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