DEPT OF PREVENTIVE AND COMMUNITY

DENTISTRY
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Depi of Pieveniive and Communiiy Deniisiiy
PIDC
CCCu Al1L8nCCn
Depi of Pieveniive and Communiiy Deniisiiy
PIDC :
lnLroducLlon Lo ubllc PealLh
O Definiiion
O Hisioiy of public lealil
O Clanging concepis of lealil
O Concepis of causaiion
O Clanging concepis of public lealil
O Piimaiy lealil caie
O Concepi of pieveniion
Depi of Pieveniive and Communiiy Deniisiiy
PIDC
LA8nlnC Cu1CCMLS
O Ai ile end of ile leciuie, ile siudeni slould be able io
O Desciibe ile diffeieni concepis and plases of public
lealil
O Discuss ile lisioiy of public lealil and concepis of
causaiion
O Ouiline ile piinciples of piimaiy lealil caie
O Ideniify and explain ile concepis of pieveniion
Depi of Pieveniive and Communiiy Deniisiiy
PIDC
PLA1P
Siaie of compleie plysical , menial and social well being
and noi meiely ile absence of disease oi infiimiiy
PUBLIC HEALTH:
Siudy and piaciice of managing ilieais io ile lealil of
communiiy.
Goal:
To impiove lives iliougl ile pieveniion oi iieaimeni of
disease.

Depi of Pieveniive and Communiiy Deniisiiy

PIDC
Jlnslow's ueflnLlon (1920)
Tle science and aii of :
O pieveniing disease
O piolonging life and piomoiing plysical and menial efficiency
iliougl oiganized communiiy effoii foi ile saniiaiion of ile
enviionmeni
O coniiol of communicable infeciions, ile educaiion of individual
O Educaiion of ile individual in peisonal lygiene
O ile oiganizaiion of medical and nuising seivices foi ile eaily
diagnosis and pieveniive iieaimeni of disease and ile
developmeni of ile social maclineiy io insuie eveiyone a
siandaid of living adequaie foi ile mainienance of lealil
O Oiganizing ilese benefiis io enable ile biiiliigli of lealil and
longeviiy io eveiy individual

Depi of Pieveniive and Communiiy Deniisiiy

PIDC
PlS1C8? Cl u8lC PLA1P
O i -Edwaid }ennei came wiil ile ileoiy of
immunizaiion
Inoculaied an old boy wiil cowpox (small pox
viius) and subsequenily obseived ilai le was iesisiani
and immune io small pox .He inseiied pus ialen fiom
cowpox pusiule inio an incision on ile boy's aim.

Depi of Pieveniive and Communiiy Deniisiiy

PIDC
MlASMA 1PLC8? Cl ulSLASL
Mid ioos
Explains ile spiead of cloleia in London and Paiis
Deail was believed io be caused by miasma
(polluiion) was consideied io be a poisonous vapoi oi
misi filled wiil paiiicles fiom decomposed wasie and
maiiei (miasmaia).
Disease was said io be pievenied by basic lygiene
piaciices.

Depi of Pieveniive and Communiiy Deniisiiy

PIDC
CCPS'S CS1uA1LS
O ios
O Demonsiiaied ilai aniliax was caused by ile
bacieiium bacillus ANTHRACIS.
O Useful in deieimining and assessing ile cause of ile
disease by miciooiganisms.

Depi of Pieveniive and Communiiy Deniisiiy

PIDC
CL8M 1PLC8? Cl ulSLASL
}oln Snow- Science of Epidemiology
Pioposes ilai miciooiganisms aie ile cause of many
diseases
Souice of ile i Cloleia epidemic in ile solo
neiglboilood of London was iiaced
Siaiisiical analysis slowed ilai diinling waiei was ile
vessel of iiansmission of ile disease
Cases occuiied in lomes wlicl was supplied by ile
bioad siieei pump ai ile ceniie of ouibieal
io
Depi of Pieveniive and Communiiy Deniisiiy
PIDC
CCnCL1S Cl PLA1P
O BIOMEDICAL CONCEPT
O ECOLOGICAL
O PSYCHOSOCIAL
O HOLISTIC
ii
Depi of Pieveniive and Communiiy Deniisiiy
PIDC
8lCMLulCA
W Healil is viewed as absence of disease
W Fiee fiom disease is consideied lealily
W Based on geim ileoiy of disease
W Does noi accouni in enviionmenial, social and culiuial
faciois of lealil
i:
Depi of Pieveniive and Communiiy Deniisiiy
PIDC
LCCCClCA
O Healil is ile dynamic equilibiium beiween man and
lis enviionmeni
O Disease is a iesuli of ile disiupiion in ile equilibiium
O Focuses on impeifeci man and impeifeci enviionmeni
O Adapiion of enviionmeni leads io longei life
expeciancies and a beiiei qualiiy of life
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Depi of Pieveniive and Communiiy Deniisiiy
PIDC
?SCPCSCClA CCnCL1
W Healil is noi jus a biomedical plenomenon bui is also
influenced by social, psyclological, culiuial, economic
and poliiical faciois.
W Healil is boil a biological and social plenomenon
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Depi of Pieveniive and Communiiy Deniisiiy
PIDC
PClS1lC
O Synilesis of all oilei concepis and implies ilai all
seciois of socieiy play a iole in ile deieiminaiion of
lealil
O Recognizes ile siiengil and significance of social,
economic, poliiical and enviionmenial influences on
lealil
O Emplasizes on ile piomoiion and pioieciion of
lealil
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Depi of Pieveniive and Communiiy Deniisiiy
PIDC
CCnCL1S Cl CAuSA1lCn
O EPIDEMIOLOGICAL TRIAD
O MULTIFACTORIAL CAUSATION
O NATURAL HISTORY OF DISEASE
O WEB OF CAUSTAION
O RISK FACTORS AND RISK GROUPS
O SPECTRUM OF DISEASE
O ICEBERG OF DISEASE
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Depi of Pieveniive and Communiiy Deniisiiy
PIDC
LluLMlCCClCA 18lAu
Enviionmeni
AGENT HOST
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Depi of Pieveniive and Communiiy Deniisiiy
PIDC
ACLn1
O Living oi biological agenis
(Eg:Bacieiia, viius, Fungi)
O Non Living oi inanimaie
a) Nuiiieni agenis (Pioiein, fai)
b) Clemical agenis (Aisenic,Lead)
i) Inieinal (Uiea,Keione Bodies)
:) Exieinal (Tempeiaiuie, piessuie)
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Depi of Pieveniive and Communiiy Deniisiiy
PIDC
PCS1
O Demogiaplic claiacieiisiics :
Age, Gendei, Eilniciiy
O Biological claiacieiisiics:
Geneiic, baclgiound, plysiologic and bioclemical
claiacieiisiics, immune siaius, nuiiiiional siaius
O Socioeconomic claiacieiisiics:
Social class, ieligion, educaiion, maiiial siaius
O Life Siyle:
Living labiis, food labiis eic
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Depi of Pieveniive and Communiiy Deniisiiy
PIDC
Lnvl8CnMLn1
O Souice oi ieseivoii foi ile agenis of disease
O Helps in ile iiansmission of agenis io ile losi,
biinging aboui ile coniaci and inieiaciion
O Can be favoiable and unfavoiable io man and
enviionmeni
Two iypes
Inieinal
Exieinal
:o
Depi of Pieveniive and Communiiy Deniisiiy
PIDC
O Inieinal
Peiiains io "eacl and eveiy componeni paii, eveiy
iissue, oigan and oigan sysiem and ileii laimonious
funciioning wiilin ile sysiem".
O Exieinal
"All ilai wlicl is exieinal io ile individual luman
losi"
Macio-enviionmeni is anoilei ieim used io denoie
exieinal enviionmeni
Micio-enviionmeni is ieim used io denoie one's
peisonal enviionmeni compiised by ile individual's
way of living and life siyle
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Depi of Pieveniive and Communiiy Deniisiiy
PIDC
O Plysical enviionmeni:
Space aiound man coniaining gases, liquids and
solids.
O Biological enviionmeni:
Tle univeise of all living ilings ilai suiiound man,
compiising of animals and planis.
O Social enviionmeni:
Compiises of all luman beings aiound man and ileii
aciiviiies and inieiaciions, inclusive of social and
economic faciois.
::
Depi of Pieveniive and Communiiy Deniisiiy
PIDC
Mu1llAC1C8lA CAuSA1lCn
O Concepi was pui foiil by Peiienlofei of Municl (ii-
ioi).
O "Modein" diseases of civilizaiion lile coionaiy leaii
disease and canceis could noi be explained on ile
basis of ile 'single cause idea'.
O Concepi offeis muliiple appioacles foi ile pieveniion
of disease.
:
Depi of Pieveniive and Communiiy Deniisiiy
PIDC
naLural PlsLory of ulsease
O Tlis model signifies ile way in wlicl a disease evolves
ovei iime fiom peiiod of iis eailiesi siage io iis
ieiminaiion as iecoveiy oi deail
Consisis of : plases
O Peiiod of pie-pailogenesis-Tle piocess in ile
enviionmeni. Tle disease ageni las noi yei enieied
man, ii's ile faciois wlicl favoi iis inieiaciion wiil
ile luman losi aie pieseni in ile enviionmeni
O Peiiod of pailogenesis- Tle piocess in man, begins
wiil ile eniiy of ile disease ageni inio ile luman
losi.
:
Depi of Pieveniive and Communiiy Deniisiiy
PIDC
JL8 Cl CAuSA1lCn
O Coined by MacMalon and Pugl
O Applicable in ceiiain diseases, wleie ile causaiive
ageni may be unlnown oi unceiiain and ile disease is
ile iesuli of inieiaciion of muliiple faciois
O Removable of some of ilem oi even one of ilem may
be sufficieni io coniiol disease
:
Depi of Pieveniive and Communiiy Deniisiiy
PIDC
JL8 Cl CAuSA1lCn
Caiies
Diei
Socioeconomic siaius
Age
Reduced saliva
Lacl of lnowledge
Time
Caiiogenic micio oiganisms
Malaligned ieeil
Pooi oial lygiene
:
Depi of Pieveniive and Communiiy Deniisiiy
PIDC
8lS lAC1C8S Anu 8lS C8CuS
O An aiiiibuie oi exposuie ilai is significanily associaied
wiil ile developmeni of disease
O A deieiminani ilai can be modified by inieiveniion,
ileieby ieducing ile possibiliiy of occuiience of
disease oi oilei specified ouicomes.
O Risl gioups aie ilose wlo aie exposed io iisl faciois.
:
Depi of Pieveniive and Communiiy Deniisiiy
PIDC
:
Depi of Pieveniive and Communiiy Deniisiiy
PIDC
SLC18uM Cl ulSLASL
O Ii is a giaplic iepieseniaiion of ile vaiiaiions in ile
manifesiaiion of disease
O Tle sequence of evenis ilai occui in ile luman losi
fiom ile iime of coniaci wiil ile eiiologic ageni up io
ile poini of ile uliimaie ouicome
O Exiends fiom subclinical io ile faial, piogiession can
be lalied by pieveniive measuies
:
Depi of Pieveniive and Communiiy Deniisiiy
PIDC
lceberg of ulsease
O Healil piofessionals obseive only a paii of ile
illness in ile communiiy , jusi as only ile iip of ile
icebeig is visible above ile suiface of ile waiei.
O Tle inappaieni cases aie impoiiani as iley aie
equally poieni in ile naiuie of iiansmission and
spiead.
O Managemeni pioceduies cannoi be diiecied only io
clinically appaieni cases.
o
Depi of Pieveniive and Communiiy Deniisiiy
PIDC
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Depi of Pieveniive and Communiiy Deniisiiy
PIDC
ConcepLs of ubllc PealLh
O Disease coniiol plase (io-i:o)
Disease coniiol plase was aimed ai ile coniiol of man's
plysical enviionmeni
O Healil piomoiional plase (i:o-io)
Iniiiaied as peisonal lealil seivices (moilei and clild lealil
seivices, sclool lealil seivices, indusiiial lealil seivices
O Social engineeiing plase (io-io)
A new facioi "iisl faciois" as deieiminanis of ilese disease
came inio exisience wiil clionic diseases
O Healil foi all plase (ii-:ooo)
Tle oiganized applicaiion of local siaie, naiional and
inieinaiional iesouices io aclieve lealil foi all"
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Depi of Pieveniive and Communiiy Deniisiiy
PIDC
PREVENTIVE DENTISTRY:
O It encompasses all the dental practices that aIIect oral health
status at individual & community levels.
LEVELS OF PREVENTION:
Primary
2Secondary
3Tertiary
ii]:]:oii Penang Inieinaiional Denial College
OTo piomoie lealil
OTo pieseive lealil
OTo iesioie lealil
OMinimize suffeiing and disiiess
Coals
ii]:]:oii Penang Inieinaiional Denial College
PRIMARY PREVENTION:
O ction taken prior to the onset oI disease that eliminates the
possibility Ior the occurrence oI the disease
O It is more than just preventing the disease and promoting health,
it`s a concept oI positive health encouraging achievement &
maintenance oI acceptable levels oI health
O Enables every individual to lead a socially and economically
productive liIe
ii]:]:oii Penang Inieinaiional Denial College
ADVANTAGES:
O ow cost
O SaIe
O ComIortable
O Easy
ii]:]:oii Penang Inieinaiional Denial College
PRIMORDIAL PREVENTION:
Pieveniion of ile emeigence oi developmenial iisl faciois in couniiies oi
populaiion gioups in wlicl iley lave noi yei appeaied.
Tle majoi inieiveniion is by individual and mass educaiion.
Example: Effoiis diiecied iowaids encouiaging balanced diei
POPULATION (MASS) STRATEGY:
Diiecied ai ile wlole populaiion iiiespeciive of individual iisl levels so as
io biing aboui belaviouial and lifesiyle clanges.
Example: Beiieimeni of ile aveiage oial lygiene siaius of a populaiion would
deciease ile incidence of denial disoideis.
Higl-iisl Siiaiegy:
Ii aims io biing pieveniive caie io individuals ai special iisl
A8CACPLS 8LCCMMLnuLu lC8 8lMA8?
8LvLn1lCn 8? JPC
ii]:]:oii Penang Inieinaiional Denial College
O MODES OF PRIMARY PREVENTION:
O ealth promotion:
'It is the process oI enabling people to increase control over, and to
improve health It is not directed against any particular disease, but
it is intended to strengthen the host through a variety oI
interventions like:
O ealth education
O Environmental modiIication
O Nutritional interventions
O Behavioral changes
O iIe style adaptations
ii]:]:oii Penang Inieinaiional Denial College
OSpecific pioieciion:
Piovision of condiiions foi noimal menial and plysical
funciioning of ile luman being individually and in ile
gioup. Ii includes ile piomoiion of lealil, ile pieveniion
of siclness and cuiaiive and iesioiaiive medicine in all iis
aspecis.
Example: Fluoiide applicaiion and pii and fissuie sealanis
foi caiies pieveniion.
ii]:]:oii Penang Inieinaiional Denial College
O SECONDARY PREVENTION:
Actions which arrest the progression of the disease at its early
stage & prevents further complications.
It is majorly based on early detection , diagnosis & adequate
treatment.
The earlier the disease is diagnosed and rectified, the better it is
from the point of view of prognosis and preventing further
complications and long term disability.
ii]:]:oii Penang Inieinaiional Denial College
ADVANTAGES:
O Reduces high mortality & morbidity
O Interception oI prognosis oI the disease
DISADVANTAGES:
W Expensive
ii]:]:oii Penang Inieinaiional Denial College
O TERTIARY PREVENTION:
O ll measures available to reduce and limit impairments &
disabilities
O Its aim to minimize suIIering & to promote patients rehabilitative
capacity
ii]:]:oii Penang Inieinaiional Denial College
O MODES OF TERTIARY INTERVENTION:
O Disability limitation:
The objective is to prevent or halt the transition oI the disease
process Iorm impairment to handicap
O Ex- loss oI teeth,inability to talk
O Rehabilitation
It is the combined and coordinated use oI medical, vocational, social and
educational measures Ior training and retraining the individual to the
highest level possible oI Iunctional ability
ii]:]:oii Penang Inieinaiional Denial College
Preventive procedures
Parental counseling prenatal
postnatal
Caries control
Space maintenance
ExIoliation oI deciduous teeth
Treatment oI abnormal Irenal attachments
Treatment oI locked permanent Iirst molars
bnormal oral musculature related habits
ii]:]:oii Penang Inieinaiional Denial College
Caries control procedures:
O Diet and oral hygiene Maintenance
O Regular Checkup
O Fluoride applications
O Prophylactic odontomy
O Pit and Iissure sealants
O Restorative procedures like silver amalgam, Glass Ionomers,
Cermets, Stainless steel crown
O Immunization
ii]:]:oii Penang Inieinaiional Denial College
Diet and Oral hygiene maintenance
alanced diet
which contains varieties oI Iood, in such quantity and
proportion that the need Ior energy ,amino acids, vitamins, Iats,
carbohydrates and other nutrients is adequately met Ior
maintaining health
The cariogenic potential oI Iood depends on
many variables such as
presence oI Iermentable sugar sucrose
ability to be retained by teeth
ability to Iorm acids
ability to dissolve enamel
ii]:]:oii Penang Inieinaiional Denial College
The solid Ioods containing sucrose are more cariogenic than
liquid Ioods
The Irequency in time oI ingestion oI Ioods are also important
The sucrose containing Iood becomes more dangerous iI it is eaten
more Irequent
The patient should be aided in identiIication oI those Ioods
which are likely to cause oral diseases
ii]:]:oii Penang Inieinaiional Denial College
The 3 to 6 yrs olds require parental assistance to achieve
eIIective plaque removal
Parents should be instructed to brush Ior the child at least
once a day
Bedtime is the ideal time to establish this routine because the
salivary Ilow rate slows during sleep
dditional brushings may be perIormed by the child
Parents need to remain active in supervising the home care
practices oI 6-2 yrs old
ii]:]:oii Penang Inieinaiional Denial College
Regular check-up:
The parents should bring their child Ior his/her Iirst dental visit early at least by the
time the baby is 6 months oI age
Frequency oI recall visits have to be decided according to the individual needs
Usually a 3 monthly recall checkup is advised to monitor oral hygiene status
alI yearly visit to the dentist should be routine
ii]:]:oii Penang Inieinaiional Denial College
Immunization
Immunization with Streptococcus mutans should induce an immune
response which might prevent the dental caries in Iollowing ways :
It will prevent ability oI the microorganisms to colonize on to the
tooth surIaces
It can alter the pattern oI polysaccharide metabolism by the bacteria
and thereby reduces adhering capacity on to the tooth surIaces
Oral administration or subcutaneous injection oI killed Streptococcus
mutans can induce the Iormation oI speciIic Ig, IgG, IgM in the
blood
ii]:]:oii Penang Inieinaiional Denial College
ii]:]:oii Penang Inieinaiional Denial College
PREVENTION IS ALWAYS BETTER THAN CURE