Download Lec. 1 Prevention of Oral Diseases

Preventive Dentistry
‫عذراء مصطفى‬.‫د‬
Lec. 1
Prevention of Oral Diseases
Prevention
Preventive Dentistry is a branch of dentistry, deals with the preservation of healthy
teeth and gingiva and the prevention of dental and oral disease.
• The field involves dental procedures, materials and programs that prevent the
occurrence of oral diseases or retard their further progression.
why? Prevention is important
• In children
a.Dental caries is the most common chronic childhood disease.
b. Over 50% of 5- to 9-year-olds have at least one cavity or filling; by age 17, the
percentage has increased to 78%.
c. As a part of childhood, children have many injuries to the head, face, and neck.
d. Twenty-five % of the children have not seen a dentist before entering
kindergarten.
e. More than 51 million school hours are lost each year to dental-related illness.
• Adults
a. Most adults show signs of periodontal or gingival diseases. Severe periodontal
disease [measured as 6 millimeters of periodontal attachment loss (pockets)] affects
about 14% of adults aged 45 to 54.
b. Employed adults lose more than 164 million hours of work each year because of
dental disease and dental visits.
c. A little less than two-thirds of adults report having visited a dentist in the past 12
months.
Older adults
a. Twenty-three % of 65- to 74-year-olds have severe periodontal disease
(characterized by 6 millimeters or more of periodontal attachment loss). At all ages,
men are more likely than women to have more severe disease.
b. About 30% of adults 65 years and older are edentulous, compared to 46% 20
years ago.
c. Oral and pharyngeal cancers are diagnosed in about 30,000 Americans annually.
Nine thousand die from these diseases each year. Prognosis is poor.
d. At any given time, 5% of Americans aged 65 and older (currently some 1.65
million people) are living in long-term care facilities where dental care is
problematic.
Objectives of prevention
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Prevent factors predispose to disease
Prevent the disease it self
Prevent factors evoke severe manifestation of acute disease
Prevent factors which maintain the disease in chronic state
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2)
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4)
5)
Principles of Preventive Dentistry
Control of disease
Patient education and motivation
Development of host resistance
Restoration of function
Maintenance of oral health
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1) Control of disease
Emergency treatment and relief from pain
Active caries should be controlled
Removal pf plaque and calculus
Extraction of infected and decayed teeth.
2) Patient education and motivation
• Evaluation and education by audiovisual aids
• Home care
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3) Development of host resistance
Nutrition and balanced diet
Water fluoridation
Topical fluorides
Use of dentifrices and mouth washes
4) Restoration of Function
• Permanent restoration
• Prosthodontic, orthodontic restorations etc
5) Maintenance of oral health
• Periodic oral health check up
• Follow up of instructions
• Successful prevention depends upon:
• A knowledge of causation,
• Dynamics of transmission,
• Identification of risk factors and risk groups,
• Availability of prophylactic or early detection and treatment measures,
1)
2)
3)
4)
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Levels of Prevention
Primordial
Primary
Secondary
Tertiary
Primordial preventionPrimordial prevention consists of actions to minimize
future hazards to health and hence inhibit the establishment factors
(environmental, economic, social, behavioral, cultural) known to increase the
risk of disease. It addresses broad health determinants rather than preventing
personal exposure to risk factors, which is the goal of primary prevention.
Thus, outlawing alcohol in certain countries would represent primordial
prevention, whereas a campaign against drinking and would be an example of
primary prevention.
• Primary prevention: seeks to prevent the onset of specific diseases via risk
reduction: by altering behaviors or exposures that can lead to disease, or by
enhancing resistance to the effects of exposure to a disease agent. Examples
include Primary prevention reduces the incidence of disease by addressing
disease risk factors or by enhancing resistance. Some approaches involve
active participation, as with regular tooth brushing and flossing to prevent
dental caries. Other approaches are passive: adding fluoride to the municipal
drinking water to harden tooth enamel and prevent caries. Primary prevention
generally targets specific causes and risk factors for specific diseases.
• Secondary prevention: is preventing the establishment or progression of a
disease once a person has been exposed to it. Examples include early detection
via screening procedures that detect disease at an early stage when
intervention may be more cost-effective.
• Tertiary prevention
Employs measures necessary to replace lost tissues and to rehabilitate patients
to the point that functions is as near normal as possible, after the failure of the
secondary prevention
Oral Disease:
In general dental disease can be grouped in to four categories, these are:
1- Dental caries.
2- Periodontal disease.
3- Acquired oral condition.
4- Hereditary disorder.
The most prevalent oral diseases are dental caries and periodontal disease
these are known as plaque related diseases.
These are infectious diseases caused by bacteria of dental plaque. Strategies
to prevent, arrest or reverse the plaque disease are based on:
1- Reducing numbers of challenge oral pathogens.
2- Building up the defenses of teeth.
3- Enhancing the repair process.
Strategy in prevention of oral diseases
These three points can be achieved by:
-Mechanical and chemical plaque control
Mechanical plaque control by using of tooth brush and inter dental cleaning
devices (as tooth picks, dental floss, inter dental brush). While chemical
plaque control is through the uses of chemo prophylactic agents as tooth paste
and mouth rinses (as chlorhexidine).
- Uses of fluoridated products either systemic or topical fluoride agents.
- Diet and sweet restriction by controlling the frequency and consistency of
sugar intake.
-Uses of fissure sealants, this will mechanically prevent accumulation of
bacteria on tooth surfaces.
-Health education, by:
- Patient's educations and motivation,
- Well- planned programs as school based programs
-Public educational programs.
Strategies to Prevent the Plaque Diseases
(1) reducing the number of challenging oral pathogens,
(2) building up the tooth resistance and maintaining a healthy gingiva,
(3) enhancing the repair processes.