Dental Health and Fluoride Practices

Concepts of Prevention in Dentistry

• Prevention in dentistry aims to stop, slow, or prevent the recurring dental diseases and conditions.
• It uses a proactive approach combining patient education, lifestyle changes, regular checkups, and specific interventions.
• The main goal of prevention is to enable individuals to maintain their oral health, identify potential issues early, and work collaboratively with dental professionals to minimize the impact of dental diseases.

Primary Objectives

• Promoting Optimal Oral Health: Encouraging individuals to maintain proper oral hygiene, educating patients on a balanced diet's impact on oral health, and emphasizing the role of lifestyle choices such as tobacco cessation and limiting alcohol intake for optimal well-being.
• Preventing Onset of Dental Diseases: Implementing primary prevention measures to reduce risk factors, advocating for community-based interventions like water fluoridation, and applying dental sealants to protect vulnerable areas from damage.
• Early Detection of Oral Health Issues: Conducting regular check-ups and screenings to spot disease signs early. Using diagnostic tools, including X-rays and visual examination, to detect hidden oral health concerns.
• Minimizing Progression of Dental Diseases: Implementing secondary prevention strategies focusing on treating diseases in their early stages. Providing non-invasive interventions for incipient cavities such as fluoride treatments or remineralization agents. Offering periodontal treatments to address early signs of gum disease.
• Reducing the Need for Extensive Dental Interventions: Emphasizing proactive dental care to stop advanced dental diseases and decrease the necessity for complex restorative or surgical procedures.
• Empowering Patients through Education: Providing individuals with knowledge around oral health, preventive practices, and lifestyle choice impact, while encouraging active participation in their oral health journey.
• Improving Overall Well-being: Recognizing oral health's connection to overall health and well-being. Collaborating with patients to create a comprehensive preventative dental care plan that aligns with their well-being goals.

Levels of Prevention

• Primary Prevention: Preventing the onset of dental diseases and promoting general oral health. Examples include community water fluoridation and promoting good oral hygiene practices.
• Secondary Prevention: Early detection and treatment of dental diseases to stop progression and minimize potential complications. Examples include regular check-ups, screenings, and early intervention through non-invasive treatments for incipient cavities(e.g., fluoride therapy).
• Tertiary Prevention: Managing and preventing the progression of advanced dental diseases. Aims to restore oral health and function after disease development. Examples include restorative procedures, periodontal treatments, and prosthodontic interventions.

Approaches of Prevention

• Individual Approach: Focuses on high-risk individuals, and popular amongst healthcare providers. It fits clinical approaches including vaccination.
• Community Approach: Aims to reduce risk factors in a whole population by addressing the underlying causes of disease.

Approaches of Prevention II

• Indicated approach: Identifying individuals exhibiting early signs of disease to target their specific needs via programs to limit further complications. Example include oral cancer in Indians who chew betel nuts.
• Targeted Approach: Selecting groups at risk for a specific disease through virtue of their membership to a particular segment (e.g., community/population) for targeted interventions.
• Universal Approach: Addressing the entire population with intervention programs aimed at preventing or delaying certain diseases (e.g., fluoridated drinking water).

Common Risk Factor Approach

• Focuses on standard underlying health factors to improve overall population health. Examples include diet, stress, hygiene, and the political/physical/social environments.

Impact of Dental Caries

• Disability: Functional limitations or impairments caused by cavities or related oral health issues. Examples include pain, problems eating, or maintaining oral hygiene. Severe cases can vary depending on the extent and progression of caries.
• Handicap: Social, economic, or personal disadvantages experienced from caries. This includes limitations in daily activities, social interactions, and barriers to education/employment.

Conclusion

• Prevention in dentistry is a comprehensive strategy.
• It emphasizes proactive measures to eliminate or minimize risk factors before disease develops.
• Secondary prevention focuses on early detection for proper intervention.
• Tertiary prevention aims to restore oral health and function post-disease development.
• Different approaches are used to target individuals, communities, and the general population.

Books to Read

• 1. Murray, J.J., Nunn, J.H., & Steele, J.G. (2003). The prevention of oral disease.
• 2. Daly, Blánaid, et al. Essential Dental Public Health (2013)
• 3. Alison Chapman, Simon H. Felton. Basic Guide to Oral Health Education and Promotion, 3rd Edition.

Oral Hygiene Measures

• Mechanical Measures: Toothbrushes, dental floss/tape, interdental brushes, single-tufted brushes.
• Chemotherapeutic Measures: Toothpastes, mouthwashes, chewing gum.
• Description of specific techniques & materials for use in oral hygiene Various instructions and procedures are described in the provided context, including images, step-by-step procedures, and descriptions of tools/products.

Toothbrushing for Children, Adults, Elderly

• Children: Adults should perform toothbrushing until the child is six years old. Brushing should begin when the child's first tooth erupts.
• Adults: Chronic marginal gingivitis in adults suggests poor brushing compliance or low-performance dexterity.
• Elderly: Diminished cognition and/or medical conditions can hinder toothbrushing in elderly individuals; caregivers/individuals should adjust the tooth brushing technique appropriately, depending on individual needs.

Dental Floss

• Removing interdental plaque and reducing gingival inflammation.
• Waxed or unwaxed, fluoridated floss typically.
• Requires greater dexterity than toothbrushing.

Interdental Brush

• Removes plaque and food debris, especially in locations inaccessible to toothbrushes.
• Delivers chemotherapeutic agents to promote better health.
• Reduces gingival inflammation.
• Requires good manual dexterity.
• Not suitable for children and elderly.

Single-tufted Toothbrush

• Specialized dental tool for isolated clusters of bristles at the tip.
• Practical for various applications involved in oral care.
• Used for orthodontic care, difficult-to-reach areas, wisdom teeth, implants, periodontal pockets, and interdental spaces.

Toothpaste/Dentifrice

• A gel- or paste-like substance used in conjunction with a toothbrush for cleaning and maintaining dental health.
• Includes abrasive materials to remove food and bacteria.
• Contains active ingredients such as fluoride to prevent tooth decay and cavities.
• Also Freshes breath and reduces tooth sensitivity.

Fluoride

• Systemic use: Water, milk, salt.
• Topical Use: Toothpaste, Mouthrinse, Fluoride Gels, and Varnish.

Fluoride Toxicity

• The probable toxic dose for fluoride (PTD) is 5mg F per kg of body weight.
• Ingesting too much fluoride can cause various symptoms such as diffuse abdominal pain, diarrhoea, vomiting, excessive salivation etc.

Minimal Intervention Dentistry (MID)

• Conserves maximum amount of tooth tissue.
• Focuses on prevention, control, and treatment based on factors affecting disease onset and progression.
• Minimally invasive operative approaches for managing cavitated lesions.