Community Oral Health

Broadly caries are of 3 types

1. 1. Pit and Fissure caries.
2. 2. Smooth surface caries.
3. 3. Cervical caries.
4. 4. Nursing bottle caries.

Mechanism of tooth decay.

• Bacteria in the presence of sugary substance produce acid that causes demineralization of teeth.
• Enamel is affected first then the dentin and eventually the pulp as the decay continues.

Solution

• Filling
• Root canal treatment (RCT)

Prevention of Caries

• Reduce sugar intake.
• Brushing twice a day.
• Flossing once daily.
• Use of mouthwash.
• Healthy snack habit.
• Proper brushing method

• Inflammation of the gingival tissue.
• Bleeding gums.
• Factors may also be hormonal, drug induced.

Prevention of gingivitis.

• Maintain good oral hygiene.
• Cleaning of teeth.
• Interruption of bad habit.[smoking , mouth breathing.]
• Proper brushing technique.

• Infected gum recedes.
• Plaque and Ca++ continue to increase.
• Pockets become infected.
• Bone loss starts.
• Periodontal disease causes 70% of tooth loss.
• It affects 3 out of 4 people.

Causes of periodontal disease.

• Lack of daily, complete oral hygiene.
• Broken fillings/teeth.
• Misaligned/crowded teeth.
• A poorly balanced diet.
• Systemic disease.
• Drugs [xerostomia]

Prevention of periodontitis.

• Scaling.
• Maintenance of oral hygiene.
• Flap operation.
• Bone grafting.
• Replacement of tooth loss.

Loss of one or more teeth.

Restore it by:

• RPD [Removal partial denture].
• FPD [Fixed partial denture].
• CD [Complete denture].
• Implant.
• Prosthesis – obturator.

Causes

• Tobaco smoking and chewing.
• Heavy use of alcohol.
• HPV infection.
• Sun.
• Betel nut chewing.
• Age and heredity.

Sign and Symptoms of Cancer.

• Ulcer, irritation in mouth, lip or throat.
• White or Red patch in oral cavity.
• Feeling that something is caught in throat.
• Difficulty in chewing/swallowing.
• Numbness in tongue/lower lip.
• Poorly fitting denture due to swelling in jaws.
• Pain in ear without hearing loss.

• Proper oral hygiene can prevent tooth loss, periodontal disease and tooth decay.
• A lifetime of proper hygiene improves quality of life
• Proper Teeth Brushing Technique reduces possible sources of infection and maintains integrity of teeth and gums.
• Promotes a better appetite
• The correct use of topical and oral medications should also be identified.
• Dental Visits should be encouraged on a regular 6 monthly visit to the dentist.

• Expand the number of health care settings
• Strengthen the oral health workforce, expand capabilities of existing providers and promote models that incorporate other clinicians.
• Improve the knowledge skills and abilities of providers to serve diverse patient population
• Promote health professional training in cultural competence
• Assisting individuals and families in assessing oral health services and connecting with a dental home.
• Create dental homes
• Create local, regional and statewide partnerships that bridge the aging population and oral health systems
• Support the collection of data stratified by sex and race and pertaining to oral health.

Role of Health Services

• Collaboration with clinicians
• Collaboration with other essential sectors e.g.
• Social and welfare services, educational services, employment opportunities, housing support, debt management and financial planning advice, immigration support community groups

• Structural changes in the environment such as improvement in housing
• Legislation and regulation such as tighter controls on the marketing of sugary foods and drinks for children
• Fiscal policy such as sugar levy on sugary food and drinks
• Community action- community engagement on road safety
• Programmes that focus on oral health education for children, market woman
• Programmes the prioritize disadvantaged population groups such as groups nutrition programmes targeted at low income familiar

Most effective form of prevention

Can be achieved by a professional or can be self-administered

Can be divided into two

• Health promotion
• Health prevention

This can be at the level of individual or community.

Health promotion

Individual approach

• Diet planning
• Periodic dental check up
• Plaque control
• Patient education

Community approach

• Dental health education programme
• Promotion of research
• Policy and regulation

Specific Protection

Individual approach

<> Self-administered

• Appropriate use of fluoride
• Fluoride dentifrices
• Oral hygiene practices
• Use of fluoride prescription if needed

Provided by professionals

• Topical application of fluoride
• Pits and fissure sealants {for high risk group}

Community approach

• Community or school water fluoridation
• School fluoride tablet
• School sealant programme

Individual approach

• By self: Self examination
• Use of Dental services

Professional Treatment

• Complete examination
• Prompt treatment of incipient lesions
• Preventive resin restoration
• Simple restorative treatment

Community approach

• Periodic screening and referral
• Provision of dental services

Individual approach

• Use of dental services

By professionals

• Complex restorative treatment – RCT
• Extraction
• Removable and fixed prosthesis
• Implants