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Dental Public Health. Dental Public Health. Introduction. Historical Development Dental Care Delivery in the United States around the world Financing Dental Care Legislative Initiatives Education and Promotion Target Populations Lesson Plan Program Planning Program Evaluation.

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Dental Public Health

Introduction


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Historical Development

Dental Care Delivery

in the United States

around the world

Financing Dental Care

Legislative Initiatives

Education and Promotion

Target Populations

Lesson Plan

Program Planning

Program Evaluation

Oral Epidemiology

Research Methods

Biostatistics

Evaluation of Literature and Products

Careers in the Government

Entreprenurial Initiatives

Board Review

Topics


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The Prevention Movement

Dental Hygiene’s Relation to Dental Public Health


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Historical Development

  • Dental Hygiene as Forerunner to the Prevention Movement

  • Dr. Alfred Fones

  • Founder of Dental Hygiene School and First Author of Dental Hygiene College Textbook


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Historical Development Continued

  • Practice Settings

    • Schools

    • Industry

    • Military

    • Hospitals

  • Professional Organizations


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Preventive Modalities

  • Dental Hygiene Treatment

  • Fluoridation

  • Xylitol

  • Dental Sealants

  • Oral Cancer Exams and Tobacco Cessation

  • Nutritional Counseling

  • Atraumatic Restorative Treatment (ART)

  • Mass Education/Media


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Dental Care Delivery

In the United States



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Dental Public Health

The oral health care and education, with an emphasis on the utilization of dental hygiene sciences, delivered to a target population


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Factors Affecting Dental Health

  • Access to Care

    • Restriction of dental hygiene services

    • Shortage of Medicaid providers

    • Financial Situations

      • Insurance

      • Medicaid

    • Transportation


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Factors Affecting Dental Health, Continued

  • SES Relation to Dental Health

  • Dental Hygiene Sciences

  • Increase in the Geriatric Populations

  • Malpractice

  • Insurance Changes



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Department of Health and Human Services

  • Public Health Service Operating Division

  • Human Services Operating Division


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National Institutes of Health

Food and Drug Administration

Centers for Disease Control and Prevention

Agency for Toxic Substances and Disease Registry

Indian Health Services

Health Resources and Services Administration

Agency for Health Care Policy and Research

Substance Abuse and Mental Health Services Administration

Public Health Service Operating Division


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Centers for Medicaid and Medicare

Medicaid

Medicare

Administration for Children and Families

Administration on Aging

Human Services Operating Division


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Public Health Service

  • PHS works toward improving and advancing the health of our nation.

  • U.S. Surgeon General

  • Dental Hygienists work as Public Health Officers.


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Agriculture

Defense

Education

Justice

Labor

State

Treasury

Veteran’s Affairs

United States Peace Corps (which is an executive branch agency)

Other Federal DepartmentsInfluencing Dental Care


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Individual State Influence

  • State Dental Divisions

  • Medicaid

  • S-CHIPS

  • Prisons

  • Tribal Clinics

  • Institutions

  • Community Clinics


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Dental Health Care Personnel

  • Need

  • Demand

  • Utilization

  • Supply

  • Dental Hygiene Shortages

  • Dental Hygienist to Dentist Employment Ratio = 1:2


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Dental Finance

Public and Private

Funding of Dental Care


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Historical Funding of Dental Care

  • Patient’s Responsibility

  • The Advent of Dental Insurance

  • Medicaid Coverage for Dental Services

  • Today’s Dental Financing


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Payment Methods

  • Fee-for-Service

  • Capitation Plans

  • Encounter Fee Plans

  • Barter System


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Fee-for-Service

  • A dental practice sets a fee, and a patient and/or third party pays for the fee.

  • UCR: usual, customary and reasonable fee

  • Indemnity plans pay fee-for-service.

  • Discounted coverage available and sliding scales for certain patients in certain clinics


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Capitation Method

  • Dental Managed Care

  • A certain amount is paid to a dental practice for a certain number of patients. Payment is received whether treatment is provided or not.

  • Many times employees will state that they are not paid for “cleanings” provided; however, this is not an accurate statement.


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Encounter and Barter

  • Encounters are for an arrangement paid for each visit.

  • Barter system is used when the dental provider negotiates payment by exchanging goods and services.


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Insurance Plans

  • Dental Service Corporations

  • Health Service Corporations

  • Preferred Providers Organizations

  • Individual Practice Associations

  • Capitation Programs


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Dental Billing

  • Claim Form

  • ADA CDT

  • Payment Plans

  • Dental Credit Cards

  • Explanation of Benefits


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Government Role

  • Research

  • Disease Prevention

  • Disease Control

  • Program Planning and Operation

  • Funding for the Education of Dental Professionals

  • Regulation


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Government’s Role

  • U.S. PHS

  • Federal Block Grants

  • State Governments

  • Local Governments


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Medicaid

  • Title XIX

  • State/Federal Program

  • Your State’s Medicaid Program

  • Other State’s Medicaid Program


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Dental Care Delivery

Around the World


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International Dental Health Care

  • Dental Diseases

  • Historical Perspective

  • Demographics and the Dental Hygienist

  • Global Education of the Dental Hygienist

  • The Role of the Dental Hygienist

  • Access to Care in Other Countries


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International Dental Health Care, Continued

  • Dental Public Health Programs and Campaigns

  • Oral Health Policies

  • Lobbying Groups

  • International Dental Organizations


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Related Dental Professionals

Regulation of Dental Hygienists

Independent Practice

Portability of Licensure

Future of Dental Hygiene

International Overview



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Issues in the United States

  • Preceptorship/Alternative Education

  • On-the-Job Training for Supragingival Scaling

  • Restrictive Supervision Laws Affecting Access to Care

  • Advanced Dental Hygiene Practitioner


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State Governments

  • Legislative

  • Executive

  • Judicial


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Major Bodies of Law

  • Common Law

  • Statutory Law

  • Constitutional Law

  • Administrative Law


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State Dental Hygiene Practice Act, sometimes referred to as the statute

Supervision Status

Laws Pertaining to Dental Hygiene


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State Dental Board the statute

  • Administrative Law

  • Governs Dental Hygienists and the Practice of Dental Hygiene

  • Rules and Regulations

  • Self-Regulation


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Unsupervised the statute

Independent Practice

Collaborative Practice

General Supervision

Indirect Supervision

Direct Supervision

Supervision Types


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Related Dental Professionals the statute

Regulation of Dental Hygienists

Independent Practice

Portability of Licensure

Future of Dental Hygiene

International Overview


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Dental Health the statute

Education and Promotion


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Health Education Principles the statute

  • Five Dimensional Health Model

    • Physical

    • Mental

    • Social

    • Spiritual

    • Emotional


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Dental Health Education the statute

  • Goal: to prevent dental diseases utilizing appropriate dental health interventions


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Health Education Principles the statute

  • Health Education: the education of health behaviors that bring an individual to a state of health awareness

  • Health Promotion: the informing and motivating of people to adopt health behaviors

  • Health Behavior: an action that helps prevent illness and promotes health for a population


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Goals of Dental Health Education the statute

  • Provide Effective Dental Health Education. 

  • Change Values Aimed at Improving Health. 

  • Healthy Behaviors 


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Stages of Learning the statute

  • Unawareness 

  • Awareness 

  • Self-Interest 

  • Involvement 

  • Action 

  • Habit


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Transtheoretical Model the statute

  • Precontemplation

  • Contemplation

  • Preparation

  • Maintenance

  • Action


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Theory of Reasoned Action the statute

  • Attitude toward the behavior

  • Subjective norms

  • Perceived behavioral control

  • Intention

  • Behavior


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Social Cognitive Theory the statute

  • Self-Efficacy Theory

  • Knowledge – Behavior – Environment


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Empowerment Models the statute

  • Participant Oriented

  • Social Environments


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Motivation the statute

  • Motivation is the will of the individual to act.


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Maslow’s Heirarchy of Needs the statute

  • Self-Actualization

  • Need for Self-Esteem

  • Belongingness and Love

  • Safety Needs

  • Physiological Needs


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Behavioral Conditioning the statute

  • Classical Conditioning

  • Operant Conditioning

  • Modeling


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Lesson Plan the statute

Development


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Assessment Phase the statute

  • Assess target populations’

    • needs

    • interests

    • abilities

  • Assess resources


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Dental Hygiene Diagnosis the statute

  • Formulate Findings from Assessment into a Diagnosis.

  • Prioritize Goals.


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Planning the statute

  • Broad Goal Formulation

  • Specific Objectives

  • Select Teaching Methods.


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Implementation the statute

  • Be Prepared.

  • Effective Teacher Characteristics


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Evaluation the statute

  • Qualitative Measurement

  • Quantitative Measurement

  • Information Provided to Appropriate Parties


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Target Populations the statute

For the Practicing Hygienist


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Target Populations the statute

A group of individuals with similarities of some sort whether it be age, race, educational background, life situations, and/or health conditions


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Family Caregivers the statute

Health Care Workers

Hospice Workers

Persons with Medical Conditions/Diseases

Developmentally Disabled

Hearing Impaired

Visual Impairments

School Teachers

Social Workers

Ages

Prenatal

Infancy

Children

Adults

Older Adults

Specific Target Populations


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Cultural Diversity the statute

The social, ethnic, and cultural elements that compose a person.



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Program Planning the statute

For the Dental Hygienist


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What is a dental public health program? the statute

Educational, clinical, and referral services to a target population


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Preventive Programs the statute

  • School Fluoride Mouthrinse Programs

  • School Dental Sealant Programs

  • Xylitol Programs

  • Mouthguard Programs

  • Dental Health Educational Programs

  • Tobacco Cessation Programs

  • Denture Identification Programs


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Dental Public Health Programs the statute

  • Healthy Smile Program

  • Inner City Health Center Dental Program

  • Soroptomist Dental Project

  • Matthew 25

  • Operation Smile


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Dental Hygiene Program Planning Paradigm the statute

  • Assessment

    • Population’s dental needs

    • Demographics

    • Facility

    • Personnel

    • Existing Resources

    • Funding


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Dental Hygiene Program Planning Paradigm, Continued the statute

  • Dental Hygiene Diagnosis

    • Prioritization of needs

    • Formulation of diagnosis to provide goals and objectives for blueprint

  • Planning

    • Methods to measure goals

    • Blueprint

    • Address constraints and alternatives.


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Dental Hygiene Program Planning Paradigm, Continued the statute

  • Implementation

    • Program will begin operation.

    • Revision and changes identified and employed

  • Evaluation

    • Measuring goals

    • Qualitative and quantitative evaluation

    • Ongoing revisions employed


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Program Evaluation the statute

Dental Public Health


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Program Evaluation the statute

  • Program Planning → Objectives

  • Measurement of Objectives

  • Formative

  • Summative


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Evaluation Techniques the statute

  • Traditional Nonclinical Measurements

    • Interviews

    • Surveys

  • Clinical Methods

    • Basic

    • BSS

    • Dental Indexes


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Government’s Evaluation the statute

  • Healthy People 2010 Objectives and Evaluation Mechanisms

  • NOHSS

  • Call to Action


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Oral Epidemiology the statute

  • Study of Oral Diseases

  • Multifactorial Nature of Disease

  • Terminology

    • Epidemic Prevalence

    • Endemic Incidence

    • Pandemic Etiology

    • Disease Rates Surveilance

    • Mortality Risk Factors

    • Morbidity Index


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Oral Epidemiology Reports the statute

  • Morbidity and Mortality (MMWR)

  • Healthy People Reports

  • Surgeon General’s Report

  • Call to Action

  • Global Oral Data Bank


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Epidemiology of Oral Diseases the statute

  • Periodontal Diseases

  • Tooth Loss

  • Dental Caries

  • Oral Cancer

  • Cleft Lip/Palate

  • Injury

  • Toothaches


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Research the statute

In Dental Hygiene


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Significance of Research to Dental Hygiene the statute

Dental public health is based upon programs that have demonstrated effectiveness in achieving health for the population.


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Historical the statute

Descriptive

Survey

Observational

Case Studies

Correlational

Epidemiological

Longitudinal

Cross-sectional

Retroactive

Experimental (Prospective)

Quasi-experimental

Types of Research


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Beginning Research the statute

  • Research Question

    • Does Brand X toothpaste whiten teeth?

  • Positive Hypothesis

    • Brand X toothpaste does significantly whiten teeth.

  • Null Hypothesis

    • There is no statistically significant difference between Brand X and a placebo when comparing the whitening of teeth.


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Research Design the statute

  • Formulating a hypothesis

  • Review of the literature

  • Methods and materials

  • Statistical evaluation


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Experimental Approaches the statute

  • Two group pretest/post-test designs

  • Time series

  • Post-test only

  • Solomon three and four group

  • Factorial

  • Placebos

  • Control groups


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Sampling Techniques the statute

  • Randomization

  • Systematic

  • Convenience

  • Stratifying


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Informed Consent the statute

  • Informed Consent is part of examining the ethics of the research project as a whole.


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Dental Research the statute

Biostatistics


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Categorizing Data the statute

  • Discrete or Continuous

    • Nominal

    • Ordinal

    • Interval

    • Ratio


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Descriptive Statistics the statute

  • Measures of Central Tendency

    • Mean

    • Median

    • Mode

  • Measures of Dispersion

    • Range

    • Variance

    • Standard Deviation


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The Normal Distribution the statute

  • Gaussian Distribution

  • Bell-Shaped Curve

  • Skewed Data


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Graphing Data the statute

  • Frequency Distribution Table

  • Grouped Frequency Table

  • Bar Graph

  • Histogram

  • Polygon


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Correlation the statute

  • Correlation Coefficients

  • Positive Correlation

  • Negative Correlation

  • Strong Correlation


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Correlation the statute

  • Pearson Product Movement Correlation Coefficient

  • Spearman Rank-Order Correlation Coefficient


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Statistical Decision Making the statute

  • Probability

  • Type I Error

  • Type II Error

  • Degrees of Freedom


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Inferential Statistics the statute

  • Parametric Inferential Statistics

    • Student t-test

    • Analysis of Variance

  • Nonparametric Inferential Statistics

    • Chi Square Test

    • Other Nonparametric Tests


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Interpretation of Data the statute

  • Statistical Significance

  • Clinical Significance


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Research Results the statute

  • Validity: Results of the study can be inferred to the general population.

  • Reliability: The study was conducted in a controlled manner and if repeated would lend the same results; thus, the study is reproducible.


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Evaluation of the statute

Scientific Literature and Dental Products


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Regulation of Dental Care Products the statute

  • Food and Drug Administration

  • American Dental Association Seal of Acceptance


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Dental Hygienist’s Role the statute

  • Critical consumer

  • Patient education

  • Awareness of advertising techniques


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Introduction the statute

Purpose

Research Design

Sample Selection

Product Usage

Examiners

Statistical Significance

Results

Evaluation of Scientific Literature


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Careers in the statute

Dental Public Health


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Positions for the RDH the statute

  • U.S. PHS

  • VA Hospitals

  • Federal Prisons

  • Military Base Clinics

  • Other Agencies


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United States RDH Positions the statute

  • Commissioned Officer Positions

  • Civil Service Positions

  • National Health Service Corps


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Other Options the statute

  • Independent Contractor

  • Employee of Dental Staffing Agency

  • Student Opportunities

    • COSTEP


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Strategies for Creating Dental Hygiene Positions the statute

In Dental Public Health Settings


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Populations the statute

  • Homebound

  • Institutionalized

  • Populations with Disabilities

  • Rural Area Residents

  • Population with Dental Phobias

  • Populations faced with Language or Cultural Barriers

  • Patients without Financing


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Proposed Plan for Action the statute

  • Dental Hygiene Program Planning Paradigm

    • Assessment

    • Dental Hygiene Diagnosis

    • Planning

    • Implementation

    • Evaluation


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Practice Management Issues the statute

  • Patient tracking

  • Appointment scheduling

  • Practice promotion

  • Collection of fees


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Proposal Development and Presentation the statute

  • Introduction

  • Significance of Position

  • Blueprint of the Operational Program

  • Conclusion

  • Contracts

  • Teaching Strategies


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Dental Public Health the statute

Review


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Community Health/Research Principles the statute

  • Promoting health and preventing disease within groups

  • Participating in community programs

  • Analyzing scientific information, utilizing statistical concepts, and applying research results


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Dental Public Health: Contemporary Practice the statute for the Dental Hygienist:

“The Dental Hygienist is the Premier Dental Public Health Provider. “


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