Perspectives on Oral Health
The purpose of the course is to provide a wider, generalized perspective on concepts like ‘diseased’ and ‘healthy’ which are fundamental to the everyday activities of a dentist. We use these terms with confidence, but there are a number of questions that may be raised. What are the consequences of oral diseases for the quality of life? What are the consequences of oral diseases for health in general?
A two-hour lecture will be given weekly for 8 weeks. Six different lecturers are involved, and the topics that will be addressed are listed for each lecturer.
Bjørn Hofmann: Concepts and definitions of diseases
Ethical reflections in the lectures, the significance of the ‘disease-concept’ in modern health care will be discussed – both theoretical and practical perspectives. Among the issues that will be raised are the criteria applied to identify disease, and if the ‘disease-concept’ is appropriate to demarcate the responsibilities of health services. Disease will be discussed in three main perspectives: personal, professional and societal. Furthermore, methods and models for ethical reflection will be discussed. How do we assess and handle these difficult situations ? How do we tackle the moral dilemmas of every day life ? The last part of the course address professional ethics: In what ways are meeting moral challenges influencing the profession ? What is the social responsibility of the dentist and what is the demand from individuals and society ? What confidence does individuals and society have in the dentist ?
Ivar Espelid: Reliability in the recording of disease
Is man a good observer? Properties of tests or diagnostic methods may be expressed as reliability, validity, sensitivity, specificity, and predictive values. The implication of these concepts will be discussed in relation to how the prevalence of the disease will affect the result of the test. Bayes theorem will be presented and examples will be given to illustrate how the precision of the diagnosis may be improved by new tests.
Decisions in a situation of uncertainty - A model which may be applied to reach the best clinical decision in a situation of uncertainty will be presented. A certain amount of information is needed in order to use the method. Among other things, a ‘price tag’ will have to be attached to the various outcomes of the decisions and examples of this will be given.
Dorthe Holst: Oral health related to quality of life
The presentation will provide a survey of the difference between recording of oral health and oral disease and treatment. Alternative end-point dimensions have been developed which cover new aspects of oral health. The theory stimulating this development will be presented, and examples of new methods will be demonstrated. Oral health related quality of life has been addressed in a national survey in Norway, and results from this study will be presented.
Jørn A. Aas: How does the microflora vary in different parts of the oral cavity?
By using medium-independent molecular-genetic methods nearly 800 different bacteria have been identified in the oral cavity. About half of these cannot be cultured by the traditional laboratory methods. The implication is that limited information exists about a major part of the oral microflora. An outline will be presented of methods and results related to identification of species of fungi and bacteria that may or may not be cultivated in studies associated with normal flora, caries and periodontitis. The purpose of the lectures is to update the participants on current research in microbiology/molecular-genetics, and the potential for new research in this area.
Ingar Olsen: How may the oral microflora be distributed in the human body, and what are the diseases outside the oral cavity which may be associated with this distribution?
The subject will be surveyed based on epidemiologic studies, animal experiments and in vitro studies. The main focus is a discussion of mechanisms that may support current opinion about a potential association between periodontal disease and circulatory diseases.