A broader understanding of the concepts of public health will enhance your role as a dental care professional, says Fiona Ellwood.
Interest in public health continues to grow across a number of health care professionals in the UK. Public health covers a broad remit but is said to be 'difficult to define and comprehend'.1 What becomes clear is the ever changing agenda of public health and the crossing of paths of other health agencies2 and the impact of global health challenges.3
According to the UK Government, Public Health England 'exists to protect and improve the nation's health and wellbeing and reduce health inequalities'.4 The strategic plan from Public Health England for 2020-2025 set out to 'protect people and help people live longer in good health'.5 However, as a result of COVID-19, Public Health England has since joined others to become the National Institute for Health Protection.6
What becomes more pertinent is the growing interest in dental public health from the wider dental team. Dental public health has until more recently been a specialist pathway and only open to general dental practitioners, unlike general public health which is open to the wider field.
Dental public health specialists work in the community predominantly preventing and controlling dental diseases and dental wellness. Those in these roles work closely with health agencies, are involved in research, education, and strategic direction. Oral health is however in this instance the key priority, recognising that it is an integral part of general health.
Dental public health is defined as 'the science and practice of preventing oral diseases, promoting oral health, and improving quality of life through organised efforts of society'.7 Many ask how does dental public health differ from dentistry and how do both fields come together?
In the simplest of terms, it is perhaps best explained by a comparison of the two fields (Table 1).
Table 1.
Dental Public Health (population level) | Clinical Dentistry (Clinical level) |
Needs Assessment | Examination |
Analysis of Data | Diagnosis |
Service Planning | Treatment Planning |
Ethics | Consent |
Change Agent | Care/cure/advice |
Finances | Payment |
Appraisal | Recall |
Underpinning dental public health is:8
Epidemiology and medical statistics
Health promotion and health improvement
Sociology and psychology
Health economics and service management
Evidence informed practice
Demography, teaching and research.
The core themes of dental public health practice being:
Concepts of health
Determinants of health
Concept of need
Inequalities.
The public health principles must focus on upstream thinking rather than continuing to deal with and manage downstream thinking. This very much lends itself to the Ottawa Charter of 1986 with a focus on:
Building healthy public policy
Creating supportive environments for health
Strengthening community action for health
Developing personal skills
Reorientating health services.
So, back to grass roots. Implementing and addressing the dental public health agenda in the dental setting although challenging in part, has to be a priority. For dental care professionals (DCPs) fortunate enough to gain a place on a dental public health course the leap will be far less; for others wishing to study dental public health but unable to access the dental public health courses, it can be extremely rewarding to look to general public health. The principles are similar and in undertaking such a qualification the benefits can be enormous.
Dental public health specialists work in the community predominantly preventing and controlling dental diseases and dental wellness.
Public health provides the opportunity to study wider population issues, the social determinants of health, health inequalities, epidemiology, disease prevention and health promotion, lifestyle approaches and behaviour change - all of which can be applied within your role within the dental team.
For those providing oral health advice the broader understanding of the concepts of public health will certainly enhance your role. It will allow you to plan and design an appropriate and effective learning space; it will allow you to consider behaviour change and why some individuals make the choices that they do and how to evaluate and monitor progress.
Finally, what does the training and learning look like? As with any courses there are common elements. Looking across the education landscape many universities offer public health, global public health, and some offer dental public health courses. Public health and global health courses are more widely available and advertised.
The courses are predominantly either MSc or MPH, but most offer a stepped approach: Post Graduate Certificate (1 year), Post Graduate Diploma (2 years) and the full programme of Master's in public health or Master of science in public health; the course can take between 1-6 years in some cases. There are options to study part-time, full-time or via distance learning and online. The entry requirements vary; some offer two routes to attract applicants from diverse backgrounds:
Route 1 - Traditional academic background, applicants must hold an undergraduate degree with a minimum of a 2.2 from a recognised university
Route 2 - Prior work experience and a range of previous qualifications.
An example of fields that may be studied in public/global health9 is shown in Table 2.
Table 2.
Year 1 PG Cert |
Introduction to Public Health Epidemiology for Public Health Practice Introduction to Epidemiology and Statistics Fundamental of Health Economics |
Year 2 PG Dip |
Public Health Policy Foundation of Health Promotion Introduction to qualitative research methods Research design for public and global health |
Year 3 MSc/MPH |
Dissertation project Advanced practice in healthcare Elective modules |
Course fees vary too, some starting at £3,747 for the PG Cert and £11,222 for the full Master's programme, but some are approximately £16,000 plus. The credit values are as expected, PG Cert 60 credits, PG Dip 120 credits and the Master's holds 180 credits. Many of the courses are multidisciplinary and have international students as part of the study groups which enhances learning. Applicants are also required to provide up to two references to support the application.
Public health has an enormous part to play in the health and wellbeing in all countries and the ability to work collaboratively to address inequalities
When it comes to dental public health there is a specialist pathway and an option to study dental public health. Entry requirements in general require a previous dental or medical degree at 2.1 or above and are available either full-time, part-time or in a flexible learning mode. In some cases, the credit value differs to 15 credit modules. Important to note is the requirement for a personal statement at application of approximately 4,000 words. It is important to note that the UK fees differ from overseas applicants' fees.
An example of fields that may be studied in dental public health10 is shown in Table 3.
Table 3.
Introduction to public health | Oral Health diseases in populations |
Health Promotion, theory and methods | Fundamentals of epidemiology |
Implementing strategy in dental services | Research methods |
Practical statistics for population health | Evidence based practice |
Biostatics | Dissertation for dental public health |
Public health has an enormous part to play in the health and wellbeing in all countries and the ability to work collaboratively to address the inequalities in health, this includes oral health.
As the UK continues through a period of transition as a result of the unique pandemic, SARS-CoV-2, there has never been a more important time to take up the reins and mantra of the public health bodies. Furthermore, the Chief Dental Officers of the UK have made it clear that prevention must be a central focus of both dental and public health and a key focus of the transition and recovery intentions. It goes without saying there must be a well informed and equipped workforce to carry out such intensions if we are to mobilise an informed, efficient and effective workforce.
Useful resources
Queen Mary University of London. MSc Global Public Health. Available at: https://bit.ly/3hEtQId (accessed July 2021).
Brunel University. Masters of Public Health. Available at: https://bit.ly/3xkq7Gw (accessed July 2021).
Swansea University. Public Health & Health Promotion, MSc/PGDip. Available at: https://bit.ly/3dLBcbC (accessed July 2021).
University of Bradford. Public Health and Community Wellbeing. Available at: https://bit.ly/3xqy3WE (accessed July 2021).
University of Essex. Master of Public Health (MPH). Available at: https://online.essex.ac.uk/courses/master-of-public-health-mph/ (accessed July 2021).
King's College London. MSc Public Health. Available at: https://bit.ly/3wprrGx (accessed July 2021).
UCL. Dental Public Health. Available at: https://www.ucl.ac.uk/prospective-students/graduate/taught-degrees/dental-public-health-msc (accessed July 2021).
University of Leeds. Dental Public Health. Available at: https://courses.leeds.ac.uk/g579/dental-public-health-msc (accessed July 2021).
University of Sheffield. Dental Public Health. Available at: https://www.sheffield.ac.uk/postgraduate/taught/courses/2021/master-dental-public-health-mdph-mdph (accessed July 2021).
University of Sheffield. Master in Dental Public Health. Available at: https://www.sheffield.ac.uk/postgraduate/taught/courses/2021/master-dental-public-health-mdph-mdph (accessed July 2021).
Author information.
Fiona is the President and Executive Director of the Society of British Dental Nurses and a member of the Dental Professional Alliance (DPA). She has received a British Empire Medal (BEM) and acts as a key opinion leader and advisor for oral health and preventative practice, infection prevention and professional practice. She has a strong interest in population level health matters and inequalities in health. Fiona is heavily involved in education across the sector and invests a great deal of time on programme design and development with a strong focus on quality assurance and assessment.
References
- 1.Schneider M. Introduction to public health (6th edition). Burlington: Jones and Bartlett Learning, 2021.
- 2.Wilson F, Mzwandile M. Key concepts in public health. London: Sage Publications Limited, 2011.
- 3.Benatar S, Brock G. Global health: ethical challenges (2nd edition). Cambridge: Cambridge University Press, 2021.
- 4.Public Health England. About us. Available at: https://www.gov.uk/government/organisations/public-health-england/about (accessed June 2021).
- 5.Selbie D. PHE Strategy 2020-2025. September 2019. Available at: https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/830105/PHE_Strategy__2020-25__Executive_Summary.pdf (accessed June 2021).
- 6.Hancock M, Department of Health and Social Care. Government creates new National Institute for Health Protection. 18 August 2020. Available at: https://www.gov.uk/government/news/government-creates-new-national-institute-for-health-protection (accessed July 2021).
- 7.Daly B, Batchelor P, Treasure E T, Watt R. Essential dental public health (2nd edition). pp 4. Oxford: Oxford University Press, 2013.
- 8.Bridgman C. Dental public health explained. National Oral Health Promotion Conference, 2016.
- 9.University of Essex. Master of Public Health (MPH). Available at: https://online.essex.ac.uk/courses/master-of-public-health-mph/ (accessed July 2021).
- 10.University of Manchester. MRes Dental Public Health. Available at: https://www.manchester.ac.uk/study/masters/courses/list/08238/mres-dental-public-health/ (accessed July 2021).