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Future Directions

Unit 7 - A collection of resources dedicated to my thoughts and hopes for the future of dentistry. 

A discussion provided by several stakeholders regarding the needs of the future of dentistry. 

Canadian Centre For Policy Alternatives. (2011). Putting Our Money Where Our mouth is: The Future of Dental Care in Canada. https://www.caphd.ca/sites/default/files/Putting%20our%20money%20where%20our%20mouth%20is.pdf

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An article discussing how the oral cavity is a vital portion of overall health. The article discusses what is currently known about the oral systemic link for diseases such as atherosclerotic disease, pulmonary disease, diabetes, and how periodontal disease is related to low birth weight. 

Kane, S., (November 2017). The effects of oral health on systemic health. General Dentistry. 65(6):30-34. https://www.agd.org/docs/default-source/self-instruction-(gendent)/gendent_nd17_aafp_kane.pdf

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A guide created by Dalhousie Dentistry (among other shareholders) to aid those working in long term care with providing oral care to residents. 

McNally, M., (2011). Brushing Up on Mouth Care: An oral health resource for those who provide care to older adults.  https://cdn.dal.ca/content/dam/dalhousie/pdf/dept/ahprc/BrushingUp-OCManual.pdf

 

An article discussing the awareness in dentists regarding the oral-systemic link. The article also discusses some of the mechanisms within this link. 

Nazir, M., Izhar, M., Akhtar, K., Almas, K., (2019). Dentists' awareness about the link between oral and systemic health. Journal of Family & Community Medicine. 26(3): 206-212. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6755758/

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Discussion related to the change in oral health in long term care settings in the past few decades, and how this care is going to change in the future. 

Stein, P., Aalboa, J., Skelton, J., Bright, B., Housley, M., (September 2012). Meeting Oral Health Challenges in Long-Term Care Facilities. Annals of Long-Term Care: Clinical Care and Aging. 20(9):30-34. https://www.managedhealthcareconnect.com/articles/meeting-oral-health-challenges-long-term-care-facilities

A book written in 2014 discussing homelessness within Canada. Chapters containing statistics, policies/programs, and possible new strategies to combat homelessness and its effects. 

Guirguis-Younger, M., McNeil, R., Hwang, S., (2014) Homelessness & health. University of Ottawa Press. https://ruor.uottawa.ca/bitstream/10393/30952/1/9780776621487.pdf 

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An article by Hwang in 2001 disucussing the negative health effects that the homeless populations deals with, and how they fit within the healthcare system. 

Hwang, S., (January 2001). Homelessness and Health. Canadian Medical Association Journal.https://www.cmaj.ca/content/cmaj/164/2/229.full.pdf

 

An article discussing the history of homelessness, what it means to be homeless, why individuals may become homeless, and some of the population groups who are homeless. 

Rech, N., (April 2019). Homelessness in Canada. The Canadian Encyclopedia. https://www.thecanadianencyclopedia.ca/en/article/homelessness-in-canada

 

An article discussing HIV, how homelessness can cause and perpetuate HIV spread and lack of viral control. 

Rourke, SB., Bacon, J., Mcgee, F., Gilbert., (December 2015). Tackling the social and structural divers of HIV in Canada. Canada Communicable Disease Report.  https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5864300/pdf/CCDR-41-322.pdf

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A discussion from the Canadian Dental Association about populations within Canada that do not have access to regular dental care. They discuss seniors, Low-income populations, people with special needs, children, and Aboriginal people. 

CDA Board of Directors. (May 2010). Position paper on Access to Oral Health Care for Canadians. https://www.cda-adc.ca/en/about/position_statements/accesstocarePaper/

 

The NIHB benefits guide, each treatment option broken down by coverage, as well as required supporting documents. 

Government of Canada (October 2020). Dental benefits guide: Non-insured health benefits program. https://www.sac-isc.gc.ca/eng/1579538771806/1579538804799

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An article by CBC discussing the case of a First Nations woman who was denied coverage (by NIHB) for dental implants as a result of a cleft palate. The article discusses that while NIHB denied to cover this treatment, it would be covered through the Alberta Cleft Palate Dental Indemnity Program. 

Labby, B., (May 2017). Unequal treatment: First nations woman denied medical coverage readily available to non-Aboriginals. https://www.cbc.ca/news/canada/calgary/first-nations-siksika-cleft-palate-indigenous-funding-denied-discrimination-1.4131449\

 

A discussion about publicly funded dental care throughout Canada, offering an in-depth look at the NIHB program, and the authors opinion (and evidence) about this program. 

Lange, T. (October 2019).  Polishing-up for the Election: Lessons from Indigenous Dental Care. YYC policy. https://www.yycpolicy.org/blog/2019/10/10/polishing-up-for-the-election-lessons-from-indigenous-dental-care

 

An article discussing the many shortfalls of the NIHB program, and how it greater divides the gap between indigenous and non-indigenous dental health. 

Mosby, I., Carstairs, C., (October 2018). The government's Indigenous dental health program is ignoring the role its policies played in causing Indigenous-non-Indigenous dental health disparities. Policy options. https://policyoptions.irpp.org/magazines/october-2018/federal-policies-undermine-indigenous-dental-health/

 

A CBC article discussing how the federal government spent over $110,000 to deny coverage to a Indigenous girl access to necessary orthodontic treatment. 

 Tasker, P., (September 2017). Ottawa spent $110K in legal fees fighting First Nations girl over $6K dental procedure. https://www.cbc.ca/news/politics/health-canada-legal-fees-first-nations-girl-dental-coverage-1.4310224

Vulnerable Populations 

Unit 6 - A collection of resources regarding indigenous dental care, as well as homeless dental care & HIV. 

Chronic Disease Prevention & Management  

A bulletin released by Cardiovascular Health Nova Scotia discussing prevalence of hypertension in Nova Scotia, as well as within Canada. This bulletin also discusses reasons why some individuals may not be tested, and what may lead to poor hypertension control. 

Cardiovascular health Nova Scotia. (Fall 2015). The Bulletin: Improving Cariovascular Health of Nova Scotians. 11:2. 
http://www.cdha.nshealth.ca/system/files/sites/documents/fall-2015.pdf

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A background document produced by Diabetes Canada surrounding statistics of those diagnosed, complications that may arise from a diagnosis, programs that aid to prevent diagnosis, as well as challenges these programs encounter. 

Diabetes Canada. (February 2020) Diabetes in Canada. https://diabetes.ca/DiabetesCanadaWebsite/media/Advocacy-and-Policy/Backgrounder/2020_Backgrounder_Canada_English_FINAL.pdf

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A background document produced by Diabetes Canada discussing the prevalence (and projected prevalence) of diabetes within Nova Scotia. This article also discusses the implications of diabetes, programs/policies within Nova Scotia, and Diabetes Canada's recommendations to Nova Scotia. 

Diabetes Canada. (May 2019) Diabetes in Nova Scotia. https://www.diabetes.ca/DiabetesCanadaWebsite/media/About-Diabetes/Diabetes%20Charter/2019-Backgrounder-Nova-Scotia.pdf

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A Stats Canada document discussing the statistical breakdown of diabetes diagnosis' within Canada. 

DeGuire, J., Clarke, J., Rouleau, K., Roy, J., Bushnik, T. (February 2019) Health Reports: Blood pressure and Hypertension. Stats Canada. https://www150.statcan.gc.ca/n1/en/pub/82-003-x/2019002/article/00002-eng.pdf?st=mWxGvkWV

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Nova Scotia's health Profile (from 2015), this contains a collection of statistics that provide an overview of the health of Nova Scotians 

Government of Nova Scotia. (2015) Nova Scotia Health Profile 2015. 
https://novascotia.ca/dhw/publichealth/documents/Population-Health-Profile-Nova-Scotia.pdf

 

The ADA discusses hypertension, oral implications, as well as treatment recommendations in the dental office. 

American Dental Association. (2020). Oral Health Topics: Hypertension (High Blood Pressure). 

https://www.ada.org/en/member-center/oral-health-topics/hypertension

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An evidence based discussion within the journal of Clinical, Cosmetic, and Investigational Dentistry about the challenges, and solutions of managing a patient with hypertension. This article provides a great background on hypertension, its classes, risk factors, pharmacological treatments, and dental considerations/complications. 

Southerland, J., Gill, D.,  Gangula, P., Halpern, L., Cardona, C., Mouton, C. (October 2016) Dental management in patients with hypertension: challenges and solutions. Clinical, Cosmetic and investigational Dentistry. (8 111-120). 

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5074706/pdf/ccide-8-111.pdf

 

A fact sheet by the Ontario Dental hygienists' association discussing the types of diabetes, its implications on dental treatment, dental risk factors it can cause, as well as strategies to aid patients in preventing oral complications. 

Ontario Dental Hygienists’ Association. (N.D.) Dental Hygiene Facts: Diabetes and Oral Health. https://odha.on.ca/wp-content/uploads/2016/08/REV-ODHA-Diabetes-15-1.pdf

 

A review discussing diabetes, its relation to periodontal disease, as well as the relation of periodontal disease to diabetes. 

Preshaw, P., Alba, A., Herrera, D., Jepsen, S., Konstantinidis, A., Makrilakis, K., Taylor, R. (2011) Periodontitis and diabetes: a two-way relationship. Diabetologia  55:21-31. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3228943/pdf/125_2011_Article_2342.pdf

Unit 5 - An in-depth look at how chronic disease, in particular hypertension & diabetes, affect dental health & my clinical practice 

Social Ecological Model of Health 

A review & explanation of the social ecological model of health, as well as an example of its use applied to childhood obesity. 

Agency for Toxic Substances and Disease Registry. (June 2015) Models and Frameworks for the Practice of Community Engagement. 

https://www.atsdr.cdc.gov/communityengagement/pce_models.html 

 

The Canadian Dental Association's definition, explanation and recommendations regarding early childhood caries. 

Canadian Dental Association (2010). Childhood Caries. https://www.cda-adc.ca/en/about/position_statements/ecc/ 

 

The Canadian Dental Association Magazine featuring two articles about ECC. The first (page 9) from the CDA's president discussing the importance of children's 1st visit to the dentist before age 1. The second  (page 33) an interview with Ross Anderson, the head of the pediatric dentistry division at Dalhousie & Chief of dentistry at the IWK dentistry here in Halifax, NS. He discusses how we as dental professionals play a crucial role in educating caregivers about prevention. 

Canadian Dental Association (2014). CDA Essentials: The Canadian Dental Association Magazine. 1(4). https://www.cda-adc.ca/en/services/essentials/2014/issue4/files/assets/common/downloads/publication.pdf

 

A discussion applying the social ecological model to preventing violence. 

CDC (2021) The Social-Ecological Model: A Framework for Prevention. https://www.cdc.gov/violenceprevention/about/social-ecologicalmodel.html

 

A summary of the results of the 2007-2009 Oral health findings in the Canadian health Measures survey. Containing many statistics regarding oral health, as well as information about each of Canada's provinces and territories. 

Health Canada (2010) Summary Report on the Findings of the Oral Health Component of the Canadian Health Measures Survey 2007-2009. http://publications.gc.ca/collections/collection_2010/sc-hc/H34-221-1-2010-eng.pdf

 

An article from the Journal of Agromedicine discussing the uses and history of the social ecological model. 

Kilanowski, J.F. (2017). Breadth of the Socio-Ecological Model. Journal of Agromedicine, 4,295. From https://doi.org/10.1080/1059924X.2017.1358971

 

A systematic review of Canadian literature to describe the burden of ECC within Canada, its prevalence and associated risk factors, and its impact on childhood health. 

Pierce, A., Singh, S., Lee, J., Grant, C., Cruz de Jesus, V., Schroth, R., (November 2019) The Burden of Early Childhood Caries in Canadian Children and Associated Risk Factors. Frontiers in Public Health. 7(328). https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6861386/pdf/fpubh-07-00328.pdf

 

A manual released in 2019 by the WHO providing general information about ECC, as well as specific multi-level directions for control & prevention. 

World Heath Organization (2019) Ending Childgood Dental Caries: WHO implementation Manual. https://apps.who.int/iris/rest/bitstreams/1266137/retrieve

Unit 4: An understanding of Early Childhood Caries using the Social Ecological Model of Health

Social Determinants of Health 

The Canadian Public Health’s association description, how the determinants can affect an individual’s life, and also how the government shapes policy around the determinants. 

Canadian Public Health Association. (N.D.) What are the social determinants of health? (Accessed on feb 7th 2021) https://www.cpha.ca/what-are-social-determinants-health

 

A list of the determinants in Canada, their definition of health inequalities/equity, and how these inequities can be reduced to give everyone the same opportunities to be healthy. 

Goverment of Canada. (October 2020) Social determinants of health and health inequalities. https://www.canada.ca/en/public-health/services/health-promotion/population-health/what-determines-health.html

 

Mikkonen & Raphael discuss each of the determinants in-depth & how they both negatively and positively impact individuals. 

Mikkonen J., Raphael, D., (2010) Social Determinants of Health: The Canadian Facts. https://thecanadianfacts.org/The_Canadian_Facts.pdf 

 

A FAQ page for the CDC that discusses the definition of health equity, what the social determinants of health are, factors that impact the social determinants/health outcomes. This page also discusses why addressing the social determinants is helpful in attaining health equity for all. 

Center for disease Control and Prevention. (December 19th 2019) Frequently asked questions: Health Equity. https://www.cdc.gov/nchhstp/socialdeterminants/faq.html 

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A news article from the Nova Scotia advocate discussing how healthcare in Nova Scotia is lacking, particularly in low income areas in Halifax, which over the past years in Halifax has increased the divide between the ‘rich and poor’. 

Kronstein, Alex. (May 11 2017) The Social determinants of health in Nova Scotia. Part 1: Poverty makes you sick. https://nsadvocate.org/2017/05/11/the-social-determinants-of-health-in-nova-scotia-part-1-poverty-makes-you-sick/

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A report created by the Federal, Provincial & Territorial Advisory Committee discussing population health & healthy Canadians. This article (on page 7 discusses a case story displaying how intertwined each of the social determinants are). 

Federal, Provincial, and Territorial Advisory Committee on Population Health. The (1999). Toward a healthy future : Second report of healthy Canadians. Ottawa : Minister of Public Works and Government Services Canada.http://publications.gc.ca/collections/Collection/H39-468-1999E.pdf 

Unit 3 - A look at the social determinants of health, how they affect every aspect of health, and how they relate to one another. 

What is Health? 

Unit 2: Discussion surrounding the World Health Organization's outdated definition of health. What a new definition should include, and what health means to me. 

The World Health Organization's definition of health. 

World Health Organization. (2020) Constitution of the World Health Organization. https://apps.who.int/gb/bd/PDF/bd47/EN/constitution-en.pdf?ua=1

 

Huber & colleagues discuss how and why the WHO definition of health does not fit our current population. They also propose a change to place emphasis on the ability to adapt & self manage with social, physical and emotional challenges. 

Huber, M., et al., (2011). Health: how should we define it? British Medical Journal, 343, (7817), 235-237. https://doi.org/10.1136/bmj.d4163

 

A news article discussing how today health can still be achieved and maintained in the presence of chronic disease, especially in older adults with multiple diseases & conditions. 

Fallon, C.K., Karlawish, J., (July 17 2019) Its time to change the definition of 'health'. Stat news. 

https://www.statnews.com/2019/07/17/change-definition-health/

 

World data about life expectancy throughout the world. 

Life expectancy of the Word Population. (2020) Worldometer. Retrieved February 2021. https://www.worldometers.info/demographics/life-expectancy/

 

A German-Croatian physiatrist discusses how the WHO definition of health is outdated, and suggested an alternative set of definitions. 

Sartorius, N,. (2006). The meaning of Health and its Promotion. Croatia Med Journal, 47 :662-664. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2080455/pdf/CroatMedJ_47_0662.pdf

 

An editoral discussing that health is more than just the presence or absence of disease. It is instead adapting to ones environment. This allows us to create a more compassionate, comforting, and creative program for medicine. 

The Lancet. (2009). What is health? The ability to adapt. The Lancet, 373(9666), 781. https://doi.org/10.1016/S0140-6736(09)60456-6

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