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Dr. Tin MawIntroduction to Preventive DentistryAmerican Board of Dental Public health (modified Winslows definition of Health) the science and art of preventing and controlling dental disease and promoting dental health through organized community efforts

It is that form of dental practice which serves thecommunity rather than the individual. It concerned with1, dental health education2, research and the application of findings3, administration of programs of dental care for groups &4, control of dental disease through a community approach.Dental Public Health (definition)10th November 2014Year 2, KOD, IIUM, Dr.Tin Maw.3WHO (World Health Organization) 1948 a state of complete physical, mental & social well being & not merely the absence of disease or infirmity

Talcott Parsons (sociologist) a state of optimum capacity for the performance of valued task

Health (definition)10th November 2014Year 2, KOD, IIUM, Dr.Tin Maw.4

Nick Vujicic10th November 2014Year 2, KOD, IIUM, Dr.Tin Maw.5In broad sense a condition or quality of the human organism expressing the adequate functioning of the organism in given conditions, genetic or environmental.In a narrow sense no obvious evidence of disease, a person is functioning normallySeveral organs are functioning adequately in relation to one another, which implies a kind of equilibrium or homeostasis.

Operational Definition of Health10th November 2014Year 2, KOD, IIUM, Dr.Tin Maw.6Biomedical conceptEcological conceptPsychosocial conceptHolistic conceptChanging Concepts of Health7Biomedical conceptHealth = absence of disease (inadequate)Ecological conceptHealth as a dynamic equilibrium between man and his environment and any maladjustment in this will lead to disease.Psychosocial conceptWhich is influenced by Social, Psychological, Cultural, Economic & Political. Both biological and social phenomenonHolistic conceptIt is a synthesis of all the above mentioned concept and implies that all sectors of society have and affect of health.

Changing Concepts of Health10th November 2014Year 2, KOD, IIUM, Dr.Tin Maw.8

The main determinants of healthDahlgren G, Whitehead M.Policies and strategies to promote social equity in health.Copenhagen: WHO Regional Office for Europe; 1992.

10th November 2014Year 2, KOD, IIUM, Dr.Tin Maw.9Social isolationSelf esteemSocial attractivenessFear/ anxietyaestheticsTime attending servicesImpact of Oral DiseasesFunctional limitationIndividualSocialTime off workPain/discomfortCost of treatmentSocietyCost to National Health careEducational performanceReduce productivity of workforceSleepless nightsTime off school10There I am standing by the shore of a swiftly flowing river and I hear the cry of a drowning man.So I jump into the river, put my arms around him, pull him to the shore and apply artificial respiration,just when he begins to breathe, there is another cry for help. So I jump into the river, reach him. Pull him to shore, apply artificial respiration,and then just as he begins to breathe, another cry for help. So back in the river again, without end, goes the sequence, you know I am so busy jumping in pulling them to shore, applying artificial respiration, that I have no time to see who at the upstream pushing them all in.LOOKING UPSTREAM(McKinlay 1979)McKinlay JB. A case for refocusing upstream the political economy of illness. Processing of the American Heart Association. Conference on applying behavioural sciences to cardiovascular risk; 1974. p. 7-17.11

10th November 2014Year 2, KOD, IIUM, Dr.Tin Maw.12? upstream,? midstream or? downstream

? Or a sensible combination of the three

McKinlay JB. A case for refocusing upstream the political economy of illness. Processing of the American Heart Association. Conference on applying behavioural sciences to cardiovascular risk; 1974. p. 7-17.

LOOKING UPSTREAM(McKinlay 1979)10th November 2014Year 2, KOD, IIUM, Dr.Tin Maw.13Iceberg concept of Disease

Seen by the clinicianNot seen by the clinicianSymptomatic diseaseLatent, unapparentundiagnosed carriers10th November 2014Year 2, KOD, IIUM, Dr.Tin Maw.14Disease prevention includes measures not only to prevent the occurrence of disease risk factor reduction arrest its progress and reduce its consequences once established.

(Nutbeam D (1998) Health promotion glossary. Health Promotion. Int.13(4): 349-264)Prevention: concept10th November 2014Year 2, KOD, IIUM, Dr.Tin Maw.15The concept of prevention is best defined in the context of levels, traditionally called Primary prevention Secondary and Tertiary prevention.A fourth level, called Primordial prevention, was later added.

(Wien Klin Wochenschr (2009) 121: 168-172)Prevention: concept16Figure: The process of disease intervention

The natural history of diseaseProcesswellnessillnessrecoverydeathdisabilityInterventionPrimary preventionPreventive careHealth promotionSecondary preventionClinical careTertiary preventionRehabilitationMaintenance carePrepathogenesis Pathogenesis phasePost Pathogenesis10th November 2014Year 2, KOD, IIUM, Dr.Tin Maw.17 It is defined as action taken prior to the onset of disease which removes the possibility that a disease will even occur.

to forestall the onset of diseaseto reverse the progress of the initial stages of diseaseto arrest the disease process before treatment become necessaryPrimary Prevention10th November 2014Year 2, KOD, IIUM, Dr.Tin Maw.18Signifies intervention in the pre-pathogenesis phase of a disease or health problem.

May be accomplished by measures of Health Promotion and Specific Approach.

Primary Prevention10th November 2014Year 2, KOD, IIUM, Dr.Tin Maw.19Primary PreventionHealth PromotionSpecific ApproachHealth EducationEnvironmental modificationNutritional InterventionsLife style and behavioral changesPit and Fissure SealantTopical FluoridePreventive Resin Restoration10th November 2014Year 2, KOD, IIUM, Dr.Tin Maw.20Defined as actions which halt the progress of a disease at its incipient stage and prevent complications.

The specific interventions are early diagnosis (e.g. screening) and adequate treatment.Secondary Prevention10th November 2014Year 2, KOD, IIUM, Dr.Tin Maw.21Employs routine treatment methods - to terminate a disease process - to restore tissues to as near normal as possiblee.g. Amalgam, GIC restoration

Secondary Prevention

10th November 2014Year 2, KOD, IIUM, Dr.Tin Maw.22Defined as all the measures available to reduce or limit impairments and disabilities, and to promote the patients adjustment to irremediable conditions.

Tertiary Prevention10th November 2014Year 2, KOD, IIUM, Dr.Tin Maw.23Employs 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.

E.g. construction of dentures

Tertiary Prevention (cont)

24Prevention Clinical relationshipPreventArrest or ReversePeriodontal surgeryExodonticsDeep scalingRestorationEndodonticsProsthodonticsPrimary PreventionSecondary PreventionTertiary Prevention10th November 2014Year 2, KOD, IIUM, Dr.Tin Maw.25procedures in the practice of dentistry and community health programs which prevent the occurrence of oral diseases and abnormalities.

Optimum oral health is within the reach of every individual, but achievements requires the combined efforts of the practitioner, the patient and the community.

American Dental Association, 1980Definition of Preventive Dentistry10th November 2014Year 2, KOD, IIUM, Dr.Tin Maw.26Definition: The manner in which a dentist/doctor approaches his practice and what he tries to achieve.Philosophy of Dental Practice10th November 2014Year 2, KOD, IIUM, Dr.Tin Maw.27Prevention is better than cure. Desiderius Erasmus (1466 1536)

An ounce of prevention is worth a pound of cure Ben Franklin