Year : 2019 | Volume
: 6 | Issue : 1 | Page : 30--32
Problem-solving for the postgraduate students of public health dentistry
Department of Public Health Dentistry, Dr. D. Y. Patil Vidyapeeth, Dr. D. Y. Patil Dental College and Hospital, Pune, Maharashtra, India
Department of Public Health Dentistry, Dr. D Y Patil Vidyapeeth, Dr. D Y Patil Dental College and Hospital, Pimpri, Pune, Maharashtra
|How to cite this article:|
Kakodkar P. Problem-solving for the postgraduate students of public health dentistry.J Dent Res Rev 2019;6:30-32
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Kakodkar P. Problem-solving for the postgraduate students of public health dentistry. J Dent Res Rev [serial online] 2019 [cited 2020 Sep 22 ];6:30-32
Available from: http://www.jdrr.org/text.asp?2019/6/1/30/256804
As a curriculum requirement, the postgraduate students in the Department of Public Health Dentistry are trained in the problem-solving activity. Most of the time, they solve hypothetical problems addressing the situation of people in a village or a district. The need of the hour is to get acquainted to the real-life situations since the scope of the work of Public Health Dentist is widening.
However, this article presents a compilation of real-life situation, wherein the student will have to think out of the box and make use of the tools of Dental Public Health, the planning cycle, and the health statistics of that place. Furthermore, the candidate will have to research the background of the place, see for any reported health literature of the population, and design a solution for the problem. The problems presented here are observations made during the camp conducted in that place. The student has to plan for a survey to document the baseline data and further uplift the health status of the people.
Problem 1: (Contributed by Dr. Vinayak Kamath, Lecturer, GDC, Goa, India)
Goa is a state with approximately 14.5 lakhs population. Along the sea line, the main occupation of the people is fishing and tourism. Toward the interiors, the main occupation is agriculture including special crop of cashews. Considering Pali as a village in Goa, it is inhabited by a population of 2000 people. 30% of the population is below 18 years. People are having tobacco habit (80% males and 20% females). Among oral health problems, periodontitis is more common. The population belongs to the lower middle and lower classes. Each house has some or other kind of vehicle for commuting. Television and mobile phone are present in every house. People chewing tobacco are well aware of the ill effects but do not want to quit. There is one primary health center in the vicinity, but no dental treatment is provided; government dental college is 1 hour away. As a public health dentist plan, a survey to document oral health statistics and detail how will you address the situation to improve the overall health of the people.
Problem 2a: (Contributed by Dr. Ravishankar Telgi, Professor and HOD, Kotiwale Dental College, Moradabad, Uttar Pradesh, India)
In Moradabad district, there are around 1 lakh handicraft industry (brass) workers. They belong to lower socioeconomic class. As an occupational hazard, the workers have developed black stains over their teeth. These workers are also seen to eat khaini and keep it anteriorly in the labial sulcus (32–42 region). White lesions are seen to develop in this region. There are two dental colleges in the vicinity. As a public health dentist, how will you address this situation?
In Moradabad city, the patients are reporting to the dental college with treatment complications following treatment from the quacks. Patient visits the quack for treatments such as extraction and dentures. The people's literacy level is low, and they belong to the low socioeconomic class. Quackery is highly prevalent in Moradabad. The reasons for consulting quacks are low cost, no appointment queue, and no transportation problems as they are available in the vicinity. The people have more confidence in the quacks. As a public health dentist, how will you motivate and educate the people to make them realize the importance of consulting a dentist and to stop taking treatment from the quacks.
Problem 3: (Contributed by Dr. Prinyanka Bhusan, Reader, Santosh Dental College, Ghaziabad, Uttar Pradesh, India)
In Imphal (Manipur), the Meitei population resides in the Tarung village. They are mostly Hindu and value their tradition and culture and are traditional people. They have a habit of chewing 8–10 pan daily. They are not aware about the ill effects of pan chewing with areca nut. The males are seen to smoke tobacco. The population has attrition, stains, caries, and periodontitis. The Meitei population has a very healthy practice of consuming Kangshiou (a soup of all vegetables and leaves). There is one government dental college in the vicinity. Public Health Dentist is approached to collect baseline data about the oral health status of this population and plan a comprehensive oral health program.
Problem 4: (Contributed by Dr. Jitender Solanki, Reader, Rajasthan Dental College, Jaipur, Rajasthan, India)
Guda village in Jodhpur has the population of 2500 people. There is one primary health center, one anganwadi, and one dental college 11 km away. People including children aged 9–10 years are seen to consume supari. Oral submucous fibrosis (OSMF) has been reported among the population. Though there is no documented data with statistics. The belief of the family is that supari chewing is good for health. Government is not taking any steps to educate people about the ill effects of supari chewing. As a public health dentist plan, a program to educate the people about the ill effects of supari, motivate the people to take treatment for OSMF and also plan an OSMF treatment program.
Problem 5: (Contributed by Dr. Vithaldas Shetty, Professor and HOD, Sinhgad Dental College, Pune, Maharashtra, India)
Dental checkup was undertaken by the Department of Public Health Dentistry, Pune. It was observed that the majority of the children from slums were suffering from dental caries.
Description of the population
Children: 40%, population above 60 years: 25%, and population of the slum: 150,000.
Population of the preschool children: 14% and population of the schoolchildren: 20%.
Male-to-female ratio: 1:0.9. HIV-positive cases: 5%. The majority of the slum dwellers are factory workers. Oral precancerous and cancerous lesion: 15%.
Facilities available in and around the slum
There is one community hall with public address system, every house has a television, and there are two non-Governmental organizations working for the welfare of the slum. There is one Municipality Hospital and one Primary Health Center.
Develop a plan for addressing the oral health problems.
Problem 6: (Contributed by Dr. Ramya R Iyer, Reader, K M Shah Dental College and Hospital, Sumandeep Vidyapeeth, Gujarat, India)
You are deputed to Kheda district, Gujarat, on special duty to plan and implement dental public health programs, with intended benefit coverage to 1862 villages with a population of 2,610,432. Literacy rate of the population is 70%. Kheda is the major producer of tobacco in Gujarat, and majority of the working population is engaged in tobacco farming. A significant population is also employed at the Milk Dairy in Anand (around 30 km from Kheda). In the year 2017, out of the 30,174 newly diagnosed/treated oral cancer patients at Gujarat Cancer Research Institute, 3081 were from Kheda district. A recent school oral health survey conducted in the district showed that mean Decayed/Missing/Filled Teeth (DMFT) and mean DMFT scores across all age groups of school-going children were 4 and 5, respectively. The Health Department of Kheda district has 8 Block Health Officers, 50 Primary Health Centers, 332 subcenters, and 1 district governed hospital. The district headquarters – Nadiad has a dental college and hospital.
Plan and devise implementation strategies to combat the dental public health problems in the said community after detailed situational analysis.
Problem 7: (Contributed by Dr. Priti Dargad, Public Health Dentist)
A social worker from Pune, Maharashtra, approaches you as a representative of ragpickers' cohort. She has 1000 ragpickers in her informal organization based on different parts of the town and their general and oral health is in poor condition. About 90% of them are women in an age range of 17–65 years. They cannot afford to buy medicines or see a doctor. They work in an unorganized sector, and therefore, their work conditions are abysmal. Their literacy rate is low and living conditions unsanitary. The social worker tells you,
“You are a doctor, can you help us? These women have multiple problems and most of them have a habit of tobacco/gutka chewing. It is not enough to ask them to stop because their working conditions are such that, they cannot function without these stimulators and now they are addicted. Many of them have vision problems, skin diseases, GIT disorders, and constant weakness and fatigue.”
You are an MDS student and the resources you have are whatever the college can provide you. The other resource you have is your grit and ability to negotiate and collaborate with others to solve this problem.
How would you help this social worker?
Kindly make a plan starting from the goals and ending at evaluation strategies.
Wherever the information seems ambiguous, you can make your assumptions and clearly mention them.
Hints/Pointers to think on while solving this problem.
What is the main problem here? Can you analyze the issues that these people are dealing with and their interlinkages? How are these affecting their health and oral health (directly or indirectly)?Would it be better to first address the oral health or would it be better to collaborate with others to solve their general health issues or can it be done simultaneously?Who are the various stakeholders that you can collaborate with to solve their problems?What government schemes can benefit them and how can they avail it?How can you incorporate oral care in questions 3 and 4?Will the regular behavioral change model of deaddiction work here or would you need any special strategies which are context specific?What are the indicators (measurable/nonmeasurable) that will tell you if the work you're doing is going in the right direction or not?
The author wishes to acknowledge the effort of all the contributors who have taken out time and effort to compile the problem.
Financial support and sponsorship
Conflicts of interest
There are no conflicts of interest.