Prevention is derived from the word “PRAEVENTO” it means a forestalling = to act before hand

1. GOOD MORNING
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2. Preventive Dentistry
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“An ounce of prevention is worth a pound of
dental cure”.

3. Contents
• Introduction
• History of Preventive Dentistry
• Objectives
• Levels of Prevention
• Dental Caries
• Periodontal Diseases
• Malocclusion
• Oral Cancer
• Role of public health dentist
• Future challenges
• Conclusion 3

4. Introduction
• Prevention is derived from the word
“PRAEVENTO” it means a forestalling = to act
before hand
• PREVENTION= To keep from happening
• MAKE IMPOSSIBLE BY PRIOR ACTION
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5. Definition
• Prevention is defined as “ actions taken
prior to the onset of disease, which
removes the possibility that a disease will
ever occur.”
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6. History of Preventive Dentistry
• 19th
century: Majority - satisfied by home care remedies
• 20th
century: etiologic factors of most oro dental disease were identified
emergence of prevention
• In the first three decades
– Great emphasis was placed on oral hygiene
• In the fourth and fifth decade
– Anticarious effect of fluorides was established
– Water fluoridation and topical fluoridation started
• In the sixth and seventh decade
– Fluoride toothpastes, mouthwashes, rinses, gels & varnishes became
popular
– Pit and fissure sealants were also used widely
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7. Objectives of Prevention
• To avert initiation of disease process
• To intercept their progress
• To control their spread
• To limit their complications and after effects
• To provide rehabilitation
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8. Scope of preventive dentistry
• Factors predisposing to disease
e.g. – Dental plaque & other deposits
• Factors encouraging the advancement of disease
e.g. – host resistance & TFO
• Complication of disease & deformity
e.g. – Loosening, Drifting of teeth
• Factors interfering with rehabilitation
e.g.- Defective restorative dentistry
• Factors causing recurrence of disease
e.g. - poor oral hygiene , lack of
patient motivation 8

9. Successful prevention
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10. • Levels of
Prevention
1. Primordial prevention
2. Primary prevention
3. Secondary prevention
4. Tertiary prevention
• Modes of
Intervention
(Preventive
services)
1. Health promotion
2. Specific protection
3. Early diagnosis & treatment
4. Disability limitation
5. Rehabilitation
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11. Primordial Prevention
• Prevention of emergence or development of risk
factors in countries or population groups in which
they have not yet appeared
e.g. – efforts directed towards discouraging
children from adopting harmful life styles
• Here the main intervention is by individual and
mass education 11

12. Primary prevention
• Defined as “Action taken prior to onset of disease which
removes the possibility that a disease will ever occur”
• Phase of intervention: PRE-PATHOGENESIS PHASE
• Specific causal factors (risk factors) are already present .
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13. Modes of intervention for primary
prevention
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14. W.H.O. approaches for primary prevention of chronic
diseases
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15. Population (Mass) Strategy
• Directed at the whole population irrespective of
individual risk levels.
• Aims at socio-economic ,behavioral and lifestyle changes.
Eg.- A small reduction in the average blood pressure of a
population would produce a large reduction in cardiovascular
disease.
- Health education to improve oral hygiene practices.
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16. High –risk strategy
• Aims to bring preventive care to individuals at special
risk.
• Requires detection of individuals at high risk by the
optimum use of clinical methods.
• Eg: Topical fluoride application for those with high
risk.
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17. Secondary prevention
• Defined as “Action which halts the progress of disease in
its incipient stage and prevent complications.”
• PATHOGENESIS PHASE
Health programmes - Initiated by government
are at this level.
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18. Modes of intervention for secondary
prevention
Early Diagnosis
And Prompt Treatment
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19. Tertiary prevention
• Defined as“All measures available to reduce or limit
impairments and disabilities, minimize suffering caused
by existing departures from good health to promote
patients adjustment to irremediable conditions”.
• LATE PATHOGENESIS PHASE
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20. Modes of intervention for tertiary
prevention
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21. Health promotion
• Defined as a “process of enabling people to
increase control over and to improve health.”
• It involves “organizational , political , social and
economic interventions designed to facilitate
environment and behavioral adaptations that will
improve or protect health.”
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23. Health education
• One of most cost-effective intervention.
• Adequate information about diseases and encouraging
people to take necessary precautions in time.
• Target group for educational efforts include General
public, patients, high risk groups, community leaders ,
decision makers , health providers.
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24. Environmental modifications
 The history of medicine – many infectious diseases have been
successfully controlled in western countries through this intervention.
 Non- clinical and do not involve the physician.
Examples: * Provision of safe drinking water
* Improvement of housing
* Control of insects and rodents
* Community water fluoridation
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25. Nutritional interventions
• Examples:
* Food distribution & nutrition improvement of
vulnerable groups
* Child feeding programmes
* Dietary counseling
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26. Lifestyle and behavioural changes
 Examples: Motivating people to avoid smoking, pan-
chewing and drinking alcohol.
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27. Specific protection
 To avoid disease altogether is the ideal but this is possible
only in limited number of cases.
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28. Early diagnosis and prompt treatment
 In order to prevent overt disease or disablement , the
criteria of diagnosis if possible be based on early
biochemical , morphological and functional changes
that precede the occurrence of manifest signs and
symptoms.
 The earlier a disease is diagnosed , the better it is from the
point of view of prognosis and preventing the occurrence of
further cases or any long term disability.
eg: Oral cancer screening, hypertension,
AIDS
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29. Concept of disability
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DISEASE

30. Rehabilitation
• Medical rehabilitation
Restoration of function – Prosthesis
Speech therapy
• Vocational rehabilitation
Restoration of capacity to earn livelihood
• Social rehabilitation
Restoration of family and social relationships
• Psychological rehabilitation
Restoration of personal dignity and confidence
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34. -Use of
protective
device
-Habit control
-Mouth guard
programmes
-Safety
measures for
play
Caries control;
Periodontitis control;
Space maintainers
prenatal care parent
counseling
Use of dental
professional
services
Use of dental
professional
services
Use of
dental
professional
services
Minor
orthodontics
Major
orthodontics
surgery
Health
promotion
Specific
protection
Early diag
& prompt
treatment
Disability
limitation
Rehabilit
ation
Indivl
Comm
Dent
prof
Primary prevention
Secondary
prevention
Tertiary
prevention
Prevention of malocclusion
Periodic visits
to dentist
-DHE Programme
-Promotion of
Protective coverings
& protective guards
Patient
education
Maxi-facial
& Prostho
Plastic
surgery
Provision of
dental
services
Provision of
dental
services
Provision of
dental
services

35. -Avoidance of
known irritants
-Removal of known
irritants in the oral
cavity
-Self -
examination &
referral;
Use of dental
professional
services
Use of
dental
professional
services
-Complete
examination ;
-Biopsy;
-Oral cytology;
-Complete
excision
Chemo-
therapy
Radiation
Surgery
Health
promotion
Specific
protection
Early diag
& prompt
treatment
Disability
limitation
Rehabilit
ation
Indivl
Comm
Dent
prof
Primary prevention
Secondary
prevention
Tertiary
prevention
Prevention of oral cancer
Periodic visit to
dental clinic
DHE programme
Promotion of
research efforts
Patient Education
& motivation
- Periodic
screening &
referral
Provision of
dental
services
Provision of
dental
services
Maxi-facial
& Prostho
Plastic
surgery

36. Role of public health dentist in
prevention
• Identify and define the problem and risk groups
• Advocate and involve appropriate preventive
measures
• Evaluate the applied programme .
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37. Future challenges
• Socio-economic disparities in providing health
care
• Reoccurrence of some communicable diseases,
which are successfully controlled past
• Prevention of chronic non-communicable
diseases
• Population control. 37

38. Conclusion
• In the developing country like India – more efforts on the part of
individual and government is needed to bring the developments in
preventive dentistry within the reach of common man
“Our objective should be the perpetual preservation of what remaining
rather than meticulous restoration of what is missing”
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39. References
• Dunning J.M. Principles of Dental Public Health.
• Park K. Textbook of Preventive and Social Medicine.
• Soben Peter. Essentials of Community Dentistry
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