ROCACURVA, NIÑA ELMIRA MAVIR P.

DENT I

Preventive Dentistry
By Lisette Hilton

Definition
Preventive dentistry is the area of dentistry that focuses on those procedures and life practices
that help people to prevent the beginning or progression of oral disease. It includes at-home
dental care performed by patients, as well as dental care and education by professional dental
staff in the office or clinic.

Purpose
Preventive dentistry includes two aspects of dental care, both performed to help patients avoid
dental disease or to catch it in its early, more treatable stages. In part, it is the oral hygiene care
performed by the patient at home. Preventive dentistry also encompasses what is done by the
dental staff in their offices to help patients maintain healthy teeth and gums. In either case, the
objective is to stop the development of oral disease or to find it at an early stage. Dental health
professionals most often look for early signs of periodontal disease, dental decay, and other
changes in the soft tissue of the mouth that could lead to oral cancer.
Precautions
Preventive dentistry should always be prescribed and not harm patients when done correctly. At
times, dentists do need to take precautions when someone has a medical condition that would be
affected by some of the procedures. Dentists need to be aware of certain medical conditions, such
as mitral valve prolapse, which need to be treated with prophylactic antibiotics. Allergies to any of
the medications or materials used in preventive dentistry are rare.
Description
Preventive care in a dental office includes prophylaxis, or the cleaning of the teeth, which
removes accumulations of calculus. It includes examination of the teeth and soft tissue, using
visual and tactile exams, radiographic examination, such as x rays, and oral cancer screening.
Newer techniques to diagnose periodontal, or gum disease, include computerized measurement
devices that measure the bacterial content in the mouth. Sometimes, dentists prescribe
medications to help prevent dental disease. These include anti-inflammatory mouthwashes to
prevent periodontal problems.
Preventive procedures often performed by dentists for children include the use of fluoride
supplements and applications. Dentists apply dental sealants to children's teeth, forming a barrier
between tooth crevasses and bacteria to help ward off dental decay. Dental health professionals
also look for malocclusions, and might refer patients to a dental specialist, such as an
orthodontist, to correct a patient's bad bite. Experts state that children should be evaluated by an
orthodontist by age seven.
An important part of preventive dentistry performed by dental professionals is educating patients
about at-home care, nutrition, and smoking cessation. At-home procedures performed by patients
that help ward off dental disease include regular and proper brushing, flossing and sometimes use
of mouth rinses and at-home fluoride applications. Dentists and their staff explain proper brushing
and flossing techniques. Proper brushing includes use of a soft nylon toothbrush with round-ended
bristles. Patients should place the bristles along the gum line at a 45-degree angle to cover the
tooth surface and gum line. The brushing technique should be gentle and in a rolling back-and-
forth motion, with two to three teeth being brushed at a time. Patients should brush the inner
surfaces of their teeth and tilt the brush vertically to brush the front teeth. Ideally, patients should
use a back-and-forth motion to brush the biting surface of the teeth and the tongue. Flossing
removes plaque from between teeth and at the gum line. It should be done with an 18-inch strip
of floss wrapped around the middle fingers of each hand. The remaining one to two inches of floss
that is inserted between the teeth should be directed by the thumbs. By keeping the floss taut,
patients can use their index fingers to guide the floss between the lower teeth with a gentle zig-
zag motion, while contouring the floss around the sides of the teeth. They should floss each tooth
with a clean section of the floss and ensure that the floss goes under the gum line.
Preventive dental care should begin in infancy, within the first year of life before teeth first
appear, and continue throughout life. Even before teeth erupt, parents can clean infants' gums
after feeding. Preventive care in adolescence includes brushing and flossing, as well as wearing
custom-made mouth guards to protect the teeth during contact sports. Considering that 75% of
Americans have some form of dental disease, regular dental visits are particularly important for
adults. Seniors often benefit from training in proper techniques of denture care and cleaning,
which include brushing the replacement teeth. Those who have problems moving their hands
because of arthritis, for example, also benefit from tips for adapting toothbrushes for easier
handling.
Results
The results of good preventive dental care are healthy teeth and gums throughout one's life and
the early detection of oral disease. Preventive procedures, such as fluoride applications and
sealants, can prevent tooth decay. Regular dental checkups and oral cancer screenings can catch
oral cancer at its most treatable stages. Dental checkups and consistent at-home preventive
dental care can stave off caries (tooth decay) and periodontal disease, which can lead to tooth
loss. An estimated 75% of adults have periodontal disease. Regular dental checkups can reduce
the risk of permanent tooth and gum damage, and expensive treatment in the future. As a result
of preventive dental care, people tend to keep their original teeth throughout life and don't need
as much restorative dental work. Preventive dental examinations also ensure that a dentist will
notice any oral signs of systemic disease. A dental checkup might reveal a lesion in the mouth
that could lead to a referral to a physician for further investigation.
Treatments resulting from preventive dental procedures are designed to stop the process of the
disease. Restorative dentistry, including the placement of fillings, crowns, and dental work,
addresses tooth decay and tooth loss that can result from periodontal disease. Periodontal
treatments help restore healthy gums and can prevent tooth loss.
Health care team roles
The dentist oversees the process of examination, diagnosis, treatment planning, and education.
The allied dental personnel include the dental hygienist and dental assistant. Dental hygienists
sometimes perform preventive techniques, including cleaning, fluoride and sealant application,
and patient education. The dental assistant in some states, depending on state licensing, can
perform many of the same procedures as the hygienist, assist the dentist during checkups, and
provide patient guidance and education.

Read more: http://www.healthline.com/galecontent/preventive-dentistry/2#ixzz1GWCHG1V9

Healthline.com - Connect to Better Health
Oral health: A window to your overall health
By Mayo Clinic staff
Did you know that your oral health can offer clues about your overall health? Or that problems in
your mouth can affect the rest of your body? Understand the intimate connection between oral
health and overall health and what you can do to protect yourself.

What's the connection between oral health and overall health?

Your mouth is teeming with bacteria — most of them harmless. Normally the body's natural
defenses and good oral health care, such as daily brushing and flossing, can keep these bacteria
under control. However, harmful bacteria can sometimes grow out of control and cause oral
infections, such as tooth decay and gum disease. In addition, dental procedures, medications, or
treatments that reduce saliva flow, disrupt the normal balance of bacteria in your mouth or breach
the mouth's normal protective barriers may make it easier for bacteria to enter your bloodstream.

What conditions may be linked to oral health?

Your oral health may affect, be affected by or contribute to various diseases and conditions,
including:
 Endocarditis. Gum disease and dental procedures that cut your gums may allow bacteria to
enter your bloodstream. If you have a weak immune system or a damaged heart valve,
this can cause infection in other parts of the body — such as an infection of the inner lining
of the heart (endocarditis).
 Cardiovascular disease. Some research suggests that heart disease, clogged arteries and
stroke may be linked to oral bacteria, possibly due to chronic inflammation from
periodontitis — a severe form of gum disease.
 Pregnancy and birth. Gum disease has been linked to premature birth and low birth weight.
 Diabetes. Diabetes reduces the body's resistance to infection — putting the gums at risk.
In addition, people who have inadequate blood sugar control may develop more-frequent
and severe infections of the gums and the bone that holds teeth in place, and they may
lose more teeth than do people who have good blood sugar control.
 HIV/AIDS. Oral problems, such as painful mucosal lesions, are common in people who have
HIV/AIDS.
 Osteoporosis. Osteoporosis — which causes bones to become weak and brittle — may be
associated with periodontal bone loss and tooth loss.
 Alzheimer's disease. Tooth loss before age 35 may be a risk factor for Alzheimer's disease.
 Other conditions. Other conditions that may be linked to oral health include Sjogren's
syndrome — an immune system disorder — and eating disorders.
Be sure to tell your dentist if you're taking any medications or have had any changes in your
overall health — especially if you've had any recent illnesses or you have a chronic condition.

How can I protect my oral health?

To protect your oral health, resolve to practice good oral hygiene every day. For example:
 Brush your teeth at least twice a day.
 Replace your toothbrush every three to four months.
  Floss daily.
 Eat a healthy diet and limit between-meal snacks.
 Schedule regular dental checkups.
Also, watch for signs and symptoms of oral disease and contact your dentist as soon as a problem
arises. Remember, taking care of your oral health is an investment in your overall health.

References
Oral-systemic health, medications. American Dental Association. http://www.ada.org/4081.aspx?
currentTab=2. Accessed Nov. 15, 2010.
Diabetes and oral health. American Dental Association.
http://www.ada.org/sections/publicResources/pdfs/patient_18.pdf. Accessed Nov. 15, 2010.
Pregnant? Tips for keeping your smile healthy. American Dental Association.
http://www.ada.org/sections/publicResources/pdfs/patient_34.pdf. Accessed Nov. 15, 2010.
Krall KE. Bone health and oral health. The Journal of the American Dental Association.
2007;138:616.
American Dental Association. Healthy mouth, healthy body. Journal of the American Dental
Association. 2006;137:563.
Michalowicz BS, et al. Treatment of periodontal disease and the risk of preterm birth. The New
England Journal of Medicine. 2006;355:1885.
Loesche W. Dental caries and periodontitis: Contrasting two infections that have medical
implications. Infectious Disease Clinics of North America. 2007;21:471.
Links between oral and general health. Centers for Disease Control and Prevention.
http://www.cdc.gov/OralHealth/publications/factsheets/sgr2000_fs4.htm. Accessed Nov. 15,
2010.
Casamassimo PS. Oral and systemic health. http://www.uptodate.com/home/index.html.
Accessed Nov. 15, 2010.
Wilder RS, et al. Gingivitis and periodontitis in adults: Classification and dental treatment.
http://www.uptodate.com/home/index.html. Accessed Nov. 15, 2010.
Gatz M, et al. Potentially modifiable risk factors for dementia in identical twins. Alzheimer's &
Dementia. 2006;2:110.
Endocarditis. National Heart, Lung, and Blood Institute.
http://www.nhlbi.nih.gov/health/dci/Diseases/endo/endo_all.html. Accessed Nov. 16, 2010.
Anorexia nervosa (eating disorders). American Dental Association.
http://www.ada.org/3104.aspx?currentTab=1. Accessed Nov. 16, 2010.
Sjogren's syndrome: Questions and answers about Sjogren's syndrome. National Institute of
Arthritis and Musculoskeletal and Skin Diseases.
http://www.niams.nih.gov/Health_Info/Sjogrens_Syndrome/default.asp#drymouth. Accessed
Nov. 16, 2010.
 HHS and EPA announce new scientific assessments and actions on fluoride
Agencies working together to maintain benefits of preventing tooth decay
while preventing excessive exposure
WASHINGTON – The U.S. Department of Health and Human Services (HHS) and the U.S.
Environmental Protection Agency (EPA) today are announcing important steps to ensure that
standards and guidelines on fluoride in drinking water continue to provide the maximum
protection to the American people to support good dental health, especially in children. HHS is
proposing that the recommended level of fluoride in drinking water can be set at the lowest end of
the current optimal range to prevent tooth decay, and EPA is initiating review of the maximum
amount of fluoride allowed in drinking water.
These actions will maximize the health benefits of water fluoridation, an important tool in the
prevention of tooth decay while reducing the possibility of children receiving too much fluoride.
The Centers for Disease Control and Prevention named the fluoridation of drinking water one of
the ten great public health achievements of the 20th century.
“One of water fluoridation’s biggest advantages is that it benefits all residents of a community—at
home, work, school, or play,” said HHS Assistant Secretary for Health Howard K. Koh, MD, MPH.
“Today’s announcement is part of our ongoing support of appropriate fluoridation for community
water systems, and its effectiveness in preventing tooth decay throughout one’s lifetime.”
“Today both HHS and EPA are making announcements on fluoride based on the most up to date
scientific data,” said EPA Assistant Administrator for the Office of Water, Peter Silva. “EPA’s new
analysis will help us make sure that people benefit from tooth decay prevention while at the same
time avoiding the unwanted health effects from too much fluoride.”
HHS and EPA reached an understanding of the latest science on fluoride and its effect on tooth
decay prevention and the development of dental fluorosis that may occur with excess fluoride
consumption during the tooth forming years, age 8 and younger. Dental fluorosis in the United
States appears mostly in the very mild or mild form – as barely visible lacy white markings or
spots on the enamel. The severe form of dental fluorosis, with staining and pitting of the tooth
surface, is rare in the United States.
There are several reasons for the changes seen over time, including that Americans have access
to more sources of fluoride than they did when water fluoridation was first introduced in the
United States in the 1940s. Water is now one of several sources of fluoride. Other common
sources include dental products such as toothpaste and mouth rinses, prescription fluoride
supplements, and fluoride applied by dental professionals. Water fluoridation and fluoride
toothpaste are largely responsible for the significant decline in tooth decay in the U.S. over the
past several decades.
HHS’ proposed recommendation of 0.7 milligrams of fluoride per liter of water replaces the current
recommended range of 0.7 to 1.2 milligrams. This updated recommendation is based on recent
EPA and HHS scientific assessments to balance the benefits of preventing tooth decay while
limiting any unwanted health effects. These scientific assessments will also guide EPA in making a
determination of whether to lower the maximum amount of fluoride allowed in drinking water,
which is set to prevent adverse health effects.
The new EPA assessments of fluoride were undertaken in response to findings of the National
Academies of Science (NAS). At EPA’s request, in 2006 NAS reviewed new data on fluoride and
issued a report recommending that EPA update its health and exposure assessments to take into
account bone and dental effects and to consider all sources of fluoride. In addition to EPA’s new
assessments and the NAS report, HHS also considered current levels of tooth decay and dental
fluorosis and fluid consumption across the United States. HHS is expecting to publish final
guidance for community water fluoridation by spring 2011.
source: http://www.hhs.gov/news/press/2011pres/01/20110107a.html
Eight Steps to Dental Health
Reviewed by the Faculty of Columbia University College of Dental Medicine

It takes more than just brushing.

OK, so you know about brushing and flossing. But there are other steps you should take if you
want to keep your teeth for a lifetime. Some people assume they will lose their teeth as they age.
That doesn't have to happen. David A. Albert, D.D.S., M.P.H., suggests these steps to keep your
teeth and your mouth healthy. Dr. Albert is an assistant professor of clinical dentistry at the
Columbia University College of Dental Medicine.

Step 1: Understand your own oral health needs.

"Your oral health depends on many factors," Dr. Albert said. "These include what you eat, the type
and amount of saliva in your mouth, your habits, your overall health and your oral hygiene
routine."
Changes in your overall health status often result in changes in your oral health. "For example,
many medicines, including more than 300 common drugs, can reduce the amount of saliva in your
mouth, resulting in dry mouth," he said.
"Women who are pregnant go through oral changes. This often includes inflammation of the
gums, which is called pregnancy gingivitis. Patients with asthma often breathe through their
mouths, particularly when sleeping. This can result in dry mouth and increased plaque formation
and gingivitis."

Step 2: Commit to a daily oral health routine.

Talk to your dentist or dental hygienist about your oral health practices. Based on the discussion,
come up with an effective routine. It should be easy to follow and should take your situation into
account. For example, if you are taking medicine that dries your mouth, you may want to use
fluoride every day. Pregnant women, people with health conditions such as diabetes, and people
with braces also may want or need special daily care.

Step 3: Use fluoride products.

Everyone can benefit from fluoride, not just children. Fluoride strengthens developing teeth in
children. It also helps prevent decay in adults and children. Toothpastes and mouthwashes are
good sources of fluoride. Your dentist can prescribe a stronger concentration of fluoride in a gel,
toothpaste or rinse if you need it.

Step 4: Brush and floss to remove plaque.

Everyone should brush at least twice a day. It's even better to brush three times a day or after
every meal. In addition, you should floss at least once a day. These activities remove plaque,
which is a complex mass of bacteria that constantly forms on your teeth. If plaque isn't removed
every day, it can turn the sugars found in most foods and drinks into acids that lead to decay.
Bacteria in plaque also cause gingivitis and other periodontal diseases. It's important to brush and
floss correctly and thoroughly. You need to remove plaque from all sides of the tooth and where
the tooth meets the gums. If plaque is not removed, it can lead to gum problems and cavities.
Step 5: Limit snacks, particularly those high in simple sugars, and eat a balanced diet.
Every time you eat, bits of food become lodged in and around your teeth. This food provides fuel
for the bacteria in plaque. The bacteria produce acid. Each time you eat food containing sugars or
starches (complex sugars), your teeth are exposed to these acids for 20 minutes or more. This
occurs more often if you eat snacks and the food stays on your teeth for a while. These repeated
acid attacks can break down the enamel surface of your teeth, leading to a cavity. If you must
snack, brush your teeth or chew sugarless gum afterward.
A balanced diet is also important. Not getting enough minerals and vitamins can affect your oral
health, as well as your general health.

Step 6: If you use tobacco in any form, quit.

Smoking or using smokeless tobacco increases your risk of oral cancer, gingivitis, periodontitis and
tooth decay. Using tobacco also contributes to bad breath and stains on your teeth.

Step 7: Examine your mouth regularly.

Even if you visit your dentist regularly, you are in the best position to notice changes in your
mouth. Your dentist and dental hygienist see you only a few times a year, but you can examine
your mouth weekly to look for changes that might be of concern. These changes could include:
 Swollen gums
 Chipped teeth
 Discolored teeth
 Sores or lesions on your gums, cheeks or tongue
A regular examination is particularly important for tobacco users, who are at increased risk of
developing oral cancer. If you smoke or use smokeless tobacco, your dentist or dental hygienist
can show you where a sore, spot, patch or lump is most likely to appear.

Step 8: Visit the dental office regularly.

Talk to your dentist about how often you should visit. If you have a history of cavities or crown
and bridge work, or are wearing braces, you should visit the dentist more often. Some people,
such as diabetics or smokers, have more gum disease than the general population. They also
should visit the dentist more often. People with suppressed immune systems also are more likely
to have dental problems. Examples include people who are infected with HIV or are receiving
cancer treatment. More frequent visits for these groups are important to maintain good oral
health.
Source:
http://www.simplestepsdental.com/SS/ihtSSPrint/r.WSIHW000/st.32218/t.32497/pr.3/c.314656.h
tml
COMMUNITY DENTISTRY ARTICLES
PHILIPPINES : Camiguin steps up campaign on oral care
Tendersinfo News
March 10, 2011
The Philippine Dental Association (PDA), Camiguin Chapter successfully completed its massive
dental outreach to community folks, school children and school teachers in the island last
month.The activity was among those lined up by PDA, Camiguin as they joined the nation in
celebrating the Oral Health Month of February.

The event featured advocacy on the importance of preventive services like keeping good oral
hygiene and scheduling regular dental visits, especially among children to develop good
habits.Dental services like oral examinations, tooth cleaning or extraction and other restorative
care were likewise extended to all beneficiaries in priority barangays and schools.During the
community outreach program, PDA in partnership with Colgate, Phils. also distributed complete
oral hygiene kit consisting of toothpaste, toothbrush, dental floss and mouthwash in two (2)
barangays of the province.Children in other beneficiary communities, likewise, received set of
toothpaste and toothbrush given by the Camiguin Provincial Government Camiguin Provincial
Dental Coordinator, Dr. Ophelia M. Sahay, said that the dental outreach program is a year-round
activity which prioritizes school children, dubbed as the Orally Fit Child Program .For preventive
care, we also have the Essential Health Care Package (EHCP) in partnership with Fit for School
Foundation where all grade levels 1 to 4 elementary students were given health care kits
consisting of hand washing soap, toothbrush and fluoride toothpaste, Sahay said.She also said the
EHCP was expanded last year to cover all pre-schoolers. All these children will enjoy year-round
supply of the basic hygiene kit, she added.Sahay noted that the local government also launched
Gov. Romualdo s dental program which caters to the Grade 5 and 6 levels and extends services to
all high schools and college scholars of the Provincial Youth Grantees (PYG).

Copyright 2011 Tendersinfo News, distributed by Contify.com

All Rights Reserved
TYPES OF FLUORIDE

SODIUM FLUORIDE
Sodium fluoride is an inorganic chemical compound with the formula NaF. A colorless solid, it is a
source of the fluoride ion in diverse applications. Sodium fluoride is less expensive and less
hygroscopic than the related salt potassium fluoride.
Fluoride salts are used to enhance the strength of teeth by the formation of fluorapatite, a
naturally occurring component of tooth enamel. Although sodium fluoride is also used to fluoridate
water and, indeed, is the standard by which other water-fluoridation compounds are gauged,
hexafluorosilicic acid (H2SiF6) and its salt sodium hexafluorosilicate (Na2SiF6) are more
commonly used additives in the U.S. Toothpaste often contains sodium fluoride to prevent
cavities.

HEXAFLUOROSILICIC ACID
Hexafluorosilicic acid is the inorganic compound with the formula H2SiF6. It is a product of the
production of hydrogen fluoride and the production of phosphate fertilizers. The majority of the
hexafluorosilicic acid is used for the production of aluminium metal.
Hexafluorosilicic acid is also commonly used for water fluoridation in several countries including
the United States, Great Britain, and Ireland. In the U.S., about 40,000 tons of fluorosilic acid is
recovered from phosphoric acid plants, and then used primarily in water fluoridation, sometimes
after being processed into sodium silicofluoride.

STANNOUS FLUORIDE
Tin(II) fluoride, known by the common name stannous fluoride, is a chemical compound with the
formula SnF2. It is a colorless solid used as an ingredient in toothpastes that are typically more
expensive than those that use sodium fluoride. Stannous fluoride converts the calcium mineral
apatite into fluorapatite, which makes tooth enamel more resistant to bacteria generated acid
attacks. Sodium fluoride and sodium fluorophosphate, on the other hand, become biologically
inactive when combined with calcium. Used in combination with calcium minerals, sodium fluoride
is ineffective while stannous fluoride remains effective in strengthening tooth enamel. Stannous
fluoride has also been shown to be more effective than sodium fluoride in controlling gingivitis.
Stannous fluoride was used, under the trade name "Fluoristan," in the original formulation of the
toothpaste Crest, though it was later replaced with sodium monofluorophosphate, or "Fluoristat."
It is the active ingredient in Crest Pro Health brand toothpaste. Crest Pro Health issues a warning
on the tube that stannous fluoride may cause staining which can be avoided by proper brushing,
and that its particular formulation is resistant to staining. Any stannous fluoride staining that
occurs due to improper brushing is not permanent.
Stannous fluoride is also readily available in over-the-counter rinses, most notably found in
MEDActive® brand Patient-Friendly™ Oral Relief Rinse.

SODIUM MONOPHOSPHATE
Sodium monofluorophosphate, commonly abbreviated MFP, is the inorganic compound with the
formula Na2PO3F. Typical for a salt, MFP is odourless, colourless, and water-soluble. This salt is an
ingredient in some toothpastes.
MFP is best known as an ingredient in toothpastes. It is claimed to protect tooth enamel from
attack by bacteria that cause dental caries (cavities). Though developed by a chemist at Procter
and Gamble, its use in toothpaste (Colgate toothpaste) was patented by Colgate-Palmolive, as
Procter and Gamble was engaged in the marketing of Crest toothpaste (containing stannous
fluoride, marketed as "Fluoristan"). In the early 1980s, Crest was reformulated to use MFP, under
the trademark "Fluoristat."
MFP is also used in some medications for the treatment of osteoporosis.
In 1991, sodium monofluorophosphate was found by Calgon to inhibit the dissolution of lead in
drinking water when used in concentrations between 0.1 mg/L and 500 mg/L.

LABORATORY EFFECTIVENESS OF DIFFERENT TYPES OF FLUORIDE COMPOUNDS

Aust Dent J. 1976 Jun;21(3):231-6.
Shannon IL, Wescott WB.
Abstract
The enamel solubility reducing characteristics of four fluorides -- sodium fluoride (NaF), acidulated
phosphate fluoride (APF), stannous fluoride (SnF2), and sodium monofluorophosphate (Na2PO3F),
each prepared to contain 1.23 per cent F are evaluated. Initial solubility reduction by SnF2, 81.7
per cent was significantly (P less than .01) higher than that of 76.9 per cent provided by APF,
however, after repeated exposure to acid etches the protection by APF became significantly (P less
than .01) higher than that derived from SnF2. The durability of protection provided by SnF2 after
overnight washing, was significantly (P less than .01) higher than that of APF. Results for NaF and
MFP were significantly (P less than .01) lower than those of either APF or SnF2 at any point in the
experiment.
PMID: 1068684 [PubMed - indexed for MEDLINE]