Operative Dentistry Prevention Lecture 2

8/3/2019 Operative Dentistry Prevention Lecture 2

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OPERATIVE DENTISTRYOPERATIVE DENTISTRYThe branch of Oral Health Services dealing with:The branch of Oral Health Services dealing with:

1. Prevention.1. Prevention.

2. Restoration.2. Restoration.Of the Defects of Natural Teeth


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DEFINITION :

Operative dentistry is the science and

art dealing with the prevention and

restorations of any Defect that

occurs in the hard tooth structures.


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Two Main Braches:Two Main Braches:1. Preventive dentistry

2. Restorative dentistry

1. Primary Prevention

2. Secondary Prevention

3. Tertiary Prevention

A. Diagnosis

B. Interception

C. Prevention

D. Preservation

E. Restoration


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DIFFERENT LEVELS OF PREVENTIONDIFFERENT LEVELS OF PREVENTION

1.1. Primary prevention.Primary prevention.

2.2. Secondary prevention.Secondary prevention.

3.3. Tertiary prevention.Tertiary prevention.


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Classification of preventive dental servicesClassification of preventive dental services

1.Primary preventive services

2.Secondary preventive services

3.Tertiary preventive service

Preventive services are provided by :

i. Community agencies

ii. Dental professionalsiii. Publicindividuals


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COMMUNITY AGENCIESCOMMUNITY AGENCIES

THESE ARE :THESE ARE :

1.1. Governmental health organizations :Governmental health organizations :

a. federal health ministrya. federal health ministry

b. provincial health ministryb. provincial health ministry

e.g. secretary health, directore.g. secretary health, director

health , DHO , etchealth , DHO , etc

c. nazim officialsc. nazim officials

2.2. Non governmental health organizationsNon governmental health organizations

For example :For example :world health organizationworld health organization


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Dental professionalsDental professionals

The dentistsThe dentists

The dental technologistsThe dental technologists

The dental therapistsThe dental therapists

The dental hygienistsThe dental hygienists

The dental educationistsThe dental educationists

The dental assistantsThe dental assistants

The dental attendantsThe dental attendants The secretary of dental officeThe secretary of dental office

etc etcetc etc


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The publicThe public

The peoples of a community should beThe peoples of a community should be

made aware, educate and motivate tomade aware, educate and motivate to

take interest and participate to recieve thetake interest and participate to recieve the

benefits of the preventive measures.benefits of the preventive measures.


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PRIMARY PREVENTIONPRIMARY PREVENTION

SERVICES BY THE COMMUNITY-AGENCIES

1. Water fluoridation :

a. Community water fluoridation.b. School water fluoridation.

2. Fluoride supplements programmes.

(Tablets, Losenges, Oral drink, Drops, Salts etc)3. Fluoride Mouth rinse programmes.

4. Pits & Fissures sealants programmes in

schools

.


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PRIMARY PREVENTIVE SERVICES BY THE COMMUNITYWater fluoridation:

Fluoridation is the upward adjustment of the fluoride ions content of thecommunity water supply to an optimal level, physiologically acceptable, for the

prevention of dental carries

Community water fluoridation.The optimum level of fluoride in the water is 0.7-1.2 p.p.m adapted in

accordance with the amount of water consumed related with warmer and

cold climates.

School water fluoridation.The school water fluoridation is strongly recommended in that area of

population where the community water fluoridation is not available

Optimum level of fluoride is 4-5 p.p.m as this upward adjustment is to

compensate for the reduced water intake' since the school day and year is

shorter, hence the time spent at school


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Systemic effect of water fluoridationSystemic effect of water fluoridation

During the development of the tooth theingested fluoride is incorporated in the

structure of the tooth The Hydroxy-apatite crystals is replaced by Hydroxy-fluoro-apatite

crystals which are more resistance to carries attack.


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MECHANISM OF ACTION OFMECHANISM OF ACTION OF

SYSTEMIC FLUORIDESYSTEMIC FLUORIDEThe cariostatic mechanism of systemicThe cariostatic mechanism of systemicfluoride is as follows :fluoride is as follows :

1.The enamelbecome more resistant to acid1.The enamelbecome more resistant to aciddissolutiondissolution

2.Inhibition of bacterial enzyme system2.Inhibition of bacterial enzyme system--enzymatic actionenzymatic action

3.Modification in the size and shape of teeth3.Modification in the size and shape of teethto be less susceptible to cariesto be less susceptible to caries


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PRIMARY PREVENTIVE SERVICES BY THE COMMUNITY

Fluoride supplements programmes.(Tablets, Losenges, Oral drink, Drops, Salts etc).

Using the swish and swallow technique, the dailyrecommended dose of fluoride is as follows:

i. Dose for child below 2years is 0.5 mgii. Dose for child b/w 2-3 years is 0.5-0.7 mg

iii. Dose or child above 3 years is 1.0-1.5 mg

Fluoride tablets are commercially available as NaF tablets of 2.2mg, 1.1mg, and

0.5mg fluoride respectively.


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PRIMARY PREVENTIVE SERVICES BY THEPRIMARY PREVENTIVE SERVICES BY THECOMMUNITYCOMMUNITY

Fluoride supplements programmes.Fluoride supplements programmes.

Tablets : swish and swallow technique :Tablets : swish and swallow technique :

With the use of tablets, it seems logical that if a childWith the use of tablets, it seems logical that if a child

would chew the tablets, then swish the saliva b/w thewould chew the tablets, then swish the saliva b/w theteeth for a minute before swallowing .teeth for a minute before swallowing .

Both a topical and systemic use of flouride achievedBoth a topical and systemic use of flouride achieved

this swish and swallow method is advocated wheneverthis swish and swallow method is advocated whenever

tablets are used .tablets are used .


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Fluoride Mouth rinse programmes.

(Flavored, Breath Freshening, Innocent to tissue)Two major regimens :

(mostly school based program)

i. Sodium fluoride (0.05%) rinse : it contains 230 ppm fluoride which isused daily---- 5-10 ml of this solution is asked to rinse for oneminute.

Ii. Sodium fluoride (0.2%) rinse it contain 900 ppm Flouride which isused weekly or fortnightlyrinse for 1 minute

The schedule is for one year---30 weeks


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Pits & Fissures sealants programmes in schools.

To prevent Primary carries:

Teeth with deep Pits & Fissures which are not carious,

filled with composite materials / Glassionomers pits andfissures sealants.

Pits and fissures are sealed by pits and fissures sealants


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PRIMARY PREVENTIONPRIMARY PREVENTIVE SERVICES BY THE

DENTAL PROFESSIONALS

Two levels:i. In dental clinics / hospitals

ii. Community or public programmes


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Plaque control (scaling & polishing).

Dental caries activity tests.

Simple remedies.a. Professional topical fluorideapplication.

b. Pits & fissures sealants etc.

Diet counseling.Dental health education, Demonstrations &

Training to patients.

PRIMARY PREVENTIVE SERVICES BY THE DENTAL

PROFESSIONALS

Services in clinics or hospitals:


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PRIMARY

PREVENTION

PRIMARY PREVENTIVE SERVICES BY THEDENTAL PROFESSIONALS

1.Plaque control (scaling & polishing)

Scaling and polishingby dentist twice a year.

Birthday once a year, dentist twice a year.


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Simple remedies.a. Professional topical fluoride

application.





PROFESSIONALS



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PRIMARY PREVENTIVE SERVICES BY THE DENTALPRIMARY PREVENTIVE SERVICES BY THE DENTALPROFESSIONALSPROFESSIONALS

Dental caries activity testsDental caries activity tests

A test used to predict the probability ofA test used to predict the probability of

developing new or increased decay; maydeveloping new or increased decay; mayinclude assessments of saliva and plaque forinclude assessments of saliva and plaque forthe presence of certain designated microthe presence of certain designated micro--organisms or studies of salivary secretion andorganisms or studies of salivary secretion and

sugar clearance.sugar clearance.


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PRIMARY PREVENTIONPRIMARY PREVENTIONPRIMARY PREVENTIVE SERVICES BY THEPRIMARY PREVENTIVE SERVICES BY THE

DENTAL PROFESSIONALSDENTAL PROFESSIONALS

Dental caries activity tests.Dental caries activity tests.

(Caries susceptibility tests)(Caries susceptibility tests)

.. To show existing condition of carriesTo show existing condition of carriessusceptibility in mouthsusceptibility in mouth

. These test are used as motivational tools for. These test are used as motivational tools forpatients education and to develop habits forpatients education and to develop habits forprevention like regular brushing and mouthprevention like regular brushing and mouthrinsingrinsing


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Caries activity testsCaries activity tests

FFollowing testsollowing tests1.Synder's Test1.Synder's Test

2.Lactobacilli colony count Test2.Lactobacilli colony count Test

3.Alban's Test3.Alban's Test

4.salivary buffer capacity Test4.salivary buffer capacity Test

5.Enamel solubility Test5.Enamel solubility Test

6.salivary reductase Test6.salivary reductase Test

7.streptococcus mutans level in saliva Test7.streptococcus mutans level in saliva Test


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Synder Test:Synder Test:Used a colour indicator to show amount ofUsed a colour indicator to show amount of

acid formed by microacid formed by micro--organisms in carbohydrateorganisms in carbohydratemediummediumshow carries activities.show carries activities.

PRINCIPLPRINCIPLE:E:

Amount of acidAmount of acidproduced isproduced isproportionatproportionate to thee to thenumber ofnumber of

acidacidproducingproducinglactobacillilactobacillipresentpresent

PROCEDUREPROCEDURE11 ml of paraffinml of paraffin

stimulated sa

liva ofstimu

lated sa

liva ofthe patient is addedthe patient is added

to glucose agarto glucose agarcontainingcontainingbromocresol greenbromocresol green

dye and incubateddye and incubatedforfor 7272 hrs athrs at 3737 c.c.The colour change isThe colour change isexamined afterexamined after 2424hours tillhours till 7272 hrs.hrs.

INFERENCEINFERENCE::

The sooner theThe sooner thecolour changescolour changesfrom green tofrom green toyellow theyellow thegreater is thegreater is the

caries activity.Ifcaries activity.Ifcolour does notcolour does notchanges in 72changes in 72hours then thehours then thepatient is immunepatient is immune

to caries.to caries.


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application.





PROFESSIONALS



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PRIMARY PREVENTIVE SERVICES BYPRIMARY PREVENTIVE SERVICES BYDENTAL PROFESSIONALSDENTAL PROFESSIONALS

Simple remedies:Simple remedies:a.a. Professional topical fluoride application.Professional topical fluoride application.

b. Pits & fissures sealants.b. Pits & fissures sealants.


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Professional topical fluoride application in clinics:Professional topical fluoride application in clinics:

Topical Fluorides:Topical Fluorides: Three Agents:Three Agents:

a.a. Sodium fluorides (2% solution):Sodium fluorides (2% solution):

Four applications :Four applications :

at one week interval per yearat one week interval per yearat ages 3,7,11

and13 years.at ages 3,7,

11and

13 years.

b. Stannous Fluorides (8b. Stannous Fluorides (810% solution):10% solution):

One application per year.One application per year.

c. Acidulated phosphate Fluorides (1.2% fluoride gel):c. Acidulated phosphate Fluorides (1.2% fluoride gel):

Two applications per yearTwo applications per year

Fluorides in mouthwashes, solution, varnish, gel(duraphat, fluorprotector),Fluorides in mouthwashes, solution, varnish, gel(duraphat, fluorprotector),lozenges and drops are available.lozenges and drops are available.

PRIMARY PREVENTIVE SERVICES BYDENTAL PROFESSIONALS


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METHOD OF APPICATION OF TOPICAL FLUORIDMETHOD OF APPICATION OF TOPICAL FLUORID

i. clean and polish all the surfaces of teeth.i. clean and polish all the surfaces of teeth.

ii. Isolation of the teeth with cotton roll orii. Isolation of the teeth with cotton roll or

rubber dam.rubber dam.

iii. Dry the teeth with cotton or compressed air.iii. Dry the teeth with cotton or compressed air.

iv. Freshly prepared soultion or gel or varnishiv. Freshly prepared soultion or gel or varnish

of fluoride is applied to the teeth with cottonof fluoride is applied to the teeth with cotton

applicator.applicator.


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METHOD OF APPICATION OF TOPICAL FLUORIDMETHOD OF APPICATION OF TOPICAL FLUORID

v.v. 22% sodium fluoride is applied on the teeth% sodium fluoride is applied on the teeth

forfor 44 min.min.

vi.vi. 88% SnF is applied on the teeth for% SnF is applied on the teeth for 44 min &min &

ReRe--application of solution to tooth is doneapplication of solution to tooth is done

everyevery 1515--3030 second.second.

vii. The APF gel / solution is applied forvii. The APF gel / solution is applied for 44 minmin& is continuously and repetedly applied& is continuously and repetedly applied

with cotton applicator .with cotton applicator .


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METHOD OF FLUORIDE VARNISH APPLICATIONMETHOD OF FLUORIDE VARNISH APPLICATION

1. Oral prophylaxis1. Oral prophylaxis2.Teeth are dried2.Teeth are dried

3.Teeth are not isolated with cotton rolls as3.Teeth are not isolated with cotton rolls as

varnish being sticky has a tendency to stickvarnish being sticky has a tendency to stickto cotton.to cotton.

4.The application is done first on lower arch4.The application is done first on lower arch

as saliva collects more rapidly around it,as saliva collects more rapidly around it,and then on the upper arch.and then on the upper arch.


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METHOD OF FLUORIDE VARNISH APPLICATIONMETHOD OF FLUORIDE VARNISH APPLICATION

5. Application of varnish is done with single5. Application of varnish is done with single

tufted small brush.tufted small brush.

6.Set the patient with open mouth for 4 min.6.Set the patient with open mouth for 4 min.7. Ask the patient not to rinse or drink any7. Ask the patient not to rinse or drink any

thing for one hr and dont eat hard till nextthing for one hr and dont eat hard till next

morning.morning.


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application.





PROFESSIONALS



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Pits and fissures sealantsPits and fissures sealants

Pits and fissures of the teeth provide a shelteredPits and fissures of the teeth provide a sheltered

niche (recess) for bacterial proliferation whichniche (recess) for bacterial proliferation whichcause dental caries.cause dental caries.

By providing an impervious barrier to pits andBy providing an impervious barrier to pits and

fissures system, the pit and fissure sealants canfissures system, the pit and fissure sealants canhelp to prevent dental caries.help to prevent dental caries.


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Definition:Definition:

A cement or a resin which is filled to the unprepared pits and fissuresA cement or a resin which is filled to the unprepared pits and fissuresof the teeth which are susceptible to caries, forming a mechanical andof the teeth which are susceptible to caries, forming a mechanical andphysical protective layer against the action of acit released by thephysical protective layer against the action of acit released by thebacteria.bacteria.

Indications:Indications:

> Non carious deep pits, fissures, grooves and fossae are sealed.> Non carious deep pits, fissures, grooves and fossae are sealed.

> A small carious pit is filled and rest of pits and fissures are sealed.> A small carious pit is filled and rest of pits and fissures are sealed.

sealing the pits and fissures just after tooth eruption may be the most sealing the pits and fissures just after tooth eruption may be the mostimportant event in their resistance to caries.important event in their resistance to caries.


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Sealants are not recommended on patients whoSealants are not recommended on patients whodo not have signs of caries activity.do not have signs of caries activity.

If caries activity is noted either clinically orIf caries activity is noted either clinically orradiographically, sealing all pits and fissuresradiographically, sealing all pits and fissuresshould be strongly recommendedshould be strongly recommended


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g


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Pits and fissures sealants

Types :Following materials are used as sealants :

i. Polyurethanesii. Cyanoacrylatesiii. BIS-GMA (Bisphenol A-Glycidyl Methylacrylate)

These materials are polymerised by two methods :i. Light curingii. Chemical curing

Pi d fi l


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Pits and fissures sealantsTechnique of pits and fissures sealants application :Technique of pits and fissures sealants application :

i. Clean the surface of the toothi. Clean the surface of the tooth

ii. Isolate and dry the toothii. Isolate and dry the tooth

iii. Etch for 20 sec. With 30iii. Etch for 20 sec. With 30--50% phosphoric acit50% phosphoric acit

iv. Wash thoroughly , reiv. Wash thoroughly , re--isolate and dry very well,isolate and dry very well,avoid the contact of saliva with the toothavoid the contact of saliva with the tooth

v. Apply the pits and fissure sealant on the etchedv. Apply the pits and fissure sealant on the etched

pits, fissures, grooves and fossaepits, fissures, grooves and fossae

vi. Now let the sealants polymerizedvi. Now let the sealants polymerized

vii. Do the occlussal adjustment if requiredvii. Do the occlussal adjustment if required


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Light curing a fissure sealant.


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Chemically curing fissures sealant


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Simple remedies.a. Professional topical fluorideapplication.


Diet counseling.

Demonstrations & Training to

patients.

PRIMARY PREVENTIONPRIMARY PREVENTIVE SERVICES BY THE DENTALPROFESSIONALS


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Diet CounselingDiet Counseling

Objectives :Objectives :11. To correct nutritional inadequacies of. To correct nutritional inadequacies of

the diet that may affect the patient'sthe diet that may affect the patient's

general health and be reflected in oralgeneral health and be reflected in oralhealthhealth

22.To prevent damage to the teeth and.To prevent damage to the teeth and

other oral tissues as a consequence ofother oral tissues as a consequence ofthe type & frequency of foods takenthe type & frequency of foods taken

Di t A l iDi t A l i


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Diet AnalysisDiet AnalysisIndications :Indications :

1.High caries activity in the mouth1.High caries activity in the mouth2.unusual caries pattern2.unusual caries pattern

3.Suspected dietary erosion3.Suspected dietary erosion


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Diet CounsellingDiet Counselling

1. First phase{ Assessment phase } : Dietary analysis1. First phase{ Assessment phase } : Dietary analysis

2. Second phase : Diet advice / instruction / planning.2. Second phase : Diet advice / instruction / planning.

P

hases: Two general phases

DIET COUN ELINGDIET COUN ELING


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DIETCOUNSELINGDIETCOUNSELINGFirst phaseFirst phase ::{Assessment / analysis phase} :{Assessment / analysis phase} :

To evaluate the patient's nutritionalTo evaluate the patient's nutritionalstatus and diet.status and diet.

Activities during the assessment phase:Activities during the assessment phase:

i. Complete medical and sociali. Complete medical and socialhistoryhistory

ii. Thorough clinical examinationii. Thorough clinical examination

iii. A detailed dietary analysisiii. A detailed dietary analysis


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Diet AnalysisDiet Analysis


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Diet AnalysisDiet AnalysisMethod of diet study :Method of diet study :

(most widely used method)(most widely used method)A consecutiveA consecutive 33 days analysis (days analysis (11 weekweek

oror 22 weeks) of the diet of theweeks) of the diet of the

patient with recording the :patient with recording the :

a. Time of diet takinga. Time of diet taking

b. Content of the diet takingb. Content of the diet taking

c. Quantity of the diet consumingc. Quantity of the diet consuming

d. Frequency of diet takingd. Frequency of diet taking

In addition,times of toothbrushing after mealIn addition,times of toothbrushing after meal

and before bed time should be noted.and before bed time should be noted.

et Ana ys set Ana ys s


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et Ana ys set Ana ys sMethod of diet analysis :Method of diet analysis :

11.Ring the main meals. If in.Ring the main meals. If in

any doubt, identify thoseany doubt, identify thosesnaks that containsnaks that contain

carbohydrates.carbohydrates.

Assess nutritional value ofAssess nutritional value of

meals.meals.

22.Underline all refined.Underline all refined

sugar intakes in redsugar intakes in red

colour.colour.33.Identify the snaks b/w.Identify the snaks b/w

the meals.the meals.

44.Decide on a maximum of.Decide on a maximum of

three recommendations.three recommendations.

Diet counse ing


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Second PhaseSecond Phase

Diet advice / instruction / planning:Diet advice / instruction / planning:This should include an explanation of theThis should include an explanation of the

affect of sugary snaks eating & drinkingaffect of sugary snaks eating & drinking

b/w the meals.b/w the meals.

It must also be personal , practical andIt must also be personal , practical and

positivepositive

The suggestion that a child should selectThe suggestion that a child should selectcrisps when friends / class fellows arecrisps when friends / class fellows are

buying sweets is more likely to bebuying sweets is more likely to be

followed than total abstinence.followed than total abstinence.

Diet counse ing

Di t d i / i t ti / l iDi t d i / i t ti / l i


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Diet advice / instruction / planning.Diet advice / instruction / planning.

Key factors for successful diet adviceKey factors for successful diet advice::

1. Implement gradual changes/reduction in sugar1. Implement gradual changes/reduction in sugar

intake rather than drastic/sudden changes orintake rather than drastic/sudden changes or

reduction all at oncereduction all at once2.Utilized dietary substitutions rather than outright2.Utilized dietary substitutions rather than outright

eliminationelimination

33.Utilize continual psychological reinforcement.Utilize continual psychological reinforcement


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Diet advice / instructions / planning.Diet advice / instructions / planning.4.Restrict the number of eating times to three main4.Restrict the number of eating times to three main

meals.meals.

5.Avoid refined sugary snaks in b/w meals.5.Avoid refined sugary snaks in b/w meals.

6.Take low carbohydrates or alternative to sugar like6.Take low carbohydrates or alternative to sugar like

xylitole containing food.xylitole containing food.

7.take high protein snaks and fibrous fruits in b/w7.take high protein snaks and fibrous fruits in b/wmealsmeals

8.Increase eating of high protien food like8.Increase eating of high protien food like

meat, fish , milk, egg, pulses, etc.meat, fish , milk, egg, pulses, etc.

Diet advice / instruction / planningDiet advice / instruction / planning


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9.Restrict carbohydrates eating so9.Restrict carbohydrates eating so

that they only provide 30that they only provide 30--50% of50% of

total calories required to the body.total calories required to the body.

10.Eliminate eating sticky sweets10.Eliminate eating sticky sweets

like chocolates, candies, toffies,like chocolates, candies, toffies,

cakes, pasteries, etc. if notcakes, pasteries, etc. if not

completely then as much ascompletely then as much as

possible.possible.

11.Eat firm food like raw vegetables11.Eat firm food like raw vegetables

and fruits which will reduce dentaland fruits which will reduce dentalplaque formation and increaseplaque formation and increase

salivary flowsalivary flow

Diet advice / instruction / planningDiet advice / instruction / planning


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Some Suggestions to patients :Some Suggestions to patients :

11.Suggest saving sweets to be eaten on one day,.Suggest saving sweets to be eaten on one day,e.g saturday dinner timee.g saturday dinner time

22.All.All--inin--one chocolate are preferable to packetsone chocolate are preferable to packets

on individual sweetson individual sweets33.Food which stimulates salivary flow (e.g cheese,.Food which stimulates salivary flow (e.g cheese,

sugar free chewing gum) can help to reverse thesugar free chewing gum) can help to reverse the

pH drop due to sugar, if eatenpH drop due to sugar, if eaten

afterwardsafterwards


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1.1. Diet advice / instruction / planning.Diet advice / instruction / planning.

Some other Suggestions toSome other Suggestions to

patients:patients:

44.Treacle and honey are.Treacle and honey are

CariogenicCariogenic

55. Artifical sweetners are. Artifical sweetners arerecommended in adults butrecommended in adults but

should be avoided in preshould be avoided in pre--

school childrenschool children

66.Fibrous foods e.g fruit are.Fibrous foods e.g fruit are

preferable to a sucrosepreferable to a sucrose

snaksnak


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application.


Diet counseling.

Dental health education, Demonstrations &Training to patients.


PROFESSIONALS


D t l h lth d tiD t l h lth d ti


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Dental health educationDental health education

Establish a preventive setupEstablish a preventive setup

in the dental clinic consistingin the dental clinic consistingof :of :

a. chartsa. charts

b. modelsb. models

c. picturesc. picturesd. audiod. audio--visual devices .etc.visual devices .etc.

Dentist and the auxilliariesDentist and the auxilliariesare available to:are available to:i. To educate the patientsi. To educate the patients

ii. To make them awareii. To make them awareabout the dental diseasesabout the dental diseasesand their consequencesand their consequencesiii. To motivate them to followiii. To motivate them to followthe advices to prevent thethe advices to prevent the

dental diseasesdental diseases

PRIMARY PREVENTION


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PRIMARY PREVENTIONPRIMARY PREVENTIVE SERVICES BY THE

DENTAL PROFESSIONALS

Two levels:i. In dental clinics / hospitals

ii. Community or public programmes

PRIMARY PREVENTIVE SERVICESPRIMARY PREVENTIVE SERVICES


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Services by dental professionals in theServices by dental professionals in thecommunity or public programmes:community or public programmes:

Dental health education :Dental health education :

It is a process that informs, motivates andIt is a process that informs, motivates andhelp the people adopt and maintain healthyhelp the people adopt and maintain healthypractices and life styles.practices and life styles.

The people bring the changes in theirThe people bring the changes in theirenvironment to get the goal.environment to get the goal.

The professional conduct their professionalThe professional conduct their professional

training and research to get the goal.training and research to get the goal.



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Services by dental professionals in theServices by dental professionals in the

community or public programmes:community or public programmes:Objective of health education:Objective of health education:

i.i. Awareness and informing of the peopleAwareness and informing of the people

ii.ii. Motivating the peopleMotivating the people

iii.iii. Guiding the people into actionGuiding the people into action

iv.iv. ReinforcementReinforcement


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Communication in health education:Communication in health education:

The key elements in the communication process:The key elements in the communication process:i.i. The communicators (the professionals)The communicators (the professionals)

ii.ii. The messageThe message

iii.iii. The audience or the publicThe audience or the public

iv.iv. The channels of communicationsThe channels of communications



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I.I. Communicators or the professionalsCommunicators or the professionalsThey are the originator of the message. To beThey are the originator of the message. To beeffective, a communicator must know:effective, a communicator must know:

i.i. ObjectivesObjectives clearly definedclearly defined

ii.ii. AudienceAudience its need, interest and abilitiesits need, interest and abilities

iii.iii. MessageMessage its content, validity and usefulnessits content, validity and usefulness

iv.iv. ChannelsChannels different channels ofdifferent channels of

communicationcommunication


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PRIMARY PREVENTIVE SERVICESPRIMARY PREVENTIVE SERVICES Services by dental professionals in the community orServices by dental professionals in the community or

public programmes:public programmes:Communication in health education:Communication in health education:

Message: it is the information, the professional wishes hisMessage: it is the information, the professional wishes hisaudience or public to receive, understand, accept and actaudience or public to receive, understand, accept and actupon.upon.

A good message must be:A good message must be:i.i. In line with objectivesIn line with objectivesii.ii. Carefully chosenCarefully choseniii.iii. Clear and understandableClear and understandableiv.iv. SpecificSpecific

v.v. TimelyTimelyvi.vi. AppealingAppealingThe message must fit into the existing frame work of attitudesThe message must fit into the existing frame work of attitudes

and interests of peopleand interests of people


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The audience or public:The audience or public:

They are the consumers of the message. TheThey are the consumers of the message. Theaudience may be the total population or aaudience may be the total population or a

specific group within the population.specific group within the population.


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Channels of communications:Channels of communications:Health education is carried out at three main levels:Health education is carried out at three main levels:

a.a. Individual and familyIndividual and family

b.b. Groups of peopleGroups of people

c.c. General publicGeneral public


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Diet counseling parents and their children


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Services by dental professionals in the community orServices by dental professionals in the community orpublic programmes:public programmes:


Education of the general public:Education of the general public:For education of the general public mass media ofFor education of the general public mass media of

communication is employed.communication is employed.

They are :They are :i.i. TelevisionTelevisionii.ii. RadioRadioiii.iii. PressPressiv.iv. FilmsFilmsv.v. MagazineMagazinevi.vi. PostersPostersvii.vii. Health exhibitions (mobile or stationary)Health exhibitions (mobile or stationary)viii.viii. Health museumHealth museum


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Diet counselling:Diet counselling:

This can be carried out by the professionals,This can be carried out by the professionals,when working in the community through thewhen working in the community through thedental health education of the public.dental health education of the public.

DIET COUNCELING


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DIETCOUNCELINGA village dental

camp


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Diet counseling parents and their children


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PRIMARY PREVENTIVE SERVICES BY THE INDIVIDUALSPRIMARY PREVENTIVE SERVICES BY THE INDIVIDUALS

AgeAge--group of individualsgroup of individuals

1.1. Infants & Children of age below 5 years old .Infants & Children of age below 5 years old .

2. School going children & adults.2. School going children & adults.

DENTAL CAREDENTAL CARE


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DENTAL CAREDENTAL CARE

PROGRAMPROGRAM

(Involve Parents)(Involve Parents)

1.1. Early infancy.Early infancy.1.1.Care of toothless gums.Care of toothless gums.2.2.Care of even single toothCare of even single tooth

(when appears).(when appears).3.3.Care of milk teeth.Care of milk teeth.4.4.Bottle feeding.Bottle feeding.5.5.Care of permanent teethCare of permanent teeth(when appear).(when appear).

2.2. A young child of 3A young child of 355years oldyears old..


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PRIMARY PREVENTION


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Schools going Children & Adults.

Self examination.

Diet planning & control.

Oral hygiene practice (home care).

PRIMARY PREVENTION(INDIVIDUALS)


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SELF EXAMINATION



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PRIMARY PREVENTIONPRIMARY PREVENTION(INDIVIDUALS)(INDIVIDUALS)

DIET PLANNING AND CONTROLDIET PLANNING AND CONTROL1.1. Nutrition and Host resistance.Nutrition and Host resistance.

a.a. Children Children

b.b. Adults Adults

2.2. FluorideFluoridea.a. Local applicationLocal application

b.b. Systemic use Systemic use

3.3. Sweets & Host resistanceSweets & Host resistancea.a. Amount of sweet taking.Amount of sweet taking.

b.b. Frequency of sweet takingFrequency of sweet taking(gradual decrease in sugar taking)(gradual decrease in sugar taking)

a.a. Sticky food Sticky food

b.b. Alternative to refine sugar e.g. saccharine, xylitol, sorvitolAlternative to refine sugar e.g. saccharine, xylitol, sorvitol


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DIET CONTROLDIET CONTROL

Fruits are preferred over sweets


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PRIMARY PREVENTION

(INDIVIDUALS)

ORAL HYGIENE

Principles and Practice of Hygieneas applied to mouth.It includes all the steps and measures

that the individuals, professionals andcommunity carry out for the preventionof diseases of the oral tissues andmaintenance of the optimal oral and

dental health.


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HYGIENE

Principles & Practice of General &

Personal Cleanliness for the promotion

of health and prevention of diseases.


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PRIMARY PREVENTION

HOME CARE INSTRUCTIONS1. Plaque disclosing agents (Tincture Iodine,

coloring agents).2. Tooth brushes (selection and uses).3. Dentifrices (powder, paste, liquid, gel).4. Tooth brush techniques.5. Inter-dental hygiene.6. Special cleaning aids.7. Electric tooth brushes.

8. Irrigation devices (water, fluoride, saline,M/W).9. Chemically plaque control (chlorhexidine).10. Fluoride supplement programme (Tablets,

Losenges, Oral Drink, Drops)


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PLAQUE DISCLOSING


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PRIMARY PREVENTION

Home Care InstructionsTooth brushing techniques

a. Horizontal Reciprocating

b. Vertical sweepingc. Rotating

d. Vibrating

Inter-dental Hygiene(Tooth pick, inter-dental brushes, Dental floss,

Gauze strips, Polishing cloth, Rinsing etc)


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PRIMARY PREVENTION

Home Care Instructions

Tooth brushing techniques

a. Horizontal Reciprocating

b. Vertical sweeping

c. Rotating

d. Vibrating


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BASS TECHNIQUE

VIBRATING MOVEMENTS


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VERTICAL SWEEPING


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HOME CARE INSTRUCTIONSHOME CARE INSTRUCTIONSINTERINTER--DENTAL HYGIENEDENTAL HYGIENE

(Tooth(Tooth pick,pick, interinter--dentaldental brushes,brushes,

DentalDental floss,floss, GauzeGauze strips,strips, PolishingPolishingcloth,cloth, RinsingRinsing etc)etc)


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INTER DENTAL FLOSSING


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INTERDENTAL FLOSSING


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INTERDENTAL GUAZESTRIPS


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INTERDENTAL BRUSHES


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WATER JET DEVICE


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PRINCIPLES OF PREVENTION

Prevention of disease.

Control of disease.

Patient awareness, education,motivation and instructions.

Development of host resistance.

Restoration of the function &

rehabilitation.

Maintenance of Oral Health.



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PRIMARY PREVENTIONPRIMARY PREVENTIONEDUCATIONEDUCATION

PATIENT AWARENESS AND COMMUNICATIONPATIENT AWARENESS AND COMMUNICATIONa.a. AwareAware thethe patientpatient aboutabout presentpresent

disease/dangersdisease/dangers ofof badbad oraloral hygienehygiene..

b.b. AwareAware thethe patientpatient aboutabout causativecausative factorsfactors..

c.c. SimpleSimple clinicalclinical proceduresprocedures (e(e..gg.. simplesimple filling,filling,scalingscaling etc)etc)..

d.d. PastPast historyhistory of of repeated/progressiverepeated/progressivediseasesdiseases..

e.e. DisclosingDisclosing agentagenttoto showshow plaqueplaque onon thetheteethteeth..

f.f. ToTo encourageencourage thethe patientspatients toto improveimprove thetheconditioncondition..


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MOTIVATE THE PATIENTMOTIVATE THE PATIENT

a.a. Give various goalsGive various goals

1.1. To prevent decay .To prevent decay .2.2. To prevent periodontal diseases.To prevent periodontal diseases.

Change the attitude from repair toChange the attitude from repair toprevention.prevention.

Outline steps & measures to prevent oralOutline steps & measures to prevent oraldiseases.diseases.

Good appearance ofmouth.

Preserve masticatoryapparatus.

Reduce restorativeneed.



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INSTRUCTIONSINSTRUCTIONS (revise)(revise)

CLEAR INFORMATION ABOUT;CLEAR INFORMATION ABOUT;

1.1. Tooth brush and its types.Tooth brush and its types.

2.2. Tooth brush techniques.Tooth brush techniques.

3.3. Interproximal cleaning aids.Interproximal cleaning aids.

4.4. Provide disclosing tablets and mouth mirror.Provide disclosing tablets and mouth mirror.

5.5. Instructions the clean teeth and its timing.Instructions the clean teeth and its timing.



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Demonstration,Demonstration,AssessmentAssessment

& Retraining& Retraining

a.a. Training &Training &Demonstration toDemonstration topatient in clinic.patient in clinic.

b.b. Periodic reinforcementPeriodic reinforcementto patient.to patient.


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Control of disease.

Patient awareness, education & motivation.


Restoration of the function & rehabilitation.




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(INDIVIDUALS)(INDIVIDUALS)

DEVELOPMENT OF HOSTDEVELOPMENT OF HOSTRESISTANCERESISTANCE1.1. Nutrition and Host resistance.Nutrition and Host resistance.

a.a. ChildChildb.b. GeriatricGeriatric

2.2. FluorideFluoridea.a. Local applicationLocal applicationb.b. Systemic useSystemic use

3.3. Sweets & Host resistanceSweets & Host resistancea.a. Amount of sweet taking.Amount of sweet taking.b.b. Frequency of sweet takingFrequency of sweet takingc.c. Sticky foodSticky food



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Control of disease.






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SECONDARY PREVENTIONSECONDARY PREVENTION

CONTROL OF DISEASECONTROL OF DISEASE

a.a. Arrest & treat the disease.Arrest & treat the disease.b.b. Control the infection causing factors.Control the infection causing factors.

c.c. Prevent the recurrence.Prevent the recurrence.



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Control of disease.





TERTIARY PREVENTION


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TERTIARY PREVENTION

RESTORATION OF FUNCTION

1. Treat the established disease2. Prevent loss of function

3. Rehabilitation



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Control of disease.






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TERTIARY PREVENTION

MAINTENANCE OF ORAL HEALTH

Goals of maintenance therapy1. Re-examination & Re-evaluation.

2. Re-motivation & New information to patient.

3. Re-instructions in home care procedures.

4. Plaque removal in clinic.

5. Topical fluoride application in clinic.

6. Simple fillings etc.


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Operative Dentistry Prevention Lecture 2

Documents

Transcript of Operative Dentistry Prevention Lecture 2