1. Basic Knowledge and Practices on Oral Health; Experience among us at KCMC 1

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3. DEFINED Oral health is all about functional efficiency of oral cavity and its neighboring structures To live and practice good oral health one needs at least basic knowledge and practices on it. 3

4. RATIONALE Basic oral health knowledge enables one in a community to understand etiology/causes of commonly occurring oral conditions and diseases, Be able to identify them at early stages, Therefore be able to prevent them through effective/conducive oral health practices on daily life. 4

5. SITUATION In developing countries including ours, these commonly occurring oral conditions and diseases are behavioral related. Therefore, prevention of these diseases needs knowledge and enabling factors for changing ones behaviour into those conducive for good oral health daily practice. 5

6. CULPRITS Looking at these conditions and diseases FIRST WE HAVE: two conditions leading to a group of diseases affecting part of soft tissues of the oral cavity. These two conditions are plaque and calculus accumulation around the neck of a tooth. 6

7. CULPRITS These two conditions are behavioral related. If one does not consistently brush the teeth properly likely to accumulate the plaque on non self cleansing areas of tooth Over time plaque will calcify and accumulate calculus or tartar on non self cleansing surfaces of a tooth. 7

8. Bacterial plaque at work! 8

9. Over time plaque calcify = Tartar! 9

10. Plaque= bacteria + material alba on saliva mucus 10

11. CULPRITS Plaque or calculus around the neck of a tooth will lead to constant irritation of the gums Constant irritation of the gums will lead to inflammatory process of the gums. In early stage this inflammation is called gingivitis Gingivitis is an expression of cardinal signs of inflammation: pain, swelling, redness of the affected gums and easy bleeding of gums on touch or brushing teeth. 11

12. CULPRITS If this inflammation is left unchecked it will spread from the gum deep into the periodontal ligaments anchoring the tooth to the bone. Now this is periodontitis These two diseases: gingivitis and periodontitis are collectively called chronic periodontal diseases. We use the term chronic because of the bacterial plaque/calculus irritation NOT due to bacteria infection into the gum tissues. 12

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14. CULPRITS LASTLY WE HAVE: One dietary behavioral practice leading to a disease affecting the hard tissues of the oral cavity. This behaviour is all about abuse of diets containing sucrose. Abuse here means higher frequency of consumption of sucrose containing diet/ (medicine!) especially in between major meals (snacks) 14

15. CULPRITS Frequent intake of sucrose containing diet will lead to caries attack over time. Here the oral micro flora ferments the sucrose you have ingested to produce weak acids Weak acids corrode the tooth surface. Over time period the cavity forms Cavity may progress to expose the pulp chamber with eventual infection of the pulp soft tissues. 15

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17. Sequelae of dental caries 17

18. PREVENTION (TAKE HOME (TH)) Having this basic knowledge one can easily be motivated to practice good oral health instead of informal/formal instructive oral health information. How? 18

19. Prevention of gingivitis (TH 1 ) Gingivitis which is an easy bleeding of gums on touch or brushing teeth is prevented and TREATED by observing proper ( tooth brushing technique and use of dental floss) Tooth brushing and flossing decrease accumulation of plaque in non self cleansing surfaces of a tooth. One needs to brush at least twice a day in the morning before breakfast and before retire to bed in the evening or night. 19

20. Prefer Modified Bath Method 20

21. Reaching for non self cleansing areas 21

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23. Prevention of dental caries (TH 2 ) Consider possible Dental Caries process at pits, fissures, proximal surfaces and cervical part of the tooth. 23

24. Prevention of dental caries (TH 2 ) Ingest sucrose containing diet ONLY DURING major meals (breakfast, lunch, supper/dinner) DO NOT snack sucrose containing diet. However, if used the frequency should be very low; consistence of such snacks matters a lot. CONSIDER SUBSTITUTES. Sticky sucrose containing diet will remain for a longer time on non self ceasing areas of the teeth thereby constantly release acids for prolonged times. 24

25. Prev. of dental caries and reduction of plaque formation (TH 3 ) Use fluoridated tooth paste. Fluoridated tooth paste has shown to decrease dental caries in the community to the magnitude of 20-30%. Here fluoride in a tooth paste is utilized to facilitate re-mineralization of de-mineralized tooth sub surfaces. It also interfere with bacteria enolase enzymes during the fermentation of sucrose containing diet thereby rendering inhibition of plaque growth. 25

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27. Early detection for timely intervention/treatment (TH 4 ) Do regular visits to a dentist or dental personnel. This will provide opportunity for early detection of dental diseases or conditions therefore timely intervention. It is recommended to visit a dentist at least every after six month to one year or less depending on an individual oral health risk factors. 27

28. Mom that syringe is fat!! 28

29. Experience among us at KCMC We did a survey study in 2014 on a population of student nurses (N=214) at KCMC and KCMUCo Results were very surprising considering the role of nurses towards patients and community health care! 29

30. Oral health Knowledge of student nurse population (N=214) QuestionsResponse on knowledge Positive (%)Negative (%) Do you know what causes easy bleeding of gums? 9.890.2 How can you prevent your gum from bleeding? 31.868.2 Do you know what causes dental decay?43.956.1 How can you prevent your teeth from decaying? 33.666.4 Once caries has occurred, how can you timely manage it? 47.252.8 30

31. Oral health practice of student nurse population (N=214) QuestionsResponse on practice Positive (%)Negative (%) When did you last visit dental personnel? 14.585.5 How often do you brush your teeth? 81.818.2 How often do you use dental floss? 38.861.2 31

32. TOO LITTLE ORAL HEALTH KNOWLEDGE AND PRACTICE INFORMATION AT SCHOOLS? These students are our country sec. school products and our products /to be. It is not good here to extrapolate but where do we stand? How about other health workers in services dealing directly with health care/promotion in our community and the country at large? 32

33. Please help yourself! You can access free copy of our publication on this basic oral health knowledge and practices of our student nurses at BMC Oral health: Rwakatema et al.BMC Oral Health (2015) 15:23 DOI 10.1186/s12903-015-0008-8 33

34. THANK YOU PLEASE DO NOT FORGET YOUR 4 ppt TAKE HOME! 34