Public Health

Public Health

Definition of public health by Winslow (1920):
“the science and art of preventing disease, through organized community efforts”.
Dental public health defined by - American board of dental public health - (ABDPH ) :
”the science and prolonging life and promoting physical health and efficiency art of preventing and controlling dental disease and promoting dental health through organized community efforts”.
Dental public health
It is that form of dental practice that serves the community as a patient rather than the individual . it is concerned with dental health education of the public , with applied dental research , and with the administration of group dental care programs, as well as the prevention and control of dental disease as a community basis.
History of public health
Public health has traversed through three phases into present , fourth phase that is centered on the present social needs of the time and the progression of industrialization and technology of the world.
Phase I :
During the first phase (1849-1900) , public health activities were related to the elimination and control of disease that grow out of rapid industrialization and crowded and poor living condition . Many activities were aimed to reducing the morbidity and mortality of such disease as colera ,polio and plague . efforts were directed at basic sanitation methods.
Phase II :
In the second phase ( 1900 - 1930 ) population – based prevention strategies were possible with advances in bacteriology and immunizations , reducing the effects of infectious disease . immunization programs were an outgrowth of this phase .
Phase III :
Continued advancements in technology in a third phase (1930- 1975) allowed a further shift to the treatment of disease through more and more complex medical treatment. During this phase , many major infectious disease , such as smallpox , were eradicated , and cures for many acute health problems were developed.
Phase VI :
The present, or fourth, phase arises from the understanding that technology may be unusually effective in the treatment or cure of acute health problem but ineffective in managing chronic lifestyle disease and controlling the increase cost of high technology health care. This present phase now underline a border approach to health . it goes further than prevention of specific disease to include the concept of in general wellness . for example , choosing not to smoke or choosing to stop smoking can reduce the risk for lung cancer , hypertension , heart disease or emphysema.

Procedural pattern

The previous correlation between the procedure employed the dental clinician and public health worker may be summarized as follows:


Patient
community
Examination
Survey
Diagnosis
Analysis
Treatment planning
Program planning
Payment of services
Finance
Evaluation
Appraisal

Survey :

Methods for collection of data, analysing and evaluating them in order to determine the amount of disease problems in a community.
Extent of dental problem must be determined.
Carefully choose random sample that validity reflects the experience of the population as a whole.
Measure the disease existence in the population by using indices.

Analysis:

Analysis of the information that has been collected from the population in certain statistical methods in order to define the characteristic of specific community health problem.
This analysis indicated a need for the services.


Program planning :
Decision making for solving the particular health problem.
Finance :
Operational finding is usually provided by government agencies.
Once the analysis has been made , one can proceed to make plane effective.
Appraisal :
To assess the effectiveness of the program.
Prevalence :
It is the proportion of a given population that exhibits the disease or condition at a given time.
For example : prevalence of dental caries in the population was 20% or the population showed 20% caries Prevalence simply means that on average out of every 100 individuals in the population , 20 showed evidence of dental caries in one or more teeth.
Incidence:
The number of new cases of disease or condition originated between two point of time. Practical difference between prevalence and incidence is that for prevalence - only one examination is needed, whereas for incidence - two examination are needed : one at the beginning and one at the end of prescribed time period .

Increment :
The number of new cases of disease occurring over a given period of time.

Morbidity and Mortality :

Morbidity : indicated the proportion of the population (in %) which is suffering from the disease.

Mortality :
is defined as the number of deaths due to a disease in a general population or in a community (that is, not just cases).
Mortality :
For population : Death divided by the population raised by a power of 10 (100 or 1000 ) depending on the circumstances).
For teeth : Lost teeth divided by the total number of teeth possible in the group (or alternatively missing teeth per person).
Fatality:
For population : Death divided by cases of disease raised by a power of 10 .
For teeth : Missing teeth divided by the total decayed , missing and filled teeth (DMF).