Very summarized(yet detailed) class notes for preventative & communicative dentistry. Great for review the night before the exam and for any last-minute review before entering the exam. bullet points used.
➢ Prevention
○ Measure to reduce probability of disease or slow down its progression
○ Set of actions to avoid disease development
○ Goal is to maintain health by avoiding disease
○ Dual health-illness aspect that constitutes dynamic pattern
➢ Natural history of disease (Leavell & clark)
○ Natural evolution of a pathological process(start to end) untouched by human
hand
■ Possibility of detecting disease in early stages + prevent its impact
■ Any human disease is the result of a dynamic process
■ Process involves series of causes that affect interaction btw individual
hosts whose effects are massively characterised in pop
● The pre-pathogenic period= before illness= Primary prevention
● Pathogenic period= illness appeared(usually no
signs/symptoms)= Secondary prevention
● Rehabilitation= Tertiary prevention
○ Epidemiological chain or “chain of Infection
■ is used to explain the rltn/ship btw the different
elements(host/agent/environ) that lead to the disease
○ Environment
■ promotes link btw host and agent(physical(climate), socioeconomic &
biological factors)
○ Host
■ Living organism that allows lodging of agent > ill
○ Agent
■ Microorganism, radiation, chemical
➢ Pathogenic period
○ Onset of disease before the symptoms appear
○ It's a period of interaction btw Exo/endogenous factors that result in the
development of the disease
○ 2 stages
■ Subclinical
● Host is asymptomatic(only detected w examinations)
● Incubation or latency period
○ Agent multiplies & cause biochemical + cellular
changes in host
, ■ Clinical
● Clinical horizon- when first manifestations appear(unique to
each disease)
● signs /symptoms present(can be chronic{chronicity})
● Divided into 3 periods:
○ Prodromal
■ Confusing symptoms and signs that make it
difficult to make an exact diagnosis.
○ Clinical
■ manifested by signs and specific symptoms that
facilitate its diagnosis and management.
○ Resolution
■ final stage:
● illness disappears
● may become chronic
● Or patient dies
■ Preventive measures. Are based on modern epidemiological
knowledge to reduce incidence the occurrence in a pop
➢ Leavell and Clark prevention measures
○ 3 levels:
■ Primary prevention:
● Preventing onset(pre pathogenic period)
○ Health promotion level: Attention to personal
develop./health programmes/nutrition/housing
conditions/medical exams
○ protection= immunisation/
hygiene/cleanliness/nutrients/ no allergens
■ Secondary prevention
● Goal is to interrupt progression(pathogenic stage)
○ Active case finding(screening);recruit risk groups
○ Intervention(cure/prevent) via early diagnosis/lab tests
○ Prevent spread of transmissible diseases & reduce
periods of disability
○ Clinical analysis/xrays/removal of lesion/cavity
filling/fluoride
● Damage limitation:
○ treatment to stop the disease and prevent it from
progressing.
■ restorations w/ permanent materials, pulp
capping, root canal treatments and extractions
when needed
■ Tertiary prevention
● Limit damage & rehabilitate patient(pathogenic period)
○ Provide resources to hospitals for maximum recovery
, ○ Occupational therapy
○ Educate pop to incorporate rehabilitated ppl
○ State protection for disabled patients
● Includes treatments like:
○ Crown & Bridge
○ Partial removable prosthesis
○ Complete removable prosthesis
➢ Community dentistry
○ preventing and controlling oral disease and promoting health through
organised community efforts(attention given to community instead of
individual
○ Derives from concept of public health
○ Related to sociology/epidemiology/demography/stats/administration
○ Definitions:
■ EPIDEMIOLOGY:
● Changes in patterns of appearance and distribution of oral
diseases have been very important in recent years.
■ EVIDENCE BASED DENTISTRY:
● incorporation of evidence-based Dentistry constitutes an
instrument to aim the effectiveness and efficiency of
clinical-decision making
■ DEMOGRAPHIC CHANGES:
● developed countries are characterised by an important
population ageing and by an increase in the young population
for countries with a lower economic level.
■ COMMUNITY HEALTH:
● step towards the evolution of public health. It has emerged
from public health(ie planning, administration and control of
health actions)
○ has to be a proper promotion of primary health care.
Its implementation is carried out within the primary care
team, whose components carry out functions in an
integrated manner.
■ These functions are health promotion, health
care and social work (community and health
centre).
■ Goals:
● Achieve favourable health environments.
● Strengthen community action.
● Develop personal skills.
● Redirect health services.
➢ Public health
○ preventing disease, prolonging life, and promoting health through the
organised efforts of society
○ Acheson Report=
, ■ serious social inequality btw classes(mortality & chronic dis. higher in
lower class)
○ Medicine vs health
■ Medicine treats diseases and establishes health by correcting the
imperfections that appear in life
■ Health is the natural state of things. Hygiene knows the natural laws
that keep the body and mind healthy. It also teaches these laws to the
community
○ Asclepius (son of Apollo, Greek God of Medicine) / Aesculapius (Medicine
associated sign):
■ · Epione: calmed pain · Panacea: Medicine Goddess · Macaon and
Podalirius (doctors) · Hygia: higiene · Telesforo: recovery · Yaso: cure
➢ New public health(1970-now)
○ Reasons
■ 1- poverty reduction
■ 2- Improve nutrition
■ 3- Infectious disease control
■ 4- extension of health care
○ Alma-Ata Declaration. WHO 1978.
■ 30 yrs ago
■ Defined primary health as
● set of guiding values for health develop
● set of principles for the organisation of health services
● variety of criteria to address priority health needs and
determinants of health fundamentals
■ objective of the WHO is to achieve the highest possible level of health
for all people
○ · Ottawa Declaration. WHO, 1986.
■ was a response to the high demand for a new conception of public
health in the world.
■ focused first on industrialised countries but later focused on the rest. It
took as a starting point the Alma-Mata meeting on primary care.
Unit 2: Dental Biofilm
➢ Saliva
○ Viscous liquid covers all of oral mucosa except
■ The gingival sulcus
○ Composed of
■ pH is 6.5 to 7.5
■ 99% water
■ Inorganic elements(Ca/P/F/Mg/Cl/K/Na/etc)
■ Organic elements(proteins/glycoproteins/peptides/carbs/lipids)
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