Preventive Sheet #1 By Huda Awamleh

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Preventive lec no 1
Huda awamleh
7/2/2012
Today we are going to talk about introduction to the prevention of oral disease we are going to define prevention and what diseases we can prevent and what is the primary secondary and tertiary preventive and how we can prevent the oral diseases.
An apple a day keep the doctor away but it is not that easy but the prevention keep the doctor away, the history of dentistry in the past if someone has toothache they extract that tooth were extraction was the treatment now with the invention of the drill the handpiece the anesthesia the radiographs we could do restoration where we remove tooth tissue and replace it with material but now we try to limit the disease as much as possible so we try to prevent disease from occurring so we will not got a destruction and removal from tooth structure.
The fissure sealant prevent the occlusal caries
Why it has changed ? why its become the restoration the way that we prevent the disease? Bcz we understand the carious process we know now that its an infectious disease causes by bacteria it’s a disease it’s a period of demineralization ,with the recognition of the benefit of fluoride and how we can use it in many way to prevent caries by patient in their home or by a dentist in the dental chair ,we can use it either way also we got a material that help us not to remove as much tooth structure as we have the adhesive material that help us just to remove only the diseased tissue like composite and some kind of cement or a material that are combination of both these material are adhesive and u don’t have to go deep and cut a resistance and retention form to keep the material in its place .
u know GV BLACK and the < extention for prevention > to extend the cavity to prevent disease but this not really accepted anymore but now we are talking about prevention for extention .
What is prevention ?it is the stopping the disease from occurring or it is avoiding the occurance of an event by avoiding the thing that make the disease , its important to know the cause in order to prevent the disease, what kind of disease that we can prevent ? caries , periodontal disease, (they are the most common oral diseases) and we can prevent tooth wear like erosion that caused by acid and we can prevent oral cancer , candidal infection such as denture stomatitis ,we can prevent dental trauma as well and malocclusion.
Why do we want to prevent oral disease? To prevent pain ;p, esthetic ,to preserve function ,its highly cost to have ur teeth treated so to preserve our money ,and its take along time from patient to treat his teeth , and in certain case if the patient has a medical disorder immunocompromised patient the disease or the infection can be life threatening or even ur treatment can be life threatening as well like doing exraction for a patient has a bleeding disorder that’s why we are talking abt preventive diseases bcz we want to limit all of these ,first category in the treatment plan is the prevention .
Now we are going to talk abt the terminology ; the basic three aspect the primary ,secondary and tertiary prevention .
primary prevention :we are basically protecting the individual against disease by removing or replacing a barrier between the causes of disease and the tooth, an example fissure sealant we put it in the occlusal fissure of the molars and replacing a barrier btw the tooth structure and the plaque and bacteria so here we are replacing a barrier now if we want to remove an etiological agent for example we can give them diet advise abt the sugar to reduce the sugar intake and removing that part that causes dental disease so this is the primary prevention were we prevent the disease onset the disease isn’t there .
secondary prevention: is to limit the progress of the disease as early as possible after it has occurred but in early stage part of it is the early diagnosis so if we diagnose it early u can prevent it from getting worse and becoming more serious so if u have a white spot lesion we shouldn’t remove by bur just apply a fluoride varnish and seat and aim for arresting carious lesion this is an ex. Of secondary prevention so with secondary we still have to implement primary prevention we still have to give a diet advise .
tertiary prevention : the disease has happened but know we have to limit the extent of disability once the disease has occured and to limit any kind of functional limitation and that mean that u provide the best treatment and to minimize the impact of the disease u dnt wait until too late and more complicated and require more aggressive treatment like extraction so if u do ur treatment as early as possible and properly so u will limit the disability from that disease .
theses three basic prevention can be applied nt just for oral disease but to any other kind of disease like prevention of skin cancer (primary prevention for skin cancer u can tell ur patient to stay out of the sun and apply sunscreen and that’s how u prevent the disease from occurring and if u have an early sign of the disease so its secondary prevention the early detection is important, the tertiary prevention if u have the disease as using latest available treatment option to treat this disease )unless u apply this terminology not just to prevention the oral diseases but prevention in general .
Dental caries the idea here its not something we have to have as part of growing up , the causes we know them basically the fermentation of sugars by bacteria and dissolve in acid ,acid destroy the tooth structure .prevention has worked and now we have lower rate of carious tooth due to prevention and this is one of the survey its from the UK its called UK NATIONAL SURVEY and its look for different diseases one of them is dental caries and different age groups of children and as we saw 1973 we had 96% of this group had caries 10 yrs later it became 80% and another 10 yrs 59% then 50% then 45% had caries so there is a decrease and we say that generally there has been a decrease in dental caries but it is becoming polarized that mean that we have less children are exhibiting more of the disease ,we have got 50%from children having the disease and the other 50%caries free and these children having the disease have severe progress disease as well (its important to differentiate btw high risk caries and low risk caries people in order to be able to give them the effective treatment and prevention ) .
Fluoride work better on proximal surface rather than occlusal surface so it is more effective in reducing proximal caries than occlusal caries .
Dental caries affected by geography and social class it has sth to do with stress , education ,economic all these factors has to do with how likely to develop dental disease, ex. Dental caries in JORDAN there is a study looking at number of Jordanian children and English school children they took 6 yrs old and 12 yrs old in both countries what they found is 6 yrs old Jordanian children had a significantly higher DMFT SCORE than English country and they found that the decay component here in jordan is much more . DMFT SCORE; it is an index to record caries and its stand for D ;means decay. M; is for missing teeth . F; is for filling teeth , the score is giving for each surface ,they looked again at dmft for grp old they found it similar but when they looked at the component of the dmft they found that our children have more decay teeth and more missing teeth while in England they have more filled teeth that mean our children have either untreated caries or they had an extraction as a treatment basically they come too late to have restoration while in England they treated their decay .
its important to educate the parents and to give the children preventive treatment , its difficult to control the etiological agent in dental caries so its difficult to stop or control the caries and difficult to control the patient diet and the sugar intake its bcz it is a behavioral change and it is a personal habit and it is easier to do it in the early age as children bcz if u change their diet they will get used of it, that is why when u see a child give them the basic oral hygiene instructions so they will get used of routine brushing twice a day ,,there is no magic bullet to stop the caries progression bcz it is involve more than one factor , so prevention of dental caries has four things: diet ,plaque control, fluoride, fissure sealant.