Lec 1-1st sem3334

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Dental Health Education

• Lec 1-1st sem3334
• CHS 483
• By Dr. Ebtisam Fetohy

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Impact of oral disease

• Dental decay (cavities) is one of the most common
  chronic illnesses among children. Although most
  dental diseases are preventable, many children
  unnecessarily suffer from dental disease because
  of
• inadequate home care, and
• lack of access to dental services.
• An estimated 51 million school hours per year are
  lost in the U.S. because of dental-related
  illness.
• Poor oral health has been related to
• Decreased school performance,
• Poor social relationships and
• Less success later in life.

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• Employed adults in the United States lose more
  than 164 million hours of work each year as a
  result of oral health problems or dental visits.
• About 30 of adults 65 years old and older have
  lost all of their natural teeth.
• Older Americans with the poorest oral health are
  those who
• Are economically disadvantaged,
• Lack insurance and
• Are members of racial and ethnic minorities.
• As the nation ages, oral health issues related to
  gum disease and the impact of medical treatments
  and medicines will increase.
• Maintaining good oral health throughout a
  person's life is important.

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Oral diseases

• Even in adults, can affect
• one's overall health,
• one's ability to eat healthy food, and
• one's ability to get and keep a job.
• Several reports link low-grade infection in the
  mouth (periodontal disease) to systemic illnesses
  such as
• cardiovascular diseases (heart disease),
• respiratory ailments (pulmonary or lung disease),
  and
• poor pregnancy outcomes (babies born too small
  and too soon).
• Persons with diabetes are also at increased risk
  for periodontal infections.

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Programs and Initiatives

• Preventive Dentistry for High-Risk Underserved
  Children's Program
• Physically Handicapped Children's Program
• Dental Rehabilitation Program
• Preventive Dentistry Program for Deaf/Adolescent
  Children
• Prenatal programs
• Senior oral health programs
• Special needs persons Health Program
• Water Fluoridation
• School Fluoride Program The Self-Applied
  Fluoride Education Rinsing Program (SAFER)
• School-Based Health Center Dental Program
  (SBHC-D)
• Preventive Dental Services

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Dental Health Education

• Process that informs, motivates, and helps
  persons to adopt and maintain health practices
  and lifestyles, advocates environmental changes
  as needed to facilitate this goal and conducts
  professional training and research to the same
  end.
• Refers to actions that are intended either to
  alter lifestyles or the living environment of
  persons to improve health
• Water Fluoridation
• Reducing or eliminating access barriers
• Removing financial barriers

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Dental Health Educator

• Must have knowledge of
• -Available resources
• - Demographic Changes affecting dental health
  (socio-economic-Health services and weigh
  (external-Internal) variables in relation to
  clinical and behavioural reasrch findings

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Designing a Community Program

• When designing a community program that will be
  effective in achieving long term results and
  knowledge of program planning and community
  organization and skill development.
• All mothers and infant caretakers need to know
  how to prevent oral diseases.
• Reinforcing good oral health habits of future
  generation-school health education, community
  activities

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Possible Future Dental Health Problems

• Health education should address
• Water (fluoridation to prevent caries)
• Oral self care behaviours
• Oral screening and risk factors
• Baby Bottle tooth decay
• Oral health effects of anorexia nervosa and
  Bulimia
• Oral health effects of HIV/AIDS
• Cultural issues inherent in dental health
  education (swak)
• Dental health education for older adults
  (xerostomia and nutrition)
• Dental Health Education for special needs
  population
• Domestic violence, identification and referral

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Oral screening and risk factors for oral cancer
dental health education

• Efforts are done by
• Dentists
• Oral health care professionals
• Community health educators
• Class room Teachers

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Baby Bottle Tooth Decay

• Efforts of Dental Health Educators are targeted
  to
• Doctors
• Pediatricians
• Nurses
• Parents and caregivers

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Basic Concepts of dental Health Education

• A persons behavior is the result of both
  internal and external forces
• Beliefs , attitudes, interests, values, needs,
  motives, personality, expectations, perceptions
  and biologic factors (internal forces) plus.
• The influence of family, peer groups, education
  and media, (external forces) shape and affect
  actions.
• Socio- demographic factors such as age, race ,
  culture, gender, occupation, and income

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• To develop effective dental health education
  program, the educator must be aware of the
  interaction of all forces on the learners to
  develop and implement a rational educational
  program that will result in a sustained
  behavioural changes

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Effective Preventive community Program

• Community water fluoridation single most
  effective and efficient means for preventing
  dental caries in children and adults regardless
  of race or income level
• It s defined as the adjustment of the
  concentration of fluoride of the community water
  supply for optimal oral health
• It ranges from 0.7 to 1.2 part per million (ppm)
  fluoride depending on the mean maximum daily air
  temperature over a 5 year period
• 1ppm fluoride1mg fluoride per litre of water

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Natural Fluoridation

• All water contains at least trace amount of
  fluoride
• Adjusted fluoridation is by adding fluoride
  chemicals to fluoride deficient water
• Safety falsely attributed Allergies- AIDS,
  Alzheimers disease, cancer, heart disease,
  kidney disease, bone disease
• 50-70 of caries was prevented by adjusted
  fluoridation (early studies)
• In USA 30-60 in children (3-5y)
• 20-40 in children (6-12 y)
• 25-35 for adolescents and adults
• 17-35 root caries in seniors
• Cost effective for every dollar spent on water
  fluoridation ,80 saving in treatment

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• Dental Fluorosis Excessive intake of Fluoride
  leads to
• hypo-mineralization and
• disruption of enamel developments
• It is caused by
• Prolonged use of formula milk and
• Tooth paste ingestion (younger than 6 years)

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Deciduous Teeth

• Start 5th or 6th week in Utero
• Lower first
• Continue after birth until full set (10 upper
  maxillary and 10 lower mandibular)
• Take 2-3 years to form

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Permanent Teeth

• Start during 4-5th month in Utero
• First lower
• Development continue till after birth until 16
  upper and 16 lower form
• Take9-10 yrs to form

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Bud stage

• Tooth development starts with the formation of a
  germ which produces the different layers of the
  tooth.
• This stage is often referred to as the bud
  stage because the tooth layers thicken and grow
  downwards resembling the shape of a bud.

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Cap stage

• The cells multiply at a rapid rate and take on
  the shape of a cap.
• The tooth buds of the permanent teeth begin to
  form.

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Bell stage

• As the cells increase in number, they assume the
  shape of a bell.
• Latter the cells become specialized and form the
  different layers of the tooth.

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How does a tooth form?

• While the tooth germ is developing, the
  surrounding area of the jaw also continues to
  develop.
• The bone cells form the upper jaw (maxilla) and
  the lower jaw (mandible).
• The tooth takes on the shape of a crown and a
  root.
• During the final stage of tooth formation, the
  enamel and dentine increase in layers until the
  tooth is completely shaped.
• However, when the eruption of a tooth occurs,
  only a small portion of the root has formed.

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How does a tooth form?/2

• The tooth will be fully erupted for approximately
  2 years before the full root length is attained.
• In the final stage of tooth development, the
  different layers calcify. Once a tooth is formed
  it cannot repair itself (if damaged) like bone or
  skin. Damage at this point can have a great
  impact on the health of teeth.

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Tooth Structure
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Tooth structure

• The portion of the tooth visible in the mouth is
  called the crown.
• The crown is covered with enamel which is a hard,
  white, shiny substance. Enamel is a highly
  calcified bone and is the protective layer of the
  tooth.
• Enamel is made up of millions of tiny rods which
  form the framework of the tooth. It is thickest
  at the biting surface of the tooth and very thin
  near the gum line.

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• The color of enamel ranges from yellow to white
  depending upon its translucency-the more
  translucent the enamel, the more yellow color of
  the underlying dentine is apparent.
• The enamel portion of the tooth has no feeling.
• Even though the enamel is very hard, it can wear
  away???? due to
• Attrition (abrasion) (????) or
• Erosion (be dissolved by acid) (??????) and it
  may be fractured due to
• Stress, and or
• Affected by dental decay.

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• The layer found under the enamel is the dentine,
• It forms the bulk of the crown and the roots,
• It is yellowish in color.
• Dentine is softer than enamel and
• It carries sensations such as temperature and
  pain to the pulp.
• The pulp is the innermost portion of the tooth
  and is the only soft tissue of the tooth.
• It is made up of blood vessels, cellular
  substance and nerves.
• It supplies nutrients to the tooth and
• Its nerve endings transmit sensations such as
  pain and temperature.

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Tooth structure

• Cementum forms a very thin layer over the root of
  the tooth
• It is similar to bone.
• It is yellowish in color and also
• It carries sensations such as temperature and
  pain to the pulp.
• If the gum recedes from the tooth and the
  cementum is exposed, there may be a sharp
  sensation when brushing the teeth or eating food
  (this is usually an adult condition)

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Tooth types

• Deciduous teeth are also known as baby teeth,
  milk teeth, primary teeth or first teeth.
• They are shed and replaced by permanent
  teeth-this process is called exfoliation.
• deciduous teeth are much whiter than permanent
  teeth and
• They are softer. Therefore, deciduous teeth can
  appear very worn???? due to grinding (?????) and
  normal wear ???? through eating.
• The incisors are used for cutting,
• The canines for tearing and
• The molars for chewing

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• In the lower arch (mandible) there are ten
  deciduous teeth
• 2 central incisors
• 2 lateral incisors
• 2 canines
• 2 first molars
• 2 second molars

• In the upper arch (maxilla) there are ten
  deciduous teeth
• 2 central incisors
• 2 lateral incisors
• 2 canines
• 2 first molars
• 2 second molars

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Healthy deciduous teeth are important for

• Efficient mastication of food.
• Maintaining normal facial appearance.
• Formulating clear speech.
• Maintaining a proper diet-missing or badly
  decayed teeth may cause young children to reject
  foods that are difficult to chew.
• Maintaining space for the permanent teeth.
• Jaw development
• Self-esteem.

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Tooth eruption

• Deciduous teeth
• Although deciduous teeth begin to form in utero,
  they dont usually begin to erupt till 6 months
  of age.
• Eruption times vary from child to child just as
  the individual growth rate varies.
• Normally no teeth are visible in the mouth at
  birth.
• Occasionally, however, some babies are born with
  an erupted incisor tooth (neonatal tooth), but
  these are not true teeth and are usually lost
  after birth. They dont usually begin to erupt
  until 6 months of age

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Eruption patterns

• Lower teeth usually erupted before the upper
  teeth
• Girls usually precede boys in tooth eruption
• The teeth in both jaws usually erupt in pairs-one
  on the right and one on the left.
• By the time the child reaches the age of 2 to 3
  years of age, all the deciduous teeth should have
  erupted.

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Permanent teeth
At about 6 years of age, the first permanent
molars and lower permanent incisors begin to
erupt. -Between the age of approximately 6 and 12
years, children have mixture of permanent and
deciduous teeth. This is known as mixed
dentitions. -By the age of 12, most children have
all their permanent teeth except the third
molars, which erupt between the age of 17-21
years
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Baby Teeth

• Front TeethA. Central incisorB. Lateral
  incisorC. Canine or eye tooth
• Back TeethD. First molarE. Second molar

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Permanent Teeth

• Tooth Names
• Front Teeth1. Central incisor2. Lateral
  incisor3. Canine or eye tooth
• Back Teeth4. First premolar5. Second
  premolar6. First Molar7. Second Molar8. Third
  Molar Or Wisdom Tooth

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The temporomandibular

• The temporomandibular joints are the two jaw
  joints, one at each side of the face.
• Movement of the lower jaw is made possible by
  this joint.
• The upper jaw is called the maxilla and is joined
  to the temporal bone.
• The lower jaw is called the mandible or
  mandibular bone.
• The term "temporomandibular" refers to the
  connection between these two bones.
• Chewing and speech would not be possible without
  this joint.

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Thank You