Introduction to

Preventive Dentistry
Dr. Tin Maw

Dental Public Health

(definition)

American Board of Dental Public health

(modified Winslows definition of
Health)

the science and art of preventing and controlling

dental disease and promoting dental health through
organized community efforts
It is that form of dental practice which serves the
community rather than the individual. It concerned with
1, dental health education
2, research and the application of findings
3, administration of programs of dental care for groups &
4, control of dental disease through a community approach.

Health (definition)
WHO (World Health Organization) 1948
a state of complete physical, mental & social
well
being & not merely the absence of disease or
infirmity

Talcott Parsons (sociologist)

a state of optimum capacity for the performance
of valued task
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Year 2, KOD, IIUM, Dr.Tin

Maw.

Nick
Vujicic

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Operational Definition of
Health
In broad sense a condition or
quality of the human organism
expressing the adequate functioning
of the organism in given conditions,
genetic or environmental.
In a narrow sense
a) no obvious evidence of disease, a
person is functioning normally
b) Several organs are functioning
adequately
in relation to one
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10th November 2014
another, whichMaw.
implies a kind of

Changing Concepts of
Health
1.
2.
3.
4.

Biomedical concept
Ecological concept
Psychosocial concept
Holistic concept

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Year 2, KOD, IIUM, Dr.Tin

Maw.

Changing Concepts of
Health
Biomedical concept
Health = absence of disease (inadequate)
Ecological concept
Health as a dynamic equilibrium between man and his
environment and any maladjustment in this will lead to
disease.
Psychosocial concept
Which is influenced by Social, Psychological, Cultural,
Economic & Political. Both biological and social phenomenon
Holistic concept
It is a synthesis of all the above mentioned concept and
implies that all sectors of society have and affect of health.
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The main determinants of health

Dahlgren G, Whitehead M.Policies and strategies to

promote social equity in health.Copenhagen: WHO
Regional Office for Europe; 1992.
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Maw.

Societ
y
Socia
l
Time off
school

Education
al
performan
ce

Individ
ual

Pain/discomf
ort

Functional
limitation

Impact of Oral
Diseases

Sleepless
nights

Fear/
anxiety

aestheti
cs
Social
attractiveness

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Time off work

Time attending
services

Reduce
productivity of
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workforce

Cost of
treatment

Cost to
National
Health
care

Self
esteem
Social
isolation

LOOKING UPSTREAM
(McKinlay 1979)
There I am standing by the shore of a swiftly flowing
river and I hear the cry of a drowning man.
So I jump into the river, put my arms around him,
pull him to the shore and apply artificial
respiration,
just when he begins to breathe, there is another cry
for help. So I jump into the river, reach him. Pull
him to shore, apply artificial respiration,
and then just as he begins to breathe, another cry
for help. So back in the river again, without end,
goes the sequence, you know I am so busy jumping
in pulling them to shore, applying artificial
respiration, that I have no time to see who at the
upstream pushing them all in.
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 McKinlay JB. A case for refocusing upstream the political

economy of illness.
Processing of the American Heart Association. Conference on
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applying

LOOKING UPSTREAM
(McKinlay 1979)
? upstream,
? midstream or
? downstream
? Or a sensible combination of the three
McKinlay JB. A case for refocusing upstream the political
economy of illness. Processing of the American Heart
Association. Conference on applying behavioural
sciences to cardiovascular risk; 1974. p. 7-17.

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Iceberg concept of
Disease
Seen by the
clinician

Symptoma
tic disease

Not seen by
the clinician

Latent,
unappare
nt
undiagnos
ed
carriers

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Prevention: concept
Disease prevention includes measures
not only to
1. prevent the occurrence of
disease
2. risk factor reduction
3. arrest its progress and
4. reduce its consequences once
established.
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Prevention: concept
The concept of prevention is best
defined in the context of levels,
traditionally called
1. Primary prevention
2. Secondary and
3. Tertiary prevention.
4. A fourth level, called Primordial
prevention, was later added.
Year 2, KOD,
IIUM, Dr.Tin
(Wien Klin Wochenschr
(2009)
121: 168-172)
Maw.

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The natural history of disease

Prepathogenesis

Process

wellnes
s

Pathogenesis
phase

illness

Post Pathogenesis
recover
y
disabili
ty
deat
h

Interventio
n

Primary
prevention
Preventive care
Health
promotion

Secondary
prevention
Clinical care

Tertiary
prevention
Rehabilitation
Maintenance
care

Figure: The process of disease intervention

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Primary Prevention
It is defined as action taken prior to
the onset of disease which
removes the possibility that a
disease will even occur.
to forestall the onset of disease
to reverse the progress of the initial
stages of disease
to arrest the disease process before
treatment become necessary
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Primary Prevention
Signifies intervention in the prepathogenesis phase of a disease or
health problem.
May be accomplished by measures of
Health Promotion and
Specific Approach.

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Primary Prevention

Health
Promotion

Specific
Approach

Health Education
Environmental
modification
Nutritional
Interventions
Life style and
behavioral
changes
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Pit and Fissure

Sealant
Topical Fluoride
Preventive Resin
Restoration

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Secondary Prevention
Defined as actions which halt the
progress of a disease at its incipient
stage and prevent complications.
The specific interventions are early
diagnosis (e.g. screening) and
adequate treatment.

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Secondary Prevention
Employs routine treatment methods
- to terminate a disease process
- to restore tissues to as near normal
as
possible
e.g. Amalgam, GIC restoration

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Tertiary Prevention
Defined as all the measures available
to reduce or limit impairments and
disabilities, and to promote the
patients adjustment to irremediable
conditions.

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Tertiary Prevention
(cont)
Employs measures necessary to
replace lost tissues and to rehabilitate
patients to the point that function is
as near normal as possible after the
failure of secondary prevention.
E.g. construction of dentures

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Prevention Clinical relationship

Prevent

Primary
Preventio
n

Secondary
Prevention

Tertiary
Prevention

Arrest or Reverse

Deep scaling

Restoration

Periodontal
surgery

Endodontics

Exodontics

Prosthodontics
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Definition of Preventive
Dentistry
procedures in the practice of dentistry and
community health programs which prevent
the occurrence of oral diseases and
abnormalities.
Optimum oral health is within the reach of
every individual, but achievements requires
the combined efforts of the practitioner, the
patient and the community.
American Dental Association, 1980
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Philosophy of Dental
Practice
Definition:
The manner in which a
dentist/doctor approaches his
practice and what he tries to
achieve.

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 Prevention is better than cure.

Desiderius Erasmus
(1466 1536)
An ounce of prevention is worth a
pound of cure
Ben Franklin

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