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Chapter 06: Oral Health Programs in the Community
Test Bank
1. Dental caries:
a. is transmissible.
b. is an acute disease.
c. can be prevented.
d. a and c
ANS: D
Dental caries is a transmissible chronic disease that can be prevented.
REF: p. 168
2. School-based pit and fissure sealant programs reduce dental caries as much as __%.
a. 50
b. 60
c. 70
d. 80
ANS: B
They reduce dental caries as much as 60%.
REF: "p. 183, 184"
3. Evidenced-based practices means:
a. things that seem to be true over time.
b. what is seen in clinical practice.
c. those that have been scientifically proven to be effective.
d. the consensus of what clinicians believe is true.
ANS: C
Evidenced-based practices are those that have been scientifically proven to be effective, as opposed to empirical, or what people believe to be true.
REF: p. 169
4. Which of the following is the federal government’s principal agency for protecting the health of all Americans?
a. Department of Health and Human Services (DHHS)
b. Food and Drug Administration (FDA)
c. National Institutes of Health (NIH)
d. Health Resources and Services Administration (HRSA)
ANS: A
DHHS is the federal government’s principal agency. DHHS is the largest grant-making agency in the federal government. DHHS works with state and local governments and funds services at the local level through state or county agencies or through private sector grantees. The rest of the choices are public health service operating divisions of the DHHS.
REF: p. 169
5. Approximately __% of the states have full-time dental directors who provide leadership and guidance in the planning, funding, and implementation of oral health promotion programs for the residents of the states they serve.
a. 50
b. 66
c. 75
d. 90
ANS: B
Approximately two thirds of the states have full-time state dental directors of oral health promotion programs. These programs vary in their scope of services and organization across the United States. A state’s program may include, in addition to the state dental director, regional dental directors, public health educators, clinical dentists, dental hygienists, and dental assistants who provide oral health services to underserved populations.
REF: p. 169
6. Many individual county and city health departments have federally funded clinics that offer services on a sliding scale fee schedule and accept clients who receive public assistance through:
a. Medicare.
b. Medicaid.
c. the U.S. Department of Agriculture (USDA).
d. workforce development.
ANS: B
The clinics accept clients who are receiving public assistance through Medicaid. These clinics employ both public health dentists and dental hygienists and sometimes have supplemental clinical coverage provided by local dental professionals. Hours of operation are also tailored to best meet the needs of the population that they serve.
REF: p. 170
7. The Essential Public Health Services for Oral Health:
a. describe the roles of state oral health programs.
b. were developed by the Environmental Protection Agency (EPA).
c. have been used in the development and evaluation of public health activities at the state level.
d. a and c
ANS: D
The Essential Public Health Services for Oral Health were developed by the Association of State and Territorial Dental Directors. These guidelines describe the roles of state oral health programs and have been used in the development and evaluation of public health activities at the state level.
REF: p. 170
8. An oral health coalition is:
a. a division of the Department of Labor.
b. a cooperative effort on the part of many individuals and organizations to build systems and develop programs that improve community health.
c. a collaboration between dental schools and dental hygiene programs.
d. a yearly event that provides care for low-income individuals with no out of pocket expense.
ANS: B
An oral health coalition is a cooperative effort on the part of many individuals and organizations to build systems and develop programs that improve community health. For example, the Washington State Oral Health Coalition was formed in 1993 to further improvements in oral health. It has proved to be an excellent means of bringing dedicated professionals together to resolve oral health issues through policy development. Anyone interested in achieving the goal of optimal oral health for Washington residents is invited to join.
REF: p. 170
9. The community is viewed as the patient in public health, and ____________ can be compared with the evaluation of the patient’s treatment.
a. assessment
b. planning
c. implementation
d. evaluation
ANS: D
Evaluation and review of the program can be compared with the evaluation of the patient’s treatment. The community survey is comparable to the patient’s examination for assessment. The program plan and implementation are similar to the treatment plan and the treatment of the patient.
REF: p. 172
10. Implementation:
a. is an organized and systematic approach to identify a target group and to define the extent and severity of oral health needs present.
b. is an organized response to reduce or eliminate one or more problems.
c. includes the process of putting the plan into action and monitoring the plan’s activities, personnel, equipment, resources, and supplies.
d. is the method of measuring results of the program against objectives developed during the early planning stages.
ANS: C
Implementation includes the process of putting the plan into action and monitoring the plan’s activities, personnel, equipment, resources, and supplies. This step should include feedback from personnel and participants as well as ongoing evaluation mechanisms.
REF: p. 172
11. Which of the following is true of formative evaluation?
a. It involves judging the merit or worth of a program after it has been in operation.
b. It is an attempt to determine whether a fully operational program is meeting the goals for which it was developed.
c. It is an examination of the processes or activities of a program as they are taking place.
d. a and b
ANS: C
Formative evaluation, or the internal evaluation of a program, is an examination of the processes or activities of a program as they are taking place. Summative evaluation involves judging the merit or worth of a program after it has been in operation. This step is an attempt to determine whether a fully operational program is meeting the goals for which it was developed.
REF: p. 172
12. If a community’s perception of needs is adhered to exclusively, actual clinical health problems may go untreated because:
a. funding is limited.
b. people are not knowledgeable about many areas of health care.
c. there are differences between wants and needs.
d. desires are endless.
ANS: B
People are not knowledgeable about many areas of health care. The solution to this dilemma involves striking a delicate balance between negligence and overzealousness. Although it is unethical to impose one’s own perceptions on a community, it is the professional’s responsibility to inform people of existing problems and their consequences.
REF: p. 173
13. Developing goals and objectives is a part of the _________ process during the development of an oral health program in the community.
a. assessment
b. planning
c. implementation
d. evaluation
ANS: B
Developing goals, objectives, and program activities is part of the planning process. During this stage, it is essential to have community involvement and participation. The formulation of program goals and objectives is an active process, offering specific proposals for changes to be made in the community.
REF: p. 174
14. Which of the following is the key to a measurable objective?
a. The time frame
b. The performance verb
c. The condition
d. A specific goal
ANS: B
The performance verb is the key to a measurable objective; it is an action word, such as “write,” “demonstrate,” or “recite.” The performance verb is essential in writing a measurable objective. The inclusion of a condition and a criterion makes the objective more specific and useful to the learner.
REF: p. 174
15. Which area of program planning describes how the objectives will be accomplished?
a. Program goals
b. Program objectives
c. Program activities
d. Program implementation
ANS: C
Program activities describe how the objectives will be accomplished. In planning these program activities, one must carefully consider the type of resources available as well as program restraints.
REF: p. 175
16. The implementation phase of program planning should answer ________, which in this case are the activities required to achieve the objective.
a. who
b. what
c. when
d. why
ANS: B
The strategy should answer who (the individuals responsible for each activity), what (the activities required to achieve the objective), when (the chronologic sequence of events), and why (the effect of the objective to be achieved).
REF: p. 175
17. Using a smaller population for a community oral health program with the intent to expand later on is called:
a. test marketing.
b. pilot testing.
c. a stratified sample.
d. testing the waters.
ANS: B
It is called pilot testing. This implementation strategy allows for an opportunity to test the program’s effectiveness and provides ease in control and monitoring of the program activities. A pilot program provides useful information and enables decisions to be made about the future of the program. Piloting is a form of evaluating the implementation.
REF: p. 175
18. Which of the following is the first step in evaluation of a community oral health program?
a. Examine the specific measurable objectives.
b. Evaluate the measurable outcomes.
c. Perform pilot testing.
d. Review the program goals.
ANS: D
The first step in evaluation is to review the program goals and then examine the specific measurable objectives. The data that are obtained through measuring the objectives are called the measurable outcomes. Each objective should be reviewed to determine how well it is meeting the program goals.
REF: p. 176
19. Which of the following is true for evaluation of a community oral health program?
a. Evaluation determines whether the program accomplishes what it was designed to accomplish.
b. A summary of what went well and what did not is adequate.
c. A negative outcome means that the program has been a failure.
d. Drawing conclusions based on intuition is adequate.
ANS: A
Evaluation determines whether a program has accomplished what it was designed to accomplish. The objectives themselves must be specifically addressed. Summarizing what went well and what did not or drawing conclusions based on intuition is not adequate. A negative outcome does not mean that the program has been a failure.
REF: p. 176
20. If the objectives of a community health program are not met, it does not mean a program is a failure because:
a. the workers were reimbursed for their time.
b. if a program is evaluated properly in some sense, it has been a success.
c. some form of care was delivered to the public.
d. at least the implementers tried.
ANS: B
If a program is evaluated properly so that negative outcomes become learning experiences and indicators of future programming and research, it has been a success in some sense. Formative evaluation during the implementation process can point out problems and identify opportunities to correct program deficiencies early on.
REF: p. 176
21. Which of the following has been recognized as one of the top ten public health measures of the 20th century?
a. Cosmetic bonding
b. Fluoridation of water
c. Silver dental amalgam
d. Porcelain fused to metal crowns
ANS: B
Fluoridation has been recognized as one of the top ten public health measures of the 20th century. As a result of the general availability of public water sources to most people, the adjustment of the natural fluoride content found in the water to levels optimal for combating oral disease has proven to be a successful public health measure.
REF: p. 176
22. The average number of decayed, missing (because of caries), or filled permanent teeth (DMFT) steadily declined from 1967 to 1992 in the United States because of:
a. improved oral hygiene.
b. populations residing in fluoridated communities.
c. improvements in the design of toothbrushes.
d. the use of dental floss.
ANS: B
The average number of DMFT steadily declined from 1967 to 1992 because of populations residing in fluoridated communities.
REF: p. 177
23. The total population receiving community water fluoridation was __% in 2006.
a. 41.5
b. 51.5
c. 61.5
d. 71.5
ANS: C
As of 2006, the total population receiving adjusted community water fluoridation was 61.5%, up from 57.6% in 2000. Approximately 184 million U.S. residents currently benefit from community water fluoridation. The target is 75% of the population.
REF: p. 178
24. The mean annual per capita cost is lower in community water fluoridation systems for larger populations (>50,000) than it is for smaller populations (<10,000). The lifetime cost of fluoridation per person is less than the cost of one dental filling.
a. Both statements are true.
b. Both statements are false.
c. The first statement is true; the second statement is false.
d. The first statement is false; the second statement is true.
ANS: A
The mean annual per capita cost of community water fluoridation ranges from $0.68 for systems with a population greater than 50,000 to $3.00 for systems with fewer than 10,000 people. The lifetime cost of fluoridation per person is less than the cost of one dental filling.
REF: p. 178
25. The recommended levels for water fluoridation in the United States range from 0.7 to 1.2 parts per million (ppm) of fluoride, depending on the:
a. size of the population younger than 14 years of age.
b. average daily temperature for that area.
c. proximity to an ocean.
d. cost.
ANS: B
The recommended levels for water fluoridation depend on the average daily temperature for that area. This range is based on the hypothesis that water consumption increases with increasing climatic temperature. This assumption may not be as accurate as earlier research indicates because of the increased use of air conditioning and the increased consumption of soft drinks and bottled water.
REF: p. 180
26. Which of the following offers the benefits of fluoride in a structured environment in communities where a public water source is not available or where community water fluoridation is undesired for various reasons?
a. Fluoridated salt
b. Fluoride supplemented sports drinks
c. School-based fluoride mouth rinse programs
d. Fluoridated chewing gum
ANS: C
School-based fluoride mouth rinse programs offer the benefits of fluoride in a structured environment. The mouth rinse program is administered by school personnel or volunteers on a weekly basis to participating children. The children rinse for 60 seconds with 10 mL of 0.2% sodium fluoride.
REF: p. 180
27. Advantages of community water fluoridation over a community-based fluoride supplement program include:
a. reduced need for compliance.
b. lower installation and startup costs.
c. decay prevention and oral health benefits for the entire population.
d. a and c
ANS: D
The need for compliance over an extended period of time is a major procedural and economic disadvantage of community-based fluoride supplement programs. Although the total costs of the purchase of supplements and administration of a program are small compared with the installation and start-up costs associated with fluoridation equipment, the overall cost of supplements per child is much greater than the per capita cost of community water fluoridation. Community water fluoridation provides decay prevention and oral health benefits for the entire population.
REF: p. 181
28. Fluoride varnish:
a. is self-applied by the patient at home.
b. is intended to be permanent, much like dental sealant.
c. may be used to prevent root surface caries on adults with gingival recession.
d. a and c
ANS: C
Varnishes may be used to prevent root surface caries on adults with gingival recession. The varnish is applied by an operator, with a recommended twice-yearly reapplication for optimal benefit. The varnish is not intended to be permanent, like a sealant, but to hold the fluoride in contact with the tooth for a period of time.
REF: p. 181
29. Which of the following is the most cost-effective, most practical, and safest means of preventing tooth decay?
a. Dental sealants
b. Regular dental visits
c. Community water fluoridation
d. Fluoride varnish
ANS: C
Even though other sources of fluoride are available and despite the increased risk of fluorosis, community water fluoridation remains the most cost-effective, the most practical, and the safest means of preventing tooth decay.
REF: p. 182
30. Which of the following is true regarding antifluoridationists?
a. They provide inaccurate false information to the public.
b. Their arguments against fluoridation do have some merit based on scientific knowledge.
c. They attempt to link adverse health effects with fluoridation.
d. a and c
ANS: D
Antifluoridationists provide inaccurate false information to the public and to elected officials and attempt to link adverse health effects with fluoridation. Their arguments against fluoridation do not have any merit based on scientific knowledge. The economic and health benefits of fluoridation for millions of Americans have been confirmed in numerous studies by renowned scientists.
REF: p. 183
31. Which of the following is true of dental sealants?
a. Little increase in the percentage of school-aged children with sealants has occurred among children in low-income populations.
b. One goal of Healthy People 2010 was to have 90% of children receiving dental sealants on their permanent molars.
c. According to the 1988 to 1994 baseline data, about 51% of 14-year-old adolescents had dental sealants on their permanent molars.
d. Dental insurance will not reimburse for sealants.
ANS: A
Little increase has occurred among children in low-income populations. One goal of Healthy People 2010 was to have 50% of children receiving dental sealants on their permanent molars. According to the 1988 to 1994 baseline data, only 23% of 8-year-old children and 15% of 14-year-old adolescents had dental sealants on their permanent molars.
REF: p. 183
32. To reach the Healthy People 2020 goal of increasing the proportion of children who have received dental sealants on their molar teeth, many states have instituted:
a. reimbursement through dental insurance programs.
b. expansion of dental assisting and dental hygiene educational programs.
c. school-based sealant programs (SBSPs).
d. educational grants for sealant placement in public health programs.
ANS: C
Many states have instituted SBSPs. In some programs, mobile dental vans are sent to schools, and the sealants are applied in the van. In other programs, portable equipment is transported from school to school and is set up in available space.
REF: p. 183
33. For health education programs to be effective:
a. the cognitive model alone has proven to be effective in producing change.
b. the participant must be actively involved in the learning process.
c. internal rather than external factors should be considered in developing an oral health educational program.
d. external rather than internal factors should be considered in developing an oral health educational program.
ANS: B
The participant must be actively involved in the learning process. The cognitive model alone (attitude + knowledge = behavior change) has been ineffective in producing change. Both internal and external factors should be considered in developing an oral health educational program. The outcome of the oral health educational process will be successful only if all factors are considered.
REF: p. 184
34. Most dental educational programs have been implemented for:
a. children.
b. adolescents.
c. adults.
d. the elderly.
ANS: A
Oral health education for children is a priority because of the high prevalence of dental caries in this group. If a society free of dental disease is the goal, educational programs must be targeted for the future of society the children.
REF: p. 185
35. Which of the following represents the correct sequence for the five-step lesson plan described by Gagliardi?
1. Guided practice activities
2. Anticipatory planning
3. Instruction/information
4. Closure
5. Objectives
a. 1, 2, 5, 1, 3
b. 5, 2, 3, 1, 4
c. 2, 5, 3, 1, 4
d. 2, 5, 1, 3, 4
ANS: C
The five-step lesson plan described by Gagliardi includes preparation, anticipatory planning, objectives, instruction/information, guided practice activities, and closure.
REF: p. 186
36. Approximately __% of Americans visit a dental office yearly.
a. 20
b. 40
c. 60
d. 80
Copyright © 2011 Saunders, Inc., an affiliate of Elsevier Inc. All rights reserved.
ANS: C
Approximately 60% of Americans visit a dental office yearly. Cost is a major reason why people do not see a dentist. People often wait to visit a dentist only in emergencies. Financial barriers and geographic access have become reasons why people do not receive primary prevention.
REF: p. 190
37. Establishment of a dental home begins no later than ___ year(s) of age and includes referral to dental specialists when appropriate.
a. 1
b. 3
c. 6
d. 12
ANS: A
Establishment of a dental home begins no later than 1 year of age. The dental home is the ongoing relationship between the dentist and the patient, inclusive of all aspects of oral health care delivered in a comprehensive, continuously accessible, coordinated, and family-centered way.
REF: p. 191
38. The fastest growing segment of the population in the United States is:
a. children.
b. adolescents.
c. young adults.
d. older adults.
ANS: D
Between 1990 and 1994, the number of older adults increased 11-fold. These people are now the fastest growing segment of the population in the United States. The Census Bureau projects that the number of persons age 65 years and older will more than double by the middle of the twenty-first century to approximately 80 million.
REF: p. 191
39. Which one of the following federal initiatives that provide funding to states administers the Head Start program?
a. Special Supplemental Nutrition Program for Women, Infants, and Children (WIC)
b. Administration for Children and Families (ACF)
c. Children’s Health Insurance Plan Reauthorization Act (CHIPRA)
d. Medicaid (Title XIX)
ANS: B
Administration for ACF, an agency of the Department of Health and Human Services, is responsible for 60 programs that provide assistance to needy children and families, including the administration of the Head Start program, which serves approximately 900,000 preschool children annually.
REF: p. 194
40. A federally qualified health center (FQHC) has been designated by the federal government by adhering to regulations pertaining to the scope and quality of health services provided to anyone:
a. with a substance abuse problem.
b. regardless of ability to pay.
c. older than 18 years of age.
d. who has served in the military.
ANS: B
An FQHC has been designated by the federal government by adhering to regulations pertaining to the scope and quality of health services provided to anyone, regardless of ability to pay.
REF: p. 194
Copyright © 2011 Saunders, Inc., an affiliate of Elsevier Inc. All rights reserved.