Community Dentistry PowerPoint

Preventative Dentistry

1. Community Dentistry

2. What is community dentistry? Community dentistry, also knows as dental public health, is involved in the assessment of dental health needs and improving the dental health of populations rather than individuals Public health dentistry is practiced generally through governmentally sponsored programs, which are for the most part directed toward public-school children in the belief that their education in oral hygiene is the best way to reach the general public.

3. Community Dentistry In the broadest sense, primary components of the dental public health infrastructure include, but are not limited to: Government Education Workforce

4. Government State and local health departments, as well as federal agencies such as the Indian Health Service (IHS), Federal Bureau of Prisons (BOP), the Centers for Disease Control and Prevention (CDC), Health Resources and Services Administration (HRSA), the Agency for Children and Families (ACF), and National Institutes of Health (NIH). Other entities here would include the Commissioned Corps of the U.S. Public Health Service (USPHS) and Federally Qualified Health Centers (FQHCs). Education: Traditionally, academia involved

5. Education Traditionally, academia involved in oral health includes schools of Dentistry, Dental Hygiene, and Public Health. In recent years in light of a greater emphasis on an interdisciplinary approach to patient care and increased medical/dental collaboration, this area has expanded to include Schools of Medicine, Nursing, and other allied Health Sciences. It also includes preschool programs such as Head Start, primary and secondary schools, trade schools, vocational educational programs, dental residencies, and dental public health fellowships.

6. Workforce Dentists, dental hygienists, dental assistants, all members of the dental, and many traditional non-dental providers: physicians, nurse practitioners, physician assistants, midwives, pharmacists, nurses, home health aides, water plant operators, teachers, parents, school administrators, health boards, community health workers, and promotoras (culturally competent or ethnically affiliated liaisons that bridge the gap within health care for the underserved).

7. Examples of Community Dentistry Community water fluoridation : the controlled addition of a fluoride compound to a public water supply to achieve a concentration optimal for dental caries prevention; All water contains at least trace amounts of fluoride Sealant programs: The pits and fissures that characterize the biting surfaces of posterior teeth provide a haven for food debris and decay-causing bacteria. Not surprisingly, these sites are often the first and most frequent to be affected by decay in children and adolescents. The width of most pits and fissures is narrower than a single toothbrush bristle, making cleaning of their deepest recesses almost impossible. According to national estimates, as much as 90 percent of all dental caries in schoolchildren occurs in pits and fissures. The teeth at highest risk by far are permanent first and second molars Oral Health Education

8. Target Populations and Preventative Strategies Term used to represent a certain segment of the population that consists of groups of individuals with similarities of some sort, such as: Age Race Educational background Life situation Health conditions

9. Pregnant patients The dental professional possesses the knowledge and technology to assist parents in raising children free of dental disease Women are particularly susceptible to periodontal disease, because female hormones affect the periodontal structures. With bad oral hygiene, the predominant manifestations are gingival enlargement, tissue sensitivity, and spontaneous bleeding.

10. Pregnant patients cont … Tooth brushing can also be problematic if the mother is experiencing morning sickness. The placement or movement of the toothbrush in the posterior of the oral cavity may trigger an overactive gag reflex that is common in morning sickness A relationship has been drawn between the incidence of periodontitis and low birthweight (LBW), preterm babies It is important to provide oral health counseling throughout pregnancy Proper nutrition during pregnancy is essential

11. Pregnant patients cont … Alteration of the dental chair incline It is recommended that the mother not be reclined completely in the third trimester because of potential decrease in blood flow and increase pressure to the fetus. Other suggestions are frequent breaks; radiographs should be avoided in the first trimester Dental diseases left untreated during pregnancy can lead to problems for both the mother and the fetus. The collaboration of medical and dental providers can ensure that both the mother and the child are given the greatest opportunity for optimal oral health.

12. Pediatrics Oral health is essential in children 's overall health, functional capacity, and social welfare. Due to an absence of dental care, children can experience pain, infection, dysfunction, poor appearance, and low self-esteem as well as drastic alterations to their ability to eat, communicate, sleep, and play. By limiting children 's experience of dental pain and infection, their capacity to function well, grow normally, and engage in normal activities will be enhanced. Every time a child is present for treatment, parental concerns must be considered as well

13. Pediatrics cont … 3 Basic Child Temperaments Easy child Characterized by regularity, easy adaptability, and a positive mood in the approach to new situations Difficult child Demonstrates considerable irregularity, many negative mood expressions, slow adaptability, and frequently reacts negatively to new situations Slow-to-warm-up child Low activity level and mild reactions, is somewhat negative, and shows low adaptability

14. Pediatrics cont … Parents Influence how children think, socialize, and become self-aware Level of anxiety in dental office that is experienced by children is often a reflection of parental fears. Therefore, a child 's behavior during the dental appointment is affected significantly by the parents.

15. Pediatrics cont.. Economics These kids are vulnerable to feelings of shame, anxiety, and anger. They are unable to coordinate behavior with identified authority, particularly adults who are authoritative and seek compliance Low-income Families Children learn to communicate adversely, their vocabulary development suffers, acquire language slowly, retain immature pronunciations longer, and speak in shorter sentences. Therefore, it is suggested that the clinician speak slower, repeat information more than usual, and use visual aids when communicating with low-income children.

16. Pediatrics cont … Tell-Show-Do A straightforward strategy to help introduce a new experience in conjunction with helping to minimize fear of the unknown: Tell Verbal explanation that the patient understands Show Demonstration for the patient Do Completion of the procedure

17. Pediatrics cont … Positive Reinforcement The presentation of a stimulus immediately after desirable patient behavior that results in an increase in the frequency of the behavior This includes: Verbal reinforcers “ Good job ” Physical demonstrations Shaking child 's hand or stickers Nonverbal gestures Smile or thumbs up Tangible reinforcers Toys or stickers

18. Geriatrics People in the United States are living longer and healthier lives than ever before. The present geriatric population is one of the fastest growing segments of our society. Moreover, increasing numbers of “ well elderly ” are able to retain their natural teeth and enjoy normal oral function throughout old age Oral health professionals must be aware of the special management needed to treat this group of patients

19. Geriatrics The most common illnesses found in older American adults are arthritis, hypertension, impaired hearing, heart disease, and impaired vision For the first time in recorded history, there are now more older adults with natural teeth than without teeth; therefore, they are able to maintain functional dentition. This decline in edentulism appears to be the result of water fluoridation, increased public awareness of preventive approaches, improved access to services, and a decrease in early tooth loss

20. Geriatrics Many frail older adults can be seen at a regular dental office, provided that they are mobile and the office is accessible and senior-friendly Oral health care professionals must address how this aging population will manage in a variety of dental settings, and at a minimum, have accessible senior-friendly offices, medical history forms printed in large type, as well as easy-to-read signs, health literature, and appointment cards

21. Medically Compromised Population It is important for professionals to understand what oral changes may occur as a result of an altered medical state. The dental professional should be aware of approaches unique to each patient and their condition

22. Arthritis Arthritis literally means joint inflammation Consider the need for shorter visits. Allow the patient to walk around as needed, adjust any physical supports, or change position frequently while in the dental chair. The patient with an arthritic condition may not have the strength, movement, or dexterity to perform typical self-care regimens

23. Eating Disorders Two most common eating disorders are anorexia and bulimia The practitioner must pay special attention to the condition of the teeth. These patients commonly present with evidence of damage due to their carbohydrate intake and acid intake These patients should be placed on a self-care fluoride regimen in addition to professionally applied fluoride

24. Erosion Due to Bulimia

25. Cancer The dental professional should start with a thorough health history of their patients at each visit, followed by an oral cancer screening Some oral manifestations Xerostomia (dry mouth) Ulcers Increased susceptibility to infection Poor healing Important that infection does not perpetuate in the oral cavity and compound the patients condition Maintaining the teeth and tissue will allow the patient to eat property and regain a healthier state

26. Cancer Saliva substitutes should be recommended to keep the oral cavity moist Self-care fluoride treatments are most beneficial for patients with cancer. Most common risk factors are tobacco use, unprotected sun exposure, poor diet, infectious diseases, chemicals, and radiation exposure

27. Heart Disease Patients may express a number of the same problems that cancer patients have due to medication usage Xerostomia Gingival bleeding Rampant caries Patients with congestive heart failure will also be uncomfortable in the chair if the chair is reclined Brings increased fluid around the heart and patients feel as if they are suffocating

28. Tobacco Cigarette smoking is the most popular means of tobacco use, however, smokeless tobacco is also very popular Patients who use tobacco are seen to have greater incidence of periodontitis and a higher caries rate The most important role of the dental provider is to educate patients to not engage in these types of damaging activities

29. Summary

30. Developmental Disabilities Dental professionals need an understanding of the limits and conditions that could possibly affect patients who have disabilities. Populations with developmental disabilities can have varying degrees of functional level Preventive care is provided through the individual or the caregiver. Goals Need regular maintenance appointments Individualized treatment plans for individual 's abilities Sufficient use of preventive aids

31. Developmental Disabilities Although patients with developmental disabilities are able to brush their own teeth, it is very important to intimately involve the patient 's primary caregiver in oral hygiene instruction. Personalized techniques can be demonstrated and explained to suit each patient 's needs