community weiner

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Health: Public Health; Dental Public Health: Community: Epidemiology: 0 Epidemic: Endemic: Pandemic: Mortality: Morbidity: COM 1 COMMUNITY terminology A state 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 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. 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. Compares groups or specific populations Measures the circumstances under which a disease occurs among groups Prevalence of a disease is greater than normal *** The disease spreads rapidly and there are more than the expected number of incidents The normal prevalence ofdisease It includes the expected number of cases and usually they are indigenous to a specific area or people *** Worldwide Death rate = # of deaths Extent ofdisease - amount of disease Dental Hygiene National Board Review Jane Weiner, RDH, Board Reviews. Inc.

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  • Health:

    Public Health;

    Dental Public Health:

    Community:

    Epidemiology:

    0 Epidemic:

    Endemic:

    Pandemic:

    Mortality:

    Morbidity:

    COM 1

    COMMUNITY

    terminology

    Astate of complete physical, mental and socialwell being, including the absence of diseaseThe science of preventing disease, prolonginglife, and promotion physical health throughorganized community efforts

    The concern for the improvement of and thepromotion of dental health for an entirepopulation, 4. fIt serves a community as a patient, notanindividual as a patient.

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

    Compares groups or specific populationsMeasures the circumstances under which adisease occurs among groups

    Prevalence of a disease is greater thannormal ***The disease spreads rapidly and there aremore than the expected number of incidents

    The normal prevalence ofdiseaseIt includes the expected number of cases andusually they are indigenous to a specific areaor people ***

    Worldwide

    Death rate = # of deaths

    Extent ofdisease - amount ofdisease

    Dental Hygiene National Board ReviewJane Weiner, RDH, Board Reviews. Inc.

  • Rate:

    Incidence:

    9 Prevalence:

    COM 2

    Numerical ratioThe # of people who have the disease is thenumerator and the # of possible occurrences isthe denominator

    r # of people with the diseased[ # of people in a community]

    The rate or# of new cases at a given time

    The percent of the population affected*** "The total # of cases of a specific disease orcondition in existence in a given population at a certaintime"

    (Wilkins 8"^ ed. Page 294 )P = Cases x100%

    population

    Most dental surveys (DMF) counts measurethe prevalence of dental disease within a givenpopulation

    Reliability: Reproducible***Measures consistently at different timesMeasurement must have stabilityImportant in evaluating (Board info)

    o Validity : Examiner measures what they are supposedto measure ***

    i Internal validity: when the independent variablealone brings about a change In the dependentVariableExtemal validity: when the survey reflectsaccurately things that would occur in reality

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

    Calibration:

    Index:

    Examiners evaluate what is found in common(x), compare results and come to an agreement

    Assess reversible & irreversible diseases or acombination

    Dental Hygiene National Board ReviewJane Weiner, RDH, Board Reviews, Inc.

  • Index Selection:

    Types of indices:

    jnt[-arater reliability:

    1nterrater reliability:

    Variable:

    Independent variable:

    g Dependent variable:

    Data:

    Statistics:

    COM 3

    Determined byType of condition to beassessed

    B. Age ofthe group to be studiedC. The purpose ofthe research

    Cumulative indexMeasures all the evidence of a condition pastand presentEx: DMFTSimple indexMeasures the presence orabsence ofaconditionEx: One that measures the presence ofbiofilmwithout evaluating its effect on the gingiva

    The same examiner remains consistent inscoringStandardized with self***

    Consistency occurs between examiners(Board info: when 2 or more people view asubject the same way, a higher interraterreliability exists) ***

    Which would increase interrater reliability***Utilizing the same tool for measurementKeeping the subjects the sameMonitor the same independent variableBe sure that the examiners are calibrated

    Condition or concept which can vary

    Condition manipulated orcontrolled by theinvestigator ***

    Condition thought to have changed due to theabsence, presence, or manipulation of theindependent variable ***

    Numbers that are collected from numbers oramounts

    Analyzes &uses numerical dataMeasure values based on sample data, eitherdescriptive or inferential (experimental)

    Dental Hygiene National Board ReviewJane Weiner, RDH, Board Reviews, Inc.

  • Descriptive statistics;

    ANOVA

    *Measure of centraltendency:

    *Mean:

    ''Median:

    'Mode:

    Variance:

    'Standard deviation:

    COM 4

    Nunnerically describe &summarize datacollectedNo attempt made to find out anything beyondthe immediate sample

    Analysis of varianceAnalyzes effects of two or more independentvariables at the same time in the sameresearch designTests for differences among three or moremeans

    Describes what is typical in a samplegroup based on accumulated data

    Ratio statisticSum of values divided by # of itemsAffected by extreme scores

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

    Most frequently occurring scoreRanks people by numbers (nominal status)

    The sum of the squared deviations from themean divided by NSquare root of the variance gives us the

    standard deviation

    Analyzes the dispersion of scores from themean

    The smaller the SD, the more homogeneous agroupMeasures variability

    [Board example: If the mean is 8 and the standard deviation is one, the scoresrepresented are: 5-9

    6-107-9

    Dental Hygiene National Board ReviewJane Weiner, RDH, Board Reviews, Inc.

    r>

  • wCorrelation:

    Inferential statistics:

    Parameter:

    Non-Parameter

    Scales^ Ordinal:

    Nominal:

    Inten/al:

    Ratio:

    s. Skewed:

    s

    COM 5

    Determines the strengtli of the linearrelationship between two variablesRanges from -1.0 to +1.0 (perfect)Strongest correlation closest to -1 or +1(Board example: -.95 Is it strong or weakcorrelation? Strong)Positive : closer to +1 , both variable's valuesincreaseNegative : closer to -1, one variable valueincreases while the other decreasesNull: no difference

    Infers findings form the sample to the generalpopulationUsed to generalize results

    Value inferred from a statistic (assumptions)Inferential statistical procedures which yieldfewer, ifany, assumptions

    ***

    " Ranks in empirical order[students according to grades] (Bd.-related)Observations fitted into categories[good oral hygiene - poor oral hygiene]

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

    Characterized by presence of absolute 0[age, height orweight]Notan even bell shape (lopsided )Positive skew is skewed rightMore scores are in lower rangeNegative skew is skewed leftMore scores are in higher range

    Tables and graphs lose details but make ^results easierto calculate and to identify trendsand give a more concise presentation of facts.Histograph; measures things over a long time

    Dental Hygiene National Board ReviewJane Weiner, RDH, BoardReviews, Inc.

    \1rk*

  • Dispersion;

    Significance Level:

    p-Value:

    t-Test:

    Chi square test (x2):

    Third partypayment plan:

    Index to DentalLiterature:

    COM 6

    Variability of spread of scores

    Odds for detemnining the operation of chancefactors in producing the obtained result(Probability level, or p-value)

    The probability of observing a value equal to ormore extreme than its table value[p < 0.05 = results statistically significant]

    95% chance what is found isdue to tx.0.5% chance due to sampling error

    [p > 0.05 = result not statisticallysignificant]

    [p = 0.05 = observed difference occurs bychance

    Test for significance between 2 means ( groups)Analyzes discrete and nominally scaled dataDetermines significant differences betweenobserved & expected frequenciesDivide the square of the observed numberminus the expected number by the expectednumber

    Applies to groupsEx. #1:

    Ex. #2:

    Dental prepayment plan,usually sponsored by dentalassociationCommercial insurancecompanies have no obligationto dental health of acommunity

    Most commonly used data base inresearch

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

    a. index Medicusb. Dental abstractsc. American Dental Directoryd. Index to Dental Literature

    Dental Hygiene National Board ReviewJane Weiner, RBH, Board Reviews, Inc.

    J

  • Computer References:

    0 Pilot testing:

    Assessment:

    Plan:

    Implementation:

    Evaluation:

    0 Need:

    9 Perceived need:

    Demand:

    Potential demand:

    Effective demand:

    Utilization:

    Host factor:

    Agent:

    COM 7

    Medline, PubMed, BRFSS (CDC government database)

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

    Prioritize problem/analyze data

    Define problem/set goals &objectivesAction taken

    Measures success

    Professional judgment about the type of healthservices required by an individual toattain astandard level of health ***

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

    Type of health care individual desires, usuallyat some level of price ***

    Desire for care &inability to obtain it

    Desire for care &ability to obtain it

    Amount and type of dental sen/ices consumedby a proportion of a population over a timeperiod

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

    ' and Afro Americans*perio inc. with age and lowereconomics, no difference with sexor race

    ^Chemical or bacterial irritants, viral or parasitic

    Dental Hygiene National Board ReviewJane Weiner, RDH, Board Reviews, Inc.

  • Environment:

    Masiow's HierarchyOf Needs

    COM 8

    Socioeconomic conditions, ciimate or physicalenvironment; food sourcesDetermined by education before income

    Explains the motivationarprocessClassified in a pyramid ranking importanceLower levels must be met first and once aLevel is achieved, It no longer serves toMotivate.1. Physiologic(food water, oxygen, sex)2. Security (shelter, income, stability)3. Social (love, social acceptance, friendship)4. Esteem - ego (achievement, status)5. Self-actualization (drive to be best)

    TYPES OF STUDIES OR SURVEYS7> Longitudinal study;

    "^Case control study:

    Double Blind Study:.

    Single Blind Study;.,

    Convenience study :

    A long-term study *** (histograph)

    When one group is compared to anotherGroup having disease is compared to matchinggroup not having the diseaseNecessary tools: questionnaires & medicalhistories to review past events and exposures- Relatively inexpensive (Board-relatedinformation) ***

    When neither the examiners or theParticipants know which group is controland which is experimental.Only one group knows

    Used when access to the total population is notfeasible

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

    ' (ib. .'conveniencec. case controld. random sampling

    Dental Hygiene National Board ReviewJane Weiner, RBH, Board Reviews, Inc.

    f

    I

    i"r(I

    I

    r

  • 4 Random sample:

    COM 9

    Composed of subjects chosen independentlyof 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 sizeelimination of extraneous variableselimination of researchers' bias in sample selectionaccurate measurement ofthe dependent variable

    ft Systematic RandomSample;

    Non-Random sample:

    Experimental group;

    Control group:

    -c Stratified sampling:

    Pilot Study:

    Experimental Study:

    Members are numbered consecutively &tableof random sample numbers is used forExperimental and controlled groupAssignments.***

    Intact groupsNot randomly selected from a given populousThreat to external validity

    Group receiving the independent variable

    Group receiving a placebo or no tx. at allHawthorne Effect: Particpants in a productivitystudy showed increased results even when nointervention was made

    Random choosing *** Usually from apreviously subdivided group

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

    Epidemiology study under controlled conditionsIdentifies whether there is an association between anexposure and a disease

    Variables can be manipulatedControl groups are usedTreatment groups are usedMust be double blind

    Two types of trials: Clinical trials test preventive agentsCommunity trials test community notthe individual

    Dental Hygiene National Board ReviewJaneWeiner, RBH, BoardReviews, Inc.

    r

    -m/\ .r

  • Formative Study:

    Retrospective Study:

    Prospective Study:

    COM 10

    Examination ofprocess or aspects of the program as itoccurs ^

    Used to augment the implementation process

    Studies those diagnosed with the disease and those whodo not have the disease (past exposure to risk factors)Common factors: environmental, familial, behavioral

    Observes future outcomes after exposure to risk factorsIf it involves people who share some demographiccharacteristic then it is usually a" cohort" study.

    Dental Hygiene National Board ReviewJane Weiner, RDH, Board Reviews, Inc.

    rs

  • COM 11

    PROCESS IN FORMULATING AND PERFORMING SURVEYS

    STEPS IN PRIVATE SECTOR STEPS IN PUBLIC HEALTHSurvey (Health Clinic orCenter)Analysis (Community Survey)Program Plan

    Program

    Finance

    Appraisal

    Work as a team

    Group study

    1. Exam (Dental office)

    2. Diagnosis (Dental exam)3. Treatment Plan

    4. Treatment

    5. Payment

    6. Evaluation

    7. One dentist

    8. One individual or patient

    RESEARCH

    1. Observe problem2. Review literature3. Define problem4. Hypothesis

    5. Research design6. Develop measuring techniques7. Collect data8. Analyze data9. Conclusion

    STEPS IN DEVELOPING A PROGRAM

    1. Identify needs ^a. use surveys, epidemiology, DMF indices, screeningsb. screenings always have a follow-up referral

    2. Analyze data3. Put in priority order4. Identify goals5. Develop objectives6. Budget or identify resources7. Plan program

    Dental Hygiene National Board ReviewJaneWeiner, RX>H, Board Reviews, Inc.

  • 4.5.

    LL

    I

    COM 12

    RESEARCH STEPS VS. DENTAL COMMUNITY PROFILE

    RESEARCH STEPS DENTAL COMMUNITY PROFILE

    Problem identification

    Hypothesis formulation

    Data collection

    Analysis/interpretationConclusion

    Collect infomiation to provide acomprehensive overview of acommunity

    'Rationale for development for a profilein order to understand the targetpopulation's environmentSize, location &type of thecommunity

    Analysis of dataConclusion

    (DENTAL INDICESKnowTtfielfoITowlng:What is it measuring

    Is it reversible or irreversibleHow is it scored

    What instruments are used, anything special?

    (^ptai^aries In^ipes JA. ^^^MFn^inft for >7and

  • 7. Formulaa. FNM

    FTotal DMFT

    b. Percent of decayed teeth =

    COM 13

    Indicates treatmentreceived for decay(filling needs met)

    DTotal DMFT

    Indicates treatment needed for unmet filling needs

    Unmet treatment needs Mean ofdecayed teethMean of decayed &filled

    d. Percent of missing teeth = MTotal DMFT

    Indicates number of teeth lost by decay

    Average D, M, or F per individual =

    D or M or F

    e.

    Number of People Examined

    DMFT count = Total DMFTNumber of People Examined

    Indicates number ofteeth with history ofdecay

    deft *** {dft, dfs the " d" +the "e" are combined)1. Used for under age 72. Measures caries seen in primary teeth3. e = need for extraction4. Does not take into account teeth missing dueto canes5. deft count = Total deft

    Number of children examined

    Indicates observable caries experienceIn a preschool survey using 3and 4year olds which surveywould be indicated?

    Dmftdmft

    -deftGi

    Dental Hygiene National Board ReviewJaneWeiner, RDH. BoardReviews, Inc.

  • > A

    1 ^H-

    d

    2.

    4.5.6.

    PI 11.

    2.

    \ II 0(

    Determinesa. Prevalence &severity of gingivitisUsesa. Epidemiology surveysb. Individual situations

    COM 14

    ;a ^9

  • I.

    I

    1 '

    I"J

    COM 15

    4. Examination toolsa. Mouth mirrorb. Explorer or probe (the probe is used when no plaque

    is visible)c. Aird Disclosing solution if warranted, but rf using

    this with the Gl the Gl must be perfonned first as thedisclosing solution will cover the gingival condition

    eT^ Plaque control record:Records presence of biofilm on individual surfacesAllows patient to visualize progress while leaming biofilmcontrolMeasurements:a. All teeth includedb. Four surfaces are recorded (F, L, M, D)c. Six areas can be recorded as well (MF, ML, etc.)Special measuring device: Disclosing tablet

    F;/'plaque Free Score; ^ ,1. Determines location, number and %of biofilm free surfaces2. Used as a motivator and for instructioin3. Interdental bleeding can be documented4. Measurements:

    All erupted teeth includedF, L, M, Dsurfaces are scored orrecorded

    5. Special measuring device: Disclosing tablet

    1.2.

    3.

    SBI

    4.

    1. Sulcus bleeding index2. Uses ...

    a. to detect early symptoms ofgingivitisb. short-term clinical trialsc. Reversible

    3. Calibrationa. examiners' calibrations most importantb. report results by frequency ofscore

    ***

    4. Criteriamaxillary &mandibular anterior teethpapillary &marginal bleedingscored on scale of 0-51) healthiest = 02) worst = bleeding on probing

    Dental Hygiene National Board ReviewJaneWeiner, RDH, BoardReviews, Inc.

  • COM 16

    ingival Bleeding Index:1. Determines;

    a. absence or presence of gingival inflammation by bleeding from IPgingival suici

    2. Examination tool unwaxed dental floss3. Scoring: no scoring of severity...

    Healthy: no bleedingUnhealtliy: bleeding

    EIBI: Eastman Interdental Bleeding Index ^1. Detemnines:

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

    J

    2. Examination tool: Triangular wooden interdental cleaner-^3. Recording: Record bleeding within 15 seconds for each area J-

    Cn'

    (Russell's periodontal index)Periodontal disease IndexReversible & irreversible ***Assessesa. gingivitis through occlusal & attrition mobility &lack of

    contact on six teeth'1) #3, 9, 12, 19, 25. 28 \

    '(Ramfjord's teeth)***J *b. gingiva & gingival crevicec. measures periodontal patient's progress

    4. Criteriaa. scale of 0 to 8

    1 = mild gingivitis2 = gingivitis where inflamed area totally

    circumscribes the tooth6 = Gingivitis with pocket formation8 = Advanced destojction with loss of

    masticatory function5. Formula

    a. total scores of the teeth & divide by number of teethexamined

    b. for groups: total # of individual scores and divide by #of people examined

    c

    Dental Hygiene National Board ReviewJane Weiner, RDH, Board Reviews, Inc.

    t

    t

  • If Kj OHI-S1. Simplified Oral Hygiene Index

    a. 0.0 -1.2 = good oral hygieneb. 1.3- 3.0 = fair oral hygienec. 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, morethan 2/3 exposed tooth surface

    2) Cl-S . . ,a) 0=no calculus to 3=supragingival

    1 covers more than 2/3 exposed toothsurface or continuous heavy band ofsub around cervical portion oftooth

    L ' b. six teeth .first erupted tooth distal to the secondpremolar in each quadrant

    ^ , 2) maxillary right central3) mandibular left central

    ^ r-O PHPV_/ 1, Patient hygiene performance

    2. Assesses individual's performance to remove debns intoothbrushing

    3. Uses:_ Clinical Trials(i) Criteria (prev. bd. question) ***

    fa) six teeth^ 1) #3.8,14.19.24,30

    2) know that it is first molars and incisors5. Formula

    COM 17

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

    ^ 6. Special Tool: Disclosing tablet

    Dental Hygiene National Board ReviewJaneWeiner, RDH, BoardReviews, Inc.

  • ***

    COM 18

    CPITN1. Community periodontal index of treatment needs

    Age 7 - 19 = childrenAge 20and over = adults

    2. Usesa. oral healthy surveys by World Health Organization

    3. Indicatorsa. absence or presence of ginglval bleeding

    supra or subginglval calculusperiodontal pockets divided Into 4-5 mm. & 6 mm. ormore

    Uses specialized WHO Probe1. Lightweight2, .5 mm ball tip ( black band between 3.5-5.5 mm)

    b.c.

    d.

    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 isindicated)

    5. Only one score is marked for each sextant, with a 3 or 4 indicatingthe need for a comprehensive periodontal examination

    6. An asterisk (*) means either furcation involvement ormucogingival involvement.If asterisks are in two quadrants, minimal gingivalattachment may be indicated.

    7. Ifa 2 is found throughout dentition, calculus and overhangsmust be removed. Dental biofilm instruction should be given.

    What is the best reason to use the PSR? *** Time expediencyWhat is the function of the ball? ***

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

    All of the above

    Dental Hygiene National Board ReviewJane Weiner, RDH, Board Reviews, Inc.

    r>

  • COM 19

    ' fo.^ Dean's Classification for Dental Fluorosis{ y 1. Classification tT

    ^ a. 0-2 (mild or less) not objectionable (opaque) ^ ^b. 3- (nnoderate) brown lesions gc. 4- (severe) brown lesions &pitted enamel 3

    2. CFI ^a. Community fluorosis index is assigned based on the O ,

    mean of all the scores of a study population vtb. 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 astudy, a person should have the examiners evaluate similar subjects, comparetheir results, and agree with one another.

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

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

    Which ofthe following activities is most likely to lead to ieamingretention?

    a. viewing a filmb. reading an articlec. listening to a presentationd. participating in an experience

    The first step in establishing a community dental health program is to identifythe 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 learned2. previous dental health knowledge3. developmental level of the group4 the environment where the learning occurs

    Dental Hygiene National Board ReviewJane "Weiner, RDH, Board Reviews, Inc.

    ^ ^ o

    I !

  • /COM 20

    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 healthprogram involving a minority group is to:

    a. contact the PTA(B) contact community representativesc. place TV and radio announcementsd. conduct a door-to-door canvas explaining the program

    The hardest thing to change is one's value systemOf the following factors detemnining an individual's utilization of dentalservices, which is the most difficult for the dental profession to changeSHORT TERM?

    a. cost of dental servicesb. availability of dental services^ value system related to oral healthd. 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 populusPerform researchAssess needs of individuals

    Primary care :Secondary care:

    Terciary care:

    Prevent the condition ( mouth guards, sealants, fluoride)Prevent the progression (condition is already there)(night guards, restorations)After the disease has done its damage (dentures)

    Dental Hygiene National Board ReviewJane Weiner, RDH, Board Reviews, Inc.

  • a.

    3.

    ^ Aclearer identification oftrendsb. Easier calculation ofmeasures ofcentral tendencyc. A loss of detaild. All ofthe above

    COM 21

    SAI^LE BOARD QUESTIO^

    1 If one were to compare baseline and post-program evaluation dat^ in ordj todetermine the program effectiveness which of the foUowmg needs to be done?a. The study must be double-blindb. The sample must be chosen randomly^c. The cost ofthe program must be consideredd. The same measures must be completed both times

    measurements).

    2. Grouping data results could result in:

    Athree vear program to provide dental treatment for agroup ofjunior schooliuS w^ conlcted. The following infonnatioin was obtained at basehne andat completion of the program:

    Mean Number of Surfaces

    D

    Baseline 18Post program 2

    What could beconcluded from the data?

    a. The program was not successfiil because the mean number ofMsurfacesb. Sfpiam was successful because the proportion ofthe untreated disease

    M F

    5 2

    10 22

    success&l because the total DMFS greaHy increasedc.

    d. None ofthe above

    ^ Dental Hygiene National Board ReviewJane Weiner, RDH, Board Reviews, Inc.

  • COM 22

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

    a. The nurses oneach floor ofthefacilityb. The residentsc. The administrator of thefacilityd. The family membersofthe residents

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

    Aperiodontis wants to select an effective interdental oral physiotherapy aid for his/herpatients. Astudy was conducted inthe of&ce to test the effectiveness oftwo interdentalaids. Patients were randomly assi^ed to one ofthree groups and they all received thesame instructions in plaque control, prevention ofdental disease, and toothbrushingtechniques. Group Awas also given instruction in the use ofaPerio Aide and GroupBwas given instruction inthe use ofan oral iirigator. They were all examined and 'OHI-S scores are:

    Group

    MEANOmSCORES

    Appt 1 Appt 2 Appt. 3

    A 4.83 3.97 3.69

    B 3.11 2.86 2.28

    C 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 Aideb. The education that the patients's receivedc. None ofthe above

    Dental Hygiene National Board ReviewJaneWeiner, RDH, BoardReviews, Inc.

  • COM 23

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

    a. Using oral irrigators was more effective than i^ing aPeriob. Using aPerio Aide is more effective than using an oral imgatorc. No definitive conclusions can be drawn firom this study

    7 Astatehealthcouncilstatedthat80%ofthepopulationhaduntreateddental caries. The state dental association's survey detennmed that 50/o olthe dentists had three or more unfilled appointments per day. What bestexplaios this difference indata?

    a. The health council based its figure on the need for care and thedental association based it onthedemand for care

    b. The health council based its figure on the demand for care and thedental association based it on theneedfor careThe dental association survey was not conducted properlyNo determination can be made from the data offered

    c.

    Answers:

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

    Dental Hygiene National Board ReviewJaneWeiner, RDH, Board Reviews, Inc.

  • COM 24

    MORE COMMDNITY QUESTIONS

    1. The def indice refers to: -

    a. adultsb. the elderlyc. children

    2. Standard deviation is a:

    a. measure of variabilityb. measure of a death ratec. measure of the percent of the population affected

    by diseasesd. reproducible measurement

    3. A hypothesis is a step used in:

    a. p\iblic health projectsb. research projectsc. private sector projects

    4. Which of the following activities is most likely tolead to learning retention?

    a. viewing a filmb. reading an articlec. listening to a presentationd. participating in an experience

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

    a. broad increase in sample size,b. elimination of extraneous variablesc. elimination of researchers' bias in sample

    selectiond. accurate measurement of the dependent variable

    Hygiene National Board ReviewJane Weiaer, RDH, Board Reviews, Inc.

  • COM 25

    6. The most effective way to secure cooperation for acommunity dental health program involving a minoritygroup is to:

    a. contact the PTAb. contact community representativesc. place TV and radio announcementsd. conduct a door-to-door canvass explaining the program

    7. The best reference to use in locating information ondentists' utilization of auxiliary personnel over thepast five years is:

    a. Index Medicusb. Dental Abstractsc. American Dental Directoryd. Index to Dental Literature

    8. A researcher must provide evidence of validity andreliability of the research design in order to:

    a. increase interrater reliabilityb. accurately infer results to the populationc. measure the independent variabled. 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

    a. one

    b. twoc. threed. none

    10. Which of the following correlation coefficientsindicates the strongest relationship?

    a. -.95b. +.63c. +.05d. -.05

    Dental Hygiene National Board ReviewJane Weiner, RDH, Board Reviews, Inc.

  • COM 26

    11. When different examiners get the same measurement,this is:

    a. a stratified samplingb. reliabilityc. validityd. a mean measurement

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

    a. reliability and predictabilityb. predictability and ease in calibrationc. flexibility in measurementd. reliability and ease in calibration

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

    a. results were not due to chanceb. two or more observers viewed the subjects the same wayc. the factor measured is the factor intended to be

    measuredd. one observer viewed the subjects the same way each time

    14. Those symptoms that may be discerned only by thepatients and are obtained during the case history are:

    a. subjectiveb. secondaryc. objectived. primary

    15. Which of the following must be evaluated to evaluatethe effectiveness of a program?

    a. cost to operate the programb. size of the population servedc. qualifications and size of the staffd. none of the above

    Dental Hygiene National Board ReviewJane Weiner, RDH, Board Reviews, Inc.

  • COM 27

    16. Of the following factors determining an individual'sutilization of dental services, which is the iostdifficult for the dental profession to change SHORTTERM?

    a. cost of dental servicesb! availability of dental servicesc. value system related to oral healthd. knowledge of proper oral health practices

    17. 2\n ordinal scale is based on:

    a. observation fitted into categoriesb. empirical orderc. equal intervals having no zerod. none of the above

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

    a. seek endorsementsb seek endorsements from community leaders onlyc*. teach the staff how to implement programd. identify the need for the program

    ^ 19. 900 mg. Fluoride is can be toxic to a 14 yr. oldchild. Acute nausea can occur in 30 minutes and lastup to 24 hours.

    a. First statement is true and second is falseb. First statement is false and second is truec. Both statements are trued. Both statements are false

    20. In a nursing home if smokers and non smokers werecompared what type of study would this indicate.a. longitudinalb. conveniencec. case controld. random sampling

    Dental Hygiene National Board ReviewJaneWeiner, RDH, BoardReviews, Inc.

  • COM 28

    21. A toothpaste with fluoride and tartar controlingredients gets the ADA approval for :

    a. the tartar control ingredientb. the fluoride and tartar control ingredientsc. the fluoride ingredient onlyd. none of the above

    22. A fluoride application on sensitive teeth-does NOTinclude which of the following?

    a. wipe with gauzeb. rinse with water after applicationc. air dry

    ANSWERS

    1. c 12. d2. a 13. b3. b 14. a 4. d 15. d5. c 16. c6. b 17. b7. d 18. d8. b 19. c9. a 20. b10. a 21. c11. b 22. b

    Dental Hygiene National Board ReviewJane Weiner, RDH, Board Reviews, Inc.

  • COM 29

    COMMONITY REFERENCES

    Darby, Michelle, et. al., Mosby's Comprehensive fDental Hygiene, 2nd, ed., St. Louis, Mosby-Year Book, Inc.,1991.

    Darby, Michelle, et. al., Mosby's Comprphensive Review ofDental Hygiene, 4"" . ed. , St. Louis, Mosby, Inc. 1998Darby, Michelle, et. al., Mosby's CoiaprehensiveDental Hygiene, S"' ed., Philadelphia, Mosby, Inc.

    Darby, Michelle &Walsh, Margaret, Dental Hygiene Theoryand 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 ReviewJane Weiner, KDH, Board Reviews, Inc.