::Courses : MDS : Public Health Dentistry
MDS PART II
 

PUBLIC HEALTH DENTISTRY
OBECTIVES:
At the end of 3 years of training the candidate should be able to
KNOWLEDGE:
Apply basic science knowledge regarding etiology, diagnosis and management of the prevention, promotion and treatment of all the oral conditions at the individual and community level.
Identify social, economic, environmental and emotional, determinants in a given individual patient or a community for the purpose of planning and execution of Community Oral Health Program.
Ability to conduct Oral Health Surveys in order to identify all the oral health programs affecting the community and find solution using multi-disciplinary approach.
Ability to act as a consultant in community Oral Health, tech guide and take part in research (both basic and clinical), present and publish the outcome at various scientific conference and journals, both national and international level.
SKILLS:
The candidate should be able to
Take history, conduct clinical examination including all diagnostic procedures to arrive at diagnosis at the individual level and conduct survey of the community at state and national level of all conditions related to oral health to arrive at community diagnosis.
Plan and perform all necessary treatment, prevention and promotion of Oral Health at the individual and community level.
Plan appropriate Community Oral Health program, conduct the program and evaluate, at the community level.
Ability to make use of knowledge of epidemiology to identify causes and plan appropriate preventive and control measures.
Develop appropriate person power at various levels and their effective utilization
Develop Survey and use appropriate methods to impart Oral Health Education.
Develop ways of helping the community towards easy payment plan and followed by evaluation for their oral health care needs.
Develop the planning, implementation, evaluation and administrative skills to carry out successful community oral health programs.
VALUES:
Adopt ethical principles in all aspects of Community Oral Health Activities.
To apply ethical and moral standards while carrying out epidemiological researches.
Develop communication skills, in particular to explain the causes and prevention of oral diseases to the patient
Be humble and accept the limitations in his knowledge and skills and to ask for help from colleagues when needed and promote teamwork approach.
Respect patient’s rights and privileges including patients right to information and right to seek a second opinion.
COURSE CONTENTS:
Paper – I: Applied Basic Sciences
APPlied Anatomy and History
A. Applied Anatomy in relation to
Development of face
Branchial arches
Muscles of facial expression
Muscles of mastication
TMJ
Salivary gland
Tongue
Salivary gland
tongue
Hard and soft palate
Infratemporal fossa
Paranasal air sinuses
Pharynx and larynx
Cranial and spinal nerves – with emphasis on trigeminal, facial, glossopharyngeal and hypoglossal nerve
Osteology of maxilla and mandible
Blood supply, venous and lymphatic drainage of head and neck
Structure and relations of alveolar process and edentulous mouth
Genetics – fundamentals
B. Oral History:
Development of dentition, Innervations of dentin and pulp
Periodontium – development, history, blood supply, nerve supply and lymphatic drainage
Oral mucous membrane
Pulp-Periodontal complex
APPLIED PHYSIOLOGY AND BIOCHEMISTRY
Cell
Mastication and deglutition
Food and nutrition
Vitamins and minerals
Fluid and electrolyte balance
Pain pathway and mechanism – types, properties
Blood composition and functions, clotting mechanism and erythropoiesis, Blood groups and transfusions, Pulse and blood pressure
Dynamics of blood flow
Cardiovascular homeostasis – heart sounds
Respiratory system: Normal physiology and variations in health and disease, Asphyxia and artificial respiration
Endocrinology: thyroid, parathyroid, adrenals, pituitary, sex hormones and pregnancy, Endocrine regulation of blood sugar.
A. APPLIED PATHOLOGY:
Pathogenic mechanism of molecular level
Cellular changes following injury
Inflammation and chemical mediators
Oedema, thrombosis and embolism
Hemorrhage and shock
Neoplasia and metastasis
Blood disorders.
Histopathology and pathogenesis of dental caries, periodontal disease, oral mucosal lesions and malignancies, HIV
Propagation of dental infection.
B. MICROBIOLOGY:
Microbial flora of oral cavity
Bacteriology of dental caries and periodontal disease
Virology of HIV, herpes, hepatitis
Parasitology
Basic immunology – basic concepts of immune system in human body
Cellular and humoral immunity
Antigen and antibody system
Hypersensitivity
Autoimmune disease
C. ORAL PATHOLOGY:
Detailed description of disease affecting the oral mucosa, teeth, supporting tissues and jaws.
PHYSICAL AND SOCIAL ANTHROPOLOGY:
Introduction and definition
Appreciation of the biological basic of health and disease
Evaluation of human race, various studies of different races by anthropological methods.
APPLIED PHARMACOLOGY:
Definition, scope and relation to other branches of medicine, mode of action, bioassay, standardization, pharmacodyanamics, Pharmcokinetics.
Chemotherapy of bacterial infections and viral infection – sulphonamides and antibiotics
Local anesthesia
Analgesics and anti-inflammatory durgs
Hypnotics, tranquilizers and antipyretics
Important hormones- ACTH, cortisone, insulin and oral antidiabetics.
Drug addition and tolerance
Important pharmacological agents in connection with autonomic nervous system adrenaline, noradrenaline, atropine
Brief mention of antihypertensive drugs
Emergency drugs in dental practice
Vitamins and haemopoietic drugs.
RESEARCH METHODOLOGY AND BIOSTATISTICS:
Health Informatics:
basic understanding of computer and its components, operating software (windows), Microsoft office, preparation of teaching materials like slides, project, multimedia knowledge.
Research methodology:
definitions, types of research, designing written protocol of research, objectivity in methodology, quantification, records and analysis.
Biostatics:
Introduction, applications, uses and limitations of bio-statistics in Public Health dentistry, collection of data, presentation of data, measures of central tendency, measures of dispersion, methods of summarizing, parametic and non parametric tests of significance, correlation and regression, multivariate analysis, sampling and sampling techniques – types errors, bias, trial and calibration.
Computers:
Basic operative skills in analysis of data and knowleddge of multimedia.
PAPER – II PUBLIC HEALTH
Public Health
Definition concepts and philosophy of dental health
History of public health in India and at international level
Terminologies used in public health
Health
Definition, concepts and philosophy of health
Health indicators
Community and its characteristics and relation to health
Disease:
Definition, Concepts
Multifactorial causation, natural history, risk factors
Disease control and eradication, evaluation and causation, infection of specific diseases
Vaccines and immunization
General epidemiology :
Definition and aims, general principles
Multifactorial causation, natural history, risk factors
Methods in epidemiology, descriptive, analytical, experimental and classic epidemiology of specific disease, uses of epidemiology.
Duties of epidemiologist
General idea of methods of investigating chronic disease, mostly non – infectious nature, epidemic, endemic and pandemic
Ethical conversation in any study requirement
New knowledge regarding ethical subjects
Screening of diseases and standard procedures used.
Environmental health:
Impact of important components of the environment of health
Principles and methods of identification, evaluation and control of such health hazards
Pollution of air, water, soil, noise, food
Water purification, international standards of water
Domestic and industrial toxins, ionizing radiation
Occupational hazards
Waste disposal – various methods and sanitation.
Public health education:
Definition, aims, principles of health education
Health education, methods, models, contents, planning health education programs
Public Health practice and administration system in India
Ethics and jurisprudence:
Basic principles of law
Contract laws – dentist – patient relationships & Legal forms of practice
Dental malpractices
Person identification through dentistry
Legal protection for practicing dentist
Consumer protection act
Nutrition in Public Health:
Study of science of nutrition and its application of human problem
Nutritional surveys and their evaluations
Influence of nutrition and diet on general health and oral health, dental caries, periodontal disease and oral cancers
Dietary constituents and carcinogenicity
Guidelines for nutrition
Behavioral science:
Definition and introduction
Sociology: Social class, social group, family types, communities and social relationships, culture, its effect on oral health
Psychology: definition, development of child psychology, anxiety, fear and phobia, intelligence, learning, motivation, personalities, fear, dentist – patient relationship modeling and experience.
Hospital Administration
Departmental maintenance, organizational structures
Type of practices
Biomedical waste management
Health care delivery system:
International oral health care delivery systems – Review
Central and state system in general and oral health care delivery system if any
National and health policy
National health programme
Primary health care – concepts, oral health in PHC and its implications
National and international health organizations
Dentists Act 1928, Dental council of India, Ethics, Indian Dental Association
Role of W.H.O and Voluntary organizations in Health Care for the Community.
Oral Biology and Genetics:
A detailed study of cell structure
Introduction to Genetics, Gene structure, DNA, RNA
Genetic Counseling, gene typing
Genetic approaches in the study of orals disorder
Genetic Engineering – Answer to current health problems.
PAPER – III DENTAL PUBLIC HEALTH
Dental public health
History
Definition and concepts of dental public health
Difference between clinical and community dentistry
Critical review of current practice
Dental problems of specific population groups such as chronically ill, handicapped and institutionalized group.
Epidemiology of oral disease and condition
Dental caries, gingival, periodontal disease malocclusion, dental fluorosis, oral cancer, TMJ disorders and other oral health related problems.
Oral survey procedures
Planning
Implementation
WHO basic oral health methods 1997
Indices for dental diseases and conditions
Evaluation
Delivery of Dental care:
Dental person power – dental auxiliaries
Dentist – population ratios
Public dental care programs
School dental health programs – Incremental and comprehensive care
Private practice and group practice
Oral health policy – National and in international policy
Payment for dental care
Prepayment
Post – payment
Reimbursement plans
Voluntary agencies
Health insurance
Evaluation of quality of dental care:
Problems in public and private oral health care system program
Evaluation of quality of services, governmental control
Preventive dentistry:
Levels of prevention
Preventive oral health program screening, health education and motivation
Prevention of all dental disease – dental caires, periodontal disease, oral cancer, malocclusion and Dentofacial anomalies.
Role of dentist in prevention of oral disease at individual and community level
Fluoride
History
Mechanism of action
Fluoride toxicity
Fluorosis
Systemic and topical preparations
Advantages and disadvantages of each
Update regarding fluorosis
Epidemiological studies
Methods of fluoride supplements
Defluoridation techniques
Plaque control measures
Health education
Personal oral hygiene
Tooth brushing technique
Dentifrices, mouth rinses
Pit and fissure sealant, ART
Preventive oral health care for medically compromised individual
Update on recent preventive modalities
Caries vaccines
Dietary counseling
Practice management
Definition
Principles of Management of dental practice and types
Organization and administration of dental practice
Current trends
STRUCTURED TRAINING SCHEDULE:
First year
SEMINARS
5 seminars in basic sciences subject
To conduct 10 journals clubs
Library assignment on assigned topics – 2.
Submission of synopsis for dissertation – within 6 months
Periodic review of dissertation at two monthly intervals.
CLINICAL TRAINING
Clinical assessment of patient
Learning different criteria and instruments used in various oral indioes – 5 cases each
Oral Hygiene Index – Greene and vermillion
Oral Hygiene Index – Simplified
DMF – DMF (T), DMF (S)
Def
Fluorosis Indices – Dean’s Fluorosis Index, Tooth Surface Index for Fluorosis, Thylstrup and Fejerskov Index.
Community Periodonal Index (CPI)
Plaque Index – Silness and Loe
WHO oral Health Assessment Form – 1987
Carrying out treatment (under comprehensive oral health care) of 10 patients maintaining complete records.
FIELD PROGRAMME
Carrying out preventive programs and health education for school children of the adopted school.
School based preventive programs
Topical Fluoride application-Sodium Fluoride, Stannous Fluoride, Acidulated Phosphate Fluoride preparations and Fluoride varnishes, Fluoride mouth rinses
Pit and Fissure sealant – Chemically cured (GIC) Light cured
Minimal Invasive Treatment-Preventive Resin Restoration (PRR), Atraumatic Restorative Treatment (ART)
Visit to slum, water treatment plant, sewage treatment plant and milk dairy, Public Health Institute, Anti-Tobacco Cell, Primary Health Center and submitting reports.
In additions the postgraduate shall assist and guide the under graduate students in their clinical and field programs.
Second year
SEMINARS
Seminars in Public Health and Dental Public Health Topics
Conducting journal clubs
Short term research project on assigned topics – 2
Period review of dissertation at monthly reviews.
CLINICAL TRAINING CONTINUATION OF THE CLINICAL TRAINING
Clinical assessment of patient
Learning different criteria and instrument used in various oral indices
Oral Hygiene Index – Greene and Vermillion
Oral Hygiene Index – Simplified
DMF – DMF (T), DMF (S)
Det t/s
Fluorosis indices – Dean’s Fluorosis Index, Tooth Surface Index for Fluorosis, Thylstrup and Fejerskov Index
Community Periodontal Index (CPI)
Plaque Index – Silness and Loe
WHO Oral Health Assessment Form – 1987
Carrying out treatment (under comprehensive oral health care) of 10 Patient – maintaining complete records
FIELD PROGRAM – CONTINUATION OF FIELD PROGRAM
Carrying out school dental health education
School based preventive programs
Topical Fluoride application – Sodium Fluoride, Stannous Fluoride, Acidulated phosphate, Fluoride preparations and Fluoride varnishes, Fluoride mouth rinses.
Pit and Fissure Sealant – Chemically cured (GIC) light cured
Minimal Invasive Treatment – Preventive Resin Restoration (PRR), Atraumatic Restorative Treatment (ART)
Organizing and carrying out dental camps in both urban and rural areas.
Assessing oral health status of various target groups like school children, Expectant mothers Handicapped, Underprivileged and geriatric populations. Planning dental manpower and financing dental health care for the above group.
Application of the following preventive measures in clinic – 10 cases each
Topical fluoride application – Sodium Fluoride, Stannous Fluoride, varnishes
Pit and Fissue Sealant
Planning total health care for school children in an adopted school:
Periodic surveying of school Children
Incremental dental care
comprehensive dental care
Organizing and conducting community oral health surveys for all over conditions – 3 surveys
In addition the post graduate shall assist and guide the under graduate students in their clinical and field programs
To take lecture classes (2) for undergraduate students in order to learn teaching methods (pedagogy) on assigned topic.
Third Year:
SEMINARS
Seminars on recent advances in preventive dentistry and dental public health
Critical evaluation of scientific articles – 10 articles.
Completion and submission of dissertation
CLINICAL TRAINING:
Clinical assessment of patient
Learning different criteria and instruments used in various oral indices – 5 each
Oral Hygiene Index – Greene and Vermillion
Oral Hygiene Index – Simplified
DMF – DMF (T), DMF (S)
Def t/s
Fluorosis Indices- Dean’s Fluorosis Index, Tooth Surface Index for Fluorosis, Thystrup and Fejerskov Index
Community Periontal Index (CPI)
Community Periodontal Index (CPI)
Plaque Index – Silness and Loe
WHO oral Health Assessment Form – 1987
Carrying out treatment (Under comprehensive oral health care) of 10 patients maintaining complete records
Carrying out school dental health education
School based preventive programs
Topical Fluoride application – Sodium Fluoride, Stannous Fluoride, Acidulated Phosphate Fluoride preparations and Fluoride varnishes
Pit and Fissure scalant
Minimal Invasive Techniques – Preventive Resin Restorations (PRR), Atraumatic Restorative Treatment (ART)
To take lecture classes (2) for undergraduate students in order to learn teaching methods (pedagogy)on assigned topic)
Exercise on solving community health problems – 10 Problems
Application of the following preventive measure in Clinic – 10 cases each.
Topical Fluoride application – Sodium Fluoride, Stannous Fluoride, Acidulated Phosphate Fluoride preparation
Pit and Fissure sealants
Dental – health education training of school teachers, social workers, health workers,
Posting at dental satellite centers/ Nodal centers
In addition the post graduate shall assist and guide the under graduate students in their clinical and field programs.
Before completing the third year M.D.S., a student must have attended two national conference. Attempts should be made to present two scientific papers, publication of a scientific article in a journal.
MONITORING LEARNING PROCESS:
It is essential to monitoring the learning progress of each candidate through continuous appraisal and regular assessment. It not only helps teachers to evaluate students, but also students to evaluate themselves. The monitoring be done by the staff of the department based on
participation of students in various teaching / learning activities. It may be structured and assessment be done using checklists that assess various aspects, checklists are given in section IV.
SCHEME OF EXAMINATION:
A. Theory : 300 Marks
Written examination shall consist of four question papers each of three hours duration. Total marks for each paper will be 100. Paper I,II and III shall consist of two long questions carrying 200 marks each and 6 short essay questions each carrying 10 marks. Paper IV will be on Essay questions on recent advances may be asked in any or all the papers. Distribution of topics for each paper will be as follows.
Paper – I: Applied basic sciences: Applied and Histology, Applied physiology and Biochemistry, Applied Pathology, Microbiology, oral pathology, Physical and social Anthropology, Applied Pharmacology and research methodology, and Biostatistics
Paper – II: Public Health
Paper – III: Dental Public Health
Paper – IV: Essay
Topics of current interest in community oral health
The topics assigned to the different papers are generally evaluated under those section. However a strict division of the subject may not be possible and some overlapping of topics is inevitable students should be prepared to answer overlapping topics.
B. Practical / Clinical Examination : 200 Marks
Clinical examination of at least 2 patient representing the community – includes history main complaints, examination and recording of the findings, using indices for the assessment of oral health and prescription of the observation including diagnosis comprehensive treatment planning
Performing: (50 marks – (1 ½ Hrs)
One of the treatment procedures as per treatment plan (Restorative, surgical rehabilitation)
Preventive oral health care procedure (50 marks – (1 ½ Hrs)
One of the procedures specified in the curriculum
Critical evaluation of a given research article published in an international journal (50 marks – (1 Hrs)
Problem solving – a hypothetical oral health situation existing in a community is given with sufficient data. The student as a specialist in community dentistry is expected to suggest practical solutions to the existing oral health situation of the given community (50 marks – (1 ½ Hrs)
C. Viva Voce: 100 Marks
Viva voce examination : 80 Marks
All examiners will conduct viva-voce conjointly on candidate’s comprehensive, analytical approach, expression, interpretation of data and communication skills. It includes all components of course contents. It includes presentations and discussion on dissertation also.
Pedagogy Exercise: 20 Marks
A topic to given to each candidate in the beginning of clinical examination, He / She is asked to make a presentation on the topic for 8-10 Minutes.
 

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