Dental Public Health 2 - Lecture Notes PDF

DENTAL PUBLIC HEALTH 2 PRDM152 CANVAS AND LECTURE NOTES FIRST SEMESTER | 2024 - 2025 | DR. LEA LISA SANDURAL...

DENTAL PUBLIC HEALTH 2 PRDM152 CANVAS AND LECTURE NOTES FIRST SEMESTER | 2024 - 2025 | DR. LEA LISA SANDURAL 6. It is viewed in the philosophy of positive approach which is concerned DENTAL PUBLIC HEALTH with the following: Dental Public Health can be defined as the science and practice of preventing The main social target of WHO (May 1977) is attainment of people in oral diseases, promoting oral health and improving the quality of life through the world to have a level of health that will permit them to lead a organized effort of a society. socially and economically productive life. a. Community opportunities to improves dental health The science of dental public health is concerned with making a diagnosis of a b. Attempts to prevent dental disease population’s oral health problems, establishing the causes and effects of c. Resisting the necessity of resorting to artificial dentures those problems, and planning effective interventions. The practice of dental d. Maximum acceptance of dental health principles public health is to create and use opportunities to implement effective e. The need for preserving the health of remaining sound structure solutions to population oral health and health care problems (Chappel et al. 1996 ). HEALTH A state of physical, mental, social well being not merely the absence of It is a science offering services, which are preventive and educative in nature, disease serving the community as a patient rather than an individual. DESIRABLE DENTAL HEALTH Dental public health is concerned with promoting the health of the State of normality and functional efficiency of the oral cavity in relation population and therefore focuses action at a community level. to mastication and maxillofacial complexities TERMINOLOGIES, IMPORTANCE AND PRINCIPLES COMMUNITY HEALTH Science and art of preventing disease, prolonging life and promoting COMMUNITY physical health and efficiency through organized community efforts A group of people / inhabitants living in a certain territory with their own boundaries, rules and regulations sharing common goals and and Community Efforts aspirations interacting with each other 1. Sanitation of the environment 2. Control of the community disease Factors Involved in a Community 3. Education of the individual personal hygiene 1. People must have professional competence 4. Organization of medical, dental and nursing services for the early 2. Strong leadership and involvement in community efforts diagnosis and prevention of particular disease 3. Unity 5. Development of a social machinery to ensure every individual an adequate standard COMMUNITY DENTISTRY SOURCE OF MONEY 1. Hard Money - main supply of funds from the organization itself PUBLIC HEALTH STRATEGY 2. Soft Money - from donations, sponsors A science offering service which are preventive, educated in nature and also a form of a practice which serves the community as a patient rather than an individual by preventing and controlling dental diseases ADMINISTRATION and promoting dental health and efficiency through organized Administration is the range of activities connected with organizing and community efforts supervising the way that an organization or institution functions. Administration is like the act of the principal in the school managing the Importance of Community Dentistry faculty and staff and employing the rules of the school system. 1. The objective is to offer you service at the least cost 2. Reduce the magnitude of disease Students need to learn this principle of administration as they are preparing Universal disease: dental caries and periodontal disease to the future, To ensure their efficient performance. The subject training is 3. Poor distribution of manpower community based so then they learned the connecting link between the Community dentistry is to meet the demands of the growing school and the community or themselves with the residents. This also population provide motivation to the work force and make realize the goals of the Services in the depressed areas organization. 4. Application of the learned principles in therapeutic management to prevent spread of dental diseases e.g. OPERATION SMILE FUNCTIONS OF ADMINISTRATION 5. To know the status of the community in terms if dental disease 1. PLANNING Principles Involved in Community Dentistry That is the working out in broad outline the things that need to be 1. The patient in the community as a whole with varied socio-cultural done and the methods for doing them in order to accomplish the influences purpose. 2. Attainment of goals and objectives through community efforts and 2. ORGANIZING cooperation 3. Greatest benefit to greatest number at least cost That is the establishment of the formal structure of authority 4. The most efficient method of prevention are those which does not rely through which work subdivisions are arranged. on high degree of individual competence 3. STAFFING 5. In every procedure, there should be a dental health education That is the whole personnel function of bringing in and training component the staff and maintaining favorable conditions of work. PRDM152 DENTAL PUBLIC HEALTH 2 1  DENTAL PUBLIC HEALTH 2 PRDM152 CANVAS AND LECTURE NOTES FIRST SEMESTER | 2024 - 2025 | DR. LEA LISA SANDURAL 4. DIRECTING b. STAFF ORGANIZATION That is the continuous task of making decisions and embodying ❖ It is an organizational component that exists primarily for them in specific and general orders and instructions. the purpose of providing advice and service to line units. 5. CO-ORDINATING ❖ Instead of having one single superior, there are group of That is the all important duty of interrelating the various parts of specialists to boss the workers in the various aspects of the the work. business. 6. REPORTING ❖ These are group of specialist quite responsible to the execution. That is keeping those to whom the executive is responsible informed as to what is going on, which includes keeping himself. 5. AUTONOMY 7. BUDGETING It is the freedom of control from others in matters affecting the professional quality of their work. With all that goes budgeting in the form of planning, accounting and control. 6. AUTHORITY This pertains to “material” and “social” order in the arrangement PRINCIPLES OF ADMINISTRATION of things and people. ADMINISTRATION It is the right to give orders and the power to exact prudence It concerns matters of broad policy. corollary to responsibility 1. CENTRALIZED AUTHORITY 7. DISCIPLINE To bring authority (persons in command) to a central point or Is a system of rules governing conduct to impose order. under central control, which permit efficient communication. “It is in essence obedience, application, energy, behavior and out Frenchmen HENRI FAYOL sees authority as a combination of mark of respect in accordance with the standing agreement official (derived from managerial position) and personal between the firm and employees”. (compounded of intelligence, experience, moral worth, post Fayol declares that discipline requires good superiors at all levels services and others) “SCALAR PRINCIPLE” - this pertains to the “chain of superiors” Best Means of Establishing and Maintaining Discipline from the highest to the lower ranks, where orders and ➔ Good superiors at all cost information comes from one source. ➔ Agreement as clear as possible (School President – Deans – Division Chairman – Section ➔ Sanctions (penalties) judiciously applied Coordinators – Clinical Instructors) 8. ESPRIT DE CORPS 2. SPAN OF CONTROL It is the harmony and unity among personnel. The executive should have, supervise or control a number of It is the principle that “in union there is strength”, as well as workers no larger than his control. extension of the principle of the unity. 3. DELEGATION MANAGEMENT Division of work Management is a universal phenomenon. It is a very popular and widely When an enterprise is large, more work will be needed to direct used term. All organizations - business, political, cultural or social are and operate it, therefore it becomes necessary to delegate some involved in management because it is the management which helps and of the work and also of authority and responsibility. directs the various efforts towards a definite purpose. OPERATING BAND – is the exceptional principle stating that, decisions, which occur frequently, should be delegated to the According to Harold Koontz, “It is an art of getting things done through and subordinate and only that important issue, which is not recurring, with the people in formally organized groups. It is an art of creating an should be referred to superiors. environment in which people can perform and individuals and can The idea is the economic allocation of executive resources. The co-operate towards attainment of group goals”. executive must economize on his time by dealing only with exceptional matters. According to F.W. Taylor, “Management is an art of knowing what to do, 4. LINE AND STAFF PRINCIPLES when to do and see that it is done in the best and cheapest way”. It was developed to utilize the advantages of both functional and line organization. FUNCTIONS OF ADMINISTRATION LINE PORTION serves to maintain stability and discipline. MANAGEMENT STAFF PORTION serves to bring expert knowledge to bear on Deals with the execution of policy problems. Combines people’s talents, abilities and services of material resources a. LINE ORGANIZATION of the organization in the production of the desired goals and services. ❖ Is the division in charge of units that carry services of the 1. PLANNING organization to the public. Is the formulation of steps to be taken by an agency at one future ❖ Is characterized by a direct flow of authority from the top period to achieve a designated state, which the process itself boss through various executives down to workers. specifies its objective ❖ It forms the essential skeleton of the organizational structure. ❖ There is no staff or advisory positions PRDM152 DENTAL PUBLIC HEALTH 2 2  DENTAL PUBLIC HEALTH 2 PRDM152 CANVAS AND LECTURE NOTES FIRST SEMESTER | 2024 - 2025 | DR. LEA LISA SANDURAL 2. ORGANIZING 3. STANDING ORDER Is concerned with the division of labour with its corresponding Methods of record keeping assignment of duties and the establishment of lines of authority 4. RECORDS and of communication. For the benefit of the patient and in epidemiological study 3. DIRECTING evaluation of effort for organizational control Initiates and maintains actions toward established goals.The 5. BUDGETING leader explains to his people what they are to do and helps them to do it the best of their ability Plan of work with dollar or peso sign 4. COORDINATING 6. SOURCE OF MONEY Is the synchronization of activities toward established goals. Hard Money - main supply of funds from the organization itself Soft Money - from donations, sponsors 5. ACTUATING Indicates the act of setting things into motion PLANNING 6. MONITORING AND CONTROLLING Of a certain project or ideas that we wanted to do, reaching our goals and Is keeping track of work of an agency to find out if it is being objectives is not easy. There should always be a systematic way of achieving carried out the way it should be in accordance with the standard it. We always start with careful planning. of quality and quantity agreed upon at the proper time and at the costs previously determined. Being a health professional, we have our definitive part to assist on the health care system. We have our part in developing dental plans for the 7. EVALUATING community. Is a systematic way of learning from experience using lessons learned to improve current activity and promote better oral According to E. C. Banfield, “a plan is a decision about a course or action” health program planning. According to Arnold, “it is a process of pre-action thinking to provide a basis 8. STAFFING for doing”; and Dale defines Planning as “Today’s design for tomorrow’s Is the leader attempts to find the right person for each job, similar action, an outline to the steps to be taken at some future period to solve to organizing, it is continuing job since people in the organizing problems earlier identified”. may either leave, gets fired, retire or die. 9. RECORDING OR REPORTING To sum it up. Planning is an intellectual process which is concerned with deciding in advance what, when, why, how and who shall do the work; It is a Is where records are maintained and reports are made to provide blueprint of action and operation (Marsha Conley, 2018). information on what is happening in the organizing and if necessary take steps to correct any deviations from the plans. For a plan to be successful, there is a systematic way of doing it: 10. BUDGETING 1. Defining the problem Is not only a plan but also a means of control, a comparison 2. Setting priorities budgeted and actual costs enable him to see how closely the 3. Developing specific goals and objectives company is adhering to its financial plan. 4. Determining alternative and strategies 5. Determining the methods of implementation ORGANIZATION COMPONENTS OF PLANNING Organizational control refers to processes by which agents are able to establish and maintain control over an organization. It comprises the Before we identify the components of Planning, let us analyze first the strategic planning process as well as methods and devices that make other “need” for planning. What is the purpose of planning? Listed below are the agents’ behaviors consistent with objectives. reasons for the “need” of planning: Organizational control is an important function because it helps identify Purpose of Planning errors and deviation from standards so that corrective actions can be taken 1. To match the limited resources with many problems; to achieve goals. The purpose of organizational control is to ensure that a 2. To eliminate wasteful expenditure or duplication of expenditures; specific function is performed according to established standards 3. To develop the best course of action to accomplish a defined objective; First purpose of planning is to identify the problems that may arise, there TECHNIQUES FOR ORGANIZATIONAL CONTROL may be possibilities of too many “wants” but with limited resources ORGANIZATION (manpower, facilities and money); Next is too be vigilant about the “costs”, Is refers to the structure of an agency and the way people are arranged the financial aspect. It is best to allocate the funds to what is really needed to into working groups eliminate wasteful expenditures; and to work out the best plan of action. There may be a possibility of conflicting values and ideas amongst the 1. ORGANIZATIONAL CHART members, despite of this, a common goal should be determined to achieve Evaluating and directing the chain of authority in an organization the objectives. 2. PROCEDURE MANUAL 1. ADVISORY COMPONENT Detailed analysis of the working of the organization and how It is an advisory body that assists the Secretary of Health in certain functions are to be executed setting up policies, defining guidelines to be used by the service PRDM152 DENTAL PUBLIC HEALTH 2 3  DENTAL PUBLIC HEALTH 2 PRDM152 CANVAS AND LECTURE NOTES FIRST SEMESTER | 2024 - 2025 | DR. LEA LISA SANDURAL component in formulating health plans. This is composed of the ACCORDING TO CONCERN OF THE PLAN National Health Planning Board (NHPB), NHP Commission, HP Steering Committee and Board of Health Advisors. This approach is used by identifying first what is the needs or demands of the community. 2. SERVICE COMPONENT It is the body responsible for the formulation aspect of the SCOPE AND TIME SPAN OF PLANNING planning functions in the DOH. This is composed of staff trained in health planning. SCOPE OF PLANNING This refers to the limitations of the planning. What are the things that Other studies mentioned three components of program planning: are included and excluded – to avoid misunderstanding. 1. Assessing organizational resources and needs to inform planning This includes the assessment process, description of resources 3 Factors should be considered: and data collection. 1. Resource – what are the things that can be use and those that are not needed 2. Analyzing the data to inform the planning process 2. Time – the specific tasks should be identified and its timetable This includes synthesizing the data gathered to develop priorities 3. Quality – refers to the deviation from the desired standard and prepare the report. 3. Designing a plan for sustainability The scope of planning may have a comprehensive or partial range: comprehensive – where all sectors of the economy are involved; and partial DIFFERENT APPROACHES OF PLANNING – where only a few or one sector is considered. ACCORDING TO EVOLUTION TIME SPAN OF PLANNING Plans are made by local authorities or planners after assessing their 1. LONG TERM PLANNING needs or demands. This refers to planning with a period of 3 years or more. This 1. TOP DOWN APPROACH requires a longer period of time for the objective to be achieved. The instructions come from the “top”. This people in authority (e.g. MRT/LRT construction, National election) provides the guidelines, plans, information ,and the funding then 2. MEDIUM TERM PLANNING they pass it to the middle and lower people for implementation This is concerned with ways and means of achieving predefined and control. This approach is used generally in highly organized goals and objectives indicating what type and where resources organizations. This approach often results to project failure, will be allocated. (e.g. Clean and green program, save “ilog pasig” causes reduced productivity and lockdowns. program, Buhayin ang MayniLA) 2. BOTTOM UP APPROACH 3. SHORT TERM PLANNING This approach implies a pro-active team input on the project. The This refers to an annual or biannual activities that needs to be team members are actively participating in every step of the accomplished. (e.g. Community outreach program/ Dental management. The decisions on the tasks at hand are consensus. mission/ CIVAC) This approach encourages the team members to think creatively for the benefit of the project; thus they felt involved and appreciated in every step of the way. PROBLEMS ENCOUNTERED DURING PLANNING In this approach the plans are formulated at the operational level. According to the presentation: “Introduction to Planning” by Hari Prasad The course of the plan is from the bottom to top level. Kaphle, there are different limitations and barriers to planning. 3. PARTICIPATORY APPROACH LIMITATIONS This approach is a combination of the two approaches mentioned 1. It depends up on facts and information. To get reliable information may above. The leader or top management will provide the planning not possible always. guidelines and parameters to the operational level. Then this 2. To prepare an effective plan it needs highly experienced managers. team will construct the plan and forwards to the top level for 3. Planning needs team efforts. review and approval. 4. Planning may lead to internal inflexibilities and procedural rigidities. On this approach, each participant becomes an integral part of 5. Planning is an elaborative process needs more paper work. the planning process. The key term here is “participatory”. 6. It is a time consuming and expensive process. 4. TEAM APPROACH 7. Planning is rigid and may discourage innovation. This approach involves a team whose members are equipped with BARRIERS IN EFFECTIVE PLANNING different skills to formulate a plan. They conceptualize and 1. Difficulty of accurate premising forward the draft plan to the top management for review and 2. Problem of rapid change approval. 3. Internal barriers ACCORDING TO BASE PLAN (RESOURCE BASE) Capital investment Psychological factors Given a fixed amount of resources and the plan tries to get the most Policy and procedure out of it. This approach identifies the physical resources needed to 4. External Barriers complete the project e.g. labor, equipment and materials. Government policy Political climate Trade union PRDM152 DENTAL PUBLIC HEALTH 2 4  DENTAL PUBLIC HEALTH 2 PRDM152 CANVAS AND LECTURE NOTES FIRST SEMESTER | 2024 - 2025 | DR. LEA LISA SANDURAL 5. Lack of sufficient time for planning 6. Lack of sufficient cost for planning One of the major problems encountered during program planning is about resources. The resources to be considered are: personnel, equipment and supplies, facilities, and financial resources. There are certain criteria to determine what should be included in your resources: Is it appropriate? Is it adequate? Is it effective? Is it efficient? RESOURCES ALLOCATION Apportionment of productive assets among different uses. Resource allocation arises as an issue because the resources of a society are in limited supply, whereas human wants are usually unlimited, and because any given resource can have many alternative uses General criteria considered when allocating resources: 1. Efficiency Criterion These are resources allocated to areas, which will yield a better economic return. 2. Value Criterion SITUATIONAL ANALYSIS These are resources allocated to areas, which are underserved, Generally speaking, Situational analysis refers to the process of identifying depressed and are in need. the current opportunities and challenges that may affect the planning process. It answers the question: Where are we? Samples of Allocation Problems 1. Allocation among different population groups - Mothers and infants, In Healthcare, situational analysis describes the situation regarding the disabled, OCW, elderly, cultural minorities health status and services of a given area. It assess the extent to which the 2. Allocation of resources among problems - How much to allocate to health services were given. It analyzes the problem and needs so the plan AIDS, dental health can address to them. 3. Allocation to spend on consumption or for investment - To increased hospital amenities as in buying equipment COMPONENTS OF SITUATIONAL ANALYSIS 4. Allocation among techniques or programs - How much to give to public health, to health education to prevent heart disease 1. DESCRIPTION OF PRESENT SITUATION Four Technical Areas PRINCIPLE OF EFFICIENCY a. Population Analysis – total no. of people; geographical This refers to the most effective method of significantly reducing or distribution; age-sex composition; vital statistics rate; birth rate; eliminating problems. The main purpose of this principle is to have a death rate; natural growth rate maximum production with the least cost of available resources. For us to b. Health Status – causes of sickness and death solve the problems, we have to follow a systematic approach of planning c. Health Resource Analysis – health facilities; manpower type; process. number, distribution and analysis of current and recently concluded health projects. Steps in the Planning Process d. Health Related Socio-economic Factors – nutritional disposal; 1. Situational Analysis (Where are we now?) food establishments; transportation; communication; education 2. Goals and Objectives setting (Where do we want to go?) and housing 3. Strategy or Activity setting (How do we get there?) 2. PROJECTION 4. Evaluation (How do we know we are there?) This refers to the population and the different rates of specific The image below identifies the things that should be included in every steps disease based on observed trends and further modified by of Planning Process: possible impacts of programs and trends observed in the health related socio-economic factors. 3. PROBLEM IDENTIFICATION AND EXPLANATION This refers in identifying the problems and causes in the four technical areas. The most common situational analysis tool used in the Healthcare industry is the SWOT analysis. SWOT analysis is a strategic planning technique used to identify the strength, weakness, opportunities and threats related to project planning. Strengths and weakness are frequently internally-related, while opportunities and threats commonly focus on the external environment. The name is an acronym for the four parameters the technique examines (Wikipedia: SWOT analysis): PRDM152 DENTAL PUBLIC HEALTH 2 5  DENTAL PUBLIC HEALTH 2 PRDM152 CANVAS AND LECTURE NOTES FIRST SEMESTER | 2024 - 2025 | DR. LEA LISA SANDURAL But as always, the CEU dental students meets the adversaries with high Strengths: characteristics of the business or project that give it an hopes of rendering dental services to these kids. advantage over others. Weaknesses: characteristics of the business that place the Listed below are the dental treatments given to pre-school kids as part of business or project at a disadvantage relative to others. Community Dentistry 2 Laboratory (Fieldwork): Opportunities: elements in the environment that the business or project could exploit to its advantage. 1.1 Oral Prophylaxis Threats: elements in the environment that could cause trouble Also referred to as dental cleaning/ tooth cleaning, Oral for the business or project. Prophylaxis in children and adult have some varying degrees. Although the procedures are quite the same, the instruments and materials used varies to compensate the setting; e.g. for this subject – the classroom. Definition: According to American Dental Association, Child Prophylaxis is a dental prophylaxis performed on primary and transitional dentition only, which includes scaling and polishing procedures to remove coronal plaque, calculus and stains. It is a “scale and clean” procedure done by dental personnel to remove plaque and tartar from the teeth then polishing is done after. Scaling is done with the use of hand instruments known as scalers, it removes the tartar or calcular deposits by scraping. Polishing is done to remove plaque. For very young children, like pre-school kids, manual scaling is recommended than ultrasonic scaler since you are dealing with small quantity of calcular deposits. Have you heard the term Dental Prophylaxis? Somehow, the term corresponds to Oral Prophylaxis. Dental Prophylaxis is a collective term used to describe various practices as an adjunct to oral prophylaxis. 1.2 Fluoride Application The American Dental Association acknowledges the use of MODULE 5 - LESSON 1 ORAL PROPHYLAXIS ERICA DITO AKO MAGSTART HA fluoride application as a safe and effective means of preventing AHHAAH HUHUH SORRY ANG PANGET oral cavities to school children. There are many ways on how this treatment are done: topically and systematically, self-applied and Preventive dentistry is the branch of dentistry that deals with the professionally applied. preservation of healthy teeth and gums and the prevention of dental caries There are many professional methods on how to apply fluoride to and oral disease (dictionary.com). Certain treatments include: children. The next thing to do is to decide what method are we 1. Oral Prophylaxis going to use which is more beneficial for both the clinicians and 2. Topical Fluoride Application pre-school students. The following videos presented the 2 most 3. Dental Sealant common methods of fluoride application done by dental 4. ART Technique. personnel We all know that children are usually afraid of the dentist. It is always a 1.3 Pits and Fissure Sealant (Dental Sealant) challenge for the dental profession to render dental treatments to kids. In The question of applying dental sealants to kids is answered by a Community dentistry, these challenges piled up: pre-school as patients, famous blogger in Washington, Allyssia Ready. According to her, classroom setting, and limited space of operatory. tooth decay is one of the most common chronic disease that affects young children. Sadly, some parents turned a blind eye on this fact, resulting to progression of childhood caries. This PRDM152 DENTAL PUBLIC HEALTH 2 6  DENTAL PUBLIC HEALTH 2 PRDM152 CANVAS AND LECTURE NOTES FIRST SEMESTER | 2024 - 2025 | DR. LEA LISA SANDURAL scenario can be prevented. Together with other preventive measures, Pit and Fissure Sealant can prevent the progression of dental caries up to 80% ADA recommends applying of dental sealant to kids ages 5-14, in particular on the back teeth or molars. It is characterized as a system that can be applied to occlusal surfaces of teeth to penetrate into the anatomical pits and fissures and act as a physical barrier on the tooth surface. With this description, dental sealant is also classified as a preventive measure for kids to achieve good oral health. 1.4 Atraumatic Restorative Treatment Technique (ART) ART Technique is a community based oral health program designed to remove caries by using hand instruments and fill the cavity with a glass ionomer cement. It is a simple and economic treatment of decay that can be learned by a school nurse or health care workers. It is an affordable way of providing dental services to those unreached areas. Initially, this technique was developed as part of a community oral health program but then established as a preventive restorative treatment for very young children who are afraid of the dentists. We do believe the efficiency of Art Technique to those community where scarcity of dental treatments is evident. Because of the simple procedures and instruments used, this technique can be easily learned. PRDM152 DENTAL PUBLIC HEALTH 2 7