Principles of preventive dentistry Primary prevention Secondary prevention Tertiary prevention

1. Principles of Preventive Dentistry
Dr Sudeep Madhusudan Chaudhari

2. Contents
 Introduction
 Definition
 Principles of preventive dentistry
 Levels of prevention
I. Primary prevention
II. Secondary prevention
III. Tertiary prevention
 Preventive services at each level
 Rendering the preventive services

3. Introduction
 Every disease has certain weak points that are susceptible to
attack. The basic approach in controlling the disease is to identify
these weak points and break the weakest link in the chain of
transmission.
 This requires sound epidemiological knowledge of disease that is
its magnitude, distribution in time, place and person,
multifactorial causation, sources of infection and dynamics of
transmission.

4.  Disease control involves all the measures designed to
prevent/reduce as much as possible the incidence, prevalence and
consequences of disease.
 One may have to employ more than one method to prevent the
disease.

5. Definition
 Preventive dentistry is the science of the care required to prevent
diseases of teeth and supporting structures.
 It is also defined as the procedures employed in practice of
dentistry and community dental health program which prevents
occurrence of oral disease and oral abnormalities.

6. Principles of preventive dentistry
These include –
 Control of disease
 Patient education and motivation
 Development of host resistance
 Restoration of function
 Maintenance of oral health

7. Types/levels of prevention
 Examining the levels of prevention is important especially when
considering intervention or elimination of the disease process.
 A disease state is due to the interplay of three primary factors –
1. The host
2. The agent
3. The environment

8. The three main levels of prevention are –
Primary
prevention
• Primordial
prevention
• Health
promotion
• Specific
protection
Secondary
prevention
• Early diagnosis
&prompt
treatment
Tertiary
prevention
• Disability
limitation
• Rehabilitation

9. I. Primary prevention –
 This is the action taken prior to the onset of a disease which
removes the possibility that the disease will ever occur.
 In other words the primary preventive measures are taken to
reduce the occurrence of new cases of a disease in a population.

10.  Primary prevention occurs in the prepathogenic period and
accomplished by health promotion and specific protective
measures.
 For e.g. – introduction of fluoride in communal water supplies,
professional topical fluoridation and avoidance of sucrose
containing snacks in between meals to reduce carious attacks.

11. Primordial prevention –
 It is the primary prevention in its purest sense. In this type the
efforts are directed towards discouraging children from
adopting harmful lifestyles (use of tobacco, adverse eating
pattern, harmful oral habits etc.) The main intervention is
through individuals and mass education.

12. Health promotion –
 According to WHO health promotion is a process of enabling
individuals to improve their health through personal choice and
social responsibility.

13.  This includes –
 Health education
 Attention to genetic and environmental factors that improves
the disease
 Attention to good physical and mental development and
periodic selective examinations.
 Activities such as antismoking campaigns, oral hygiene
education etc.

14. Specific protection –
 This includes protective measures like immunization (eg.
Measles), chlorination of drinking water, fluoride application,
sealant programs, mouthguards etc.

15. II. Secondary prevention -
 “It is defined as the action which halts the process of the disease
at its incipient stage and prevents complications.”
 It occurs in the early period of pathogenesis and involves early
diagnosis and prompt treatment.
 For e.g. the use of radiographs to detect initial caries and includes
resin restorations, dental restorations, interceptive orthodontics
etc.

16. III. Tertiary prevention (middle and late pathogenic period)–
 This includes all the measures available to reduce or limit
impairment and disabilities, minimize suffering cause by existing
departures for good health.
 This includes disability limitation and rehabilitation.
 E.g. pulp therapy and replacement of lost teeth by prosthesis.

17. Preventive services at each level
 There are different modes of intervention at each level of
prevention.
 This type of intervention can be defined as any attempt to
intervene/interrupt the usual sequence in the development of
disease in human.
 The various modes of intervention at each level of prevention
are –

18. I. Services at primary prevention –
i. Health promotion : includes –
 Good standard of promotion
 Diet planning
 Periodic screening/inspections

19. ii. Specific protection –
 Good hygiene practices by the individual
 Fluoridation of public water supply
 Topical fluoride application
 Sealants
 Avoidance of snacks in between meals
 Oral prophylaxis
 Preventive orthodontics.

20. II. Services at secondary prevention – includes
 Early diagnosis and prompt treatment of incipient carious
lesions
 Extension of therapy into the vicinity of the lesions for
prevention of secondary caries
 Attention to developmental defects
 Compulsory examination of school children
 Habit interception
 Interceptive orthodontics

21. III. Services at tertiary prevention –
i. Disability limitation –
 Amount of well developed lesions, pulp therapy, restoration
of natural tooth, extraction, orthodontic treatment
ii. Rehabilitation –
 Replacement of loss tooth structure to restore the harmony
and function

22. Rendering the preventive services -
The preventive services can be undertaken or rendered at –
1. Individual level
2. Community level
3. Professional (dentist) level

23. 1. Individual level – i.e. by individual himself/herself
This includes –
Maintenance of good dietary habits
Maintenance of good oral hygiene method
Periodic self inspection of the oral cavity
Periodic dental consultation

24. 2. Community level – the preventive measures at the community
level by the leaders of the community or dental health professionals.
this includes –
Community oral health campaign, education
Community inspection program
Community water fluoridation
School oral health program
School water fluoridation

25. III. Professional level – The preventive measures are rendered by
the dental health professionals for the patients attending the clinics.
This includes –
 Inspection for
abnormalities and disease
 Health education
(nutritional counseling)
 Topical fluoride
application
 Sealants
 Restorative dentistry
 Pulp therapy
 Preventive, interceptive
or corrective orthodontics
 Surgical interventions
 Prosthetic rehabilitation.