Chapter 15 Preventive Dentistry Copyright 2003, Elsevier Science (USA). All rights reserved. No part of this product may be reproduced or transmitted in any form or by any means, electronic or mechanical, including input into or storage in any information system, without permission in writing from the publisher. PowerPoint ® presentation slides may be displayed and may be reproduced in print form for instructional purposes only, provided a proper copyright notice appears on the last page of each print-out. Produced in the United States of America ISBN 0-7216-9770-4
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Chapter 15Preventive Dentistry
Chapter 15Preventive Dentistry
Copyright 2003, Elsevier Science (USA).
All rights reserved. No part of this product may be reproduced or transmitted in any form or by any means, electronic or mechanical, including input into or storage in any information system, without permission in writing from the publisher.
PowerPoint® presentation slides may be displayed and may be reproduced in print form for instructional purposes only, provided a proper copyright notice appears on the last page of each print-out.
Produced in the United States of America
ISBN 0-7216-9770-4
Copyright 2003, Elsevier Science (USA). All rights reserved.
IntroductionIntroduction
The goal of preventive dentistry is to have a healthy mouth for a lifetime. To achieve this goal, new and recurring disease must be prevented.
The goal of preventive dentistry is to have a healthy mouth for a lifetime. To achieve this goal, new and recurring disease must be prevented.
Copyright 2003, Elsevier Science (USA). All rights reserved.
What Is Preventive Dentistry?What Is Preventive Dentistry? Patient education Fluorides Dental sealants Proper nutrition Plaque control program Optimum oral health can become a reality.
Patient education Fluorides Dental sealants Proper nutrition Plaque control program Optimum oral health can become a reality.
Copyright 2003, Elsevier Science (USA). All rights reserved.
Guides for Patient Education Guides for Patient Education Listen carefully - Each patient will have different
needs. The initial instruction - Explain the relationship of
plaque to dental disease. Assess the patient’s motivations and needs -
Combine the patient’s motivating factors with the patient’s needs.
Select the home cleaning aids - Select a toothbrush, toothbrushing method, interproximal cleaning aids such as dental floss, and a toothpaste.
Keep the instruction simple - Comment positively on the patient’s efforts.
Listen carefully - Each patient will have different needs.
The initial instruction - Explain the relationship of plaque to dental disease.
Assess the patient’s motivations and needs - Combine the patient’s motivating factors with the patient’s needs.
Select the home cleaning aids - Select a toothbrush, toothbrushing method, interproximal cleaning aids such as dental floss, and a toothpaste.
Keep the instruction simple - Comment positively on the patient’s efforts.
Copyright 2003, Elsevier Science (USA). All rights reserved.
Fig. 15-1 The mother lifts the lip and looks at her child’s teeth.Fig. 15-1 The mother lifts the lip and looks at her child’s teeth.
Fig. 15-1Fig. 15-1
Copyright 2003, Elsevier Science (USA). All rights reserved.
Fig. 15-2 The intraoral camera is a valuable tool in patient education. Fig. 15-2 The intraoral camera is a valuable tool in patient education.
Fig. 15-2Fig. 15-2
Copyright 2003, Elsevier Science (USA). All rights reserved.
Dental SealantsDental Sealants Dental sealants are used as a means of
protecting the difficult-to-clean occlusal surfaces of the teeth from decay.
Sealants cover the occlusal pits and fissures where decay-causing bacteria can live.
Dental sealants are an important component in preventive dentistry.
In several states, the application of dental sealants is delegated to the dental assistant as an expanded function.
Dental sealants are used as a means of protecting the difficult-to-clean occlusal surfaces of the teeth from decay.
Sealants cover the occlusal pits and fissures where decay-causing bacteria can live.
Dental sealants are an important component in preventive dentistry.
In several states, the application of dental sealants is delegated to the dental assistant as an expanded function.
Copyright 2003, Elsevier Science (USA). All rights reserved.
Fig. 15-3 Disclosing solution shows heavy plaque formation throughout the mouth.Fig. 15-3 Disclosing solution shows heavy plaque formation throughout the mouth.
Fig. 15-3Fig. 15-3
Copyright 2003, Elsevier Science (USA). All rights reserved.
FluorideFluoride Fluoride has been our primary weapon to
combat dental caries.
Fluoride slows demineralization and enhances remineralization of tooth surfaces.
Fluoride is a mineral that occurs naturally in food and water.
A supply of both systemic and topical fluoride must be available throughout life to achieve the maximum cavity prevention benefits.
Fluoride has been our primary weapon to combat dental caries.
Fluoride slows demineralization and enhances remineralization of tooth surfaces.
Fluoride is a mineral that occurs naturally in food and water.
A supply of both systemic and topical fluoride must be available throughout life to achieve the maximum cavity prevention benefits.
Copyright 2003, Elsevier Science (USA). All rights reserved.
Ways of Receiving FluorideWays of Receiving Fluoride
Prescription-strength fluorides that are applied in the dental office
Nonprescription-strength over-the-counter products for at-home use
Fluoridated water, either bottled or community water
Prescription-strength fluorides that are applied in the dental office
Nonprescription-strength over-the-counter products for at-home use
Fluoridated water, either bottled or community water
Copyright 2003, Elsevier Science (USA). All rights reserved.
Ways of Receiving Fluoridecont’dWays of Receiving Fluoridecont’d Systemic fluoride is ingested in water, food,
beverages, or supplements. The required amount of fluoride is absorbed through the intestine into the bloodstream and transported to the tissues where it is needed. Excess systemic fluoride is excreted by the body through the skin, kidneys, and feces.
Topical fluoride is applied in direct contact with the teeth through the use of fluoridated toothpaste, fluoride mouth rinses, and topical applications of rinses, gels, foams, and varnishes.
Systemic fluoride is ingested in water, food, beverages, or supplements. The required amount of fluoride is absorbed through the intestine into the bloodstream and transported to the tissues where it is needed. Excess systemic fluoride is excreted by the body through the skin, kidneys, and feces.
Topical fluoride is applied in direct contact with the teeth through the use of fluoridated toothpaste, fluoride mouth rinses, and topical applications of rinses, gels, foams, and varnishes.
Copyright 2003, Elsevier Science (USA). All rights reserved.
Fig. 15-5 Various forms of topical fluoride.Fig. 15-5 Various forms of topical fluoride.
Fig. 15-5Fig. 15-5
Copyright 2003, Elsevier Science (USA). All rights reserved.
How Does Fluoride Work?How Does Fluoride Work? Preeruptive development: Before a tooth
erupts, a fluid-filled sac surrounds it. Systemic fluoride present in this fluid strengthens the enamel of the developing tooth and makes it more acid resistant.
Posteruptive development: After eruption, fluoride continues to enter the enamel and alter the structure of the enamel crystals. These fluoride-enriched crystals are less acid-soluble than the original structure of the enamel.
Preeruptive development: Before a tooth erupts, a fluid-filled sac surrounds it. Systemic fluoride present in this fluid strengthens the enamel of the developing tooth and makes it more acid resistant.
Posteruptive development: After eruption, fluoride continues to enter the enamel and alter the structure of the enamel crystals. These fluoride-enriched crystals are less acid-soluble than the original structure of the enamel.
Copyright 2003, Elsevier Science (USA). All rights reserved.
Safe and Toxic Levels of Fluoride Safe and Toxic Levels of Fluoride
Fluorides used in the dental office have been proved to be safe and effective when used as recommended.
Chronic overexposure to fluoride, even at low concentrations, can result in dental fluorosis in children younger than 6 years with developing teeth.
Acute overdosing of fluoride can result in poisoning or even death.
Fluorides used in the dental office have been proved to be safe and effective when used as recommended.
Chronic overexposure to fluoride, even at low concentrations, can result in dental fluorosis in children younger than 6 years with developing teeth.
Acute overdosing of fluoride can result in poisoning or even death.
Copyright 2003, Elsevier Science (USA). All rights reserved.
Fig. 15-6 A, Mild fluorosis.Fig. 15-6 A, Mild fluorosis.
Fig. 15-6 AFig. 15-6 A
Copyright 2003, Elsevier Science (USA). All rights reserved.
Copyright 2003, Elsevier Science (USA). All rights reserved.
Fluoride Precautions Fluoride Precautions
To prevent patients from receiving too much fluoride:
• Evaluate the patient’s current fluoride intake.
• Perform a fluoride “Needs Assessment.”
To prevent patients from receiving too much fluoride:
• Evaluate the patient’s current fluoride intake.
• Perform a fluoride “Needs Assessment.”
Copyright 2003, Elsevier Science (USA). All rights reserved.
Sources of Systemic Fluoride Sources of Systemic Fluoride Fluoridated water: Approximately one part per
million (ppm) of fluoride in drinking water has been specified as the safe and recommended concentration to aid in the control of dental decay.
Foods and beverages: Many processed foods and beverages are prepared with fluoridated water.
Toothpaste and mouth rinses: Toothpaste and mouth rinses containing fluoride should not be a source of systemic fluoride because with proper use any excess is spit out and never swallowed.
Prescribed dietary fluoride supplements may be prescribed by the dentist for children ages 6 months to 16 years.
Fluoridated water: Approximately one part per million (ppm) of fluoride in drinking water has been specified as the safe and recommended concentration to aid in the control of dental decay.
Foods and beverages: Many processed foods and beverages are prepared with fluoridated water.
Toothpaste and mouth rinses: Toothpaste and mouth rinses containing fluoride should not be a source of systemic fluoride because with proper use any excess is spit out and never swallowed.
Prescribed dietary fluoride supplements may be prescribed by the dentist for children ages 6 months to 16 years.
Copyright 2003, Elsevier Science (USA). All rights reserved.
Copyright 2003, Elsevier Science (USA). All rights reserved.
Fig. 15-8 Fluoride rinse and fluoride dentifrice.Fig. 15-8 Fluoride rinse and fluoride dentifrice.
Fig. 15-8Fig. 15-8
Copyright 2003, Elsevier Science (USA). All rights reserved.
Sources of Topical FluorideSources of Topical Fluoride Toothpaste containing fluoride is the
primary source of topical fluoride.
Fluoride mouth rinses
• Prescription
• Nonprescription
Brush-on fluoride gel Professional topical fluoride applications
Toothpaste containing fluoride is the primary source of topical fluoride.
Fluoride mouth rinses
• Prescription
• Nonprescription
Brush-on fluoride gel Professional topical fluoride applications
Copyright 2003, Elsevier Science (USA). All rights reserved.
Nutrition and Dental Caries Nutrition and Dental Caries
Without dietary sugars, dental caries will not occur.
Sucrose has a greater decay-causing potential than other sugars, but maltose, lactose, glucose, fructose, and their combinations do have high caries-producing abilities.
Flour and starches are not usually decay-causing, but when starch is used in conjunction with sugar, i.e. in cookies and so on, the potential for caries increases.
Without dietary sugars, dental caries will not occur.
Sucrose has a greater decay-causing potential than other sugars, but maltose, lactose, glucose, fructose, and their combinations do have high caries-producing abilities.
Flour and starches are not usually decay-causing, but when starch is used in conjunction with sugar, i.e. in cookies and so on, the potential for caries increases.
Copyright 2003, Elsevier Science (USA). All rights reserved.
Sugar SubstitutesSugar Substitutes Increasing use of less fermentable and
Artificial sweeteners are an alternative to sucrose:
• Saccharine (“Sweet and Low”)
• Aspartame (“Nutrasweet” and “Equal”)
• Sorbitol
• Xylitol
• Mannitol
Increasing use of less fermentable and noncariogenic (caries causing) artificial sweetners.
Artificial sweeteners are an alternative to sucrose:
• Saccharine (“Sweet and Low”)
• Aspartame (“Nutrasweet” and “Equal”)
• Sorbitol
• Xylitol
• Mannitol
Copyright 2003, Elsevier Science (USA). All rights reserved.
Dietary Analysis Dietary Analysis A dietary analysis is done to determine the
patient’s current food intake to assess the need for dietary counseling.
The patient maintains a food diary that includes everything they consume each day for 1 week.
The listing includes all meals, supplements, gum, snacks, and fluoridated water.
It can then be used to reveal any dietary habits that are likely to have an adverse effect on the patient’s oral health.
A dietary analysis is done to determine the patient’s current food intake to assess the need for dietary counseling.
The patient maintains a food diary that includes everything they consume each day for 1 week.
The listing includes all meals, supplements, gum, snacks, and fluoridated water.
It can then be used to reveal any dietary habits that are likely to have an adverse effect on the patient’s oral health.
Copyright 2003, Elsevier Science (USA). All rights reserved.
Plaque Control ProgramPlaque Control Program
Plaque can be kept under control by brushing, flossing, interdental cleaning aids, and antimicrobial solutions.
A goal of the program is to remove plaque at least once daily.
The techniques that are selected must be based on the needs and abilities of the individual patient.
Plaque can be kept under control by brushing, flossing, interdental cleaning aids, and antimicrobial solutions.
A goal of the program is to remove plaque at least once daily.
The techniques that are selected must be based on the needs and abilities of the individual patient.
Copyright 2003, Elsevier Science (USA). All rights reserved.
Oral Hygiene Aids and Methods Oral Hygiene Aids and Methods
§ There are a wide variety of oral hygiene products on the market today.
§ It is important for dental assistants to remain current on the newest products on the market so that they can advise patients, make recommendations, and answer their questions.
§ There are a wide variety of oral hygiene products on the market today.
§ It is important for dental assistants to remain current on the newest products on the market so that they can advise patients, make recommendations, and answer their questions.
Copyright 2003, Elsevier Science (USA). All rights reserved.
The Toothbrush The Toothbrush The two basic types of toothbrushes are:
• Manual
• Automatic
When used properly, both types are effective in the removal of dental plaque.
The two basic types of toothbrushes are:
• Manual
• Automatic
When used properly, both types are effective in the removal of dental plaque.
Copyright 2003, Elsevier Science (USA). All rights reserved.
Fig. 15-12 Various styles of manual toothbrushes.Fig. 15-12 Various styles of manual toothbrushes.
Fig. 15-12Fig. 15-12
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Toothbrushing PrecautionsToothbrushing Precautions The patient should be cautioned about
damage that may be caused by vigorously scrubbing the teeth with any toothbrush.
Over time this may cause abnormal abrasion (wear) of the tooth structure, gingival recession, and exposure of the root surface.
The patient should be cautioned about damage that may be caused by vigorously scrubbing the teeth with any toothbrush.
Over time this may cause abnormal abrasion (wear) of the tooth structure, gingival recession, and exposure of the root surface.
Copyright 2003, Elsevier Science (USA). All rights reserved.