MamaChit Comdent1 Intro

7/30/2019 MamaChit Comdent1 Intro

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I. INTRODUCTION

TO COMMUNITY

DENTISTRY

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COMMUNITY/ PUBLIC/ STATE/

SOCIETY/ NATION

A body of having a common

organization or living in the same place

under the same laws or regulations.

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HEALTH

According to WHO, it is a state of

complete physical, mental, and social

well-being and not merely the absence

of disease or infirmity.

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PUBLIC HEALTH/ COMMUNITY

HEALTH

The effort that is organized by society to

protect, promote & restore the health &

quality of life of the people.

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DENTAL PUBLIC HEALTH

PRACTITIONERS

Should be knowledgeable in both oral health

practice and dental public health.

Are dentists or dental hygienists

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COMMUNITY DENTAL HEALTH/

PUBLIC HEALTH DENTISTRY/

COMMUNITY DENTISTRY/ DENTAL

PUBLIC HEALTH

The art and science of preventing andcontrolling dental disease and

promoting dental health through

organized community efforts.

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OBJECTIVES OF DENTAL PUBLIC

HEALTH:

Health policy and program management

and administration,

Research methods in dental public health, Oral health promotion and disease, and

Oral health services delivery system.

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Principles involved in community

The patient in the community as awhole w/ varied socio-cultural

influences.

Attainment of goals and objectiveseffort and cooperation.

Greatest benefit to greatest number

The most efficient method of preventdoes not rely on a high degree of

individual.

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Dynamics of Public Health

Although dental disease is prevalent and

oral health a worthy goal, not all people

avail themselves of dental services. There

are many barriers to dental care, some

relate to education, some to finances,some to cultural habits, and some to the

dental care.

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Social Aspect Dental care delivery system are also affected

such as whether a country as at war. Dental health care professional need to be

aware of current and changing conditions thatmay affect dental care delivery systems

throughout the world. Planning, implementing, and evaluating any

dental health care delivery System require a

multidisciplinary approach including thebehavioral, political, and social

sciences, as well as the dental sciences.

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2. ECONOMIC CONCEPT

It describes the methods of payment for

dental care.

One such development is the change of

payment from a purely private out-of-

pocket transaction between dentist andpatient into a layered group financing of

dental care.

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HISTORY OF PUBLIC HEALTH

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Historical perspective with the 19th century

came two dramatic advances in the

effectiveness of public health the greatsanitary awakening (Winslow, quoted in

The Future of Public Health) and the advent

of bacteriology and the germ theory. Thoseof us who see all progress in the field of

health in terms of laboratory discoveries and

the medicines have not had the experience

of living in a 19th century city.

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In New York City, piles of garbage two-

three feet high were accompanied by

epidemic smallpox and typhus. Thecrowding, poverty, filth, and lack of basic

sanitation in the working class districts of

the growing cities provided efficient breeding grounds for

communicable diseases.

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Quarantine and isolation, which were

somewhat effective against individual

cases and illness brought by travelers,were inadequate against mass endemic

disease. Moreover, industrialization and

urbanization closer. No longer able toescape to their country estates, well-to-do

families also fell prey to the highly

contagious diseases incubated among the

working class.

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In England, the Poor Law Commission led

by Edwin Chadwick studied the English

health of the working class. Their famousand controversial General Report on the

Sanitary Conditions of the Labouring

Population of Great Britain presented adamning and fully documented indictment

of the appalling conditions (Chave, in

FPH). The studies revealed that theaverage age at death for laborers was 16

years. For tradesmen it was 22 years; for

the gentry, 36 years.17SOTOUDEH.MARYAM


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GREAT PEOPLE IN HISTORY OF

PUBLIC HEALTH:

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1334 Petrarch introduces the concept of

comparison and indeed of a clinical trial.

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1603 John Graunt Bills of mortality and

the law of mortality. The first life table,

giving the probability of dying at each age.

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1700 Bernadio Ramazzini

Father of Occupational

epidemiology; also breast

cancer in-nuns.

1706 1777 Francois Bossier, de Lacroix

(known as Sauvages) systematicclassification of diseases (Nosologia

Methodica)

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1798 Edward Jenner

cowpox vaccination

against smallpox

1787-1872 Pierre Charles

Alexandre Louisthe Father of

Epidemiology, La

methodenumerique

LaPlace, Poisson

the birth of statistics.

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1847 Ignaz Semmelwies

(Vienna) discovers

transmission andprevention of puerperal fever

1914-1918 Joseph Goldberg

studies pellagra.

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MEASUREMENTS OF THE LEVEL OF

HEALTH

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I. THE MEASUREMENT OF DEATH

Deaths are classified using a standard coding

system called the ICD (InternationalClassification of Deaths), which has been

organized and published by the World Health

Organization since 1946.

In theory, the ICD is a very useful tool in the

analysis of trends and differentials in cause of

death and in the assessment of progress in

overcoming life-threatening diseases andconditions. In practice, however, the ICD

contains a number of limitations.

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First cross-national comparisons are

affected by variations in data quality.

These variations result from differences inthe diagnostic skill and type of training of

the certifying medical attendant or coroner,

in the accuracy of the diagnosis recordedon the death certificate.

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A second limitation is that ICD categories arebased on single cause of death. This is the

underlying cause that is deemed by themedical examiner to have generated the

sequelae leading to death. For populations in

developed countries, in which multiple causes

are often involved, a classification system basedon a single cause of death can result in a

distorted picture of mortality causation.

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Third trend analysis can be affected by

changes over time in the ICD categories

themselves. An apparent increase ordecrease in a cause of death may be the

result of coding/ classification change

only. While changing categorization andtransformation in disease patterns, a

downside is that some distorted trends

may emerge.

Thus, any analyst of cause of death

trends must be aware of ICD changes that

could lead to findings that are merely

artifacts of reclassification. 28SOTOUDEH.MARYAM


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II. Measurement of Morbidity

Morbidity The condition of being diseased.

Proportional morbidity The proportion of all of the diseased

animals in the population that have

the particular disease underdiscussion.

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MORBIDITY RATE

The ratio of diseased to healthy animals in

the population. The ratio is said to be

standardized when it is expressed as a

proportion of the expected rate compared

with standard group. It is also expressedas a proportionate rate when it is stated

as a proportion of all of the cases of

illness due to all causes in the group. Factors: health, vital statistics, duration.

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ETIOLOGICAL FACTORS OF

DISEASES

One of the most common bases for

classifying diseases is according to cause.

External factors that produce diseases are

infectious agents, including both

microscopic organisms, characterized by the

lack of a membrane-bound nucleus and

membrane bound organelles.

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VIRUS

Parasite with a noncellular structure

composed mainly of nucleic acid within a

protein coot. Viruses usually are too-small

(100-2,000 Angstrom Units) to be seen with

the light microscope and thus must be

studied by electron microscopes.

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PROTOZOAN

informal term for the unicellular heterotrophs

of the kingdom Protista.

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FUNGI

kingdom of heterotrophic single-celled

multinucleated or multi-cellular organisms,

including yeasts, molds.

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WORM

Common name for various unrelated

invertebrate animals with soft often long and

slender bodies. Members of the phylum

Platyhelminthes or the flatworms are the

most primitive; they are generally small and

flat-bodied and include the free-living

planarians.

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COMMUNICABLE DISEASES

illnesses caused by microorganisms and

transmitted from an infected person or

animal to another person or animal. Some

diseases are passed on by direct or indirect

contact with infected persons or with their

excretions.

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Other external agents that can cause

disease are chemical and physical agents

(drugs, poisons, radiation) which can beencountered in specific work situation,

deficiency of nutrients in the environment,

and physical injury.

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CHARACTERISTICS OF

PUBLIC HEALTH

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CHARACTERISTICS OF

PUBLIC HEALTH

Group responsibility

- Maintaining health through isolation and

quarantine.

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Rural Health Unit consists of:

Rural health Doctors

Rural health Dentist

Rural health Nurse

Rural health Midwife

Sanitarians

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Teamwork

- Physicians and sanitarians should work

together to cope up with the needs of

the community.

Prevention

- Institution of preventive measures andprograms.

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ROLE OF THE PRIVATE

PRACTITIONER IN PUBLICHEALTH COMMUNITY

DENTISTRY

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An adviser on community affairs resides

in the practicing dentist whether he wills

it or not.

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An active participant in community affairs

which will be determined by the manner in

which the dentists opportunities are

accepted and handled.

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SCOPE OF PUBLICHEALTH

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1. Those fields in which activity must be

on community bases

a. Supervision of food, water and milk

supplies of a community.

b. Insect control and vermin control.

c. Prevention of atmospheric and streampollution.

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e. Certain mental, personality and behavioural

disorders.

f. Occupational health

g. Cancer (limitation of progression :

prevention to extent possible)

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2. Those fields which deal with

presentable illness, disability or

premature death.

a.Communicable disease including

infection.

b.Dietary deficiency

c.Effects of addicting drugs and narcotics

d.Allergic manifestations and their

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DENTAL DISEASES

TWO DENTAL DISEASES OF THE

MOUTH:

1. PERIODONTAL DISEASE

- the primary cause of patient's losingteeth.

2. DENTAL CARIES- the second most common reason

for patient's losing teeth.

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IMPORTANT

CHARACTERISTICS OF THE

TWO DENTAL DISEASES OFTHE MOUTH:

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1 Th f l t i l l


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1. They are of almost universal prevalence.PREVALENCE - is the proportion of a

population affected with a disease at agiven point in time.

2. They do not undergo remission or

termination if left untreated, as do manydiseases that accumulate a backlog ofunmet needs.

3. They normally or usually requiretechnically demanding, expensive and time-consuming professional treatment.

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THEORIES IN THE CAUSATION OF

DENTAL CARIES:

1. ACIDOGENIC THEORY

2. PROTEOLYSIS THEORY

3. MICROSCOPIC SECRETIONS/METABOLIC PRODUCTS OF

MICROORGANISMS

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1. ACIDOGENIC THEORYACIDOGENIC - particular foods have

the ability to reduce the pH of plaque whenconsumed and are considered to beacidogenic. The reduction in pH is considereda necessary condition for the development of

caries.In this theory, dental decay is caused

by acids produced by microbial enzymaticaction on ingested carbohydrates. These

acids will decalcify the inorganic portion of theteeth, then the organic portion isdisintegrated, creating cavities.

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2. PROTEOLYSIS THEORY


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O O S S O

This theory claims that the organic

portion of the tooth is attacked first with

certain lytic enzymes. This leaves the

inorganic portion without a matrix support,

causing it to be washed away, creating

cavities. 3. MICROSCOPIC SECRETIONS/

METABOLIC PRODUCTS OF

MICROORGANISMS This theory have the ability to chelate

calcium from tooth substances, leaving the

organic matrix to be disintegrated.SOTOUDEH.MARYAM

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THREE ETIOLOGIC FACTORS THATPLAY A SPECIFIC ROLE IN THE

CAUSATION OF DENTAL CARIES:

1. HOST (Tooth)

2. AGENT ( Bacteria/ Plaque

microorganisms)

3. ENVIRONMENT ( Carbohydrates in the

diet)

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I HOST


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I. HOST

The tooth is the primary host factor,

but its composition, morphologicalcharacteristics and locations influencethe caries process.

1.Composition

Caries susceptibility of a tooth isinversely proportional to its fluorine,calcium and tin contents.

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2.Morphological characteristics

Accdg. To G.V Black, the ff. areas onthe tooth surface are relatively non-self-

cleansable.

Pits and fissures

Contact areas

Area of near approach

Gingival embrasures

Facial or lingual surfaces

apical; to the cervical ridge

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A t th l ti l l bl


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Areas on tooth are relatively cleansable:

Tip of cusps

Crests of marginal and crossing ridgesAll inclined planes of cusps ang ridges

Occlusal, incisal, facial, abd lingual

embrasurs

Facial or lingual surfaces, incisal or occlusal

to the height of contour with the exception of

pits

Axial angles of teeth

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3. Location

a. The closer the posterior teeth are to the

ramus, the greater is the probability of food

accumulation.

b. Malaligned teeth, causing impropercontacts.

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Saliva is the second major factor.

Salivary factors involved are:

1. Composition

Caries susceptibility is inversely

proportional to salivary phosphate content.

Higher organic content in the saliva

generally indicates more stable plaque

formation.

2. pH

Higher alkaline saliva predisposes

to less decay activity.60

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3. Viscosity

Serious saliva (low viscosity)

predisposes to more self-cleansability thanmucinous (high viscosity) saliva.

4. Flow

Higher quantities of saliva flowing in the

oral cavity predisposes to less decay

activity.

5. Antibacterial elements

Found in the saliva but, their

anticariogenecity depends on their nature,

concentration and amounts. SOTOUDEH.MARYAM61

6 Antibody elements


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II. AGENT

6. Antibody elements

Immunological activities have been

identified in the saliva.

Streptococcus mutans play a major role in

the adhesion (production of dextrane)

necessary for tooth cavitation.

III. ENVIRONMENT Physical and chemical characteristics of a diet

determine its relative cariogenecity.

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Physical characteristics:

Harder and more fibrous food material

necessitates increased masticatory activityand greater ability for cleaning the teeth

surfaces of any stagnating debris.

Chemical characteristics: Carbohydrates are known to be the most

cariogenic of all food materials.

Sucrose is the most detrimental, followedby fructose, lactose, galactose and

glucose.

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I fl id i h di


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Increase fluoride content in the diet

- decrease caries activity

- decrease the solubility of tooth structure

- decrease the surface energy of tooth

surfaces

- discouraging plaque adhesion

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THE END

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MamaChit Comdent1 Intro

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