Concepts and principles of preventive dentistry
Libyan International Medical University 2nd Year First Semester D Caroline Piske de A. Mohamed
Objectives: •
You should be able to explain and discuss:
1. Oral health trends 2. Levels of of pr prevention 3. Oral Oral dise disease ase prev preven enti tion on thr through: ough: •
Changing attitudes towards health Patient’s responsibility
Practitioner’s responsibility
D Caroline Mohamed
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Objectives: •
You should be able to explain and discuss:
1. Oral health trends 2. Levels of of pr prevention 3. Oral Oral dise disease ase prev preven enti tion on thr through: ough: •
Changing attitudes towards health Patient’s responsibility
Practitioner’s responsibility
D Caroline Mohamed
2
WHAT´S HEALTH?
D Caroline Mohamed
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World Health Organization's (WHO's) definition of "health“: "Health is a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity.“
Is: "a resource for everyday life, not the objective of living. Health is a positive concept emphasizing social and personal resources, as well as physical capacities (Ottawa Charter Charter for Health Promotion , WHO, 1986) D Caroline Mohamed
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Physical Physical Health •
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Another term for physical health is physical wellbeing. Physical wellbeing is defined as something a person can achieve by developing all health-related components of his/her lifestyle. lifestyle. Other contributors to physical physical wellbeing may include proper nutrition, bodyweight body weight management, abstaining from drug abuse, avoiding alcohol abuse, responsible sexual behavior (sexual health), hygiene, and getting the right amount
of sleep.
D Caroline Mohamed
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Mental health •
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Mental health refers to people's cognitive and emotional well-being. A person who enjoys good mental health does not have a mental disorder. According to WHO, mental health is: "a state of well-being in which the individual realizes his or her own abilities, can cope with the normal stresses of life, can work productively and fruitfully, and is able to make a contribution to his or her community" . No matter how many definitions people try to come up with regarding mental health, its assessment is still a subjective one.
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Why Is Oral Health Important?
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Oral Health is part of the global Health! In recent decades have seen a change to a more “preventive” oriented approach. Factors influencing this traditional include: 1.
2.
3. 4.
Increased understanding of the nature of dental caries and periodontal disease . Increased appreciation of the shortcomings of traditional restorative dentistry. Advances in dental materials and restorative techniques. Changing aspirations of patients.
D Caroline Mohamed
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Oral health is essential to overall health! •
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Good oral health improves a person’s ability to speak, smile, smell, taste, touch, chew, swallow, and make facial expressions to show feelings and emotions.1, 2 However, oral diseases, from cavities to oral cancer, cause pain and disability .
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Oral Health, General Health, and Well-Being •
Oral health and general health are intertwined, affecting and affected by one another. General health can affect oral health. Conversely, oral diseases and conditions can affect general health. Medical conditions often have oral implications and consequences. Signs of illness or abuse can be present in the mouth. Vitamin deficiencies; bacterial, viral, and fungal infections; congenital conditions; systemic conditions; and child abuse can have orofacial manifestations.
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Medical interventions and medications can directly or indirectly affect oral health. Altered saliva quality and quantity can be a side effect of anti-anxiety medications, anticonvulsants, antidepressants, antihistamines, decongestants, diuretics, narcotics, non-steroid anti-inflammatory medications, and sedatives. Tetracyclines and oral preparations such as iron supplements can cause staining of the teeth.
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Severe oral disease can play a part in the following: •
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Difficulty chewing. Children with severe oral disease may have difficulty chewing. These children may not eat enough or may have modified diets that do not contain the nutrients required for healthy growth and development. Reduced self-esteem. Children with severe oral disease may be reluctant to smile owing to embarrassment about the appearance of their teeth. Difficulty sleeping. Infants and children with severe oral disease may have difficulty sleeping. Missed opportunities for learning. Infants and children with severe oral disease may have frequent absences from school, child development programs, or other child care programs.
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Oral Health Trends
Access to Care
Vulnerable
populations of children (especially children from families with low incomes, those who are homeless, those in families without dental insurance, and those with special health care needs) have more oral health problems and less access to care than the general population. These
children suffer from frequent — often urgent — oral health problems and generally receive inadequate care. Factors
contributing to inadequate access include geographic maldistribution of oral health professionals, inadequate relatively few pediatric dentists who may be more likely to treat Medicaid-eligible children, individuals’ knowledge and attitudes concerning oral health, and other difficulties reaching culturally diverse populations.
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Barriers that can limit a person’s use of preventive interventions and treatments include:1,2,3 •
Limited access to and availability of dental services
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Lack of awareness of the need for care
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Cost
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Fear of dental procedures
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There are also social determinants that affect oral health. In general, people with lower levels of education and income, and people from specific racial/ethnic groups, have higher rates of disease.2, 3, 4, 5, People with disabilities and other health conditions, like diabetes, are more likely to have poor oral health.1 D Caroline Mohamed
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1. Oral Health Trends
Tooth Decay •
Dental caries is the most common chronic childhood disease —five times more common than asthma [3] .
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Trends in Oral Health
Untreated Tooth Decay •
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Among children ages 6-8, 72 percent of American Indian/Alaskan Native children, 50 percent of Hispanic children, 34 percent of black children, and 31 percent of all children experience untreated tooth decay.[9] Among libyan children dental caries prevalence in 12 year-old children was high(57.8%), the mean DMFT (1.68) was low compared with other developing countries, but higher than the WHO goal for year 2020. The high level of untreated caries is a cause for concern, representing a high unmet treatment need. Huew R, Waterhouse PJ, Moynihan PJ, Maguire A, 2011; WHO, 2003
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Oral health trends •
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The first teeth to loose…. In many 50-65 year olds, most of the molars (the most efficient teeth for chewing) have been lost.
Trends in Oral Health
Periodontal (gum) diseases •
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In Libya there is a high prevalence of periodontal disease and that is the main cause of tooth loss in adulthood. Among the 35 –44 years old, there is none with healthy periodontium and bleeding. 13% had calculus, 53% had shallow pockets, and 34% deep pockets (WHO Global Oral Data Bank (GODB), 1993). More than half of the adult population in Sebha are detected with the signs of destructive periodontitis. If this trend continues, in the coming years the severity of periodontal disease is bound to increase enormously ( Peeran, 2012).
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Oral health trends •
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Dental caries and periodontal diseases are the main indications for dental extraction.
In many industrialized and several developing countries, 30-50% of the population older than 65 years is edentulous.
Trends in Oral Health
Malocclusion •
Premature loss of primary molars predisposes children to malocclusion (improper alignment of the jaws and teeth).[10]
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Trends in Oral Health
Injury and Violence -Traffic accident, sports… •
Craniofacial, head, face, and neck injuries occur in more than half of the cases of child abuse.[15]
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