comprehensive periodontal examination
An asterisk (*) means either furcation involvement or
mucogingival involvement.

If asterisks are in two quadrants, minimal gingival
attachment may be indicated.

7.

If a 2 is found throughout dentition, calculus and overhangs
must be removed. Dental biofilm instruction should be given.
What is the best reason to use the PSR? *** Time expediency
***

What is the function of the ball? ***

To detect calculus, rough overhangs, and tooth surface irregularities
To make assessment at the probing depth easier (facilitate)
To reduce the risk of overmeasuring
All of the above

Dental Hygiene National Board Review
Jane Weiner, RDH, Board Reviews, Inc.

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'

fo.^ Dean's Classification for Dental Fluorosis

^

{ y

1.

Classification

2.

b.
3- (nnoderate) brown lesions
c.
4- (severe) brown lesions &pitted enamel
CFI

a.

0-2 (mild or less) not objectionable (opaque)

tT

^ ^

g
3
• ^

a.

Community fluorosis index is assigned based on the O ,§
mean of all the scores of a study population

vt

b.

Classification: less than 0.6 not objectionable

- -

jfr *** vvhich tooth (teeth )do you check ? *** The second most effected tooth

in order to decrease variation in assessing andT^rdlng observations during a

study, a person should have the examiners evaluate similar subjects, compare

their results, and agree with one another.

Fluoride mouth rinse programs in a non-fluoridated community have the
maximum cost benefit for control of caries in elementary school-age children.

If looking for a behavioral objective, have patient demonstrate. Use show and tell
method

Which ofthe following activities is most likely to lead to ieaming
retention?

a.
b.

viewing a film
reading an article

c.

listening to a presentation

d.

participating in an experience

The first step in establishing a community dental health program is to identify
the needs of the community, and the last step is the appraisal.

The most effective &efficient use of a dental liygienlst in a community is to:
Organize a school-based fluoride self-application ^

Program involving teachers to implement it. Hygienists teach those in

charge of the programs.

When planning learning activities for dental health education, consider.
1.

content to be learned

2.

previous dental health knowledge

3.

developmental level of the group

4

the environment where the learning occurs

Dental Hygiene National Board Review
Jane "Weiner, RDH, Board Reviews, Inc.

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/

The first step with a patient is to establish a rapport.

The best way to controi extraneous variables Is by random selection of groups.
Water fiuoridation needs endorsement by community leaders.
The most effective way to secure cooperation for a community dental health
program involving a minority group is to:
a.

(B)
c.
d.

contact the PTA

contact community representatives
place TV and radio announcements
conduct a door-to-door canvas explaining the program

The hardest thing to change is one's value system
Of the following factors detemnining an individual's utilization of dental
services, which is the most difficult for the dental profession to change
SHORT TERM?
a.

cost of dental services

b.
^
d.

availability of dental services
value system related to oral health
knowledge of proper oral health practices

In measuring oral disease: An ideal indice or index is simple, reliable, valid,
clear, objective, but not predictable
In measuring oral disease : An index must:
Assess the needs of a specific populus
Perform research
Assess needs of individuals

Primary care :
Secondary care:

Prevent the condition ( mouth guards, sealants, fluoride)
Prevent the progression (condition is already there)

Terciary care:

(night guards, restorations)
After the disease has done its damage (dentures)

Dental Hygiene National Board Review
Jane Weiner, RDH, Board Reviews, Inc.

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SAI^LE BOARD QUESTIO^

1 Ifone were to compare baseline and post-program evaluation dat^ in ordj to
determine the program effectiveness which ofthe foUowmg needs to be done?
a.

The study must be double-blind

b.
c.
d.

The sample must be chosen randomly^
The cost ofthe program must be considered
The same measures must be completed both times

measurements).

2.

Grouping data results could result in:

a.

^

Aclearer identification oftrends

b.

Easier calculation ofmeasures ofcentral tendency

c.
d.

A loss of detail
All ofthe above

Athree vear program to provide dental treatment for agroup ofjunior school
iuS
w^ conlcted. The following infonnatioin was obtained at basehne and

3.

at completion of the program:
Mean Number of Surfaces

Baseline

D

M

F

18

5

2

10

22

Post program 2

What could beconcluded from the data?

a.

The program was not successfiil because the mean number ofMsurfaces

b.

Sfpiamwas successful because the proportion ofthe untreated disease

c.

d.

^

success&l because the total DMFS greaHy increased
None ofthe above

Dental Hygiene National Board Review
Jane Weiner, RDH, Board Reviews, Inc.

COM 22

4. The dental hygienist shoidd consult with which ofthe following before initiating a
dental in-service training program for nurses' aides at an assisted living or nursing
home facility?

a.

The nurses on each floor ofthefacility

b.

The residents

c.

The administrator of thefacility

d.

The family members ofthe residents

(they might have the consulting dentist ofthe facility as well)

Aperiodontis wants to select an effective interdental oral physiotherapy aid for his/her
patients. A study was conducted inthe of&ce to test the effectiveness oftwo interdental

aids. Patients were randomly assi^ed to one ofthree groups and they all received the

same instructions in plaque control, prevention ofdental disease, and toothbrushing
techniques. Group Awas also given instruction in the use ofaPerio Aide® and Group

Bwas given instruction inthe use ofan oral iirigator. They were all examined and '
OHI-S scores are:
MEANOm
SCORES

Group
Appt 1

A

B

C

4.83

Appt 2

Appt. 3

3.97

3.69

3.11

2.86

2.28

4.76

3.95

4.14.

5. In examining the data for Group Cwhich could explain the improvement?
a. The patients's use ofthe Perio Aide®

b. The education that the patients's received
c. None of the above

Dental Hygiene National Board Review

Jane Weiner, RDH, BoardReviews, Inc.

COM 23

6. Based on the data which conclusion could be drawn?

a.
b.
c.

Using oral irrigators was more effective thani^ing aPerio
Using aPerio Aide® is more effective than using an oral imgator
No definitive conclusions can be drawn firom this study

7 Astatehealthcouncilstatedthat80%ofthepopulationhaduntreated

dental caries. The state dental association's survey detennmed that 50/o ol
the dentists had three or more unfilled appointments per day. What best
explaios this difference indata?

a.

The health council based its figure on the need for care and the

b.

The health council based its figure on the demand for care and the

c.

dental association based it onthe demand for care
dental association based it on theneedfor care

The dental association survey was not conducted properly
No determination can be made from the data offered

Answers:

^

1. (d), 2. (d), 3. (b), 4. (c), 5. (b), 6. (c), 7. (a)

Dental Hygiene National Board Review
JaneWeiner, RDH, Board Reviews, Inc.

COM 24

MORE COMMDNITY QUESTIONS
1.

2.

3.

The def indice refers to:
a.

adults

b.

the elderly

c.

children

Standard deviation i s a:

a.

measure of variability

b.

measure of a

c.

measure of the percent of the population affected

d.

by diseases
reproducible measurement

A hypothesis is a step used in:
a.
b.
c.

4.

death rate

p\iblic health projects
research projects
private sector projects

Which of the following activities is most likely to
lead to learning retention?

a.
b.
c.

d.

5.

viewing a film
reading an article
listening to a presentation
participating in an experience

Which of the following is the primary advantage of
using a random sample?
a.

broad increase in sample size,

b.

elimination of extraneous variables

c.

elimination of researchers' bias in sample
selection

d.

accurate measurement of the dependent variable

Hygiene National Board Review
Jane Weiaer, RDH, Board Reviews, Inc.

-

COM 25

6.

The most effective way to secure cooperation for a

community dental health program involving a minority
group is to:
a.

7.

contact the PTA

b.

contact community representatives

c.

place TV and radio announcements

d.

conduct a door-to-door canvass explaining the program

The best reference to use in locating information on
dentists' utilization of auxiliary personnel over the
past five years is:

8.

a.
b.

Index Medicus
Dental Abstracts

c.
d.

American Dental Directory
Index to Dental Literature

A researcher must provide evidence of validity and
reliability of the research design in order to:
a.

increase interrater reliability

b.

accurately infer results to the population

c.

measure the independent variable

d.

verify selection of the dependent variable

9.- How many modes are there in the following set of numbers?
1,1,1,2,3 , 3^ 4,5, 6, La, 8

10.

a.

one

b.

two

c.

three

d.

none

Which of the following correlation coefficients
indicates the strongest relationship?
a.
b.
c.
d.

-.95
+.63
+.05
-.05

Dental Hygiene National Board Review
Jane Weiner, RDH, Board Reviews, Inc.

COM 26

11.

12.

13.

When different examiners get the same measurement,
this

is:

a.
b.
c.

a stratified sampling
reliability
validity

d.

a

mean measurement

Which of the following are criteria for a good dental index?
a.

reliability and predictability

b.
c.
d.

predictability and ease in calibration
flexibility in measurement
reliability and ease in calibration

A study which high interrater reliability is a study in which:
a.

results were not due to chance

b.

two or more observers viewed the subjects the same way

c.

the factor measured is the factor intended to be
measured

d.
14.

Those symptoms that may be discerned only by the
patients and are obtained during the case history are:
a.
b.
c.
d.

15.

one observer viewed the subjects the same way each time

subjective
secondary
objective
primary

Which of the following must be evaluated to evaluate
the effectiveness of a program?
a.
b.
c.

cost to operate the program
size of the population served
qualifications and size of the staff

d.

none of the above

Dental Hygiene National Board Review
Jane Weiner, RDH, Board Reviews, Inc.

COM 27

16. Of the following factors determining an individual's
utilization of dental services, which is the «iost
difficult for the dental profession to change SHORT
TERM?

a.

cost of dental services

b!

availability of dental services

c.
d.

17.

value system related to oral health
knowledge of proper oral health practices

2\n ordinal scale is based on:

a.

observation fitted into categories

b.

empirical order

c.

equal intervals having no zero

d.

none of the above

18. The first thing to do in designing a school-based
fluoridation program is to:

^

a.

seek endorsements

b
c*.

seek endorsements from community leaders only
teach the staff how to implement program

d.

identify the need for the program

19. 900 mg. Fluoride is can be toxic to a 14 yr. old

child. Acute nausea can occur in 30 minutes and last
up to 24 hours.

a. First statement is true and second is false
b. First statement is false and second is true
c. Both statements are true

d. Both statements are false

20.

In a nursing home if smokers and non smokers were

compared what type of study would this indicate.
a. longitudinal
b.
c.

convenience
case control

d. random sampling

Dental Hygiene National Board Review
JaneWeiner, RDH, BoardReviews, Inc.

COM 28

21.

A toothpaste with fluoride and tartar control
ingredients gets the ADA approval for :
a. the tartar control ingredient

b. the fluoride and tartar control ingredients
c. the fluoride ingredient only
d.

22.

none of the above

A fluoride application on sensitive teeth-does NOT

include which of the following?
a.

wipe with gauze

b. rinse with water after application
c. air dry

ANSWERS

1.
2.
3.
4.
5.
6.
7.
8.
9.
10.

c
a
b
d
c
b
d
b
a
a

12.
13.
14.
15.
16.
17.
18.
19.
20.
21.

d
b
a
d
c
b
d
c
b
c

11.

b

22.

b



Dental Hygiene National Board Review
Jane Weiner, RDH, Board Reviews, Inc.

COM 29

COMMONITY REFERENCES

Darby, Michelle, et. al., Mosby's Comprehensive

f

Dental Hygiene, 2nd, ed., St. Louis, Mosby-Year Book, Inc.,
1991.

Darby, Michelle, et. al., Mosby's Comprphensive Review of
Dental Hygiene, 4"" . ed. , St. Louis, Mosby, Inc. 1998

Darby, Michelle, et. al., Mosby's Coiaprehensive

Dental Hygiene, S"' ed., Philadelphia, Mosby, Inc.

Darby, Michelle &Walsh, Margaret, Dental Hygiene Theory
and Practice, Philadelphia, W.B. Saunders Company, 1994.

Jong, Anthony, et. al.. Community Dental Health, 3rd ed.,
St. Louis, Mosby-Year Book, Inc., 1993.

Wilkins, Esther, Clinical Practice of the Dental Hygienist,
6th ed., Philadelphia, Lea & Febiger, 1989.

Wilkins, Esther, Clinical Practice of the. Dental Hygienist,
7th ed., Philadelphia, Williams &Wilkins, 1994.

Wilkins, Esther, Clinical Practice of the Dental Hygienist,
a"" ed., Philadelphia, Lippincott, William's &Wilkins,
1999.

Wilkins, Esther, Clinical Practice of the Dental Hygienist,
9th ed., Philadelphia, Lippincott, William's &Wilkins,

2005.

Dental Hygiene National Board Review
Jane Weiner, KDH, Board Reviews, Inc.

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