OPERATIVE DENTISTRY

The branch of Oral Health Services dealing with: 1. Prevention. 2. Restoration. Of the Defects of Natural Teeth

DEFINITION :

Operative dentistry is the science and art dealing with the prevention and restorations of any Defect that occurs in the hard tooth structures.

Two Main Braches:

1. Preventive dentistry

1. Primary Prevention 2. Secondary Prevention 3. Tertiary Prevention

A. Diagnosis

2.

Restorative dentistry

B. Interception C. Prevention D. Preservation E. Restoration

PREVENTIVE DENTISTRY
PREVENTION & CONTROL OF THE DISEASES OF TEETH AND ITS SUPPORTING STRUCTURES: STRUCTURES: Preventive Methods: Methods: To prevent occurrence of diseases. diseases. Control Methods: Methods: To stop the advance and prevent the spread of active diseases. diseases.

DIFFERENT LEVELS OF PREVENTION

1. 2. 3.

Primary prevention. Secondary prevention. Tertiary prevention.

Classification of preventive dental services

1.Primary preventive services 2.Secondary preventive services 3.Tertiary preventive service Preventive services are provided by : i. Community agencies ii. Dental professionals iii. Publicindividuals

COMMUNITY AGENCIES
 1.

THESE ARE : Governmental health organizations :

a. federal health ministry b. provincial health ministry e.g. secretary health, director health , DHO , etc c. nazim officials

2.

Non governmental health organizations For example : world health organization

Dental professionals
       

The dentists The dental technologists The dental therapists The dental hygienists The dental educationists The dental assistants The dental attendants The secretary of dental office etc etc

The public
 The

peoples of a community should be made aware, educate and motivate to take interest and participate to recieve the benefits of the preventive measures.

PRIMARY PREVENTION
SERVICES BY THE COMMUNITY-AGENCIES 1. Water fluoridation : a. Community water fluoridation. b. School water fluoridation. 2. Fluoride supplements programmes.
(Tablets, Losenges, Oral drink, Drops, Salts etc)

3. Fluoride Mouth rinse programmes. 4. Pits & Fissures sealants programmes in schools.

PRIMARY PREVENTIVE SERVICES BY THE COMMUNITY Water fluoridation:

Fluoridation is the upward adjustment of the fluoride ions content of the community water supply to an optimal level, physiologically acceptable, for the prevention of dental carries

Community water fluoridation.

The optimum level of fluoride in the water is 0.7-1.2 p.p.m adapted in accordance with the amount of water consumed related with warmer and cold climates.

School water fluoridation.

The school water fluoridation is strongly recommended in that area of population where the community water fluoridation is not available

Optimum level of fluoride is 4-5 p.p.m as this upward adjustment is to compensate for the reduced water intake' since the school day and year is shorter, hence the time spent at school

Systemic effect of water fluoridation

During the development of the tooth the ingested fluoride is incorporated in the structure of the tooth


The Hydroxy-apatite crystals is replaced by Hydroxy-fluoro-apatite crystals which are more resistance to carries attack.

MECHANISM OF ACTION OF SYSTEMIC FLUORIDE

The cariostatic mechanism of systemic fluoride is as follows : 1.The enamel become more resistant to acid dissolution 2.Inhibition of bacterial enzyme systemsystemenzymatic action 3.Modification in the size and shape of teeth to be less susceptible to caries

PRIMARY PREVENTIVE SERVICES BY THE COMMUNITY

Fluoride supplements programmes.

(Tablets, Losenges, Oral drink, Drops, Salts etc). Using the swish and swallow technique, the daily recommended dose of fluoride is as follows: i. Dose for child below 2years is 0.5 mg ii. Dose for child b/w 2-3 years is 0.5-0.7 mg iii. Dose or child above 3 years is 1.0-1.5 mg
Fluoride tablets are commercially available as NaF tablets of 2.2mg, 1.1mg, and 0.5mg fluoride respectively.

PRIMARY PREVENTIVE SERVICES BY THE COMMUNITY Fluoride supplements programmes.

Tablets : swish and swallow technique : With the use of tablets, it seems logical that if a child would chew the tablets, then swish the saliva b/w the teeth for a minute before swallowing . Both a topical and systemic use of flouride achieved this swish and swallow method is advocated whenever tablets are used .

PRIMARY PREVENTIVE SERVICES BY THE COMMUNITY Fluoride Mouth rinse programmes.

(Flavored, Breath Freshening, Innocent to tissue) Two major regimens : (mostly school based program) i. Sodium fluoride (0.05%) rinse : it contains 230 ppm fluoride which is used daily---- 5-10 ml of this solution is asked to rinse for one minute. Ii. Sodium fluoride (0.2%) rinse it contain 900 ppm Flouride which is used weekly or fortnightlyrinse for 1 minute

The schedule is for one year---30 weeks

PRIMARY PREVENTIVE SERVICES BY THE COMMUNITY

Pits & Fissures sealants programmes in schools.

To prevent Primary carries: Teeth with deep Pits & Fissures which are not carious, filled with composite materials / Glassionomers pits and fissures sealants.

Pits and fissures are sealed by pits and fissures sealants

PRIMARY PREVENTION
PRIMARY PREVENTIVE SERVICES BY THE DENTAL PROFESSIONALS

Two levels: i. In dental clinics / hospitals ii. Community or public programmes

PRIMARY PREVENTIVE SERVICES BY THE DENTAL PROFESSIONALS

Services in clinics or hospitals:

Plaque control (scaling & polishing). Dental caries activity tests. Simple remedies.
a. Professional topical fluoride application. b. Pits & fissures sealants etc.

Diet counseling.
Dental health education, Demonstrations & Training to patients.

PRIMARY PREVENTION
PRIMARY PREVENTIVE SERVICES BY THE DENTAL PROFESSIONALS 1.Plaque control (scaling & polishing)
Scaling and polishingby dentist twice a year.

Birthday once a year, dentist twice a year.

PRIMARY PREVENTIVE SERVICES BY THE DENTAL PROFESSIONALS

Services in clinics or hospitals:

Plaque control (scaling & polishing). Dental caries activity tests. Simple remedies.
a. Professional topical fluoride application. b. Pits & fissures sealants etc.

Diet counseling.
Dental health education, Demonstrations & Training to patients.

PRIMARY PREVENTIVE SERVICES BY THE DENTAL PROFESSIONALS

Dental caries activity tests

A test used to predict the probability of developing new or increased decay; may include assessments of saliva and plaque for the presence of certain designated micromicroorganisms or studies of salivary secretion and sugar clearance.

PRIMARY PREVENTION
PRIMARY PREVENTIVE SERVICES BY THE DENTAL PROFESSIONALS Dental caries activity tests. (Caries susceptibility tests) . To show existing condition of carries
susceptibility in mouth . These test are used as motivational tools for patients education and to develop habits for prevention like regular brushing and mouth rinsing

Caries activity tests Following tests

1.Synder's Test 2.Lactobacilli colony count Test 3.Alban's Test 4.salivary buffer capacity Test 5.Enamel solubility Test 6.salivary reductase Test 7.streptococcus mutans level in saliva Test

Synder Test:
Used a colour indicator to show amount of acid formed by micro-organisms in carbohydrate micromedium show carries activities.


PRINCIPL E:

 PROCEDURE

 INFERENCE

Amount of acid produced is proportionat e to the number of acid producing lactobacilli present

1 ml of paraffin stimulated saliva of the patient is added to glucose agar containing bromocresol green dye and incubated for 72 hrs at 37 c. 37 The colour change is examined after 24 hours till 72 hrs.

:
The sooner the colour changes from green to yellow the greater is the caries activity.If colour does not changes in 72 hours then the patient is immune to caries.

PRIMARY PREVENTIVE SERVICES BY THE DENTAL PROFESSIONALS

Services in clinics or hospitals:

Plaque control (scaling & polishing). Dental caries activity tests. Simple remedies.
a. Professional topical fluoride application. b. Pits & fissures sealants etc.

Diet counseling.
Dental health education, Demonstrations & Training to patients.

PRIMARY PREVENTIVE SERVICES BY DENTAL PROFESSIONALS

Simple remedies:
a. Professional topical fluoride application. b. Pits & fissures sealants.

PRIMARY PREVENTIVE SERVICES BY DENTAL PROFESSIONALS

Professional topical fluoride application in clinics: Topical Fluorides: Three Agents:
a. Sodium fluorides (2% solution): Four applications : at one week interval per yearat ages 3,7,11 and13 years. year

b. Stannous Fluorides (810% solution): (8 One application per year. c. Acidulated phosphate Fluorides (1.2% fluoride gel): Two applications per year

Fluorides in mouthwashes, solution, varnish, gel(duraphat, fluorprotector), lozenges and drops are available.

METHOD OF APPICATION OF TOPICAL FLUORID

i. clean and polish all the surfaces of teeth. ii. Isolation of the teeth with cotton roll or rubber dam. iii. Dry the teeth with cotton or compressed air. iv. Freshly prepared soultion or gel or varnish of fluoride is applied to the teeth with cotton applicator.

METHOD OF APPICATION OF TOPICAL FLUORID

v. 2% sodium fluoride is applied on the teeth for 4 min. vi. 8% SnF is applied on the teeth for 4 min & ReRe-application of solution to tooth is done every 15-30 second. 15vii. The APF gel / solution is applied for 4 min & is continuously and repetedly applied with cotton applicator .

METHOD OF FLUORIDE VARNISH APPLICATION

1. Oral prophylaxis 2.Teeth are dried 3.Teeth are not isolated with cotton rolls as varnish being sticky has a tendency to stick to cotton. 4.The application is done first on lower arch as saliva collects more rapidly around it, and then on the upper arch.

METHOD OF FLUORIDE VARNISH APPLICATION

5. Application of varnish is done with single tufted small brush. 6.Set the patient with open mouth for 4 min. 7. Ask the patient not to rinse or drink any thing for one hr and dont eat hard till next morning.

PRIMARY PREVENTIVE SERVICES BY THE DENTAL PROFESSIONALS

Services in clinics or hospitals:

Plaque control (scaling & polishing). Dental caries activity tests. Simple remedies.
a. Professional topical fluoride application. b. Pits & fissures sealants etc.

Diet counseling.
Dental health education, Demonstrations & Training to patients.

Pits and fissures sealants

Pits and fissures of the teeth provide a sheltered niche (recess) for bacterial proliferation which cause dental caries. By providing an impervious barrier to pits and fissures system, the pit and fissure sealants can help to prevent dental caries.

Pits and fissures sealants

Definition:
A cement or a resin which is filled to the unprepared pits and fissures of the teeth which are susceptible to caries, forming a mechanical and physical protective layer against the action of acit released by the bacteria.

Indications:
> Non carious deep pits, fissures, grooves and fossae are sealed. > A small carious pit is filled and rest of pits and fissures are sealed. sealing the pits and fissures just after tooth eruption may be the most important event in their resistance to caries.

Pits and fissures sealants

Sealants are not recommended on patients who do not have signs of caries activity. If caries activity is noted either clinically or radiographically, sealing all pits and fissures should be strongly recommended

Pits and fissures sealants

Types : Following materials are used as sealants : i. Polyurethanes ii. Cyanoacrylates iii. BIS-GMA (Bisphenol A-Glycidyl Methylacrylate) These materials are polymerised by two methods : i. Light curing ii. Chemical curing

Pits and fissures sealants

Technique of pits and fissures sealants application :
i. Clean the surface of the tooth ii. Isolate and dry the tooth iii. Etch for 20 sec. With 30-50% phosphoric acit 30iv. Wash thoroughly , re-isolate and dry very well, reavoid the contact of saliva with the tooth v. Apply the pits and fissure sealant on the etched pits, fissures, grooves and fossae vi. Now let the sealants polymerized vii. Do the occlussal adjustment if required

Light curing a fissure sealant.

Chemically curing fissures sealant

PRIMARY PREVENTION
PRIMARY PREVENTIVE SERVICES BY THE DENTAL PROFESSIONALS

Plaque control (scaling & polishing). Dental caries activity tests. Simple remedies.
a. Professional topical fluoride application. b. Pits & fissures sealants etc.

Diet counseling. Demonstrations & Training to patients.

Diet Counseling
Objectives : 1. To correct nutritional inadequacies of the diet that may affect the patient's general health and be reflected in oral health 2.To prevent damage to the teeth and other oral tissues as a consequence of the type & frequency of foods taken

Diet Analysis
Indications : 1.High caries activity in the mouth 2.unusual caries pattern 3.Suspected dietary erosion

Diet Counselling
Phases: Two general phases
1. First phase{ Assessment phase } : Dietary analysis 2. Second phase : Diet advice / instruction / planning.

DIET COUNSELING
First phase :
{Assessment / analysis phase} : To evaluate the patient's nutritional status and diet. Activities during the assessment phase: i. Complete medical and social history ii. Thorough clinical examination iii. A detailed dietary analysis

DIET COUNSELING
First Phase
Diet Analysis : To recognize the cariogenicity of food in the diet of the patients, record of one day or 4 to 7 days or one month of food intake by the patient is compiled.

Diet Analysis
Method of diet study :
(most widely used method) A consecutive 3 days analysis (1 week (1 or 2 weeks) of the diet of the patient with recording the :

a. Time of diet taking b. Content of the diet taking c. Quantity of the diet consuming d. Frequency of diet taking
In addition,times of toothbrushing after meal and before bed time should be noted.

Method of diet analysis :

Diet Analysis

1.Ring the main meals. If in any doubt, identify those snaks that contain carbohydrates. Assess nutritional value of meals. 2.Underline all refined sugar intakes in red colour. 3.Identify the snaks b/w the meals. 4.Decide on a maximum of three recommendations.

Diet counseling
Second Phase Diet advice / instruction / planning: This should include an explanation of the affect of sugary snaks eating & drinking b/w the meals. It must also be personal , practical and positive The suggestion that a child should select crisps when friends / class fellows are buying sweets is more likely to be followed than total abstinence.

Diet advice / instruction / planning.

Key factors for successful diet advice: advice:

1. Implement gradual changes/reduction in sugar intake rather than drastic/sudden changes or reduction all at once 2.Utilized dietary substitutions rather than outright elimination 3.Utilize continual psychological reinforcement

Diet advice / instructions / planning.

4.Restrict the number of eating times to three main meals. 5.Avoid refined sugary snaks in b/w meals. 6.Take low carbohydrates or alternative to sugar like xylitole containing food. 7.take high protein snaks and fibrous fruits in b/w meals 8.Increase eating of high protien food like meat, fish , milk, egg, pulses, etc.

Diet advice / instruction / planning.

9.Restrict carbohydrates eating so that they only provide 30-50% of 30total calories required to the body. 10.Eliminate eating sticky sweets like chocolates, candies, toffies, cakes, pasteries, etc. if not completely then as much as possible. 11.Eat firm food like raw vegetables and fruits which will reduce dental plaque formation and increase salivary flow

Diet advice / instruction / planning.

Some Suggestions to patients : 1.Suggest saving sweets to be eaten on one day, e.g saturday dinner time 2.All-in-one chocolate are preferable to packets .All-inon individual sweets 3.Food which stimulates salivary flow (e.g cheese, sugar free chewing gum) can help to reverse the pH drop due to sugar, if eaten afterwards

1. Diet advice / instruction / planning.

Some other Suggestions to patients: 4.Treacle and honey are Cariogenic 5. Artifical sweetners are recommended in adults but should be avoided in prepreschool children 6.Fibrous foods e.g fruit are preferable to a sucrose snak

PRIMARY PREVENTIVE SERVICES BY THE DENTAL PROFESSIONALS

Services in clinics or hospitals:

Plaque control (scaling & polishing). Dental caries activity tests. Simple remedies.
a. Professional topical fluoride application. b. Pits & fissures sealants etc.

Diet counseling.
Dental health education, Demonstrations & Training to patients.

Dental health education

Establish a preventive setup in the dental clinic consisting of : a. charts b. models c. pictures d. audio-visual devices .etc. audioDentist and the auxilliaries are available to: i. To educate the patients ii. To make them aware about the dental diseases and their consequences iii. To motivate them to follow the advices to prevent the dental diseases

PRIMARY PREVENTION
PRIMARY PREVENTIVE SERVICES BY THE DENTAL PROFESSIONALS

Two levels: i. In dental clinics / hospitals ii. Community or public programmes

PRIMARY PREVENTIVE SERVICES

 Services by dental professionals in the community or public programmes: Dental health education : It is a process that informs, motivates and help the people adopt and maintain healthy practices and life styles. The people bring the changes in their environment to get the goal. The professional conduct their professional training and research to get the goal.

PRIMARY PREVENTIVE SERVICES

 Services by dental professionals in the community or public programmes: Objective of health education: Awareness and informing of the people Motivating the people Guiding the people into action Reinforcement

i. ii. iii. iv.

PRIMARY PREVENTIVE SERVICES

Services by dental professionals in the community or public programmes: Communication in health education:  The key elements in the communication process: i. The communicators (the professionals) ii. The message iii. The audience or the public iv. The channels of communications

PRIMARY PREVENTIVE SERVICES

Services by dental professionals in the community or public programmes: Communication in health education:  I. i. ii. iii. iv. Communicators or the professionals They are the originator of the message. To be effective, a communicator must know: Objectives clearly defined Audience its need, interest and abilities Message its content, validity and usefulness Channels different channels of communication

PRIMARY PREVENTIVE SERVICES

Services by dental professionals in the community or public programmes: Communication in health education:  Message: it is the information, the professional wishes his audience or public to receive, understand, accept and act upon. A good message must be: i. In line with objectives ii. Carefully chosen iii. Clear and understandable iv. Specific v. Timely vi. Appealing The message must fit into the existing frame work of attitudes and interests of people

PRIMARY PREVENTIVE SERVICES

 Services by dental professionals in the community or public programmes: Communication in health education: The audience or public: They are the consumers of the message. The audience may be the total population or a specific group within the population.

PRIMARY PREVENTIVE SERVICES

Services by dental professionals in the community or public programmes: Communication in health education: 
Channels of communications: Health education is carried out at three main levels: a. Individual and family b. Groups of people c. General public

PRIMARY PREVENTIVE SERVICES

Services by dental professionals in the community or public programmes: Communication in health education:  Channels of communications: For the education of individual or family: The professionals are ready for consultation with the individuals or families in the clinics, hospitals, health centres or in the home of the people. Group health educations: Group teaching is an effective way of educating the community. They may be carried out in the following ways : i. Lectures ii. Group discussion iii. Panel discussion iv. Symposium v. work shop etc etc.

Diet counseling parents and their children

PRIMARY PREVENTIVE SERVICES

Services by dental professionals in the community or public programmes: Communication in health education:  Education of the general public: For education of the general public mass media of communication is employed. They are : i. Television ii. Radio iii. Press iv. Films v. Magazine vi. Posters vii. Health exhibitions (mobile or stationary) viii. Health museum

PRIMARY PREVENTIVE SERVICES

 Services by dental professionals in the community or public programmes: Diet counselling: This can be carried out by the professionals, when working in the community through the dental health education of the public.

DIET COUNCELING A village dental camp

Diet counseling parents and their children

PRIMARY PREVENTION
PRIMARY PREVENTIVE SERVICES BY THE INDIVIDUALS

AgeAge-group of individuals 1. Infants & Children of age below 5 years old . 2. School going children & adults.

DENTAL CARE PROGRAM (Involve Parents)

1. Early infancy.
1.Care of toothless gums. 1.Care 2.Care of even single tooth 2.Care (when appears). 3.Care of milk teeth. 3.Care 4.Bottle feeding. 4.Bottle 5.Care of permanent teeth 5.Care (when appear).

2. A young child of 35 3 years old.

PRIMARY PREVENTION
(INDIVIDUALS)

Schools going Children & Adults. Self examination. Diet planning & control. Oral hygiene practice (home care).

SELF EXAMINATION

PRIMARY PREVENTION
(INDIVIDUALS) DIET PLANNING AND CONTROL
1. Nutrition and Host resistance.
a. b. Children Adults Local application Systemic use Amount of sweet taking. Frequency of sweet taking (gradual decrease in sugar taking) Sticky food Alternative to refine sugar e.g. saccharine, xylitol, sorvitol

2.

Fluoride
a. b.

3.

Sweets & Host resistance

a. b. a. b.

DIET CONTROL

Fruits are preferred over sweets

PRIMARY PREVENTION (INDIVIDUALS)

ORAL HYGIENE
Principles and Practice of Hygiene as applied to mouth.
It includes all the steps and measures that the individuals, professionals and community carry out for the prevention of diseases of the oral tissues and maintenance of the optimal oral and dental health.

HYGIENE

Principles & Practice of General & Personal Cleanliness for the promotion of health and prevention of diseases.

PRIMARY PREVENTION
HOME CARE INSTRUCTIONS
1. 2. 3. 4. 5. 6. 7. 8.

9. 10.

Plaque disclosing agents (Tincture Iodine, coloring agents). Tooth brushes (selection and uses). Dentifrices (powder, paste, liquid, gel). Tooth brush techniques. Inter-dental hygiene. Special cleaning aids. Electric tooth brushes. Irrigation devices (water, fluoride, saline, M/W). Chemically plaque control (chlorhexidine). Fluoride supplement programme (Tablets, Losenges, Oral Drink, Drops)

PLAQUE DISCLOSING

PRIMARY PREVENTION
Home Care Instructions
Tooth brushing techniques
a. b. c. d.

Horizontal Reciprocating Vertical sweeping Rotating Vibrating

Inter-dental Hygiene
(Tooth pick, inter-dental brushes, Dental floss, Gauze strips, Polishing cloth, Rinsing etc)

PRIMARY PREVENTION
Home Care Instructions
Tooth brushing techniques
a. b. c. d.

Horizontal Reciprocating Vertical sweeping Rotating Vibrating

BASS TECHNIQUE

VIBRATING MOVEMENTS

VERTICAL SWEEPING

PRIMARY PREVENTION
HOME CARE INSTRUCTIONS
INTERINTER-DENTAL HYGIENE (Tooth pick, inter-dental brushes, interDental floss, Gauze strips, Polishing cloth, Rinsing etc)

INTER DENTAL FLOSSING

INTERDENTAL FLOSSING

INTER DENTAL FLOSSING

INTER DENTAL FLOSSING

INTER DENTAL FLOSSING

INTERDENTAL GUAZE STRIPS

INTERDENTAL BRUSHES

WATER JET DEVICE

PRINCIPLES OF PREVENTION
Prevention of disease. Control of disease. Patient awareness, education, motivation and instructions. Development of host resistance. Restoration of the function & rehabilitation. Maintenance of Oral Health.

PRIMARY PREVENTION
EDUCATION
PATIENT AWARENESS AND COMMUNICATION
a. b. c. d. e. f.

Aware the patient about present disease/dangers of bad oral hygiene. hygiene. Aware the patient about causative factors. factors. Simple clinical procedures (e.g. simple filling, (e. scaling etc). etc). Past history of repeated/progressive diseases. diseases. Disclosing agentto show plaque on the agent teeth. teeth. To encourage the patients to improve the condition. condition.

PRIMARY PREVENTION
MOTIVATE THE PATIENT
a. Give various goals goals
1. To prevent decay . 2. To prevent periodontal
Good appearance of mouth. Preserve masticatory apparatus. diseases. Reduce restorative need.

Change the attitude from repair to prevention. Outline steps & measures to prevent oral diseases.

PRIMARY PREVENTION
INSTRUCTIONS (revise)
CLEAR INFORMATION ABOUT; 1. Tooth brush and its types. 2. Tooth brush techniques. 3. Interproximal cleaning aids. 4. Provide disclosing tablets and mouth mirror. 5. Instructions the clean teeth and its timing.

PRIMARY PREVENTION
Demonstration, Assessment & Retraining
a.

b.

Training & Demonstration to patient in clinic. Periodic reinforcement to patient.

PRINCIPLES OF PREVENTION
Prevention of disease. Control of disease. Patient awareness, education & motivation. Development of host resistance. Restoration of the function & rehabilitation. Maintenance of Oral Health.

PRIMARY PREVENTION
(INDIVIDUALS)

DEVELOPMENT OF HOST RESISTANCE

1.

Nutrition and Host resistance.

a. Child b. Geriatric

2.

Fluoride
a. Local application b. Systemic use

3.

Sweets & Host resistance

a. Amount of sweet taking. b. Frequency of sweet taking c. Sticky food

PRINCIPLES OF PREVENTION
Prevention of disease. Control of disease. Patient awareness, education & motivation. Development of host resistance. Restoration of the function & rehabilitation. Maintenance of Oral Health.

SECONDARY PREVENTION
CONTROL OF DISEASE a. Arrest & treat the disease. b. Control the infection causing factors. c. Prevent the recurrence.

PRINCIPLES OF PREVENTION
Prevention of disease. Control of disease. Patient awareness, education & motivation. Development of host resistance. Restoration of the function & rehabilitation. Maintenance of Oral Health.

TERTIARY PREVENTION
RESTORATION OF FUNCTION
1. 2. 3.

Treat the established disease Prevent loss of function Rehabilitation

PRINCIPLES OF PREVENTION
Prevention of disease. Control of disease. Patient awareness, education & motivation. Development of host resistance. Restoration of the function & rehabilitation. Maintenance of Oral Health.

TERTIARY PREVENTION
MAINTENANCE OF ORAL HEALTH Goals of maintenance therapy
1. 2. 3. 4. 5. 6. Re-examination & Re-evaluation. Re-motivation & New information to patient. Re-instructions in home care procedures. Plaque removal in clinic. Topical fluoride application in clinic. Simple fillings etc.