Public Health and Dental Public HealthCHAPTER 1

Define public health.

Discuss the changing concepts in public health.

Characteristics of public health method.

Principles/Guidelines followed in dental public health practice.

Characteristics of public health techniques.

Define dental public health.

Functions of public health dentist.

Tools of dental public health.

Similarities between public health dentist and private dentist.

Differences between public health dentist and private dentist.

Disease control phase (1880–1920): Mainly aimed to control man's physical environment, e.g. water supply, sewage disposal, etc. Measures were not aimed to control specific disease but improve the health of the people due to disease and death.

Health promotional phase (1920–1960): It is realized that the public health had neglected the citizen as an individual, to overcome this, one more goal was added, along with disease control activities, i.e. health promotion of individuals. As a beginning, personal health services such as Mother child health services, School health services, and Industrial health services were initiated. This program was further expanded, which included:

Social engineering phase (1960–1980): Many of the acute illness problems were solved but new health problems began to appear, as the preventive medicine and practice of public health advanced. Chronic disease like diabetes, cardiovascular disease, cancer, alcoholism, etc. began to emerge in developed world. These could not be solved by isolation, immunization and disinfections. A new factor “risk factors” as determinants of these diseases came into existence. Social and behavioral aspects of disease and health were given new priority.

Health for all phase (1981–2000 A.D): Most people in the developed countries enjoy all the determinants of good health, in contrast only 10–20% in developing countries have access to health services. It was concluded that the neglected 80% of the world population have an equal claim to health care, protection from killer diseases of childhood and to the primary health care for mothers and children. Against this background, in 1981, the members of WHO pledged themselves to an ambitious target to provide “Health for all by the year 2000;” i.e. attainment for all of a level of health that will permit all people to lead a socially and economically productive life. Here, services were moved from control of communicable diseases to preventive, therapeutic, rehabilitative aspects of chronic disease and behavioral disorders, organization of medical care, safe drinking water, sanitation, nutrition, education, adequate income and comprehensive health care.

Group responsibility.

Team work.

Prevention. (It is a major objective because it is ethical, involves team work and is cost effective).

Counteracting medical indigence.

Dealing with multifactorial problem (using the science of epidemiology and biostatistical methods).

Deals with healthy or apparently healthy people as well as the sick.

Health education of the public.

Social sciences.

Logistics.

Insurance/payment.

Use of health center,

Case finding and

Use of community health council.

Health center: These are community buildings to house health administration and a number of out-patient or preventive services not easily housed in a hospital. Usually each center is for 50,000 to 1,00,000 population. Large cities will have many centers. A variant of this health unit in some countries are school based dental clinics.

Case finding: It is also called “Screening”. The objective of this is to search the diseases in the community in their early stage through simple tests.4

Community health council: These councils consists of people in the community from both voluntary and government agencies and community at large. These are associated with community fund raising efforts, interaction with various health agencies and public for development of new ideas. These agencies and councils not only serve as media for communication, but also have approval/disapproval power over both new and existing institutional health services in their areas.

Conduct health education programs to create awareness among people.

Educating and motivating an individual or community to utilize rendered dental services.

To organize dental camps and delivering dental services for the needy like people in rural areas, orphanages, mentally/physically compromised children, etc.

Conducting school dental health programs and providing preventive dental care to the school children like topical fluoride applications, pit and fissure sealants.

Conducting dental treatment camps and providing treatments like extractions, oral prophylaxis, fluoride applications, simple restorations, ART, etc. in schools or in community for general public.

Updating the knowledge of people regarding new dental preventive methods and procedures.

Conducting surveys to collect baseline data, know the nature and extent of the diseases in the community and plan programs accordingly, to decrease the incidence of the diseases.

Conducting dental public health activities and field experiences for dental students and dental nursing students.

Survey: Surveys are methods for collection of data, analyzing and evaluating them in order to determine the amount of disease problems in a community and also to identify cases that have not been identified.

Analysis: It is necessary to arrange or organize the data collected from the survey in such a way that meaningful figures are obtained. Analysis can be done manually or using computers.

Program planning: After analyzing the problem, the next step is program planning. The objective is to design the plan so that it is accepted by the community and in which they are interested in, which is comprehensive and cheaper. It has to be ensured that the community is well informed about the program so that they participate in all the steps involved.

Program operation: Execution of the program once the plan has been accepted. A public health team, which constitutes of professionals in various disciplines, has to be employed for executing the program. Example: Water fluoridation, which includes a team of dentists, engineers, chemists, water works department, public health authorities.

Financing: Financing in public health program is usually through the government or by the local or state authorities. Before planning a program, public health personnel should identify the source of funds and also plan for management of the same.

Program appraisal: Final step in any public health program where effectiveness of the program is assessed. The baseline data prior to the introduction of the program serves as an indicator against the effectiveness of the program after the implementation. The criteria for evaluation are appropriateness, adequacy, effectiveness and efficiency.

Epidemiology: Epi = upon, demos = people, logos = science.

Is defined as “the study of the distribution and determinants of health 6related states and events in population and the application of the study to the control of health problems”. It aims to minimize or eradicate the disease or health problem and its consequences and to minimize the chances of its occurrence in future. It also helps to define the magnitude and occurrence of disease in man, identify the etiologic factors and provide necessary data for planning, implementation and evaluation of programs for preventing, controlling and treating diseases.

Biostatistics: Is a branch of statistics concerned with mathematical facts and data relating to the biological events. It involves compiling, analyzing, tabulating and representing the data in the mathematical or graphical manner. It gives the correlation or association between two attributes.

Social sciences: It includes sociology, cultural anthropology, social psychology, economics and political science. Public health worker when emphasizes on organized community effort, it is necessary to know the group behaviors of individuals, their culture, customs and habits etc. Social scientists are the persons, who play an important role in understanding the group behavior and are necessary to match effort and effect.

Principles of administration: There are two main divisions in administrative work: Organization and Management.

Preventive dentistry: Prevention is better then cure, so prevent the disease before it starts. Different levels of prevention are: