Preventive Dentistry

DentinoGingival
Junction
Sarah Al Hilfi
By Badr Ibdaa
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 Latin terms ‘praevenire,’ which
means ‘to anticipate’ and ‘dens,’
which is the word for tooth.

What is preventive dentistry?

This definition assumes that the thing being prevented is anticipated, but it does not
mean that the extent, severity, or extent of the thing is always known.
Prevention in health care means action to stop ill health before it begins.
In dealing with disease, “prevention is better than a cure.”

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Is preventive dentistry still needed?

As decay rates decline, dentists turn their interest to previously underutilized therapies such
as cosmetic dentistry, orthodontics, third molar extractions, implant dentistry, and so on
that need improved preventive care.
On the other hand people are keeping most of their teeth into old age and living longer,
which means that preventing root caries, periodontal disease, and oral cancer will be even
more important than before. The frail elderly is the fastest growing segment of the
population, and they will need even more preventive care because of their increased risk
for disease.

Dental disorders are an enormous burden to society, especially when considers the
connection between poor oral health and systemic illness

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The Four Levels Of Preventive Care

Primordial Primary Secondary Tertiary

Prevention Prevention Prevention Prevention

1 2 3 4
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 The Four Levels Of Preventive Care

It is the prevention of emergence or development of risk factors (beginning with change

in social and environmental conditions) in countries or population group in which they
have not yet appeared. Individual and mass education is main intervention method in
primordial prevention.

Primordial Primary Secondary Tertiary

Prevention Prevention Prevention Prevention

1 2 3 4
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the Four Levels of Preventive Care Dental hygiene\Self care

It is defined as ‘action taken prior to the onset of the disease, which removes the possibility that a disease will even
occur’. It is carried out on healthy populations. Information and / or public health measure for the whole population
may be sufficient to maintain a disease free environment, this is the goal of primary prevention. Through primary
prevention it is possible to ‘anticipate’ disease and prevent it altogether.
Primary preventive services are those that prevent the initiation of disease .It may be accomplished by measures
designed to promote general health and well- being or by specific protective measures:

Primordial Primary Secondary Tertiary

Prevention Prevention Prevention Prevention

1 2 3 4
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a. Health promotion

: It is process of enabling people to increase control over and to improve health. This can be achieved by
1) Health education; instruction on proper plaque removal, daily tooth brushing and flossing
2) Environment modification such as safe water, control of insects

PRIMARY PREVENTION
3) Nutritional interventions: improvement of nutrition in vulnerable group.
4) Lifestyle and behavioral changes; which favor health

b. Specific protection:

These are activities designed to protect against disease agents by decreasing the
susceptibility of the host or by establishing barrier against agents in the environment.
Methods include :
• immunization, use of specific nutrition, avoidance of allergens, protection from
carcinogens, the use of fluoridated toothpaste and application of pit and fissure
sealants.
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Secondary prevention (Pathogenesis: Initial Stage of Pathogenesis) Restorative care

It can be defined as ‘actions which halts the progress of a disease at its incipient stage and prevents complications’.
The focus of secondary prevention is early disease detection, making it possible to prevent the worsening of the
disease and the emergence of symptoms, or to minimize complications and limit disabilities before the disease
becomes severe.
Secondary prevention (‘caution’) suggests that the disease has started but can be reversed, and good health can still
be achieved
. through intervening early, when the disease is just starting, and returning the subject to good health

Primordial Primary Secondary Tertiary

Prevention Prevention Prevention Prevention

1 2 3 4
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Secondary Prevention (Pathogenesis: Initial Stage Of Pathogenesis)

For example Secondary prevention includes the detection of disease in asymptomatic patients with screening or diagnostic
testing and preventing the spread of communicable diseases.
Other example include when incipient enamel lesions(white spot enamel lesions) can be arrested and reversed using appropriate
‘preventive’ measures and are reversed
before cavities form, other example gingivitis can be reversed before periodontitis sets in, it was well established that frequent oral
hygiene reinforcement by dental professionals can prevent caries, gingivitis, and periodontal disease.
.

Primordial Primary Secondary Tertiary

Prevention Prevention Prevention Prevention

1 2 3 4
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Secondary prevention (Pathogenesis: Initial Stage of Pathogenesis)

Secondary prevention of oral cancer could include identification of dysplastic tissue and its removal as well
as stopping the irritation that leads to the dysplasia. When dysplasia is found and excised before cancer
develops, thus returning to good health and controlling dental disease is possible. To prevent oral cancer,
alternatives to biopsies used for early detection and surgical removal are only now being explored. These
include various molecular based diagnostic markers.
.

Primordial Primary Secondary Tertiary

Prevention Prevention Prevention Prevention

1 2 3 4
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Tertiary Prevention (Pathogenesis: Late Stage Of Pathogenesis)
Reconstructive Care
‫انقاذ ما يمكن انقاذه‬
Actions taken when the disease process has advanced beyond its early stages i.e. intervention in late
pathogenesis phase. It can be defined as ‘all measures available to reduce or limit impairments and disabilities,
minimizing suffering caused by existing departures from good health and to promote the patients adjustment to
irremediable conditions’. The goal of tertiary prevention is to reduce the negative impact of an already-
established disease by restoring function and reducing disease-related complications (prevent further
complications
. or death).Tertiary prevention also aims to improve the quality of life for people with disease.

Primordial Primary Secondary Tertiary

Prevention Prevention Prevention Prevention

1 2 3 4
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The Four Levels Of Preventive Care

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Tool for tertiary prevention include rehabilitation

Rehabilitation: It is defined as “the combined and coordinated use of medical,

social, educational, psychological and vocational measures for training and
retraining the individual to the highest possible level of functional ability.”

01 Examples of rehabilitation: Special schools for blind pupils, provision of aids for
crippled, reconstructive surgery and modification of life for cardiac patients.

02 In dentistry, tertiary prevention measures include replacement of missing teeth with

bridges, implants, or dentures.

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Caries prevention: how far it had come in one century!

If one considers that the terminal stage of caries is the loss of a tooth, then early intervention is
obviously desirable. When the disease has progressed significantly and more drastic measures
are required (such as root canal therapy), one is still ‘preventing’ tooth loss.
This was the goal in the early days of dentistry more than a century ago when Dr. G.V. Black
proposed the “Extension for Prevention” concept during the restoration of teeth It has
taken over a century for dentistry to advance from the pioneering “extension for prevention”
concepts proposed by Dr. G.V. Black. By removing a significant proportion of tooth structure
so that only the easily cleansed tooth surfaces remained, there was a reduction in the need for
further operative treatment.
As dental decay rates began to fall worldwide in industrialized countries after Second World Loss
War, a new concept of operative dentistry began to take hold.
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 Caries prevention

It is called Minimal Intervention Dentistry (MID), as the term suggests, refers

to a principle of treatment in dentistry in which early intervention minimizes
tooth destruction because the disease is diagnosed prior to cavitation, and steps
are taken to remineralize the enamel and arrest the decay.
However, more than that assessing caries risk can be done in several ways using
how far it had come
many different approaches include: in one century!
A thorough analysis of patient history (social, medical, and dental), followed by a
careful extra- and intraoral examination will provide the necessary background
for assessing caries risk in order to determine the most appropriate preventive
therapy. Changing dietary patterns, controlling the cariogenicity of the oral
microflora, and providing a healthy environment for remineralization are primary
goals of MID.
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THANK YOU
By Sarah.AlHilfi
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