Preventive dentistry
5
th
year- dental students
College of Dentistry/ University of Kirkuk
Lec. 1 Dr.Jihan Abdulhussein
Prevention of oral diseases is concerned with maintenance of a normal
masticating mechanism by fortifying the structures of the oral cavity against
damage and disease.
It is a branch of dentistry, deals with the preservation of healthy teeth & gingiva
and prevention of dental and oral disease. The field involves dental procedures,
materials, and programs that prevent the occurrence of oral diseases or retard
their progression.
There are three levels of preventions:
Level 1: primary prevention
Pre pathogenic stage employs measures that forestall the onset of the disease to
reverse the progress of the initial stage, or to arrest the disease process before
treatments become necessary. It is the maintenance of intact dentition, ie
prevention of dental caries, gingivitis, and periodontitis in a completely healthy
mouth.
Level 2: secondary prevention
Pathogenic stage employs routine treatments methods to terminate a disease
process and restore tissues as near normal as possible. It is the prevention of
occurrence of diseases after successful symptomatic treatment.
Level 3: Tertiary prevention
It employs measures necessary to replace lost tissues and to rehabilitate patients
to the point that functions are as near normal as possible, after failure of
secondary prevention.
(Primary prevention)
Prevent, Arrest, Reverse
(tooth brushing, water fluoridation)
(Secondary prevention)
Deep scaling Restoration
Periodontal surgery Endodontics
Exodontics
(Tertiary prevention)
Prosthodontics (removable and fixed)
Implants
Maxillofacial surgery
Prevention is a philosophy of practice based on a perspective that focuses on
maintaining health rather than treating a disease.
The patient is a person not a case. The first step of motivation is:
1. Getting to know the person. Help him enough to tell us about himself to
see if he can understand dental instructions
2. Developing honest relationships. Doctor- patient relationship.
3. Developing effective oral self-care habits.
4. Reinforcing patient’s responsibility.
As a mean of providing guidance for clinical practice in correlation with the
philosophy of preventive dentistry, a procedural sequence is suggested. These
sequences are considered the basis for treatment planning.
Five phases are suggested:
Phase 1: Urgent care: is the treatment of emergency conditions ie relief of an
existing condition as Extraction and endodontic.
Phase 2: Gingival & periodontal therapy: attempt to control soft tissue
diseases.
Phase 3: Prophylaxis and anti caries therapy: involves periodic dental
prophylaxis, Fluoride therapy & fissure sealants.
Phase 4: Occlusal adjustment: achieved by surgery, restorative procedures and
construction of prosthesis.
Phase 5: counseling in self care: involves complete educational program in oral
health, started from the first visit and continue through out the entire period of
patient care even in recall period.
Oral diseases:
In general 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.
These three points can be achieved by:
1. Mechanical and chemical plaque control.
Mechanical plaque control by using of toothbrush and interdental cleaning
devices (as tooth picks, dental floss, interdental brush), while chemical plaque
control is through the uses of chemo prophylactic agents as tooth paste and
mouth rinses (as chlorhexidin).
2. Uses of fluoridated products either systemic or topical fluoride
agents.
3. Diet and sweet restriction by controlling the frequency and consistency
of sugar intake.
4. Uses of fissure sealants.
5. Health education by:
a) Patient’s education and motivation.
b) Well planned programs as school based programs.
c) Public educational programs.