Preventive and Community Dentistry Taibah Dental College

Dental treatment is time consuming and expensive Even developed countries cant afford one to one dental tx for all the population Most dental diseases permanently destroy tissues which cant be repaired or replaced Preventive dentistry is the only solution to the problem - most dental diseases can be prevented

Preventive Dentistry: Branch of dentistry - deals with prevention and interception of the progress of dental + oral diseases Prevention and limitation of disabilities Provide rehabilitation Coverage of preventive dentistry: 1. Avert initiation of dental diseases 2. Intercept progress 3. Control spread 4. Limit complications and side effects 5. Provide rehabilitation

SolutionNot curePrevention Etiological factors of almost all oral and dental diseases have been recognized and established

First half of 20 th century Scientific research - Better understanding of disease process and the etiological factors orodental diseases were recognized Emergence of preventive science First 3 decades Attention on OH Dental Hygiene courses started lectures and demonstration on oral hygiene in the school through mass communication 4 th and 5 th decade Role of fl in caries prevention -Fl water supply -Topical application of fl 6 th and 7 th decade -Increased fl water supply in many countries -Fl toothpaste, rinse, topical application (gel+vanish) - Dental caries started to decline

In developed countries caries declined since 1985 due to preventive approaches Prevention of diseases was the main objective of all Public Health Programs Ethical Much cheaper and cost effective Few side effects Marginalized and poor communities had access

Prepathogenic stage: Primary Prevention Level 1 Health promotion to increase resistance against diseases Level 2 Specific protection by increasing host resistance and establishing barriers against diseases Level of Prevention

Health Promotion (Level 1) 1. Diet planning 2. Patient education and motivation 3. Oral hygiene measure Plaque removal Brushing and flossing Promoting clean teeth Good periodontal health

Specific protection (Level 2) 1. Fluoridated water 2. Pits and fissure sealant (Mostly against Dental caries)

Primary preventive measure provided by community or government agencies 1. Municipal or community water fluoridation 2. School water fluoridation 3. Fluoride supplement program 4. Fluoride mouth rinse program 5. Oral and dental health hygiene 6. Education and motivation program

Primary preventive measure provided by the dental professionals 1. Professional topical fluoride application 2. Pits and fissure sealant 3. Diet and dietary habit counseling 4. Plaque control program

Pathogenic stage: Secondary Prevention Tertiary Prevention Level 3 Level of Prevention Level 4 Level 5

Level 3 Disease has started Prevent or intervene the progression and recurrence of the initial stage of disease pathogenesis E.g. early tx of chronic marginal gingivitis to prevent the progress into severe periodontitis Initial caries lesion to prevent pulpitis- MID

Tertiary prevention Level 4 Disease has set in and progressed to irreversible stage Tx must be provided to reduce pain and symptoms Prevent the loss of function as far as possible as a result of disease E.g. restorations, extractions Level 5 Irreversible damage has occurred Efforts are made to restore the lost function E.g. dentures, implants

Level of Prevention for Dental Caries Level of prevention Level 1Level 2Level 3Level 4Level 5 Preventive measures Health promotion Specific protection Early diagnosis and prompt treatment Disability limitation Rehabilitation Measure taken by himself Diet planning regular visit to dentist, literature, media Proper use of fluoride Regular check up by dentist Use of dental professional services Use of dental professional cervices Services provided by community DHE program promotion of research Community / school water fluoridation Periodic screening and dental check up Facilities for dental treatment Facility of dental treatment Service provided by dental profession Patient education & motivation Fluoride Pits and fissure sealant Laser prev. Complete dental examination, early diagnosis, oral prophylaxis Complete restoration, pulp treatment, root canal treatments Removal and fixed prosthodontics

Level of Prevention for Periodontal diseases Level of prevention Level 1Level 2Level 3Level 4Level 5 Preventive measures Health promotion Specific protection Early diagnosis and prompt treatment Disability limitation Rehabilitation Measure taken by himself Educational reinforcement diet planning, proper oral hygiene, visit dental surgeon Oral hygiene practice Self examination and referral, dental check up Use of dental professional services Use of dental professional cervices Services provided by community DHE program promotion of research Supervised hygiene prog. Supervised teeth brushing and mouth rinsing program in schools Periodic screening and dental check up Facilities for dental treatment Facility of dental treatment Service provided by dental profession Patient education & motivation Plaque control program Oral prophylaxis, correction of malalignment Complete dental examination, scaling and curettage Deep curettage, root planning, splinting, periodontal surgery Removal and fixed prosthodontics, implant, bone grafts