What to prevent ?
1- Dental caries
2- Periodontal disease
3- Oral cancer
4- Dental erosion
Who should give it ?
• Any health practitioner
... [Show More]
• Nurse and hygienist are accepted
How ?
1- Mass media
2- Community program
3- One to one
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Oral infections
They are :
1-Bacterial infections including
• oral mucosa infections ( Tb , syphilis , scarlet fever )
• dentoalveolar infections ( dental caries , periodontal disease , dentofacial infections )
2-Viral infections
3-fungal infections
Dental caries
• Sugar dependant infectious bacterial disease .
• Dynamic process of demineralization ( ↓pH ) & remineralization ( ↑pH) till cavitation occurs.
• Dental caries = dissolution of organic matrix + demineralization of inorganic content
• Dental caries = Bacteria + Susceptible tooth surface + Time + Carbohydrates
Enamel caries
• Initial lesion is ( chalky white spot ) due to demineralisation of prisms of subsurface layer with the surface E. layer is still more mineralized .
• Then .. smooth surface → rough surface → stained surface → pitting → cavitation
N.B : Repair may occur as remineralizes E. concentrates Fluoride which has larger crystals & ↓ surface area , while regaining organic matrix never occurs .
• Lactobacillus in fissure caries
• Strept mutans the main caries bacteria
Dentine caries
• Demineralization → Bacterial invasion
• Differs from Enamel caries due to :
1. Proximity to pulp
2. Once bacteria reaches ADJ , lateral spread occurs & under minds
Root caries
• Most commonly occurs with gingival recession
• Treated by :
1. Oral hygiene instructions ( OHI )
2. Topical Fluoride application
3. Restoration with GIC for active lesion
• Strept salivarius ,, actinomyces
Active & Inactive ( arrested ) Caries
Arrested dentine caries : Hard , Dark & Leathery
Active decay : Soft & Yellow
Arrested enamel caries : Dark brown
Susceptible sites for caries :
• Proximal enamel surface
• Cervical margins
• Pits & fissures
Caries Diagnosis
As caries can be arrested or even reversed , early diagnosis is important .
1. Good eyesight & ( clean , dry , well illuminated tooth ) so , use of magnification loops is better .
2. Blunt probe ( only to remove plaque away from fissures ) , not sharp probe which may induce scratches & stick to pits & fissures
3. Bitewing X .ray for occlusal & proximal caries.
• Best approached systematically viewing proximal , occlusal , proximal surface of each tooth ,,Enamel then dentine ,, by naked eye then viewing box or magnification.
• Clinical situation is more advanced than x-ray
• However, E caries on X. ray indicates no cavitation clinically
4. Fibro-optic trans illumination ( FOTI ) probes
• 0.5 mm tip
• Used for detection of proximal caries
• Used with B/W X.ray
5. Laser based ( DIAGNOdent® ) (CarieScan PRO®) are still of uncertain value
If in doubt whether lesion is capitated or not , use orthodontic elastic separators for 3-7 days to be visualized .
Caries prevention
I. Tooth protection ( fluoride application & fissure sealant)
II. Reduction of microbial substrate in food
III. Removal of plaque ( mechanical & chemical ) [Show Less]