Chapter 15
Preventive Dentistry
Preventive Dentistry
• To help people have maximum oral health
throughout their lives
• To achieve maximum oral health
– Dental professionals must work together with
patients to prevent new and recurring disease
Bacteria
• Various types of bacteria found in dental
plaque, are responsible for
– Dental Caries
– Periodontal disease
Patient Education
• Partnership—between patient and dental
health team
• Guidelines
– Listen carefully
– Instruct the patient on how to remove plaque
– Assess the patient’s motivations and needs
– Select the home care aids
– Keep the instruction simple
– Reinforce home care
Optimum Oral Health
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Patient education
Use of fluorides
Application of dental sealants
Proper nutrition
Plaque control program
Fluoride
• Primary weapon to combat dental caries
• Referred to as “nature’s cavity fighter”
• Provided through
– Prescription-strength fluorides that are applied
in the dental office
– Nonprescription-strength, over the counter
products for home use
– Consumption of fluoridated bottled water or
community water
Fluoride
• Systemic fluoride
– Ingested in water, food, beverages or
supplements
• Topical fluoride
– Applied directly to the teeth through the use of
fluoridated toothpaste, fluoride mouthrinses,
topical applications (rinses, gels, foams and
varnishes)
Dental Caries
• Cannot occur without dietary sugars.
• Cariogenic (caries-causing)
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Sucrose-sugars
Maltose
Lactose
Glucose
fructose
• Non-cariogenic (do not cause caries)
– Sugar substitutes
• Saccharine, aspartame, sorbitol, mannitol
Dietary Analysis
• Determines whether the patient’s current
food intake is affecting his or her dental
health.
• Food diary
– Everything eaten each day for 1 week
Plaque Control Program
• Cannot remove all plaque on teeth every
day, but it can be kept under control by:
– Brushing, flossing and interdental aids
• Goal
– Thoroughly remove plaque at least once daily
– After plaque is removed it takes
approximately 24 hours to re-form
Toothbrushes and Brushing
• Manual
– There is not an ideal toothbrush for everyone
• Too many sizes, shapes and angles
– Soft-bristled toothbrushes are recommended
• Automatic
– Various types
– When used properly, works as well as manual
Toothbrushing Methods
• Bass
– This method is useful for all types of dental conditions, especially
periodontal problems. With bristles pointed at a 45-degree angle into the
gingival sulcus, vibrate the brush gently back and forth about 20 times.
Move the brush forward and repeat.
• Rolling strokes
– This method is useful for stimulation of the gingiva. Place the brush
above the free gingiva with the bristles pointed toward the apices.
Exerting light pressure, draw the brush toward the occlusal surface
using a rolling stroke. Use a scrub technique on the occlusal surface
• Modified Stillman’s
– This method is useful for patients with hypersensitive gingiva or slightly
reduced interdental papilla. Use the rolling stroke method while vibrating
the bristles in a lateral motion.
• Charter’s
– This method is useful for patients with severe loss of interdental papilla
height, fixed prosthetic appliances, previous gingival surgery, or
subsided ulcerative gingivitis. Perform the rolling stroke first to remove
debris from the teeth. Direct the bristle tips toward the occlusal or incisal
surface. Gently rotate the handle, flexing the bristles and bringing them
into contact with the interdental tissues and exposed proximal surfaces.
Vibrate the handle of the brush with a slow, circular motion.
• Fone’s
– This method is useful for small children or others with poor manual
dexterity. First, occlude the teeth. Then, lightly press the bristles against
the posterior teeth and the gingiva. Revolve the brush head in a fast,
circular motion, using circles of large diameter. Continue the circular
motion, and slowly move the brush head toward the anterior until all
facial surfaces have been brushed. With the mouth open, use the same
circular motion on the maxillary and mandibular lingual surfaces.
Dental Flossing/Tape
• Removes bacterial plaque and reduces
interproximal bleeding
• Available in waxed and unwaxed
• Floss before brushing
– Plaque needs to be removed interproximally
first
Interdental Aids
• Used in addition for brushing and flossing
– Not take the place of
Dentures
• Need to use denture brush to clean
• Nonabrasive cleaner
Nutrition
• The science of how the body uses food for
development, growth, repair, and
maintencance.
• Nutrients
– Components in food that are needed by the
body
Key Nutrients
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Carbohydrates
Proteins
Fats
Water
Vitamins
Minerals
Food Guide Pyramid
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Fats, oils and sweets
Milk, yogurt and cheese group
Vegetable group
Meat, poultry, fish, dry beans, eggs, and
nuts group
• Fruit group
• Bread, cereal, rice, and pasta group
Eating Disorders
• Bulimia
– Referred to as “bingeing and purging”
disorder
– Believes self worth is related to being thin
– Easy to recognize because their teeth have
severe wear on the lingual surfaces caused
by stomach acid (from vomiting)
• Anorexia Nervosa
– Self-starvation-abnormal fear of becoming fat
Eating Disorders, cont.
• Female Athlete Triad
– Affects young female athletes
– Eating disorder/includes restrictive dieting,
overexercising, weight loss, and lack of body
fat
– Results are osteporosis and amenorrhea
– Dental risk—enamel decalcification, increased
caries, periodontal and soft tissue
inflammation
Management of Eating Disorders
• Anorexia and bulimia are considered
psychiatric diseases
• Dental professionals are often first to
discover disorders
Healthy Habits
• Eat right—five servings of fruits and
vegetables daily
• Keep bones strong—sufficient calcium
• Protect immune system—eat whole
grains, green leafy vegetables, seafood,
lean meats and moderate amounts of
vegetable oils and trace minerals
• Maintain a healthy body weight
• Exercise—aerobic exercises