Prevention of Dental Caries

Introduction

 Dental Caries or tooth decay is a pathological process of localized destruction of tooth tissues by microorganisms. Latin - Caries rot or decay.
Dental caries is the most prevalent chronic disease affecting the human race.

Dental Caries
A progressive, irreversible, microbial disease of multifactorial nature affecting the calcified tissues of the teeth, characterized by demineralization of the inorganic portion and destruction of the organic portion of the tooth.

The Epidemiological Triad

Agent Disease Host Environment

TIME

Interplay between Factors in Caries Etiology

Host factors:
1.Tooth:

Composition Morphologic characteristics Size Position

Composition pH Quantity Viscosity Antibacterial factors

2. Saliva

3. Immunization 4. Race & ethnic groups 5. Age 6. Sex 7. Heridity 8. Emotional disturbances 9. Diet 10.Plaque

Environmental Factors:
Latitude Sunshine Temperature Relative humidity Rainfall Fluorides and trace elements Total water hardness Urbanization Soils Industrial hazards

Prevention
Praevento = to act before; Hinder Prevention =To keep from happening;

to make impossible by prior

action

Aims Of Prevention
1. Limiting pathogen growth & metabolism

2.Increasing resistance of tooth surface to demineralization 3.Caries control methods which include operative procedures

Unsatisfied, goes to another dentist

Need for prosthetic rehab Treatment cost rises

Ptn goes to dentist with pain

Requests treatment

Dentist detects only caries lesions

Dentition deteriorates with increasing speed

Caries risk remains uninvestigated

Restoration replaced
Dentist restores lesion

Reason for failure remain uninvestigated Secdr caries develops Treatment ends with oral hygiene instructions

A/C symptoms relieved

No regular recall checks

Levels of prevention

Primordial Prevention Primary Prevention Secondary Prevention Tertiary Prevention

1. Health Promotion Primary Prevention 2. Specific Protection 3. Early diagnosis & Prompt treatment 4. Disability limitation Rehabilitation Secondary Prevention Tertiary Prevention.

Methods For Prevention

Chemical measures

Mechanical measures

Nutritional measures

Prevention of Dental Caries

I. SERVICES PROVIDED BY THE INDIVIDUAL A. Primary Prevention: 1. Health Promotion
Diet Planning Demand for Preventive Services Periodic Visits to the Dental Office

2. Specific Protection
Appropriate use of fluoride Ingestion of sufficient fluoridated water Appropriate use of fluoride prescriptions Use of fluoride dentifrice Oral hygiene practices

B. Secondary Prevention:
Early diagnosis & prompt treatment Self examination & referral Use of dental services

C. Tertiary prevention:
Use of dental services

II SERVICES PROVIDED BY DENTAL PROFESSIONAL

A. Primary prevention:

1. Health Promotion Patient education Plaque Control Program Diet counseling Recall and reinforcement Dental Caries Activity Tests
2. Specific Protection Topical application of fluoride Fluoride Supplements / rinse prescriptions Pit & fissure Sealants

B. Secondary prevention:
1.Early diagnosis & Prompt Treatment Complete oral examination Prompt treatment of incipient lesions. Preventive resin restorations Simple restorative dentistry Root Canal Therapy Pulp capping Pulpotomy

C. Tertiary prevention:
1.Disability Limitations & Rehabilitation Complex restorative dentistry Extractions Minor tooth movements Removable & Fixed Prosthodontics Implants

III SERVICES PROVIDED BY THE COMMUNITY

A. Primary prevention

1. Health promotion Dental health education programs Promotion of research, policy & legislation
2. Specific protection Community or School water fluoridation School fluoride mouth rinse program School fluoride tablet program School sealant program

B. Secondary Prevention
Early Diagnosis & Prompt Treatment

Periodic screening & referral Provision of dental services

C. Tertiary Prevention
Disability limitation & Rehabilitation

Provision of dental services

Conclusion

Conclusion
Even though the existence of the three levels of prevention, primary prevention is the most effective way to keep people healthy and to control costs before it occurs. Prevention at its community level is the most cost effective approach and has the greatest impact on the community.

The greatest doctor is one who treats not someone who is already ill but some one who is not yet ill.

Prevention of dental caries

Primary prevention

Secondary prevention
Early diag & prompt treatment - Self examination & referral; - Regular check up by dentist

Tertiary prevention
Disability limitation Rehabilit ation

Health promotion
-Diet planning -Periodic visit to dental clinic -Demand for preventive services Proper oral hygiene -DHE programme -Promotion of research efforts

Specific protection - Appropriate use of fluorides -Use of F dentifrices - Oral hygiene practice - Comm or school water fluoridation -School F mouth rinse programme - School sealants programme

Indivl

Use of dental Use of professional dental professional services services

Comm

- Periodic Provision of screening dental - Provision of Dental services services - Complete examination - Root canal - Treatment of treatment initial lesions; -Simple restorativ - Extraction dentistry

Provision of dental services

Dent prof

-Patient Education - Topical fluoride & motivation application -Plaque control - F supplements programme -Diet counseling - Pit & Fissure -Caries activity tests sealants

- Dentures - Implants