Concepts of Health & Prevention of Disease

Dr. Abdullah AlAmri

Health
Health is the state of complete physical, mental, and social well-being and not merely the absence of disease or infirmity Health triangle

physical

Health
Mental Social

Determinants of health
What Makes people Healthy or Unhealthy?

Its the range of personal, social, economic & environmental factors that influence health status

Determinants of health

World health organization & Public Health Agency of Canada has identified 12 determinants of health: 1. Income and Social Status 2. Employment/Working Conditions 3. Education and Literacy 4. Social Environments 5. Physical Environments 6. Healthy Child Development 7. Personal Health Practices and Coping Skills 8. Health Services 9. Social Support Networks 10. Biology and Genetic Endowment 11. Gender 12. Culture

Dimensions of health 1. Physical: it is an ability of human body structure to

function properly.
2. Social : it is the ability to interact with other individuals.

3. Mental : ability to process information and act properly.

4. Emotional: Ability to copy, adjust , and adapt. 5. Spiritual: it is to belief in some force or dynamic other than human. 6. Environmental

Definitions of Prevention of Disease

Prevention can be defined as preventing either the onset or the progress of a disease, or restoring function lost due to disease This definition assumes that the thing being prevented is anticipated

Criteria for Disease Prevention

1. The disease & conditions are significant

Incidence & prevalence Mortality & morbidity Economics

The natural history of disease must be understood There should be an effective intervention available

2. There is prevention that works

Criteria for Disease Prevention

3. Prevention is better than cure, repair, or doing nothing
Acceptability Economics Balance against process and outcome of disease Acceptable associated risk

4.

Availability of resources to implement the preventive measures Man power number Man power skills & ability Materials Time Political will

Criteria for Disease Prevention

5. Economic economics can be calculated
Cost efficiency Cost benefits Cost utility
Cost of implementation No. of tooth surfaces saved Cost of implementation Saving in cost of treatment Cost of implementation Benefits to quality of life

6. Ethics

Ideal public health

Efficient in reducing disease. Easily and efficiently implemented. Medically safe. Inexpensive. Uncomplicated. Accepted by patients. Minimum compliance is needed.

Why preventive dentistry is necessary?

Incidence of oral disease has increased 95 % of all Americans suffer from dental caries 90 % of the adult population suffers from some form of periodontal disease 30,800 new cases of oral cancer occur each year in the USA

What is preventive dentistry?

It is a philosophy and modern way of oral health care that includes all phases of dentistry 1. Prevention of dental caries and periodontal diseases 2. Proper restoration and replacement of teeth 3. Root canal treatment 4. Orthodontic braces 5. Surgical removal of teeth to prevent the spread of infection

Historical Aspect of Preventive Dental Care

Dr. Alfred , the founder of dental hygiene and preventive dentistry in 1916

Dr. Alfred Civilion Fones (1869 1938)

Levels of preventive care

1. Primary prevention 2. Secondary prevention 3. Tertiary prevention

Levels of preventive care

1. Primary prevention (prepathogenesis):
Action taken prior to the onset of the disease, which removes the possibility that a disease will even occur Carried out on healthy populations Health promotion Specific protection

Levels of preventive care

2. Secondary prevention: (pathogenesis: Initial stage of pathogenesis)
Actions which halt the progress of a disease at its incipient stage and prevent complications
Terminate the disease process and preventing its progressive activity to more advanced stages (prevent complications of disease) Restore tissues to as near normal as possible Can be termed restorative care

Levels of preventive care

3. Tertiary prevention: (pathogenesis: Late stage of pathogenesis)
Action taken when the disease process has advanced beyond its early stage Intervention in late pathogenesis stage All measures available to reduce or limit impairment & disabilities Rehabilitate patients The aim of tertiary prevention is to limit disability & prevent further complications & death

Level of prevention Primary prevention

Therapies and services Oral evaluation Dental prophylaxis Fluoride as a preventive agent Dental sealant Health education Health promotion Dental restoration Fluoride use on incipient caries Endodontics

Secondary prevention

Tertiary prevention

prosthodontics implants Oromaxillofacial surgery

Primary Prevention
The general approaches to the primary prevention of dental caries and periodontal diseases involve the following measures: 1. Professional oral assessments 2. Patient involvement in the control of plaque 3. Professional periodontal debridement 4. Water fluoridation 5. Use of fluoride products 6. Use of antimicrobial agents to reduce plaque biofilm

Primary Prevention
7. Use of dental sealants 8. Practice of nutritionally healthy habits including sugar discipline

Secondary and Tertiary Prevention

Development of diseases and infections which cause undesirable pain and discomfort Cost Decrease patient satisfaction

Which of the following statements are correct?

a. The absence of a disease or infirmity is a good sign of physical health but not necessarily of mental and social well-being T b. A professional football player who looks well, has no physical infirmities, but continually worries about his $10 million contract, can be considered in excellent healthNO c. An amalgam restoration that is placed in a carious occlusal pit of a molar is an excellent example of tertiary prevention F

Approaches of prevention
1. High risk (target) strategy

Population is classified in relation to the degree of risk which individual or group of individual exhibit It aims to bring preventive care to individuals or a group at special risk.

Approaches of prevention
1. High risk (target) strategy
Advantages;
Doctor-patient relationship. Better motivation. Cost benefits. Individual appropriateness. Criteria for at risk not clear. Cost of screening. Dose not solve cause of disease. Misses transitional populations.

Disadvantages;

Approaches of prevention
2. Mass (whole population) strategy

Directed at the whole population irrespective of individual risk levels Doesnt differentiate between individuals in any defined population It treats all individuals as at equal risk

Approaches of prevention
2. Mass (whole population) strategy
Advantages;
Easier. Behaviorally appropriate for whole population. Gets to the cause of disease. Reaches all who may become high risk

Disadvantages;
Requires a lot of motivation. Dilution of efforts. Dilution of effects. Less specific. Higher rate of failure. Lessened benefit to individuals.

Barriers (challenges) to preventive strategies

1. 2. 3. 4. 5. 6. Diversity of population Inherent beliefs/mores Advertising Pressure groups Access Recourses

Categories of Oral Diseases

Oral diseases & abnormalities can be conveniently grouped into three categories:

1. Dental caries & periodontal disease, both of which are acquired disease 2. Acquired oral conditions other than dental caries & periodontal diseases such as; Oral cancer, HIV/AIDS, and opportunistic infections 3. Craniofacial disorders (wide variety of conditions ranging from hereditary to accidents)

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