Volume 58, Supplement 1, 1998



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III. Develop resources, implement, and manage oral health programs for populations


Implementation and management reflect:

1. Communicating with, gaining the support of, and collaborating with critical partners and constituents for plan development, implementation, and evaluation (see I-5, 11-4, 7-9, VII, VIII-4).

2. Organizing, managing, and securing resources ac­cording to program plans.


  1. Human resources

  2. 1. Hiring and selecting program staff.
    2. Training and development.
    3. Continuing education.
    4. Negotiation and conflict resolution.
    b. Physical resources

c. Fiscal resources
d. Information (see IX, X)

3. Periodically monitoring and measuring progress indicators against program goals (see V).

4. Making appropriate program adjustments.
5. Administering policies and procedures.


IV. Incorporate ethical standards in oral health programs and activities


This competency reflects:
1. Applying the acceptable principles of ethical be­havior and professional conduct (principles of autonomy, nonmaleficence, beneficence, justice, veracity, and professionalism) as reflected in the code of ethics and standards of professional con­duct of public health, dentistry, and employing organizations.


V. Evaluate and monitor dental care delivery systems


Evaluating and monitoring reflect:

1. Identifying involved individuals, consumer groups, agencies, and organizations and obtaining their perspectives and organizational policies.

2. Collecting, organizing, analyzing, and interpreting data (see 1-2, 1-3, VI, IX, X).

3. Assessing outcomes, including safety, efficacy, costs, cost effectiveness, quality, consumer satis­faction,

and health consequences (see IX, X).

4. Evaluating changes and trends in demographics, health status, risk factors, utilization of services, dental personnel, structure of delivery systems, financing, regulations, legislation, policies (see I-2, 1-3,111-3, IX).

5. Determining extent that goals, objectives, and budget allocations are met.

6. Applying findings to program decisions.


VI. Design and understand the use of surveillance sys­tems to monitor oral health


Designing and using a surveillance system reflects:
1. Determining and documenting rationale and fea­sibility of surveillance and monitoring. Examples include the Behavioral Risk Factor Surveillance System (BRFSS), water fluoridation census, and cancer registry.

2. Developing an operational definition of a case.


3. Identifying data sources.
4. Using surveillance tools, e.g. screening, lab reports.
5. Analyzing and using data and distributing find­ings (see V-6, VII, IX).


VII. Communicate and collaborate with groups and indi­viduals on oral health issues


This competency reflects:
1. Ability to effectively communicate orally and in writing, incl. electronically (implies knowledge of subject, current and accurate information, under­standing of audience).

2. Articulating a vision for the organization.


3. Developing a communication plan & network for getting things done (coalition, steering committee).
4. Selecting appropriate approaches and relevant in­formation for targeting messages and format to audience/ individual (appropriate language and grade level of communication; choice of written, oral, or audiovisual format; use of media; or other methods).

5. Applying risk communication skills to explain lev­els of risk from real or potential hazards.

6. Collaborating sensitively and effectively with per­sons from diverse cultural, socioeconomic, educa­tional, and professional backgrounds, and with persons of all ages and lifestyle preferences (see I-5, II-8, III-1, VII, VIII-4).

VIII. Advocate for, implement, and evaluate public health policy, legislation, and regulations to protect and pro­mote the public's oral health

This competency reflects:

1. Understanding legislative, regulatory, and politi­cal processes.

2. Conforming to statutes and regulations regarding areas such as liability, restraint of trade, conflict of interest, credentialing, certification practices, con­fidentiality, and discrimination.

3. Analyzing issues and determining appropriate leg­islative or regulatory pathways to accomplish goals.

4. Collaborating with community partners to advo­cate for legislative and budgetary resources to meet

identified oral health needs including oral health expressions of general health needs (see I-5, III-1, VII).

5. Assisting groups and communities especially at risk for oral disease to advocate for themselves.


IX. Critique and synthesize scientific literature
This competency reflects:

1. Applying the principles of hypothesis develop­ment and testing.

2. Identifying appropriate, valid, and reliable meas­ures of oral health, disease, and associated factors.

3. Identifying characteristics of and rationale for dif­ferent types of study designs and analytic methods used in epidemiologic studies, experimental stud­ies, health services research, and policy analysis.

4. Identifying possible sources of bias in studies.

5. Identifying, understanding procedures for train­ing, standardization, and calibration of examiners.

6. Identifying appropriate statistical procedures, such as those for measuring examiner reliability.

7. Evaluating generalizability and validity of study findings.

8. Translating study findings into recommendations.

X. Design and conduct population-based studies to answer oral and public health questions
Designing and implementing studies reflect:
1. Defining a problem.
2. Critically reviewing the literature (see IX).
3. Formulating research objectives and hypotheses.

4. Developing a research protocol. This process in­cludes:

a. Designing research using epidemiologic princi­ples and other discipline-specific methods (e.g., health services, behavioral science methods).

b. Selecting measures of oral health, disease, and associated factors.

c. Identifying the study population, and inclusion and exclusion criteria.


  1. Developing appropriate sampling methods.

  2. Planning for recruitment and retention of par­ticipants.

  3. If appropriate, allocating subjects to treatment or control groups, using randomization or matching.

  4. Collecting, managing, and controlling the qual­ity of data.

  5. Choosing statistical techniques for sample size estimation and data analysis.

  6. Developing a budget appropriate for the re­search question.

  7. Collaborating with other members of the re­search team and consulting experts in pertinent disciplines.

5. Using human subjects' review and informed con­sent conscientiously, including sensitivity to indi­vidual rights.

  1. Implementing the protocol.

  2. Interpreting research findings.

  3. Identifying study limitations.

  4. Providing results/ feedback to community

authorities once study is completed (see VII).

  1. Formulating and disseminating conclusions and recommendations.



338 Journal of Public Health Dentistry

Competency Objectives for Dental Public Health




Group I: Health Policy and Program Management and Administration

Group Members: Joseph Doherty (chair), Dushanka Kleinman (co-chair), Joseph Alderman, Durwood Col­lier, Anthony Jong, Thomas Louden, Elbert Powell, David Grochmal (recorder), Robert Weyant (recorder).


I. OVERALL GOAL

A specialist in dental public health will have an under­standing of and be able to apply concepts involved in the planning, implementation, operation, and evalua­tion of dental public health programs. To manage oral health programs and assume a leadership role in public health, a specialist must possess technical skills in a number of areas, including planning, marketing, communications, human resources management, financial management, advocacy building, management of infor­mation, and evaluation, quality assurance, and risk management. A specialist will also have an under­standing of the processes through which health policies are developed and regulated.

II. COMPETENCY OBJECTIVES

A. Program Planning

Goal: A specialist in dental public health will have an understanding of and be able to apply principles of program planning.

Objectives: A specialist in dental public health will be able to:

01 assess strengths and weaknesses in dental public health programs.

02 identify opportunities and threats within the or-ganizational and community settings of dental public health programs.

03 identify and define oral health problems by assem­bling, summarizing, analyzing, and interpreting relevant data.

04 identify individuals and organizations influencing dental public health programs.

05 specify program goals and objectives for the pur­poses of identifying desired outcomes, providing a basis for evaluation, and for describing and justify­ing the program.

06 specify appropriate procedures and methods to be used to achieve desired goals and objectives effec­tively and efficiently.

07 establish a sequence and timetable for program implementation to achieve desired goals and objec­tives.

08 determine the level of personnel, material, and fis­cal resources necessary to achieve desired goals and objectives.

09 identify organizations, agencies, and institutions at all levels that can be used as resources for program development, operation, and evaluation.

B. Program Implementation and Operation


Goal: A specialist in dental public health will have

an understanding of the principles of program im-plementation and operation and be able to demonstrate leadership in their application.


Objectives: A specialist in dental public health will be able to:

01 demonstrate the ability to manage procurement, allocation, and control of resources throughout the operation of a program.



    1. demonstrate a knowledge of principles of human resources management.

    2. identify and group activities so that personnel can accomplish tasks effectively and efficiently.

    3. delegate tasks to personnel with appropriate supervision to ensure their completion in a timely fashion.

C. Program Evaluation
Goal: A specialist in dental public health will have an understanding of and be able to apply principles of program evaluation.

Objectives: A specialist in dental public health will be able to:

01 define criteria both internal and external to the organization by which program performance and results will be evaluated.

02 identify and define different types of program evaluation methods and techniques tailored to each aspect of an oral health program.

03 demonstrate the ability to apply evaluation findings to the continued operation of an oral health program.

D. General Skills and Knowledge in Program Management and Administration

Goal: A specialist in dental public health will have an understanding of and be able to apply general skills and knowledge of program management and administration.

Objectives: A specialist in dental public health will be able to:

01 compare and contrast program planning, strategic planning, and operational planning.


  1. describe strengths and weaknesses of current or-ganization and management structures for deliver­ing dental public health services.

  2. describe the historical development of dental public health administration at all levels in the public and private sectors.

  3. use communication tools for program manage-ment and administration.

  4. describe systems for managing information and their application to the management and ad-ministration of oral health programs.

  5. describe marketing and public relations skills needed to gain and maintain organizational,
    professional, and public support for oral health programs.

  6. describe methods for gaining advocacy support for oral health programs.

  7. identify and describe financial management concepts and analytical techniques needed to manage oral health programs.

  8. define the characteristics of a public health problem.

E. Quality Assurance and Risk Management
Goal: A specialist in dental public health will be able to identify, describe, and contrast the various features of a comprehensive quality assurance program.

Objectives: A specialist in dental public health will be able to:



  1. describe the roles of purchasers of oral health ser­vices, consumers, intermediaries, providers, and professional societies in quality assurance.

  2. identify the elements of a comprehensive quality assurance program.

  3. describe processes for establishing criteria and standards for use in dental quality assurance programs.

  4. identify and contrast methods currently used for quality assessment in dentistry.

  5. identify methods used in dentistry to ensure quality which are based on assessment results.

  6. identify major liability concerns in the delivery of oral health services in private and public settings.

  7. identify risk management methods that may be used to prevent or minimize liability.

  8. describe current federal and state efforts in risk management.

F. Health Policy
Goal: A specialist in dental public health will have an understanding of the health policy-making process and resulting policies, legislation, and regulations that affect the development and management of oral health programs at national, state, and local levels.

Objectives: A specialist in dental public health will be able to:



  1. describe the legislative and regulatory processes that result in the development of health policy at national, state, and local levels.

  2. identify major public and private agencies that influence health legislation and development.

  3. describe the ways in which major professional associations and interest groups influence the health policy process.

  4. identify major congressional committees that affect health policy in the United States.

  5. identify policies, laws, and regulations necessary to ensure program support, implementation, and suc­cess, and be familiar with ways to modify them.

06 identify and describe health policy studies that have had a major impact on the prevention, diagnosis, and treatment of oral diseases and disorders.

Group II: Research Methods in Dental Public Health Group Members: Richard Graves (chair), Gary Rozier (co-chair), Herschel Horowitz, Ronald Hunt, John Stamm, Philip Swango, Jane Weintraub, Dale Armstrong (recorder), William Milner (recorder).

I. OVERALL GOAL

A specialist in dental public health will have an under-standing of the basic concepts of planning, implementing, and conducting observational studies, experimental studies, health services research, and policy analysis. A specialist will have a knowledge of and skills in research design, biostatistics, and both general and oral-facial epidemiology. A specialist will be able to perform critical evaluations of the scientific literature, prepare scientific reports, and have an understanding of the content of research protocols for the conduct of scientific studies in dental public health. Finally, a specialist will have an understanding of the ethical issues in the design and conduct of research in dental public health.

II. COMPETENCY OBJECTIVES

A. Planning, Implementing, and Conducting Research

Goal: A specialist in dental public health will be able to identify dental public health research problems and plan, implement, and conduct re-search projects to address these problems.

Objectives: A specialist in dental public health will be able to:


  1. describe the characteristics and study designs of observational studies, experimental studies, health services research, and policy analysis.

  2. describe the epidemiology of oral diseases and conditions.

  3. formulate appropriate statements of research ob-jectives and hypotheses.

  4. identify study populations and develop appropriate sampling methods.

  5. identify appropriate, valid, and reliable measures of oral health, disease, and associated factors.

  6. identify and understand procedures for training, standardization, and calibration of examiners.

  7. identify possible sources of bias in research studies.

  8. develop systems of data management for all phases of a research project.

  9. identify and describe public and private funding mechanisms to support research in dental public health.

  10. discuss the basic elements of a research grant or contract proposal.

B. Biostatistics

Goal: A specialist in dental public health will have an understanding of the principles of biostatistics. Objectives: A specialist in dental public health will be able to:

01 understand the principles of hypothesis develop­ment and testing.

02 identify appropriate statistical procedures for measuring examiner reliability.

03 contrast the concepts of "population" and "sample" and describe what is meant by sampling variation.

04 demonstrate an understanding of statistical con-cepts including: scales (nominal, ordinal, interval, and ratio); adjusted and unadjusted rates, ratios, and proportions; distributional properties of data; measures of central tendency; measures of association; confidence intervals; parametric and non-parametric analyses; t-statistic, F-ratio, and chi-square statistic; analysis of variance; regression analysis; Type I and Type II errors; power; Irvalue; and sensitivity and specificity.

C. Observational Studies

Goal: A specialist in dental public health will be able to plan, implement, and conduct observational studies involving human subjects.

Objectives: A specialist in dental public health will be able to:



  1. compare and contrast case-control, cross-sectional, and cohort studies.

  2. define and differentiate between incidence and prevalence.

  3. discuss the advantages and disadvantages of dif-ferent types of observational study designs.

D. Experimental Studies

Goal: A specialist in dental public health will be able to plan, implement, and conduct experimental studies involving human subjects.

Objectives: A specialist in dental public health will be able to:

01 discuss the advantages and disadvantages of different types of experimental study designs.

02 allocate subjects to treatment and control groups using appropriate principles of randomization.

03 discuss the importance of blindness in experimental studies.

04 discuss the potential effects of subject attrition and level of compliance on interpretation of study results.

05 distinguish between internal and external validity of study results.

06 distinguish between clinical and statistical significance.

07 distinguish between the concepts of efficacy and effectiveness in clinical trials.

08 discuss differences between concurrent and historical control groups and the implications of their use.

E. Health Services Research and Health Policy Analysis

Goal: A specialist in dental public health will have an understanding of the methods and concepts used in health services research and policy analysis.

Objectives: A specialist in dental public health will be able to:



  1. identify the various scientific disciplines used in health services research and policy analysis.

  2. understand methods used in clinical decision analysis, cost-benefit analysis, and cost-effective-ness analysis.

  3. perform a cost-effectiveness analysis of oral health services.

  4. describe in classic economic terms the relationships among need, supply, demand, and costs of services.

  5. understand nonexperimental techniques such as modeling used in health services research and policy analysis.

  6. understand methods used in studies of the supply and requirements for oral health personnel.

  7. identify major sources of information for use in health services research and policy analysis.

F. Literature Evaluation, Scientific Writing, and Infor-mation Management

Goal: A specialist in dental public health will be able to demonstrate skills in literature evaluation, scientific writing, and information management. Objectives: A specialist in dental public health will be able to:

01 use appropriate methods for evaluating the scientific literature.

02 prepare a review article based on evaluation of the scientific literature.

03 prepare a critique of a research proposal, a project report, and a scientific manuscript.

04 prepare an article or report suitable for publication in a peer reviewed journal.

05 use computer technology to collect, process, and analyze data and to write reports.

06 use computer networks to gain access to information and for communicating with the scientific community.

G. Ethics in Dental Public Health Research

Goal: A specialist in dental public health will have an understanding of and be able to apply ethical principles in the planning and conduct of research in dental public health.

Objectives: A specialist in dental public health will be able to:

01 identify the basic ethical principles underlying the conduct of biomedical and behavioral research involving human subjects and their historical origins. 02 describe the system used for safeguarding the rights and well-being of individuals who volunteer to be subjects in biomedical and behavioral research.

03 list the basic elements used to obtain informed consent for the participation of human subjects in biomedical and behavioral research.

04 discuss the criteria used by agencies, committees, and boards for evaluating the ethical standards of research protocols.

05 discuss the differences between management ethics and biomedical ethics.

06 discuss methods used to monitor and control fraud and misconduct in the planning and conduct of dental research.

Group III: Oral Health Promotion and Disease Prevention

Group Members: Robert Faine (chair), Richard Mur­phy (co-chair), Kevin Avery, Norman Clark, Stanley Heifetz, Dennis Leverett, William Maas, Ardell Wilson, Betty DeBerry (recorder), James Tupa (recorder).

1. OVERALL GOAL

A specialist in dental public health will have an understanding of the general concepts on which health promotion and disease prevention are based; be familiar with approaches to promote oral health and prevent oral diseases and related conditions; and be able to demonstrate knowledge of planning, implementa­tion, and evaluation of oral health promotion and dis­ease prevention programs. A specialist will be able to critically evaluate preventive technologies for adoption and use in oral health programs and be familiar with current research activities in oral health promotion and disease prevention. Finally, a specialist will have a knowledge of occupational and environmental health issues in the delivery of oral health services.


II. COMPETENCY OBJECTIVES

A. General Principles of Health Promotion and Dis-ease Prevention

Goal: A specialist in dental public health will be able to define the general principles of health promotion and disease prevention and be able to interpret them relative to oral health.

Objectives: A specialist in dental public health will be able to:

01 define primary, secondary, and tertiary preven­tion.

02 define and distinguish between health promotion and health education.

03 distinguish between those preventive services that provide specific protection and those that promote health.

04 discuss those factors that enhance or impede the implementation of health promotion and disease prevention programs.

05 discuss infectious disease, behavioral, and environ­mental models of disease causation and the effect that the use of each model has on the design of health promotion and disease prevention interventions.

06 discuss the role of dental public health in the delivery of oral health promotion and disease prevention services in the public and private sec-tors.

07 identify the theoretical approaches to achieving behavior change and compliance among the public and health professionals.

B. Services to Promote Oral Health and Prevent Oral Diseases

Goal: A specialist in dental public health will be able to identify those services available to promote oral health and to prevent oral diseases and related conditions; describe the extent to which the public is exposed to these services; have a knowledge of their safety, cost, efficacy, effectiveness, and efficiency; and have an understanding of their legal, political, and biologic basis.

Objectives: A specialist in dental public health will be able to:

01 identify community and personal oral health preventive services available to the public and discuss their scientific, social, and legal history; trends in the status of each; and factors affecting their use by the public, dental public health practitioners, and clinical practitioners.

02 discuss safety considerations and the potential adverse health effects associated with different preventive services.

03 define and discuss direct and indirect costs of com­munity programs for the prevention of oral dis­eases and conditions.

04 describe the efficacy, effectiveness, and methods for implementation of strategies for promoting oral health and preventing oral diseases.

05 describe the metabolism and methods of action of the various fluoride modalities.


  1. describe and compare local, state, national, and international initiatives and policies for oral health promotion and disease prevention.

  2. discuss the role of the public policy process in oral health promotion and disease prevention.

  3. discuss factors that can enhance or impede the implementation of fluoridation.

  4. provide the scientific basis for oral health promotion and disease prevention strategies based on the etiology and natural history of oral diseases and conditions.

  5. describe the state-of-the-science of dental sealants.

  6. discuss the appropriateness and effectiveness of screening programs for oral cancer and other oral diseases and conditions.



C. Providing Community Oral Health Promotion and Disease Prevention Programs

Goal: A specialist in dental public health will be able to plan, implement, administer, and evaluate oral health promotion and disease prevention programs for a community.

Objectives: A specialist in dental public health will be able to:


  1. identify sociodemographic, biological, beh-avioral, cultural, political, and legal factors considered in determining the need for com-munity oral health promotion and disease prevention programs.

  2. discuss assessment methods for oral disease ac-tivity and health status used in planning and evaluating community oral health promotion and disease prevention programs.

  3. discuss methods used to identify individuals and populations at risk for oral diseases.

  4. collect, analyze, and interpret data to assess the need for oral health promotion and disease prevention services for a given community.

  5. select appropriate oral health promotion and disease prevention measures and intervention strategies based on characteristics of the population.

  6. discuss the advantages and disadvantages of tar-geting populations for oral health promotion and disease prevention programs.

  7. describe human and fiscal resources available in the community for development of oral health promotion and disease prevention programs.

  8. develop a program plan for the provision of oral health promotion and disease prevention services.

  9. develop protocols for implementation and monitoring of oral health promotion and disease prevention programs which ensure effectiveness, safety, and efficiency.

  10. evaluate the impact of oral health promotion and disease prevention programs using appropriate structure, process, and outcome measures.

  11. use evaluation results to make appropriate modifications in oral health promotion and disease prevention programs.

D. Critical Review of Oral Health Promotion and Dis-ease Prevention Measures

Goal: A specialist in dental public health will be aware of ongoing research studies in oral health promotion and disease prevention and be able to assess the safety, effectiveness, and costs of measures for adoption and use in oral health promotion and disease prevention programs.

Objectives: A specialist in dental public health will be able to:

01 identify and describe clinical and community trials and demonstration projects that have had a major impact on the delivery of oral health promotion and disease prevention community services.

02 describe regulatory and voluntary programs for the assessment and approval of preventive technologies.

03 assess the safety, appropriateness, effectiveness, and costs of preventive methods when used in community programs.
E. Occupational and Environmental Health and Safety

Goal: A specialist in dental public health will have a knowledge of occupational and environmental health risks related to dentistry and methods for the protection of the public, patients, and providers against these risks.

Objectives: A specialist in dental public health will be able to:


  1. identify occupational hazards associated with the practice of dentistry.

  2. discuss health risks associated with exposure to occupational hazards in dentistry, and recommendations and requirements for ensuring protection against these risks.

  3. discuss occupational and environmental health and safety laws, regulations, and standards that affect facility and equipment design, use, and operation.

  4. describe infection control recommendations and requirements for the prevention of disease transmission in oral health care settings.

  5. work with organized dentistry to develop and dis-seminate educational materials on occupational and environmental health and safety.

  6. develop protocols for occupational and environ-mental safety assurance programs in dentistry.

  7. identify and work cooperatively with agencies responsible for monitoring and regulating occupational and environmental safety in dentistry.


Group IV: Oral Health Services Delivery System

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