Membership of the Joint Dental Faculties (MJDF) Health Promotion, Prevention and Infection Control Syllabus

Health Promotion, Prevention and Infection Control syllabus — full chapter and topic list

Expand any chapter to see its topics and sub-topics. This is the whole examinable outline for Health Promotion, Prevention and Infection Control in Membership of the Joint Dental Faculties (MJDF), not a summary of it.

1. 1

   Prevention and Oral Health Promotion

   4 topics

   • Evidence-based prevention
     • Delivering Better Oral Health interventions
     • Fluoride: mechanisms, vehicles and toxicity
   • Dietary analysis and advice
   • Smoking cessation and alcohol brief intervention
   • Behaviour change models in oral health
2. 2

   Dental Public Health

   4 topics

   • Epidemiology of dental caries and periodontal disease
   • Determinants of oral health and health inequalities
   • Water fluoridation and population-level interventions
   • Commissioning and structure of UK dental services
3. 3

   Infection Prevention and Control

   4 topics

   • Decontamination and HTM 01-05 compliance
     • Instrument cleaning, sterilisation and storage
     • Surface disinfection and zoning
   • Standard precautions and personal protective equipment
   • Sharps safety and inoculation injury management
   • Blood-borne viruses and transmission risk
4. 4

   Health, Safety and Environment

   3 topics

   • COSHH, mercury hygiene and waste management
   • Radiation protection responsibilities in practice
   • Risk assessment and the safe working environment

Health Promotion, Prevention and Infection Control flashcards for Membership of the Joint Dental Faculties (MJDF)

24 of 52 cards from the Health Promotion, Prevention and Infection Control deck — real questions with worked answers.

1. Define 'evidence-based prevention' as applied in UK dentistry.

   The integration of the best available scientific evidence with clinical expertise and patient values to deliver preventive interventions. In the UK it is operationalised through 'Delivering Better Oral Health' (DBOH), the national evidence-based toolkit for prevention.

2. According to 'Delivering Better Oral Health' (DBOH), what fluoride toothpaste concentration is advised for children under 3 years and for adults/high-risk patients?

   Children under 3: at least $1000\,\text{ppm}$ fluoride, smear amount. Adults and high-caries-risk patients: $1350\text{–}1500\,\text{ppm}$; high-risk adults may be prescribed $2800$ or $5000\,\text{ppm}$ toothpaste.

3. What is the DBOH 'spit don't rinse' advice and why is it given?

   After brushing, patients should spit out excess toothpaste but NOT rinse with water, to maintain a higher intra-oral fluoride concentration and prolong its anti-caries effect.

4. In a dietary analysis, what record is used and over what period to assess cariogenic intake?

   A food/diet diary, typically covering 3–4 days including at least one non-working/weekend day, to identify the frequency and timing of fermentable carbohydrate (sugar) intake.

5. Why is the FREQUENCY of sugar intake, rather than total amount, the key cariogenic factor?

   Each sugar exposure drops plaque pH below the critical level (~$5.5$) for ~20–30 minutes (Stephan curve), causing demineralisation. Frequent exposures keep pH low for longer, reducing remineralisation time.

6. State the UK SACN/government recommendation for free sugars as a percentage of total dietary energy.

   Free sugars should provide no more than $5\%$ of total dietary energy intake.

7. What is the 'critical pH' for enamel demineralisation and what is the Stephan curve?

   Critical pH is approximately $5.5$. The Stephan curve plots plaque pH against time after a sugar exposure, showing a rapid fall below critical pH followed by gradual recovery as saliva buffers the acid.

8. What does the 'Very Brief Advice' (VBA) model for smoking cessation consist of?

   The 3 A's: ASK and record smoking status, ADVISE on the best way to quit (stopping with support is most effective), ACT by referring to local stop-smoking services / offering pharmacotherapy.

9. What is the recommended structure of an alcohol brief intervention in dental settings?

   Screening (e.g. AUDIT or AUDIT-C questionnaire) followed by brief structured advice using a model such as FRAMES (Feedback, Responsibility, Advice, Menu, Empathy, Self-efficacy).

10. State the UK Chief Medical Officers' low-risk alcohol guideline.

    No more than $14$ units per week for both men and women, spread evenly over $\geq 3$ days, with several drink-free days.

11. Name the stages of the Transtheoretical (Stages of Change) model used in oral health behaviour change.

    Precontemplation, Contemplation, Preparation, Action, Maintenance (and Relapse). It guides tailoring advice to the patient's readiness to change.

12. In behaviour change, what do the COM-B model components stand for?

    Capability, Opportunity and Motivation produce Behaviour. All three must be present for a behaviour (e.g. effective toothbrushing) to occur; it underpins the Behaviour Change Wheel.

13. What is 'motivational interviewing' in the context of oral health?

    A patient-centred, collaborative counselling style that elicits and strengthens the patient's own motivation for change by exploring ambivalence, using open questions, affirmations, reflective listening and summarising (OARS).

14. Define 'prevalence' and 'incidence' in dental epidemiology.

    Prevalence = proportion of a population with a condition at a given point in time. Incidence = number of NEW cases arising in a population over a defined time period.

15. What does the DMFT index measure and what do its components represent?

    DMFT records caries experience in permanent teeth: D = decayed, M = missing (due to caries), F = filled teeth. Lowercase 'dmft' is used for primary teeth. It is expressed as a mean per person for populations.

16. What is the SiC (Significant Caries) Index and why is it used?

    The Significant Caries Index is the mean DMFT of the worst-affected one-third of the population. It highlights high-risk groups masked by a low overall mean DMFT (skewed caries distribution).

17. What index is used epidemiologically to assess periodontal status, and what do its codes mean?

    The BPE (Basic Periodontal Examination)/CPITN. Codes: 0 = healthy; 1 = bleeding on probing; 2 = calculus/plaque-retentive factor; 3 = pocket $3.5\text{–}5.5\,\text{mm}$; 4 = pocket $\geq 5.5\,\text{mm}$; * = furcation involvement.

18. Name the key risk factors for periodontal disease.

    Dental plaque (biofilm) as the primary cause, plus modifying factors: smoking, diabetes mellitus, genetic susceptibility, stress, poor oral hygiene, and certain medications. Smoking and diabetes are the two strongest modifiable risks.

19. What are the 'determinants of oral health'?

    The wider conditions influencing oral health: socioeconomic status, income, education, housing, employment, access to care, behaviours (diet, smoking, hygiene), water fluoridation, and political/environmental factors — most lie outside the dental surgery.

20. Explain the 'inverse care law' as it relates to dental services.

    Coined by Tudor Hart: the availability of good medical/dental care tends to vary inversely with the need of the population served — those with the greatest need often have the poorest access.

21. What is the difference between 'proportionate universalism' and a targeted approach to reducing oral health inequalities?

    Proportionate universalism (Marmot) delivers actions universally but with intensity proportionate to need, addressing the whole social gradient; a targeted approach focuses resources only on the highest-risk groups, risking stigma and missing the broader gradient.

22. State the optimal concentration of fluoride in water fluoridation schemes in the UK.

    $1\,\text{ppm}$ ($1\,\text{mg/L}$) fluoride is the target concentration for artificial water fluoridation in the UK.

23. What is dental fluorosis and at what stage of development does it occur?

    Fluorosis is hypomineralisation of enamel from excess fluoride during tooth DEVELOPMENT (amelogenesis), appearing as white flecks/mottling to brown staining. It only arises before tooth eruption while enamel is forming.

24. Why is water fluoridation considered an effective public health measure against inequalities?

    It is a population-level, passive intervention requiring no individual behaviour change, so it benefits everyone regardless of socioeconomic status and disproportionately benefits deprived groups, narrowing the inequality gap.

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