Dental Public Health Overview 2022

Course Information

• Course title: Dental Public Health
• Institution: De La Salle Medical and Health Sciences Institute, College of Dentistry
• Instructor: David Pablo S. Fernandez Jr., DMD
• Year: 2022
• Location: City of Dasmariñas, Cavite, Philippines

Class Rules

• Lecture duration: 2 hours
• Grace period for tardiness: 15 minutes
• Absence exceeding 15 minutes: Absent
• Absences exceeding 20% of total class hours: Dropped
• Course materials: Readings uploaded on iLS
• Class participation: Raise hand to recite or participate
• Comfort needs: Allowed without permission

Class Materials

• Quizzes: Filler notebook
• Portfolio (final course output): Clear book
• Student representative: Required for the class

Course Introduction

Health

• World Health Organization (WHO) definition: "Health is a state of complete physical, mental, and social wellbeing and not merely the absence of disease or infirmity"
• Community perspectives: A community's concept of health is part of their customs and traditions.
• Importance: In the last few decades, health has been perceived as a basic right and a worldwide goal. It is essential for basic human needs and improves the quality of life.

Changing Concepts in Health

• Biomedical concept
• Ecological concept
• Psychological concept
• Holistic concept

Biomedical Concept

• Health: Absence of disease
• Body: A machine
• Disease: Breakdown of the machine
• Doctor's role: Repair the machine

Ecological Concept

• Health: Dynamic equilibrium between man and his environment
• Disease: Maladjustment of the human organism to the environment
• Example: Availability of food and population explosion

Psychosocial Concept

• Factors influencing health: Social, psychological, cultural, economic, and political factors of the people concerned
• Nature of health: A physical and social phenomenon

Holistic Concept

• Recognition of influences: Acknowledges the strength of social, economic, political, and environmental influences on health
• Unified process: A unified or multidimensional process involving the wellbeing of the person as a whole
• Focus: Emphasis on the promotion and protection of health

Definitions of Health

• Broad sense: Health as a condition or quality of human expressing the adequate functioning of organism in given conditions, genetic or individual
• Narrow sense: (1) No obvious evidence of disease and (2) Adequate functioning of organs in relation to one another, implying equilibrium

Dimensions of Health

• Physical: Perfect functioning of the body, every cell and organ optimally functioning
• Mental: Ability to respond to experiences of life, a state of balance between individual and surrounding world
• Social: Harmony and integration between individuals and their community, the quantity and quality of interpersonal ties and involvement in the community
• Spiritual: The individual's quest for meaning and purpose in life, intangible “something” transcending physiology and psychology
• Emotional: Relates to feelings, reflecting emotions
• Vocational: Work plays a role in physical and mental health, often associated with wellbeing

Wellbeing

• Subjective: Quality of life
• Objective: Standard of living

Standard of Living

• Factors: Income, occupation, housing standards, sanitation, nutrition, health provision, education, recreational and other services
• Measure: Used individually as measures of socioeconomic status

Quality of Life

• Combination of factors: Condition of life resulting from the combination of factors determining health, happiness, education, social and intellectual attainments
• Freedoms: Freedom of action, justice, and freedom of expression

Theories of Disease Causation

• Germ theory ("Mono causal"): Disease is caused by transmissible agents. A specific agent responsible for one disease only. Examples include work of Koch and Pasteur (1860). Isolation of bacillus causing tuberculosis (1880-1900).
• Epidemiological triad: Result of a host, agent, and the environment. An organism or noxious agent is necessary but not sufficient to cause disease.
• Web of causation: Considers all factors and their interrelationships, usefully studied for chronic diseases, possible to control diseases by removing/eliminating a single factor.
• Theory of general susceptibility: Addresses why subgroups are more susceptible, emerged in the last two decades, not concerned with single/multiple risk factors.

1st Quiz

• Content: Not specified in the provided text.

Socioeconomic Approach

• Environmental impact on health: Risk conditions from environments directly affect health by creating risks physically, behaviorally, and psychologically.
• Health improvement requires modification of these environments.

Prevention of Disease

• Definition: Action to stop ill health before it begins.

Levels/Categories of Prevention

• Primordial: Prevents emergence of risk factors in areas/populations before they develop.
• Primary: Action taken prior to disease onset, aims to prevent disease occurrence in healthy individuals.
• Secondary: Halts disease progression early, prevents complications in individuals at risk.
• Tertiary: Deals with advanced stages of disease, aims to contain disease or effects on long term basis, seeks to prevent recurrence, all available measures to reduce/limit impairments

Primordial Prevention

• Focus: Preventing risk factor development in countries/populations where it hasn't appeared yet.

Primary Prevention

• Actions: Taken prior to disease onset, aims to remove disease possibility, focused on healthy individuals/populations.
• Actions (a) health promotion; Health education; environmental modification; nutritional intervention
• Actions (b) specific protection; Immunization; specific nutrition; avoidance of allergens; protection from carcinogens; ingestion of optimally fluoridated water; application of PFS.

Secondary Prevention

• Intervening/preventing disease progression and recurrence.
• (a)Early diagnosis: Identifying disturbances of homeostasis and compensatory mechanisms while biochemical/morphological changes are reversible.
• (b)Prompt treatment: Arresting the disease process; restoring health by identifying unrecognized diseases before irreversible pathological changes occur; reversing spread of infectious diseases.
• Actions: Screening for subclinical disease, case-finding

Tertiary Prevention

• Actions: Taken at advanced disease stages, contain and prevent disease recurrence, reduce/limit impairment & disability, assist patient's adjustment to irreversible conditions, rehabilitation, and prevent death.
• (a) Disability limitation: Prevent progression to disability, focus is preventing the transition of the disease process from impairment to handicap.
• (b) Rehabilitation: Coordinated use of medical, social, educational, and vocational measures to train/retrain the individual to reach highest level of functional ability.
• Examples: Special schools for blind pupils, aids for disabled, reconstructive surgery, modifying life to aid patients with TB or heart conditions.

Barriers to Preventive Strategies

• Diversity of population
• Inherent beliefs/mores
• Advertising
• Pressure groups
• Access
• Resources