Introduction to Preventive Dentistry

Introduction to Preventive Dentistry

• Preventive dentistry focuses on preventing dental diseases rather than treating them after they occur.
• G.V. Black (1900) advocated preventive dentistry, stating that "The day is surely coming... when we will be engaged in preventive rather than reparative dentistry".

Definition of Prevention

• Prevention involves actions taken before a disease develops, thereby eliminating the possibility of disease occurrence.

History of Preventive Dentistry

• Early emphasis was placed on oral hygiene.
• The anticaries effect of fluorides became clear in the 4th and 5th decades.
• Water fluoridation and topical fluoridation were implemented in the 6th decade.
• Fluoride toothpastes, mouthwashes, gels, and fissure sealants gained popularity in the 7th decade.

Objectives of Prevention

• Aimed at avoiding the start of disease.
• Stopping the progress of disease.
• Controlling the spread of diseases.
• Limiting the complications and after-effects of diseases.
• Providing rehabilitation.

Scope of Preventive Dentistry

• Includes factors predisposing to dental disease (e.g., dental plaque, other deposits).
• Includes factors that enhance disease advancement (e.g. host resistance).
• Covers complications of disease (e.g., tooth loosening, drifting).
• Considers factors hindering treatment (e.g., defective restoration).
• Addresses factors causing disease recurrence (e.g., poor oral hygiene, lack of patient motivation).

Successful Prevention

• Requires an understanding of disease causation.
• Needs to know the mechanics of disease transmission and identification of risk factors.
• Needs prophylactic or early detection measures.
• Effective treatment procedures are necessary.
• A good organizational structure for implementing these measures is required.
• Continuous evaluation of the procedures is essential.

Levels of Prevention

• Primordial prevention aims to prevent the development of risk factors.
• Primary prevention is the phase preceding the disease.
• Focuses on health promotion
• Includes specific protection against disease risk
• Secondary prevention targets the early stages of disease to prevent complications.
• Tertiary prevention attempts to limit long-term issues and promote a patient's adjustment to irremediable conditions.

Primordial Prevention

• Involves tackling preventative issues in areas or communities where risk factors for problems have not appeared yet.
• Main focus is on education – both on individual and mass levels.

Primary Prevention

• Aims to prevent disease entirely.
• Takes place in the pre-pathogenesis phase.
• Addresses established causative risk factors.
• Includes health promotion and specific protection.

Secondary Prevention

• Works to stop disease progression and avoid complications.
• Occurs in the pathogenesis phase – when disease is already present but in early stages.
• Initiatives are often by governmental health programs.

Tertiary Prevention

• Designed to reduce impairments, minimize suffering, and readjust those impacted to manage ongoing health issues/conditions.
• Involves remedial care after obvious disease progression.

Health Promotion

• Is an enabling process to raise health awareness and encourage better control over one's health.
• Includes interventions in organizational, political, social, and economic sectors.
• Focuses on changes that improve or ensure better health protection.

Health Education Approaches

• Health education – educating people about diseases and safety precautions.
• Environmental Modifications – changing the environment to cut down on health risks.
• Nutritional Interventions – improving nutrition through better feeding programs and dietary management.
• Lifestyle and Behavioural Changes – impacting habits (e.g., dissuading smoking)

Specific Protection

• Aims to prevent diseases completely.
• This is usually only possible in limited cases.
• Techniques used include immunizations, fissure sealants, water fluoridation, and chemotherapeutic measures.

Role of Public Health Dentists

• Identifying and defining health issues/problems and those at risk.
• Suggesting and implementing relevant preventive measures.
• Assessing the effectiveness of programs that were put in place.