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University of PalestineCollege of Dentistry PREVENTIVE DENTISTRY AND NUTRTION

DR. MUSTAFA I. ELGHOULMaster of OrthodonticB.SC,B.D.S,MS(ORTHO)

preventive dentistryThe branch of dentistry that deals with the preservation of healthy teeth and gums and the prevention of dental caries and oral diseases

preventive dentistry, ,

the science of the care required to prevent disease of the teeth and supporting structures. There are three levels of preventive dentistry:

Course DescriptionProvides students with theory and clinical experience in the area of preventive and public health dentistry. Topics include:12345etiology of dental disease, patient education techniques, plaque control techniques, types and use of fluoride, diet analysis for caries control, and dietary considerations for the dental patient

Levels of Preventive Dentistry

When discussing prevention, we must first define a few key words. Health is what we want to preserve, and it is defined as a state of complete physical,

mental, and social well-being, and not merely the absence of disease or infirmity.

1. Primary preventionemploys strategies and agents to forestall the onset of disease, to reverse the progress of the disease, or to arrest the disease process before secondary preventive treatment prevention becomes necessary. the use of a topical fluoride gel to prevent caries is an example of primary prevention

2. Secondary preventionemploys routine treatment methods to terminate a disease process and/or to restore tissues to as near normal as possible.

a dental restoration is an example of secondary prevention

3. Tertiary prevention employs measures necessary to replace lost tissues and to rehabilitate patients to the point that physical capabilities and/or mental attitudes are as near normal as possible after the failure of secondary prevention a fixed bridge is an example of tertiary prevention.

It is the goal of the dental profession to help individuals achieve and maintain maximum oral health throughout their lives. Success in attaining this objective is highlighted by the decline of caries throughout the world and the dramatic reduction of tooth loss among adults in the world

Benefits of Preventive DentistryChildrena. 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.

Adultsa. 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.

To The Patient

there is little mention of the adverse affects on humans caused by dental neglect. One study points out that 51% of dental patients have been affected in some way by their oral health, and in 8% of the cases, the impact was sufficient to have reduced their quality of life. If preventive programs are started early by the patient (or, preferably, by the parents of young children) long-range freedom from the plaque diseases is possible a sound cost-benefit investment. After all, the teeth are needed over a lifetime for eating. Speech is . greatly improved by the presence of teeth. A pleasant smile enhances personality expression.

well-aligned teeth and a pleasing smile afford positive social status

Teeth also contribute to good nutrition for all ages. At rare times, teeth have even provided a means of self-defense. On the other hand, the absence of teeth or presence of broken-down teeth often results in a loss of self-esteem, minimizes employment possibilities and often curtails social interaction

BENEVITS TO THE DENTIST

Possibly the first benefit of preventive dentistry is the fulfillment of the moral commitment to the Hippocratic Oath that was taken by health professionals at graduation "to render help to those in need, and to do no harm." Through ethics and training, the dentist should derive a deep sense of satisfaction by helping people maintain their oral structures in a state of maximum function, comfort, and aesthetics.

BENEVITS TO THE DENTIST

. A well-balanced practice that actively seeks to prevent disease but is

also able to care for those individuals where prevention has failed should prosper. Patients can be outstanding public relations advocates if they are convinced that their dentist and staff are truly interested in preventing disease

ETIOLOGY OF DENTAL DISEASE Diseases of the oral cavity Common disease that have manifestations in the mouth. Clinical manifestations of the inflammatory process. Pathological conditions. Degenerative diseases of the oral tissues. Dental hygienerelated problems.

Categories of Oral DiseaseFor planning purposes, dental diseases and abnormalities can be conveniently grouped into three categories: (1) dental caries and periodontal disease, both of which are acquired conditions, (2) acquired oral conditions other than dental caries and periodontal disease (opportunistic infections, oral cancer, HIV/AIDS), (3) craniofacial disorders which would include a wide variety of conditions rangingheredity to accidents. from

Dental cariesDental caries is a sugar dependent infectious disease . Acid is produced as product of the metabolism of dietary carbohydrate by plaqe bacteria , which results in a drop of PH at the tooth service . In response calcium and phosphate ions diffuse out of enamel resulting in in demineralization appears as white spot initially

CARIES PREVENTIONPLAQUE CONTROL TECHNIQUES PATIENT EDUCATION (Dental Health Education)Fluoride Planning Therapy DIET ANALYSIS FOR CARIES CONTROL Pits and Fissure Sealant

PLAQUE CONTROL TECHNIQUESall strategies to prevent, arrest, or reverse the ravages of the plaque diseases are based on

(1) Reducing the number of challenging oral pathogens,(2) building up the tooth resistance and maintaining a healthy gingiva, (3) enhancing the repair processes.

In general,periodontal disease is a disease that involves the soft tissue and bone surrounding the affected teeth. Caries involves the demineralization and eventual cavitation of the enamel and often of the root surface. If the incipient lesions (earliest visible sign of disease) of caries and periodontal disease are recognized at the time of the initial/annual dental examination, they can often be reversed with primary preventive strategies.

PLAQUE CONTROL TECHNIQUESTo control the plaque diseases with available methods and techniques, strong emphasis has been directed to six general strategies to reduce caries and dental diseases 1.Mechanical (toothbrush, dental floss, irrigator, or rinse) 2. Chemical plaque control. Use of fluorides to inhibit demineralization and to enhance remineralization; use of antimicrobial agents to suppress cariogenic bacteria. 3. Sugar discipline.

PLAQUE CONTROL TECHNIQUES

4. Use of pit and fissure sealants, when indicated, on posterior occlusal surfaces.

5. Education and health promotion.6. Establish access to dental facilities where diagnostic, restorative, and preventive services are rendered, and where planned recalls based on risk are routine

Plaque controlDental plaque is

composed of salivary proteins that adhere to the teeth, plus bacteria and end-products of bacterial metabolism. Both cariogenic and periodontopathogens accumulate in the plaque located along the gingival margin, interproximal, and in the pits and fissures. Plaque collects more profusely in these specific areas because none of these locations is optimally exposed to the normal self-cleansing action of the saliva, the abrasive action of foods, nor the muscular action of the cheeks and tongue..

Plaque control

Plaque decreases in thickness as the incisal or occlusal surface is approached. Little plaque is found on the occlusal surface except in the pits and fissures. As would be expected, plaque forms more profusely on malposed teeth or on teeth with orthodontic appliances, where access for cleaning is often difficult

To this point, only mechanical plaque control (i.e., use of a toothbrush, dental floss, and an irrigator) has been highlighted. Rapidly growing in importance as a supplement to mechanical plaque control (but not as a replacement), is chemical plaque control. This approach utilizes mouthrinses containing antimicrobial agents that effectively help control the plaque bacteria involved in causing both caries and gingivitis. For helping to control gingivitis, a popular and economical over-the-counter product is Listerine; the most effective prescription rinse is chlorhexidine. Many studies indicate that chlorhexidine is as effective in suppressing cariogenic organisms as it is effective in controlling gingivitis and periodontitis.34,35

PATIENT EDUCATION TECHNIQUES

Oral health instructionsProvide patient with dental health education presentations on topics such as: functions of the primary and permanent teeth and the relationship of the supporting structures, function of the gingiva and the clinical signs of healthy gingiva, predisposing factors for gingival diseases, and the disease of the periodontium. Individual instructions Explain the procedures and services being delivered to the patient and/or family.

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