221 PDS Course Outline September 12, 2007 Abdullah S. Al-Swuailem BDS, MS, MPH, Dr PH

Introduction to Preventive Dentistry

Preventive Dentistry Why Prevention? Why Prevention? Definition of Health. Definition of Health. - Health: a state of complete physical, mental, and social well-being, and not merely the absence of disease or infirmity. - Health status defined per individual's perception.

Types of Prevention Types of Prevention 1. Primary Prevention: employs techniques and agents to abort the onset of disease, to reverse the progression of the initial stages of disease, or to arrest the disease process before treatment becomes necessary

Types of Prevention Types of Prevention 2. Secondary Prevention: employs routine treatment methods to terminate a disease process and to restore tissues to as near normal as possible.

Types of Prevention Types of Prevention 3. Tertiary Prevention: employs measures necessary to replace lost tissues and to rehabilitate patients to the point that function is as near normal as possible after the failure of secondary prevention.

Primary Prevention  Secondary Prevention  Tertiary Prevention Primary Prevention  Secondary Prevention  Tertiary Prevention Cost ↑, Patient's satisfaction ↓ Cost ↑, Patient's satisfaction ↓ e.g.: Polio vaccination. e.g.: Polio vaccination. Water fluoridation Water fluoridation

If primary prevention fails: 1. Early identification of disease 2. Immediate treatment of disease

Categories of oral disease: Categories of oral disease: 1. Dental caries 2. Periodontal disease 3. Other acquired oral conditions 4. Hereditary disorders

Strategies to prevent plaque diseases: Strategies to prevent plaque diseases: Dental caries and periodontal disease are caused by bacteria and hence are considered infectious diseases. Dental caries and periodontal disease are caused by bacteria and hence are considered infectious diseases. Virulent bacteria in sufficient number can cause disease in susceptible individuals. Virulent bacteria in sufficient number can cause disease in susceptible individuals. Dental plaque Composition : Dental plaque Composition : salivary components ( proteins) + bacteria + end products of bacterial metabolism. salivary components ( proteins) + bacteria + end products of bacterial metabolism.

Location of Dental Plaque : Location of Dental Plaque : along the margin of the gingiva along the margin of the gingiva Beneath the gingiva in the crevices around the teeth. Beneath the gingiva in the crevices around the teeth. In the inter-proximal areas. In the inter-proximal areas. In the deep pits and fissures. In the deep pits and fissures. Greater plaque on malposed teeth or teeth with orthodontic appliance. Greater plaque on malposed teeth or teeth with orthodontic appliance. Sub-gingival and supra-gingival plaque Sub-gingival and supra-gingival plaque plaque disclosing agents. e.g. erythrosine. plaque disclosing agents. e.g. erythrosine. Dental plaque can be effectively removed by daily tooth brushing and flossing or professionally removed (by a dentist or hygienist) every 6 month. Dental plaque can be effectively removed by daily tooth brushing and flossing or professionally removed (by a dentist or hygienist) every 6 month. The only site that dental plaque can not be removed in deep pit and fissure. The only site that dental plaque can not be removed in deep pit and fissure.

Primary Prevention in Dentistry HostBacteria Diet Caries Time

- Fluoride - Sugar and diet - Pit and fissure sealants - Public education Primary Prevention in Dentistry