This document provides an overview of epidemiology. It begins with definitions of epidemiology and its key components like frequency, distribution, and determinants. It then discusses the history and pioneers of epidemiology from Hippocrates to John Snow. The aims, scope, branches, principles, essential steps, and strategies of epidemiology are outlined. It defines who an epidemiologist is and the epidemiological triad. Basic measurements in epidemiology like rates, ratios, and proportions are explained. The document also discusses association versus causation and different types of associations.
The document discusses primary health care, its origins, principles, and implementation. It defines primary health care as the first level of contact with individuals and families through participation at an affordable cost. The key principles of primary health care are equitable distribution, community participation, intersectoral coordination, appropriate technology, and prevention. Primary health care aims to provide universally accessible essential health services and promote health through these principles.
This document discusses the tools of dental public health, which include epidemiology, biostatistics, social sciences, principles of administration, and preventive dentistry. Epidemiology is defined as the study of disease distribution and determinants in populations. Biostatistics uses mathematical facts and data related to biological events for purposes like defining normalcy and evaluating public health programs. Social sciences help adapt health programs to cultural patterns. Principles of administration involve organization and management. Preventive dentistry focuses on primary, secondary, and tertiary prevention.
A very important aspect in determining and studying disease is the knowledge of surveys. Its designs, methods etc. This elaborative presentation gives a detailed insight to the survey procedures used in dentistry. Special section on the WHO oral assessment proforma.
Risk Factors
Levels of Prevention
Upstream and Downstream Approach
Oral Health and General Health
Common Risk Factors
Rationale for Promoting Oral Health
CRFA application in Indian scenario
Introduction to Public Health and Dental Public Health.pptxPrabhuAypa1
This document provides an overview of public health and dental public health. It defines public health as "the art and science of preventing disease, prolonging life and promoting health through the organized efforts of society". Dental public health is defined as "the science and art of preventing and controlling dental diseases and promoting dental health through organized community efforts." The document discusses the history and changing concepts of public health, key WHO milestones, and how public health problems are identified. It also outlines the characteristics, roles, and tools of public health, as well as the differences between clinical dentists and public health dentists. Finally, it provides an overview of what topics will be covered regarding public health and dental public health.
Hi, I am Dr Komal Ghiya, pediatric dentist by profession, I am here to share some of my own presentations for educational purposes. I hope a presentation on DIET AND DENTAL CARIES will be useful for all the dental and medical students. Comments are welcome if you like the presentations and if not please suggest some ways I could make them better for you. All the best
Periodontal diseases are highly prevalent globally and their distribution is influenced by factors like age, gender, geography, and oral hygiene habits. Gingivitis is the most common form of periodontal disease and prevalence surveys show that it affects a large portion of all populations. The prevalence of periodontitis increases with age, from 35% in 35-40 year olds to 85% in 80-90 year olds. Risk factors for periodontal diseases include tobacco use, diabetes, poor oral hygiene leading to dental plaque and calculus buildup, and specific pathogenic bacteria. Epidemiological studies are important to understand the distribution and determinants of periodontal diseases in populations in order to guide prevention and control efforts.
The document discusses the field of public health dentistry. It provides definitions of key terms like public health and dental public health. It describes the historical development of public health and changing concepts in public health from disease control to health promotion to social engineering to health for all. It outlines tools used in dental public health like epidemiology and biostatistics. It discusses characteristics of ideal public health measures and services provided through public health dentistry.
The document discusses primary health care, its origins, principles, and implementation. It defines primary health care as the first level of contact with individuals and families through participation at an affordable cost. The key principles of primary health care are equitable distribution, community participation, intersectoral coordination, appropriate technology, and prevention. Primary health care aims to provide universally accessible essential health services and promote health through these principles.
This document discusses the tools of dental public health, which include epidemiology, biostatistics, social sciences, principles of administration, and preventive dentistry. Epidemiology is defined as the study of disease distribution and determinants in populations. Biostatistics uses mathematical facts and data related to biological events for purposes like defining normalcy and evaluating public health programs. Social sciences help adapt health programs to cultural patterns. Principles of administration involve organization and management. Preventive dentistry focuses on primary, secondary, and tertiary prevention.
A very important aspect in determining and studying disease is the knowledge of surveys. Its designs, methods etc. This elaborative presentation gives a detailed insight to the survey procedures used in dentistry. Special section on the WHO oral assessment proforma.
Risk Factors
Levels of Prevention
Upstream and Downstream Approach
Oral Health and General Health
Common Risk Factors
Rationale for Promoting Oral Health
CRFA application in Indian scenario
Introduction to Public Health and Dental Public Health.pptxPrabhuAypa1
This document provides an overview of public health and dental public health. It defines public health as "the art and science of preventing disease, prolonging life and promoting health through the organized efforts of society". Dental public health is defined as "the science and art of preventing and controlling dental diseases and promoting dental health through organized community efforts." The document discusses the history and changing concepts of public health, key WHO milestones, and how public health problems are identified. It also outlines the characteristics, roles, and tools of public health, as well as the differences between clinical dentists and public health dentists. Finally, it provides an overview of what topics will be covered regarding public health and dental public health.
Hi, I am Dr Komal Ghiya, pediatric dentist by profession, I am here to share some of my own presentations for educational purposes. I hope a presentation on DIET AND DENTAL CARIES will be useful for all the dental and medical students. Comments are welcome if you like the presentations and if not please suggest some ways I could make them better for you. All the best
Periodontal diseases are highly prevalent globally and their distribution is influenced by factors like age, gender, geography, and oral hygiene habits. Gingivitis is the most common form of periodontal disease and prevalence surveys show that it affects a large portion of all populations. The prevalence of periodontitis increases with age, from 35% in 35-40 year olds to 85% in 80-90 year olds. Risk factors for periodontal diseases include tobacco use, diabetes, poor oral hygiene leading to dental plaque and calculus buildup, and specific pathogenic bacteria. Epidemiological studies are important to understand the distribution and determinants of periodontal diseases in populations in order to guide prevention and control efforts.
The document discusses the field of public health dentistry. It provides definitions of key terms like public health and dental public health. It describes the historical development of public health and changing concepts in public health from disease control to health promotion to social engineering to health for all. It outlines tools used in dental public health like epidemiology and biostatistics. It discusses characteristics of ideal public health measures and services provided through public health dentistry.
The document discusses school health services and their objectives, which include appraising student health, counseling on findings, encouraging treatment, identifying disabilities, and providing emergency care. It also outlines components of school oral health programs like inspections, education, fluoride programs, sealant placement, and referrals. A specific program called Tattletooth that was implemented in Texas is described in detail, including its philosophy, implementation, and evaluation approach. The concepts of incremental and comprehensive dental care delivery models are also summarized.
CPITN INDEX (Community Periodontal Index of Treatment Needs)Jeban Sahu
Kalinga Institute of Dental Sciences, KIMS, BBSR-24
INTRODUCTION
CPITN was introduced by JUKKA AINAMO , DAVID BARMES , GORGE BEAGRIE , TERRY CUTRESS , JEAN MARTIN and JENNIFER SARDO-INFIRRI for Joint working committee of the WHO and FDI in 1982 .
Developed primarily to survey and evaluate periodontal treatment needs rather than determining past and present periodontal status i.e. recession of the gingival margin and alveolar bone .
SCOPE AND PURPOSE
PROCEDURE
SEXTANT
INDEX TEETH
INSTRUMENTS USED
CPITN PROBE
Introduced by WHO in 1978.
Weight: 5gms
Working force: 20-25 gms.
Designed for 2 purposes :
1. Measurement of pocket depth
2. Detection of Sub-gingival calculus
PROBING PROCEDURE
EXAMINATION PROCEDURE
CALCULATION OF CPITN
COMMUNITY PERIODONTAL INDEX (CPI)
This index is modification of CPITN.
SUMMARY
CPITN is a screening procedure for identifying actual and potential problems posed by periodontal diseases both in the community and in the individual, introduced in 1982.
The CPITN records the common treatable conditions namely,
- periodontal pockets
- gingival inflammation
- dental calculus
- other plaque retentive factors
CPITN PROBE (introduced by WHO in 1978) is used to measure of pocket depth & detect sub-gingival calculus.
COMMUNITY PERIODONTAL INDEX (CPI) is the modification of CPITN which includes measurement of “loss of attachment”
This document provides guidelines for providing anticipatory guidance to parents at different stages of their child's development. It covers topics such as oral development, nutrition, oral hygiene, fluoride use, habits, and injury prevention. Guidelines are provided for prenatal counseling, and ages 6-12 months, 12-24 months, 2-6 years, 6-12 years, and adolescence. The document emphasizes educating parents on establishing good oral health habits and preventing dental injuries at each stage.
The document discusses oral health issues in India. It begins by outlining the contents which include the effect of oral health on general health, levels of healthcare, existing infrastructure, expenditure, disease burden, and the dental workforce. It then discusses the dental workforce in more detail, describing dentists and their roles and training, as well as the various types of dental auxiliaries or assistants, including their classifications, functions, and training. The document emphasizes the increasing oral disease burden in India and need for preventive programs and greater utilization of the dental workforce across different levels of care to address this issue.
This document provides an overview of epidemiology and public health planning principles. It defines epidemiology as the study of distribution and determinants of health problems in populations and its application to control such problems. The key objectives of epidemiology are described as understanding disease causation, testing hypotheses, evaluating intervention programs, and informing public health administration. Effective public health planning requires defining goals, objectives, strategies, approaches, and approaches for monitoring and evaluation. Descriptive epidemiology involves observing the basic features of disease distribution by person, place, and time to identify problems and plan services. Developing hypotheses about potential causes involves interrogating usual suspects and looking for clues in patterns of who, where, and when individuals become ill.
This document discusses various periodontal indices used to measure oral hygiene and periodontal disease. It begins by defining what an index is and its uses. It then describes several commonly used indices including:
1) The Oral Hygiene Index which measures debris and calculus to assess oral hygiene.
2) The Gingival Index which evaluates gingival inflammation visible to the naked eye.
3) The Plaque Index which scores the amount of plaque present on tooth surfaces.
It provides the scoring criteria and calculations for each index. The document emphasizes that indices should be objective, reproducible and allow comparison across populations or studies.
1. The Cariogram is a graphical model that illustrates an individual's risk for developing new caries based on various etiological factors. It was originally developed as an educational tool.
2. Three studies evaluated the Cariogram model's ability to assess caries risk profiles of different populations. One study compared children in Laos and Sweden, finding higher caries rates and risk profiles in Laotian children. Another evaluated risk profile changes over two years in Swedish children. A third compared orthodontic patients in private vs. government clinics.
3. Additional studies evaluated the Cariogram model's ability to predict caries development. One found no association between risk profile and root-filled teeth but higher car
This document provides an overview of analytical epidemiology studies, specifically case-control studies and cohort studies. It defines epidemiology and describes the two main types of analytical studies - case-control studies which are retrospective and look backward from the effect to the cause, and cohort studies which are prospective and look forward from cause to effect. The key steps of each study type are outlined, including selection of cases/controls, measurement of exposure, and analysis. Potential sources of bias are also discussed.
Experimental epidemiology uses experimental studies like randomized controlled trials to scientifically prove causation between exposures and health outcomes. These studies manipulate an exposure under controlled conditions and compare outcomes in study and control groups. Randomized controlled trials are ideal for removing biases but have disadvantages of needing long time periods and having ethical issues. Non-randomized studies like natural experiments and before-after studies can also be used when randomization isn't possible.
Importance of caries risk assessment, factors influencing dental caries: as well as risk indicators and predictors have been included in this power point.
Diagnostic aids with description both traditional and recent methods have been covered with required evidence.
This document discusses descriptive epidemiology and the concept of association vs causation. It defines descriptive epidemiology as describing the pattern of disease occurrence in a population. The key steps in a descriptive study are defining the population and disease, describing disease characteristics, measuring disease occurrence, comparing to other populations, and formulating hypotheses. Association means two variables occur together more than by chance, while causation means a change in one variable causes a change in the other. Causation can be direct, indirect, or spurious. Multifactorial diseases have multiple causal factors that interact. Determining causation from associations requires considering multiple types of evidence.
The document discusses concepts related to health care and primary health care in India. It defines health care as services provided by health professionals to promote, maintain or restore health. Primary health care in India is delivered through a three-tier rural health system consisting of sub-centers, primary health centers (PHC), and community health centers (CHC). The PHC is the first point of contact between the population and the health system, covering about 20,000-30,000 people. It aims to provide comprehensive and affordable care through health workers and village health guides.
PIT AND FISSURE SEALANTS- PUBLIC HEALTH DENTISTRYANKUSHA ARORA
Introduction
Definition
Morphology of Pits and fissures
Types of Pit and fissure sealants
Materials used as sealants
Requirements of sealants
Diagnosis of Pit and Fissure caries
Procedure of application of sealants
Indications
Contra-indications
Factors affecting sealant retention in mouth
Summary
steps in planning - Public health dentistrySNISHAMG
This document outlines the 10 step process for planning: 1) Identify the problem through needs assessment, 2) Determine priorities by analyzing data, 3) Develop goals, objectives and activities, 4) Identify required resources, 5) Identify constraints, 6) Identify alternative strategies, 7) Develop an implementation strategy, 8) Implement the plan, 9) Monitor the implementation, 10) Evaluate whether objectives were achieved. Planning is a systematic process that involves assessing needs, setting priorities, developing a course of action to address the problem, and evaluating outcomes.
Dental auxiliaries are people who assist dentists but are not dentists themselves. They can be classified as either non-operating auxiliaries like dental assistants and hygienists who do not perform procedures in the mouth, or operating auxiliaries like dental therapists who can perform some treatments in the mouth under supervision. Common non-operating roles include dental assistants, hygienists, secretaries and lab technicians. Operating roles include dental therapists, hygienists and expanded function dental auxiliaries who have additional training to perform more procedures. The document outlines the history and duties of these different roles.
This document discusses infant oral health care and the importance of establishing a dental home. It outlines goals such as educating parents and conducting risk assessments. Key concepts covered include anticipatory guidance to discuss topics like teething and nutrition. The document provides guidance on infant oral exams, cleaning techniques, weaning, and establishing relationships with pediatricians to monitor oral health. Overall it emphasizes the foundation good oral health practices in infancy provide for lifetime oral health.
The Tattletooth Program is a school-based dental health program developed in Texas in the 1970s. It aims to develop knowledge and skills around preventing dental disease in schoolchildren. The program provides self-contained teaching packets for classroom teachers to educate students on dental health facts across 5 different age-appropriate levels, from preschool to high school. Lesson plans, materials, and strategies for parental involvement are included. The program piloted an approach of classroom dental health education to promote prevention.
This document discusses various mechanisms for paying for dental care, including private fee-for-service, post-payment plans, and private third party prepayment plans such as commercial insurance companies and non-profit plans like Delta Dental. It also covers prepaid group practice plans, capitation plans, salaries, and public programs like Medicare and Medicaid. Key aspects of reimbursement for dentists and advantages and disadvantages of different payment mechanisms are described.
https://userupload.net/ucq2c1km5pb7
Preventive dentistry aims to stop the progression of dental caries by promoting daily habits and clinical therapies that either promote the remineralization of the tooth surface or prevent the formation of the oral biofilm responsible for lowering the oral pH levels in an attempt to prevent cavity formation.
Here is an overall glance on some recent concepts/advances in preventive dentistry with a detail note on pit and fissure sealants
CHAPTER 1 ITRODUCTION TO EPIDEMIOLOGICAL METHODS.pptxjohnsniky
Technique:
The needle is held with the needle holder and it should enter the tissues at right angles and be no less than 2-3mm from the incision.
The needle is then carried through the tissue where it follows the needle’s curvature.
Sutures of any type that are placed in the interdental papilae should enter and exit the tissue at a point located below the imaginary line that forms the base of the triangle of the interdental papilla.
Epidemiology is defined as the study of the distribution and determinants of health-related states or events in populations, and the application of this study to control health problems. It aims to describe the distribution and magnitude of health problems, identify factors involved in disease causation, and provide data to plan, implement and evaluate prevention and control efforts. Epidemiology provides a framework and methodology for community health nurses to assess community health needs, evaluate nursing services, and investigate and address health problems in populations.
The document discusses school health services and their objectives, which include appraising student health, counseling on findings, encouraging treatment, identifying disabilities, and providing emergency care. It also outlines components of school oral health programs like inspections, education, fluoride programs, sealant placement, and referrals. A specific program called Tattletooth that was implemented in Texas is described in detail, including its philosophy, implementation, and evaluation approach. The concepts of incremental and comprehensive dental care delivery models are also summarized.
CPITN INDEX (Community Periodontal Index of Treatment Needs)Jeban Sahu
Kalinga Institute of Dental Sciences, KIMS, BBSR-24
INTRODUCTION
CPITN was introduced by JUKKA AINAMO , DAVID BARMES , GORGE BEAGRIE , TERRY CUTRESS , JEAN MARTIN and JENNIFER SARDO-INFIRRI for Joint working committee of the WHO and FDI in 1982 .
Developed primarily to survey and evaluate periodontal treatment needs rather than determining past and present periodontal status i.e. recession of the gingival margin and alveolar bone .
SCOPE AND PURPOSE
PROCEDURE
SEXTANT
INDEX TEETH
INSTRUMENTS USED
CPITN PROBE
Introduced by WHO in 1978.
Weight: 5gms
Working force: 20-25 gms.
Designed for 2 purposes :
1. Measurement of pocket depth
2. Detection of Sub-gingival calculus
PROBING PROCEDURE
EXAMINATION PROCEDURE
CALCULATION OF CPITN
COMMUNITY PERIODONTAL INDEX (CPI)
This index is modification of CPITN.
SUMMARY
CPITN is a screening procedure for identifying actual and potential problems posed by periodontal diseases both in the community and in the individual, introduced in 1982.
The CPITN records the common treatable conditions namely,
- periodontal pockets
- gingival inflammation
- dental calculus
- other plaque retentive factors
CPITN PROBE (introduced by WHO in 1978) is used to measure of pocket depth & detect sub-gingival calculus.
COMMUNITY PERIODONTAL INDEX (CPI) is the modification of CPITN which includes measurement of “loss of attachment”
This document provides guidelines for providing anticipatory guidance to parents at different stages of their child's development. It covers topics such as oral development, nutrition, oral hygiene, fluoride use, habits, and injury prevention. Guidelines are provided for prenatal counseling, and ages 6-12 months, 12-24 months, 2-6 years, 6-12 years, and adolescence. The document emphasizes educating parents on establishing good oral health habits and preventing dental injuries at each stage.
The document discusses oral health issues in India. It begins by outlining the contents which include the effect of oral health on general health, levels of healthcare, existing infrastructure, expenditure, disease burden, and the dental workforce. It then discusses the dental workforce in more detail, describing dentists and their roles and training, as well as the various types of dental auxiliaries or assistants, including their classifications, functions, and training. The document emphasizes the increasing oral disease burden in India and need for preventive programs and greater utilization of the dental workforce across different levels of care to address this issue.
This document provides an overview of epidemiology and public health planning principles. It defines epidemiology as the study of distribution and determinants of health problems in populations and its application to control such problems. The key objectives of epidemiology are described as understanding disease causation, testing hypotheses, evaluating intervention programs, and informing public health administration. Effective public health planning requires defining goals, objectives, strategies, approaches, and approaches for monitoring and evaluation. Descriptive epidemiology involves observing the basic features of disease distribution by person, place, and time to identify problems and plan services. Developing hypotheses about potential causes involves interrogating usual suspects and looking for clues in patterns of who, where, and when individuals become ill.
This document discusses various periodontal indices used to measure oral hygiene and periodontal disease. It begins by defining what an index is and its uses. It then describes several commonly used indices including:
1) The Oral Hygiene Index which measures debris and calculus to assess oral hygiene.
2) The Gingival Index which evaluates gingival inflammation visible to the naked eye.
3) The Plaque Index which scores the amount of plaque present on tooth surfaces.
It provides the scoring criteria and calculations for each index. The document emphasizes that indices should be objective, reproducible and allow comparison across populations or studies.
1. The Cariogram is a graphical model that illustrates an individual's risk for developing new caries based on various etiological factors. It was originally developed as an educational tool.
2. Three studies evaluated the Cariogram model's ability to assess caries risk profiles of different populations. One study compared children in Laos and Sweden, finding higher caries rates and risk profiles in Laotian children. Another evaluated risk profile changes over two years in Swedish children. A third compared orthodontic patients in private vs. government clinics.
3. Additional studies evaluated the Cariogram model's ability to predict caries development. One found no association between risk profile and root-filled teeth but higher car
This document provides an overview of analytical epidemiology studies, specifically case-control studies and cohort studies. It defines epidemiology and describes the two main types of analytical studies - case-control studies which are retrospective and look backward from the effect to the cause, and cohort studies which are prospective and look forward from cause to effect. The key steps of each study type are outlined, including selection of cases/controls, measurement of exposure, and analysis. Potential sources of bias are also discussed.
Experimental epidemiology uses experimental studies like randomized controlled trials to scientifically prove causation between exposures and health outcomes. These studies manipulate an exposure under controlled conditions and compare outcomes in study and control groups. Randomized controlled trials are ideal for removing biases but have disadvantages of needing long time periods and having ethical issues. Non-randomized studies like natural experiments and before-after studies can also be used when randomization isn't possible.
Importance of caries risk assessment, factors influencing dental caries: as well as risk indicators and predictors have been included in this power point.
Diagnostic aids with description both traditional and recent methods have been covered with required evidence.
This document discusses descriptive epidemiology and the concept of association vs causation. It defines descriptive epidemiology as describing the pattern of disease occurrence in a population. The key steps in a descriptive study are defining the population and disease, describing disease characteristics, measuring disease occurrence, comparing to other populations, and formulating hypotheses. Association means two variables occur together more than by chance, while causation means a change in one variable causes a change in the other. Causation can be direct, indirect, or spurious. Multifactorial diseases have multiple causal factors that interact. Determining causation from associations requires considering multiple types of evidence.
The document discusses concepts related to health care and primary health care in India. It defines health care as services provided by health professionals to promote, maintain or restore health. Primary health care in India is delivered through a three-tier rural health system consisting of sub-centers, primary health centers (PHC), and community health centers (CHC). The PHC is the first point of contact between the population and the health system, covering about 20,000-30,000 people. It aims to provide comprehensive and affordable care through health workers and village health guides.
PIT AND FISSURE SEALANTS- PUBLIC HEALTH DENTISTRYANKUSHA ARORA
Introduction
Definition
Morphology of Pits and fissures
Types of Pit and fissure sealants
Materials used as sealants
Requirements of sealants
Diagnosis of Pit and Fissure caries
Procedure of application of sealants
Indications
Contra-indications
Factors affecting sealant retention in mouth
Summary
steps in planning - Public health dentistrySNISHAMG
This document outlines the 10 step process for planning: 1) Identify the problem through needs assessment, 2) Determine priorities by analyzing data, 3) Develop goals, objectives and activities, 4) Identify required resources, 5) Identify constraints, 6) Identify alternative strategies, 7) Develop an implementation strategy, 8) Implement the plan, 9) Monitor the implementation, 10) Evaluate whether objectives were achieved. Planning is a systematic process that involves assessing needs, setting priorities, developing a course of action to address the problem, and evaluating outcomes.
Dental auxiliaries are people who assist dentists but are not dentists themselves. They can be classified as either non-operating auxiliaries like dental assistants and hygienists who do not perform procedures in the mouth, or operating auxiliaries like dental therapists who can perform some treatments in the mouth under supervision. Common non-operating roles include dental assistants, hygienists, secretaries and lab technicians. Operating roles include dental therapists, hygienists and expanded function dental auxiliaries who have additional training to perform more procedures. The document outlines the history and duties of these different roles.
This document discusses infant oral health care and the importance of establishing a dental home. It outlines goals such as educating parents and conducting risk assessments. Key concepts covered include anticipatory guidance to discuss topics like teething and nutrition. The document provides guidance on infant oral exams, cleaning techniques, weaning, and establishing relationships with pediatricians to monitor oral health. Overall it emphasizes the foundation good oral health practices in infancy provide for lifetime oral health.
The Tattletooth Program is a school-based dental health program developed in Texas in the 1970s. It aims to develop knowledge and skills around preventing dental disease in schoolchildren. The program provides self-contained teaching packets for classroom teachers to educate students on dental health facts across 5 different age-appropriate levels, from preschool to high school. Lesson plans, materials, and strategies for parental involvement are included. The program piloted an approach of classroom dental health education to promote prevention.
This document discusses various mechanisms for paying for dental care, including private fee-for-service, post-payment plans, and private third party prepayment plans such as commercial insurance companies and non-profit plans like Delta Dental. It also covers prepaid group practice plans, capitation plans, salaries, and public programs like Medicare and Medicaid. Key aspects of reimbursement for dentists and advantages and disadvantages of different payment mechanisms are described.
https://userupload.net/ucq2c1km5pb7
Preventive dentistry aims to stop the progression of dental caries by promoting daily habits and clinical therapies that either promote the remineralization of the tooth surface or prevent the formation of the oral biofilm responsible for lowering the oral pH levels in an attempt to prevent cavity formation.
Here is an overall glance on some recent concepts/advances in preventive dentistry with a detail note on pit and fissure sealants
CHAPTER 1 ITRODUCTION TO EPIDEMIOLOGICAL METHODS.pptxjohnsniky
Technique:
The needle is held with the needle holder and it should enter the tissues at right angles and be no less than 2-3mm from the incision.
The needle is then carried through the tissue where it follows the needle’s curvature.
Sutures of any type that are placed in the interdental papilae should enter and exit the tissue at a point located below the imaginary line that forms the base of the triangle of the interdental papilla.
Epidemiology is defined as the study of the distribution and determinants of health-related states or events in populations, and the application of this study to control health problems. It aims to describe the distribution and magnitude of health problems, identify factors involved in disease causation, and provide data to plan, implement and evaluate prevention and control efforts. Epidemiology provides a framework and methodology for community health nurses to assess community health needs, evaluate nursing services, and investigate and address health problems in populations.
Epidemiology is defined as the study of the distribution and determinants of health-related states or events in specified populations. It aims to describe disease frequency, distribution, and causative factors in order to provide data to plan, implement, and evaluate disease prevention and control programs. The epidemiological approach involves asking questions about health events and outcomes in populations, and making comparisons between groups with different exposures to identify risk factors and draw inferences about disease causation.
This document provides an introduction to epidemiology. It begins with learning objectives and then discusses the history of epidemiology, key concepts, definitions, uses and types of epidemiological study designs. Specifically, it outlines seven landmarks in the history dating back to Hippocrates and John Snow. It defines disease, illness and sickness and provides a modern definition of epidemiology as the study of disease frequency, distribution, and determinants in populations to promote health and prevent disease.
This document discusses epidemiology and screening. It defines epidemiology as the study of distribution and determinants of health-related states or events in populations. The history and scope of epidemiology are described, including key figures like John Snow. The aims and approaches of epidemiology, like asking questions and making comparisons, are outlined. Concepts around disease causation and the natural history of disease are explained. Finally, the document defines screening as searching for unrecognized disease in healthy individuals and discusses the aims, uses, and types of screening.
Epidemiology is the study of the distribution and determinants of health-related states or events in specified populations, and the application of this study to the control of health problems. It investigates how disease spreads and is caused. The key factors that influence disease transmission include characteristics of the infectious agent, environmental factors that support the agent, and characteristics of the host that influence susceptibility.
Introduction to Epidemiology
History of Epidemiology.
Definition of Epidemiology and its components.
Epidemiological Basic concepts.
Aims of Epidemiology.
Ten Uses of Epidemiology.
Scope or The Areas of Application .
Types of Epidemiological Studies.
Epidemiology is defined as the study of the distribution and determinants of health-related states in populations. It differs from clinical medicine in that it focuses on groups rather than individuals and uses quantitative tools to study communities. Epidemiology has many uses including healthcare management by making community diagnoses, understanding disease processes, guiding public health practice through disease investigation and surveillance, and informing clinical practice and research through evaluating treatments and assessing effectiveness of diagnostic procedures. Overall, epidemiology provides essential population-level insights that aid in healthcare planning, policy development, and clinical decision-making.
This document summarizes the key functions and applications of epidemiology. It discusses how epidemiology studies the spread of diseases and allows for the control and prevention of illnesses. Important discoveries are highlighted, such as Semmelweis' finding that handwashing can prevent the spread of infections in hospitals. Epidemiology also researches the causes of diseases and develops vaccines to help control diseases in populations.
This document discusses the epidemiology of periodontal diseases. It begins with definitions of epidemiology from various sources. It then covers the history of epidemiology, including important figures like John Snow. It discusses epidemiologic measures used to study diseases, including rates, ratios, proportions, incidence, prevalence, and analytical and descriptive epidemiology methods. The aims and uses of epidemiology in understanding disease distribution and risk factors are also summarized.
This document provides an introduction to epidemiology, including definitions of key terms, the history and scope of epidemiology, study designs, and methods of measuring disease frequency and distribution in populations. It defines epidemiology as the study of disease patterns in human populations and the application of this study to disease control. The summary discusses the origins of epidemiology in Hippocrates' work and its development through pioneers like John Graunt, William Farr, and John Snow. It also outlines common study designs like cross-sectional and longitudinal studies and how epidemiology is used to describe, analyze, and prevent disease.
This document provides an introduction to epidemiology. It begins with definitions of epidemiology as the study of patterns, causes, and effects of health and disease conditions in populations. It then discusses the history of epidemiology from Hippocrates' observations to modern uses. The types of epidemiological studies covered are descriptive studies like cross-sectional and analytical studies like cohort and case-control studies. The aims and uses of epidemiology are also summarized, including describing disease problems, assessing population health, informing individual decisions, understanding disease natural history, identifying causes and risks, and planning/evaluating interventions.
ARTÍCULO_Epidemiology the foundation of public health (Inglés) autor Roger De...Hilda Santos Padrón
Epidemiology is the basic science of public health as it describes the relationship between health, disease, and other factors in human populations. It uses study designs and methods to generate information to develop effective public health programs for disease prevention and health promotion. Unlike other medical fields, epidemiology is a philosophy and methodology that can be applied broadly. Successful application requires creative use of strategies and methods to answer specific health questions. Epidemiology describes disease patterns in terms of time, place, and person to understand causative agents and risk factors in order to suggest interventions.
The document provides an overview of epidemiology. It begins with definitions and history, then covers components, aims, principles, classifications, and descriptive epidemiology. Procedures discussed include defining the population and disease, describing disease distribution by time, place and person, measurement, and formulating hypotheses. Descriptive studies are meant to observe disease distribution and identify associated characteristics rather than test hypotheses. The document outlines types of descriptive studies and how epidemiology can describe disease occurrence and distribution.
Periodontal disease is a widely prevalent disease worldwide which often gets unnoticed or it often ignored due to its slowly progressive nature. It is of concern since it can cause irrepairable damage to tooth supporting structures if not early diagnosed or treated.
Epidemiology is defined as the study of the distribution and determinants of health-related states or events in specified populations. It involves the systematic collection and analysis of data related to health problems. The goals of epidemiology are to identify risk factors for disease, prevent incidence, and improve population health. Epidemiology examines the impact of public health programs and can describe disease presence and controlling factors in a population.
Epidemiology is the scientific study of disease patterns in human populations. It aims to describe disease distribution and magnitude, identify disease causes, and provide data to plan and evaluate disease prevention and control services. Epidemiology covers communicable and non-communicable diseases. It studies disease definition, occurrence, causation, outcomes, management, and prevention. Major fields include infectious disease, cancer, cardiovascular, environmental, occupational, and reproductive epidemiology. Key concepts and methods are used to investigate disease causation and the natural history and prognosis of diseases.
Epidemiology is defined as the study of the distribution and determinants of diseases and health conditions in human populations. It involves systematic observation and measurement of disease frequency and factors related to diseases. The goal of epidemiological research is disease prevention and improved population health. Epidemiology examines the impact of public health interventions on population health status and disease factors. It can describe disease presence in populations and controlling factors.
This document provides an introduction and overview of epidemiology. It discusses:
1. Epidemiology is the study of disease distribution, determinants, and frequency in human populations. It aims to prevent disease, reduce impact, and improve health.
2. Descriptive epidemiology describes the magnitude of health problems in terms of person, place, and time using narrative, tables, graphs or maps. Analytical epidemiology also seeks to identify factors that cause health problems.
3. Epidemiology has objectives like obtaining frequency and distribution data on disease to reveal causes, test hypotheses, and obtain information to plan prevention and priority health issues.
The maxillary sinus is an air-filled space within the body of the maxilla bone. It develops from the lateral nasal wall and communicates with the nasal cavity via the middle meatus. It has a four-sided pyramid shape with four walls. Its epithelial lining contains ciliated pseudostratified columnar cells that help clear mucus and debris. The maxillary sinus serves functions like warming inhaled air, moisturizing dry climates, and protecting the brain from cold temperatures. Clinical considerations include sinusitis, fistulas, and infections of the mucoperiosteal layers.
This document provides an introduction to dental anatomy and oral histology. It discusses the number and types of both deciduous and permanent teeth. The key parts of a tooth are described including the crown, root, cementum, dentin, enamel, and pulp. The normal eruption times for both deciduous and permanent teeth are outlined. Important anatomical landmarks found on teeth such as cusps, ridges, fossae, and grooves are defined. Finally, different tooth numbering systems including universal, Palmer, and FDI are explained.
The document discusses the rationale for endodontic treatment. It begins by explaining how endodontic pathology is caused by physical, chemical, or bacterial injury to the pulp, resulting in inflammatory and immune reactions. The goal of endodontic therapy is to completely debride the root canal system and achieve a three-dimensional seal during obturation. This prevents reinfection and aids healing of periapical tissues. The document covers various theories of infection spread, microorganisms involved, routes of entry, tissue changes, inflammatory responses, and the rationale behind nonsurgical and surgical endodontic treatments.
This document summarizes various diseases of the dental pulp and periapical tissues. It describes diseases such as pulpitis, periapical periodontitis, periapical abscess, and osteomyelitis. Acute and chronic forms of each disease are discussed along with their etiology, clinical features, radiographic features, histopathological features, and treatment. Different types of pulpitis include reversible and irreversible, as well as closed and opened chronic pulpitis. Periapical diseases range from acute and chronic periapical periodontitis to periapical abscesses and cysts. Osteomyelitis can be acute, chronic suppurative, or chronic focal sclerosing. Garres oste
1. Cleaning and shaping of the root canal involves removing debris and establishing a continuously tapering canal to allow for disinfection and filling.
2. There are various techniques for cleaning and shaping including step-back, crown-down, and balanced force, each aiming to optimize the mechanical, biological and clinical objectives.
3. The techniques differ in whether they work from the apex to the crown or vice versa, and use hand or rotary instruments in various sequences to safely and effectively prepare the complex root canal system.
This document discusses cavity preparation for cast metal restorations. It defines inlays and onlays, and describes the different classes of dental casting alloys based on their composition, including gold alloys, low gold alloys, non-gold platinum alloys, nickel-chromium alloys, and castable ceramics. It outlines the principles of cavity preparation, including requirements for resistance and retention form, with features like divergent walls, line angles, and beveled margins. Proper preparation is important for the strength and fit of cast metal restorations.
This document discusses factors to consider when selecting cases for endodontic treatment. It begins by introducing the importance of proper case selection to avoid treatment failures. Key considerations for case selection include assessing the need for the tooth, its restorability, periodontal health, and the clinician's ability to perform the necessary procedures. Factors associated specifically with teeth include indications for treatment, as well as contraindications like insufficient support, improper positioning, excessive calcification or abnormal canal morphology. Patient health factors that may impact treatment include medical history, physical status, and conditions requiring antibiotic prophylaxis like cardiovascular diseases. The document provides guidelines on evaluating these case selection factors to optimize endodontic treatment outcomes.
Root canal sealers are used to fill the space between the root canal filling material and the wall of the root canal. They help seal the root canal system to prevent reinfection. Dr. Ashwini M Patil is a Reader at Navodaya dental college in Raichur who has expertise in root canal sealers.
Mercury toxicity can occur from exposure to mercury in various forms. Elemental mercury is a liquid metal that vaporizes at room temperature into an odorless gas. Inorganic mercury combines with other elements to form salts, while organic mercury combines with carbon. Dental amalgam used in fillings contains mercury. Exposure risks include inhalation of vapors during placement or removal of fillings. Mercury is a potent neurotoxin that can cross the blood-brain barrier and cause neurological and developmental effects. Symptoms of toxicity depend on the level and route of exposure, ranging from rashes to kidney damage.
Direct filling gold is the oldest restorative material used in dentistry due to its biological and mechanical properties. It exists in various forms including gold foil, electrolytic precipitate, and powdered gold. Gold foil can be cohesive or non-cohesive depending on surface contaminants. Manipulation of direct gold restorations involves degassing to remove surface gases followed by compaction. It is primarily indicated for small, non-stress bearing cavities where esthetics are not a concern due to its biocompatibility and ability to be cold welded. Disadvantages include its color, potential for increased sensitivity, and difficulty of manipulation.
This document discusses dental contacts and contours. It begins by explaining the importance of proper occlusal and proximal contacts in stabilizing teeth and resisting mesial drift. Contours on the facial, lingual, and proximal surfaces protect supporting tissues during mastication. Proper proximal contacts and embrasures are important for preventing food impaction and protecting soft tissues. The document then discusses techniques for developing correct contacts and contours during restorative procedures, including tooth separation, wedging, and matrix placement. Maintaining proper contacts and contours is important for dental and periodontal health.
Root resorption can be caused by various factors and occurs through a multistep process. It begins with injury to the protective layers of the root, followed by an inflammatory response and recruitment of cells like osteoclasts and odontoclasts that resorb the hard tissues. External root resorption includes types like surface resorption from trauma that typically repairs on its own without treatment. Diagnosis involves radiographs and other advanced imaging while the goal of treatment is to arrest the resorptive process.
This document summarizes pulpal reactions to various restorative materials and dental procedures. It discusses how microbial, physical, and chemical irritants can damage the pulp, including through dental caries, operative procedures, trauma, and restorative materials. It also describes the pulp's defensive reactions like formation of reactionary dentin, reparative dentin, and inflammation. Treatment options for vital pulp like indirect pulp capping, direct pulp capping, and medicaments are outlined, with calcium hydroxide and mineral trioxide aggregate highlighted as common capping materials that stimulate hard tissue formation.
1. Periodontal diseases can damage the pulp through microbial, physical, or chemical irritants. Microbial irritants like dental caries or periodontal infections allow bacteria to enter the pulp. Physical irritants include operative procedures, trauma, orthodontic movements, and deep periodontal curettage. Chemical irritants involve dental materials and antibacterial agents.
2. In response, the pulp attempts defense reactions like tubular sclerosis, tertiary dentin formation, and varying degrees of inflammation. Calcium hydroxide is commonly used in direct and indirect pulp capping procedures due to its ability to stimulate hard tissue formation and create an alkaline environment against bacteria. Successful outcomes depend on several factors.
NON CARIOUS LESIONS AND MANAGEMENT.pptxDentalYoutube
The document discusses various types of non-carious lesions including attrition, abrasion, abfraction, and erosion. It describes the causes and characteristics of each lesion and provides examples of cases. Treatment options are focused on removing the cause, restoring the tooth if needed, and addressing sensitivity or risk of further damage. Restorative materials suggested include composites, glass ionomers, and sometimes metal restorations depending on the location and severity of the lesion. Management involves correcting habits, protecting exposed dentin, and restoring integrity and function of the tooth.
This document provides a historical overview of endodontics from the 17th century to present day. Some key developments include Fauchard describing pulp removal in 1746, the introduction of gutta-percha as a filling material in 1847, and the discovery of X-rays in 1895 which allowed for better diagnosis and treatment planning. Over time, procedures have become more refined with the adoption of rubber dams, improved instruments, irrigants, and obturation techniques. Modern endodontics utilizes technologies like CBCT, electronic apex locators, microscopes, rotary files, ultrasonic irrigation, and biocompatible sealers to optimize outcomes.
This document discusses intracanal medicaments used in endodontic treatment. It defines intracanal medicaments as temporary placement of biocompatible medications into root canals to inhibit bacterial invasion from the oral cavity. The document outlines the history and ideal requirements of intracanal medications. It describes common medications used like chlorhexidine, formocresol, calcium hydroxide, antibiotics, steroids, and herbal options. The functions and mechanisms of these various medications are summarized.
1. There are various cavity designs for amalgam restorations depending on the location and extent of the dental caries. Cavity designs are classified based on the Black Classification system as Class I through Class VI cavities.
2. Key principles of tooth preparation for amalgam restorations include establishing an outline form that extends the cavity margins into sound tooth structure. The cavity should have a primary resistance form and features like cavosurface margins, reverse curves, and retention forms or locks to resist forces and retain the restoration.
3. Specific cavity preparations are described for different classes of cavities, including designs for single surface Class I cavities, multi-surface Class I cavities, various Class II cavity designs for proximal lesions
Air abrasion uses compressed air to propel aluminum oxide particles to remove tooth structure for restorations. It is a minimally invasive alternative to drills that causes little damage to sound tooth structures. Air abrasion works quickly without vibration, pressure, or heat compared to drills. It is well-suited for removing small areas of decay, repairing existing restorations, and preparing surfaces for bonding and sealants. Precautions include protecting the patient and dental team from abrasive particles and controlling the air pressure and distance from the tooth.
PAIN CONTROL in operative dentistry.pptxDentalYoutube
This document discusses pain control in operative dentistry. It begins with definitions of pain and classifications of pain based on duration (acute, persistent, chronic) and sensory characteristics (fast and slow pain). The neural pathways of pain and various theories of pain are described. Methods of assessing pain and factors that influence pain perception are outlined. Common causes of orofacial pain are listed along with differential diagnosis of pain. Techniques for controlling pain in restorative dentistry are provided, including local anesthesia and gaining patient confidence.
Muktapishti is a traditional Ayurvedic preparation made from Shoditha Mukta (Purified Pearl), is believed to help regulate thyroid function and reduce symptoms of hyperthyroidism due to its cooling and balancing properties. Clinical evidence on its efficacy remains limited, necessitating further research to validate its therapeutic benefits.
Rasamanikya is a excellent preparation in the field of Rasashastra, it is used in various Kushtha Roga, Shwasa, Vicharchika, Bhagandara, Vatarakta, and Phiranga Roga. In this article Preparation& Comparative analytical profile for both Formulationon i.e Rasamanikya prepared by Kushmanda swarasa & Churnodhaka Shodita Haratala. The study aims to provide insights into the comparative efficacy and analytical aspects of these formulations for enhanced therapeutic outcomes.
- Video recording of this lecture in English language: https://youtu.be/kqbnxVAZs-0
- Video recording of this lecture in Arabic language: https://youtu.be/SINlygW1Mpc
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
TEST BANK For Community Health Nursing A Canadian Perspective, 5th Edition by...Donc Test
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Local Advanced Lung Cancer: Artificial Intelligence, Synergetics, Complex Sys...Oleg Kshivets
Overall life span (LS) was 1671.7±1721.6 days and cumulative 5YS reached 62.4%, 10 years – 50.4%, 20 years – 44.6%. 94 LCP lived more than 5 years without cancer (LS=2958.6±1723.6 days), 22 – more than 10 years (LS=5571±1841.8 days). 67 LCP died because of LC (LS=471.9±344 days). AT significantly improved 5YS (68% vs. 53.7%) (P=0.028 by log-rank test). Cox modeling displayed that 5YS of LCP significantly depended on: N0-N12, T3-4, blood cell circuit, cell ratio factors (ratio between cancer cells-CC and blood cells subpopulations), LC cell dynamics, recalcification time, heparin tolerance, prothrombin index, protein, AT, procedure type (P=0.000-0.031). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and N0-12 (rank=1), thrombocytes/CC (rank=2), segmented neutrophils/CC (3), eosinophils/CC (4), erythrocytes/CC (5), healthy cells/CC (6), lymphocytes/CC (7), stick neutrophils/CC (8), leucocytes/CC (9), monocytes/CC (10). Correct prediction of 5YS was 100% by neural networks computing (error=0.000; area under ROC curve=1.0).
Integrating Ayurveda into Parkinson’s Management: A Holistic ApproachAyurveda ForAll
Explore the benefits of combining Ayurveda with conventional Parkinson's treatments. Learn how a holistic approach can manage symptoms, enhance well-being, and balance body energies. Discover the steps to safely integrate Ayurvedic practices into your Parkinson’s care plan, including expert guidance on diet, herbal remedies, and lifestyle modifications.
Basavarajeeyam is a Sreshta Sangraha grantha (Compiled book ), written by Neelkanta kotturu Basavaraja Virachita. It contains 25 Prakaranas, First 24 Chapters related to Rogas& 25th to Rasadravyas.
Post-Menstrual Smell- When to Suspect Vaginitis.pptx
Epidemiology DR.SOMANATH.ppt
1. DEPARTMENT OF PUBLIC HEALTH DENTISTRY
Dr.somanath reddy kunsi
NAVODAYA DENTAL COLLEGE
2. Contents
Introduction
Etymology
Definition
Components of
epidemiology
History of …
Aims & objectives of …
Uses /scope of …
Branches of …
Principles of …
Essential steps in …
Strategy of …
Who is an
epidemiologist?
Epidemiological triad
Epidemiology vs clinical
medicine
Epidemiological
approach
Tools of measurement in
epidemiology
Basic measurements in
epidemiology
Association & causation
Methods of
epidemiology
3. I keep six honest serving men, they taught me all I know. Their
names are –
what, when, why, how, where & who.
The power of ‘reasoning’ of humans –
The story of forbidden fruit…
“No disease is sent by evils or demons, but is the
result of natural causes”- Hippocrates
Current status
Etiology X Epidemiology
Basic science of preventive and
social medicine
Introduction
Hippocrates (460-375 B.C)
4. What is epidemiology ?
Etymology
Derived from Greek word Epidemic
EPI = upon/ among
DEMOS = people
LOGOS = science/ study
Definition
Study of distribution and determinants of health
related states or events in specified populations,
and the application of this study to the control of
health problems.- John M. Last (1988)
5. Components of epidemiology
Frequency
Basic measures – rate and ratio
Facilitates comparison
Distribution
Disease occurs in patterns
Distribution patterns by time, place & person
Determinants
To identify the underlying causes or risk factors.
6. History of epidemiology
Hippocrates (460-375 B.C.)
first known epidemiologist
Claudius Gallen (130- 200 A.D)
“reason alone discovers some things, experience alone
discovers some things; but to find others, requires both
reason and experience”
Thomas Syndenham (1624- 1689 A.D.)
Founder of epidemiology
7. John Snow (1813- 1858 A.D.)
Father of epidemiology
Investigation of Cholera
epidemic in London in
1848- 49 and 1853-54
First reported systematic epidemiologic study
…History of epidemiology
9. William Budd (1811-1880)
Study on typhoid fever
Epidemiological society in London during
1850s with Earl of Shaftesbury as president
W.H. Frost (1927)
First professor of Epidemiology in U.S
R. Doll, A.B. Hill (1950, 1964)
The relationship between cigarette smoking and lung cancer
…History of epidemiology
10. History of Dental Epidemiology
Hippocrates
‘the third upper tooth is found to be decayed more frequently
than all the others’ Guerini (1967)
Edwin Saunders
Probably the first systematic dental epidemiological study in
Britain. Report to parliament entitled, “The teeth- a test of
age” in 1837.
John Tomes
Published a tooth mortality study in 1848
Atkinson
British journal of dental science 1863
11. William Fisher
Investigated public health aspects of dentistry
1885- ‘Compulsory attention to the teeth of school children’
BDA committee for study of child dental health
School dental services
The story of Mc Key and Dean
Dietary studies on humans
Vipeholm study (Gustafsson et al, 1954)
Hopewood House study (Sullivan- 1958, Harris- 1963)
Turku Sugar studies (Scheinin, Makinen et al- 1975)
…History of Dental Epidemiology
12. Initially limited to detection and control of
communicable diseases.
International Epidemiological Association –
Lowe and Kostrzewski (1973):
1. Describe size and distribution of disease
2. To provide data essential for planning, implementation and
evaluation of health services for prevention, control and
treatment of disease
3. Identify aetiological factors in pathogenesis of disease
Aims of Epidemiology
13. The ultimate aim of epidemiology is…
To eliminate or reduce the health problem
or its consequences
To promote the health and well being of
the society as a whole.
14. 1. To collect, collate and analyze all data relating to agent,
host and environment – to describe epidemiological
situation
2. To further analyze and describe occurrence,
distribution and nature of disease- constitute social and
geographical pathology of disease
3. To probe into – in order to fill- gaps for causal factors
and its role at different stages where disease is
multifactorial
4. To help administrators to channel their policies to serve
various groups of population – to meet their needs
objectives of epidemiology
15. Epidemiology has evolved considerably over the
past 50 years and the major challenge now is to
explore and act upon the social determinants of
health and disease.
- (Beaglehole & Bonita, 1997).
Early studies- causes of communicable
diseases
Identification of preventive methods
Course and outcome of disease
Support to both preventive and clinical
medicine.
Determine health status of population groups
Helps health authorities to use limited resources to the best
possible effect by identifying priority health programmes
Evaluate effectiveness and efficiency of health
services
Management of MI- Lancet study
Uses / Scope of epidemiology
16. Achievements of epidemiology
Elimination of small pox
Methylmercury poisoning
Rheumatic fever and rheumatic heart disease
Iodine deficiency diseases
High blood pressure
Smoking, asbestos and lung cancer
HIV/AIDS
Fluoride, Dental caries & Fluorosis
17. Branches of epidemiology
General epidemiology
Specific epidemiology
Experimental epidemiology
Clinical epidemiology
Evaluation epidemiology
Forecasting of epidemics
19. Essential steps in …
Acquire basic knowledge .. ..
Define the problem.. ..
Collect available data and formulate
hypothesis – NOT CONCLUSION
Planning answers to following questions:
Regarding collection of data –
How to analyze
How to interpret and present the report
Investigate each individual unit of the universe
of the disease – characteristics involved
Arrange for special investigations
20. MAC MOHAN AND PUGH:
Descriptive epidemiology
Formulation of hypothesis
Analytical epidemiology
Experimental epidemiology
Strategy of . . .
21. Who is an epidemiologist
Any person who researches into occurrence
of disease or disability in groups of people
is called an epidemiologist.
QUALIFICATIONS OF AN EPIDEMIOLOGIST
(SMILLIE):
Familiar with statistical techniques
Well grounded in diagnosis of disease
Thorough with H/O medicine, relating to epidemics
Good knowledge of bacteriology, immunology and
physiology
Knowledge of principles of preventive medicine
22. EPIDEMIOLOGICAL TRIAD
Living: bacteria, virus
Non-living:
nutrients, chemicals
MAN HIMSELF
-Age,sex
-Genetics, nutrition
-Socioeconomic status
-Living habitat, food habits
Epidemiological Triad
23. Sr.
no
EPIDEMIOLOGY CLINICAL
MEDICINE
1. Unit of study: defined population Individual/ case
2. Relevant data – identifies source of
infection, mode of spread, determines
future trend – control measures
Case- diagnosis-
prognosis- prescribes
treatment
3. Investigator goes into the community Patient comes to doctor
4. Conceptual – results in form of tables and
graphs
Based on biomedical
Concepts – refining
tech. of diagnosis and
treatment
Epidemiology vs. clinical medicine
25. Asking questions
Questions answers questions
Questions related to health events
What is the event (problem)
What is the magnitude
Where did it happen
When did it happen
Who are affected
Why did it happen
Questions related to health action
What can be done
How can it be prevented in future
What are the resources required & available
What difficulties may arise & how to overcome them
26. Making comparisons
The epidemiologist weighs, balances and contrasts
Ensure ‘comparability’
Like can be compared with like
Methods to ensure comparability
Randomization
Matching
Standardization
28. It is the frequency of a disease or characteristic
/ unit size of population or group
Indicates change in some event that takes place in a
population over a period of time
Rate =
10n produces whole no.
Numerator is a part of denominator
Eg. Annual death rate
Population at risk
X 10n
No. of events in specified period
…Tools of measurement
RATE
X
Number of deaths in one year
Mid-year population
1000
29. RATIO
Denotes relation b/w two random quantities
Numerator is not part of denominator
Ratio is one quantity divided by the other
Ratio =
Eg:
No of children with dental caries/ children with gingivitis
Dentist – population ratio = 1 : 30,000
Male female ratio in India = 1000 : 933 (in 2001)
A
B
…Tools of measurement
30. PROPORTION
It is a ratio, which expresses the relation in
magnitude of a part of the whole.
Numerator is part of denominator
Expressed as percentage
Eg:
EG: Among 5000 school children, 2000 had
dental caries
no. of school children with dental caries at a certain time
Total no. of children in school at same time
X 100
…Tools of measurement
2000
5000
X 100 = 40 %
Proportion of carious children =
31. Concept of numerator and denominator
The numerator and denominator of a rate
should be similarly restricted
Numerator
Refers to number of times an event has occurred in a
population
It is a part of denominator in rate and proportion, but not in
ratio
Denominator
Numerator has little meaning, unless accompanied by
denominator
epidemiologist has to choose an appropriate denominator
while calculating a rate.
Denominator may be related to
Population
Total events taken place
…Tools of measurement
32. Denominator related to population
Mid year population
Population estimated to be present as on the first day of July
every year.
Population at risk
Person- Time
Eg. Person- years
Person- Distance
Eg. Passenger- miles
Sub groups of the population
Eg. Age groups, sex groups, professional groups, etc.
…Tools of measurement
33. Denominator related to events
In some cases, the denominator may be related
to the events, instead of population
Eg.
Annual rate of motor vehicle accidents in Davangere
Number of accidents in one year
Mid year population
X 1000
Number of accidents in one year
Vehicle- miles
X 1000
…Tools of measurement
34. Basic measurements in epidemiology
Definition and criteria
Ideal requirements of definition
acceptable and applicable to use in large populations
Precise and valid
What do we measure in epidemiology?
Demographic variables
Mortality
Morbidity
Distribution of the causative or risk factors
Medical & health care needs
Availability & utilization of Medical & health care facilities
35. Measurement of mortality
Crude death rate
Def. The number of deaths per thousand people in a
population in a given year.
It is easy to calculate
The level of mortality is used as a public health indicator.
Number of deaths
in a year in a population
Mid- year population
X 1000
36. Specific death rates
a) Cause or disease specific- Eg. Tuberculosis, HIV/AIDS,
accident etc.
b) Related to specific groups- Eg. Age specific, sex specific,
profession specific etc.
Specific death rates help to identify
Etiology
Groups at risk
Specific death rate due to HIV/AIDS
Specific death rate for males
No. of deaths due to HIV/AIDS in a year
Mid- year population
X 1000
No. of deaths of males in a year
Mid- year population of males
X 1000
…Measurement of mortality
37. Infant mortality rate
Perinatal mortality rate
Maternal mortality ratio
No. of live- born infants who
die before age 1 in a year
No. of live births in the year
X 1000
No. of still births and deaths
within 7 days of life in a year
No. of still births + live births in the year
X 1000
No. of deaths ass. with pregnancy
or child birth in a year
No. of live births in the year
X 1000
…Specific death rates
38. Case fatality rate
Proportional mortality rate
Standardized rates
…Measurement of mortality
Total no. of deaths
Due to a disease
Total no. of cases of
the same disease
X 1000
No. of deaths due to
a disease in a year
Total no. of deaths
In that year
X 1000
• The overall rates adjusted for the effects of differences in population
composition, such as in age, sex etc.
• For comparison between two populations with different compositions
1. Direct standardization
2. Indirect standardization
39. Measurement of Morbidity
“Any departure, subjective or objective, from
a state of physiological well being”- WHO
Can be measured in terms of
frequency, duration & severity
Uses of morbidity data
Describe extent & nature of the disease and thus help in
determining priorities
Provide information, which is more useful for basic research
than that of morbidity data
A starting point for etiological studies
Useful for monitoring & evaluating disease control activities
40. Incidence
No. of new cases of a specific disease
occurring in a defined population during a
specified period of time
Incidence rate
Special incidence rates
Attack rate
Used when the population is exposed to risk factor for a
limited period of time
Secondary attack rate
The no. of persons exposed to the risk factor developing
the disease within the range of the incubation period
following exposure to the primary case
no. of new cases of a disease in a specified period of time
Population at risk during that period
X 10n
I =
…Measurement of Morbidity
41. Uses of incidence rates
Helps in taking action to control the disease
Give clues to research in to etiology and
pathogenesis of disease
Helps in the study of distribution of disease
Useful in evaluating the efficacy of preventive
and therapeutic measures
…Measurement of Morbidity
42. No. of cases (both old and new) in a defined
population at a specified point in time
PREVALENCE RATE (P):
Expressed as cases per 1000 or per 100 population
…Measurement of Morbidity
no. of people with disease at a specified time
no. of people in the population at risk at that time
P = X 10n
Prevalence
43. Types of prevalence
Point prevalence
Period prevalence
No. of all current cases of a specific disease at one point in
time in relation to a defined population
Point prevalence rate
Total no. of all current cases of a
Specific disease at a given point of time
Estimated total population at
the specific point of time
X100
…Measurement of Morbidity
44. Period prevalence
It is a measure that expresses total no. of cases of a disease
known to have existed at some time during a specified period
Period prevalence rate
Total no. of all current cases of a Specific
disease at a given period of time interval
Estimated total population at
the specific period of time
X100
…Measurement of Morbidity
45. Uses of prevalence rate
In detecting the magnitude of disease in the community
In identifying potential high risk populations
In administrative and planning purposes like, assessing
manpower needs in health services, delivery of health
services etc.
Limitations of prevalence rate
Not the ideal measure for studying etiology
Depends up on incidence and duration…
…Measurement of Morbidity
46. Relation b/w prevalence and incidence
Prevalence rate is dependent on both
incidence rate and disease duration.
Assuming that the population is stable, the
incidence value and the duration is
unchanging, a relationship can be established
as…
…Measurement of Morbidity
Prevalence = Incidence x Avg. duration disease.
P = I X D
48. Association & Causation
Association need not always be causal
Three types of association
Spurious association
Indirect association
Direct (causal) association
One to one causal association
Multifactorial causation
49. Spurious association
In a study in UK,
Place of delivery Perinatal mortality rate
Hospital 27.8
Home 5.4
?
Home is a safer place for delivery than a hospital !!!
Finding an association when none actually existed
Selection bias
50. Indirect association
Yudkin & Roddy hypothesized that people who
consume a lot of sugar are more likely to have a
heart attack !!!
Bennet et al. found that…
Further experimental studies…
Confounding factors
Can be applied to reduce the disease risk
Snow’s findings…
51. Direct (causal) association
One-to-one causal relationship
When the factor is present, the disease is present & vice versa
Eg. Measles
Koch’s postulates that a cause must be
Necessary
Sufficient for the occurrence of the disease
Although Koch postulates are theoretically sound…
Eg. Tuberculosis
Hemolytic
Streptococci
Streptococcal tonsillitis
Scarlet fever
Erysipeals
52. Multi factorial causation
Non communicable, chronic diseases
…Direct (causal) association
Factor 1
Factor 2
Factor 3
Reaction at cellular level Disease
Factor 1
Factor 2
Factor 3
Reaction at cellular level Disease
+
+
Eg. Smoking, air pollution & exposure to Asbestos Lung cancer
53. Assessing the relationship between
a possible cause and an outcome
No
Could it be due to
Selection or
Measurement bias
Could it be due to
confounding
Could it be due to
chance
Could it be causal
Apply additional criteria
No
Probably not
Probably yes
54. Additional criteria for causality
Temporal association
Strength of association
Specificity of the association
Consistency of the association
Biological plausibility
Coherence of the association
55. Methods of epidemiology
OBSERVATIONAL EPIDEMIOLOGY
Descriptive epidemiology
Analytical epidemiology
Cross sectional
Ecological
Case- Control
Cohort
EXPERIMENTAL EPIDEMIOLOGY
Randomized control trials
Field trials
Community trials
58. References
R. Beaglehole, R. Bonita, T. Kjellstrom. Basic
Epidemiology. World Health Organization,
Geneva
K. Park. Park’s Text book of Preventive and
Social Medicine, 18th edition
Soben Peter. Essentials of Preventive and
Community Dentistry, 2nd edition