Section 5. Prevention of dental diseases

Chapter 16. The main methods of prevention in dentistry

Prevention is a system of state, social, hygienic and medical measures aimed at ensuring a high level of health and preventing diseases.

Primary prevention

Primary prevention is a system of measures aimed at preventing dental diseases by eliminating the causes and conditions of their occurrence, as well as increasing the body's resistance to the effects of adverse environmental factors, industrial and household environment.

Primary prevention includes:

• health education on oral hygiene;
• dispensary supervision of the population;
• normalization of nutrition;
• improvement of working and living conditions.

Specific dental prevention includes:

• fluoridation of drinking water;
• local use of fluoride preparations;
• personal oral hygiene.

Antenatal prevention of dental diseases is a set of measures taken in pregnant women to prevent the development of fetal and, in the future, in the child of pathology of the organs and tissues of the oral cavity.

Postnatal prevention of dental diseases is a set of measures taken in the period after the birth of a child in order to prevent the development of pathology of the organs and tissues of the oral cavity.

Etiotropic prevention of dental diseases is aimed at eliminating the cause of diseases.

Pathogenetic prevention is aimed at preventing pathogenetic changes in the oral cavity.

Pathogenetic primary prevention of dental diseases is aimed at:

• general health character, the purpose of which is to increase the resistance of the body and teeth to the action of adverse factors;
• prevention of specific pathology, detection and elimination of risk factors based on knowledge about the etiology and pathogenesis of diseases.

According to the method of application of preventive measures, prevention is:

• endogenous (systemic, general) — rational nutrition, the intake of fluo­rides, macro- and microelements, biologically active substances in the body with food, water, salt, milk, in tablets or drops, strengthening the somatic health of the child;
• exogenous (local) — implementation of rational oral hygiene, remineralizing prevention with the use of toothpastes, lacquers, rinsing solutions, solutions and gels for applications, implementation of preventive hygiene, sealing of fissure, local use of various medicines.

There are three basic methods of prevention of major dental diseases, namely: mass (communal), collective (group) and individual.

Methods of mass (municipal, national, population-based) prevention of major dental diseases include:

• fluoridation of drinking water, salt, and milk in regions with reduced fluoride content in drinking water;
• production of therapeutic and preventive oral care products;
• the inclusion of hygiene education, which is aimed at improving the sanitary and medical literacy of the younger generation, in school education programs for children, as well as a number of measures aimed at maternal and child health;
• improving the working and living conditions of the population, creating various children's institutions, including specialized ones (for example, for children with congenital pathology of the maxillofacial region).

Collective (group) prevention is designed for patients who are united by common risk factors for the development of major dental diseases (age, type of nutrition, level of hygiene, profession, etc.).

Methods of group prevention

General measures:

• ensuring a healthy lifestyle, compliance with a rational daily routine;
• playing sports, introducing exercises from breathing exercises to the cycle of physical education in preschool institutions and schools to form the correct posture and position of the head;
• rational balanced nutrition, the appointment of endogenous prevention of dental caries — food additives, calcium preparations, Vitaphthorum, fluoride-containing tablets, as well as exogenous prevention-rinsing with fluoride solutions, etc.;
• control of carbohydrate intake;
• fight against infectious and general diseases.

Special events:

• timely treatment of the oral cavity organs;
• teaching children of different ages rational oral hygiene (at home, kindergartens, schools), that is, sanitary education.

Individual prevention. It differs not in methods and means, but in the individual selection of these methods and means, as well as in the individual multiplicity of their application, depending on the level of health or the nature of risk factors.

Methods of individual prevention:

• applications of remineralizing, fluoride compounds;
• individual oral hygiene with the use of fluoride-containing, remineralizing, antibacterial and anti-inflammatory hygiene products;
• individual monitoring;
• individual selection of toothpastes, gels, mouthwashes and chewing gums;
• professional hygiene of the oral cavity;
• fissure sealing;
• secondary prevention.

During the implementation of the individual program, constant contacts are made between the doctor and the patient to monitor the quality of its implementation at home.

Secondary prevention is a set of measures aimed at preventing relapses and complications of diseases, early diagnosis, dental treatment with modern methods.

Sanitation of the oral cavity is the following procedures:

• treatment of caries;
• treatment of inflammatory and dystrophic diseases of the gums and oral mucosa;
• extraction of teeth that cannot be cured;
• prosthetics, if necessary;
• correction of malocclusion, alignment of dentition;
• aesthetic restoration of teeth;
• professional cleaning of the oral cavity and teeth.