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Preventive and Community DentistryTaibah 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 diseases2.Intercept progress3.Control spread4.Limit complications and side effects5.Provide rehabilitation
First half of 20th 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
4th and 5th decade
Role of fl in caries prevention
-Fl water supply-Topical application of fl
6th and 7th 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
Level of Prevention
Health Promotion (Level 1)1.Diet planning2.Patient education and motivation3.Oral hygiene measure
• Plaque removal• Brushing and flossing• Promoting clean teeth • Good periodontal health
Specific protection (Level 2)
1.Fluoridated water2.Pits and fissure sealant
(Mostly against Dental caries)
Primary preventive measure provided by community or government agencies
1.Municipal or community water fluoridation2.School water fluoridation3.Fluoride supplement program4.Fluoride mouth rinse program5.Oral and dental health hygiene6.Education and motivation program
Primary preventive measure provided by the dental professionals
1.Professional topical fluoride application2.Pits and fissure sealant3.Diet and dietary habit counseling4.Plaque control program
Level of Prevention
Level 4
Level 5
Level 3Disease has startedPrevent 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 preventionLevel 4
Disease has set in and progressed to irreversible stage
Tx must be provided to reduce pain and symptomsPrevent the loss of function as far as possible as a
result of diseaseE.g. restorations, extractions
Level 5 Irreversible damage has occurredEfforts are made to restore the lost functionE.g. dentures, implants
Level of Prevention for Dental CariesLevel of prevention
Level 1 Level 2 Level 3 Level 4 Level 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 sealantLaser prev.
Complete dental examination, early diagnosis, oral prophylaxis
Complete restoration, pulp treatment , root canal treatments
Removal and fixed prosthodontics
Level of Prevention for Periodontal diseasesLevel of prevention
Level 1 Level 2 Level 3 Level 4 Level 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 & motivationPlaque 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