2What is Health?According to the World Health Organisation (WHO), Health is a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity.
3What is Oral Health?According to the WHO, Oral health is a state of being free from chronic mouth and facial pain, oral and throat cancer, oral sores, birth defects such as cleft lip and palate, periodontal (gum) disease, tooth decay and tooth loss, and other diseases and disorders that affect the oral cavity.Risk factors for oral diseases include unhealthy diet, tobacco use, harmful alcohol use, and poor oral hygiene.
6What is Dentistry?The branch of medicine that deals with the prevention, diagnosis and treatment of diseases of the teeth, gums, and other structures of the oral cavity.
7Specialties in Dentistry Endodontics - Endodontics is the branch of dentistry which is concerned with the morphology, physiology and pathology of the human dental pulp and periradicular tissues.Oral and Maxillofacial Surgery - Oral and maxillofacial surgery is the specialty of dentistry which includes the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region.
8Specialties in Dentistry Orthodontics and Dentofacial orthopedics- Orthodontics and dentofacial orthopedics is the dental specialty that includes the diagnosis, prevention, interception, and correction of malocclusion, as well as neuromuscular and skeletal abnormalities of the developing or mature orofacial structures.Pediatric Dentistry - Pediatric Dentistry is an age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs.
9Specialties in Dentistry Periodontics - Periodontics is that specialty of dentistry which encompasses the prevention, diagnosis and treatment of diseases of the supporting and surrounding tissues of the teeth or their substitutes and the maintenance of the health, function and esthetics of these structures and tissues.Prosthodontics - Prosthodontics is the dental specialty pertaining to the diagnosis, treatment planning, rehabilitation and maintenance of the oral function, comfort, appearance and health of patients with clinical conditions associated with missing or deficient teeth and/or oral and maxillofacial tissues using biocompatible substitutes.
11The DentitionsThe term dentition is used to describe the natural teeth in the jawbones.Primary dentition is the first set of 20 primary teeth. Also referred to as “baby teeth” or “deciduous teeth”Permanent dentition refers to the 32 secondary or “adult” teeth.Mixed dentition occurs when both primary and permanent teeth are present, usually between the ages of 6 to 12.
12Types of TeethThe functions of teeth vary, depending on their individual shape and size and their location in the jaws. The three basic food processing functions of the teeth are cutting, holding or grasping, and grinding.Incisors are single-rooted teeth with a relatively sharp thin edge referred to as the incisal edge. Located in the front of the mouth, they are designed to cut food without the application of heavy forces. Central (front teeth) and lateral (distal to the centrals) teeth are incisors.
13Canines, also known as cuspids, are located at the corner of the arch Canines, also known as cuspids, are located at the corner of the arch. They are designed for cutting and tearing foods, which require the application of force.Premolars are a cross between canines and molars. An older term for premolar is bicuspid. The pointed cusps hold and grind the food. They have a broader surface for chewing food. There are two sets of premolars in the permanent dentition and NO premolars in the primary dentition.
14Molars are much larger than premolars Molars are much larger than premolars. The molars have more cusps than other teeth that are used to chew or grind up food. There are two sets of molars in the primary dentition and three sets of molars in the permanent dentition.
17Begin to form during the first trimester of pregnancy Primary (deciduous)Consists of 20 teethBegin to form during the first trimester of pregnancyTypically begin erupting at around 6 monthsMost children have a complete primary dentition by 3 years of age1. Oral Health for Children: Patient Education Insert. Compend Cont Educ Dent.
18Secondary (permanent) Consists of 32 teeth in most cases IncisorsCanine (Cuspid)PremolarsMolarsMaxillaSecondary (permanent)Consists of 32 teeth in most casesBegin to erupt around 6 years of ageMost permanent teeth have erupted by age 12Third molars (wisdom teeth) are the exception; often do not appear until late teens or early 20sMandible
19Identifying Teeth Classification of Teeth: Incisors (central and lateral)Canines (cuspids)Premolars (bicuspids)MolarsIncisor Canine Premolar Molar
20Dental archesThe maxillary arch (upper arch), actually part of the skull, is fixed and not capable of movement. The teeth in the upper arch are set in the maxilla, the maxillary bone.The mandibular arch (lower arch) is capable of movement through the action of the temporomandibular joint (TMJ). The mandible, the mandibular bone supports the teeth in the lower arch.
22QuadrantsAn imaginary midline divides each arch into a left half and a right half. When the maxillary and mandibular arches are each divided into halves the resulting four sections are called quadrants, as follows:Maxillary right quadrantMaxillary left quadrantMandibular right quadrantMandibular left quadrant
26Directions of the Oral Cavity Anterior means toward the front of the mouth.Posterior means toward the back of the mouth.Medial means toward the middle or toward the middle of the arch.Lateral means toward the side or toward the outside of the mouth.
27Mesial means toward the mid-line of the dental arch. Distal means away from the mid-line of the dental arch.
29The 4 main dental tissues: EnamelThe 4 main dental tissues:Dental PulpDentinEnamelDentinCementumDental PulpCementum
30Dental Tissues—Enamel StructureHighly calcified and hardest tissue in the bodyCrystalline in natureEnamel rodsInsensitive—no nervesAcid-soluble—will demineralize at a pH of 5.5 and lowerCannot be renewedDarkens with age as enamel is lostFluoride and saliva can help with remineralization
31Dental Tissues—Enamel Enamel can be lost by:Physical mechanismAbrasion (mechanical wear)Attrition (tooth-to-tooth contact)Abfraction (lesions)Chemical dissolutionErosion by extrinsic acids (from diet)Erosion by intrinsic acids (from the oral cavity/digestive tract)Multifactorial etiologyCombination of physical and chemical factors
33Dental Tissues—Dentin Softer than enamelSusceptible to tooth wear (physical or chemical)Does not have a nerve supply but can be sensitiveIs produced throughout lifeThree classificationsPrimarySecondaryTertiaryWill demineralize at a pH of 6.5 and lower
34Dental Tissues—Dentin Three classifications:Primary dentin forms the initial shape of the tooth.Secondary dentin is deposited after the formation of the primary dentin on all internal aspects of the pulp cavity.Tertiary dentin, or “reparative dentin” is formed by replacement odontoblasts in response to moderate-level irritants such as attrition, abrasion, erosion, trauma, moderate-rate dental caries, and some operative procedures.
35Dental Tissues—Dentin (Tubules) PulpDentinal tubules connect the dentin and the pulp (innermost part of the tooth, circumscribed by the dentin and lined with a layer of odontoblast cells)Tubules contain fluid and nerve fibersExternal stimuli cause movement of the dentinal fluid, a hydrodynamic movement, which can result in short, sharp pain episodesTubuleOdontoblast CellNerve FibersFluid
36Dental Tissue—Cementum Thin layer of mineralized tissue covering the dentinSofter than enamel and dentinAnchors the tooth to the alveolar bone along with the periodontal ligamentNot sensitive
37Dental Tissue—Dental Pulp Innermost part of the toothA soft tissue rich with blood vessels and nervesResponsible for nourishing the toothThe pulp in the crown of the tooth is known as the coronal pulpPulp canals traverse the root of the toothTypically sensitive to extreme thermal stimulation (hot or cold)
38Dental Tissue—Dental Pulp Pulpitis is inflammation or infection of the dental pulp, causing extreme sensitivity and/or pain.Pulpitis may be reversible (treated with restorative procedures) or irreversible (necessitating root canal).Untreated pulpitis can lead to pulpal necrosis necessitating root canal or extraction.
39Periodontal Tissues Gingiva Alveolar Bone Periodontal Ligament CementumGingivaPeriodontal LigamentAlveolar boneCementum
40Oral Cavity Demineralization: mineral salts dissolve into the surrounding salivary fluid:enamel at approximate pH of 5.5 or lowerdentin at approximate pH of 6.5 or lowererosion or caries can occur
41Oral Cavity Remineralization: pH comes back to neutral (7) saliva-rich calcium and phosphatesminerals penetrate the damaged enamel surface and repair it:enamel pH is above 5.5dentin pH is above 6.5
43Did you know ?Approx. 90%of systemic disease have links to oral health.People who have periodontal disease double their risk to fatal heart attack.Infection in mouth increases risk of respiratory infection.Diabetics with periodontal disease have more difficulty in controlling blood sugar level.
44TOOTH DECAY [CARIES] Broadly caries are of 3 types 1. Pit and Fissure caries.2. Smooth surface caries.3. Cervical caries.
45Mechanism of tooth decay. Bacteria in the presence of sugary substances produce acid that causes demineralization of teeth.
46Enamel is affected first, as decay continues it reaches to dentin and then to pulp. Saved by filling.Needs RCT
47GINGIVITIS gingival tissue. Bleeding gums. Factors may also be Inflammation of thegingival tissue.Bleeding gums.Factors may also behormonal, drug induced.
48PERIODONTITIS Infected gum recedes. Pockets become infected. Bone loss starts.Periodontal disease causes 70% of tooth loss.It affects 3 out of 4 people .
49Causes of periodontal disease. Lack of daily ,complete oral hygiene.Broken fillings/teeth.Misaligned/crowded teeth.A poorly balanced diet.Systemic disease.Drugs[xerostomia]
50Symptoms of periodontal disease. Red ,puffy gums.Gum tenderness[pain]Gum that bleed during brushing.Persistent bad breath.[halitosis]Shifted/loosened teeth.Pus.
51DISEASES IN CHILDHOOD Caries. Malocclusion Mouth breathing. Tongue thrusting.Finger/Thumb sucking.
52Thumb SuckingNormal tendency Bad habit.(up till 18 months)
53DISEASES IN ADULT Caries. Periodontal disease. Edentulism. Ulcers. Cancer.Bruxuism .Staining of teeth.
54PREVENTION CARIES- Reduce sugar intake. Brushing twice a day. Flossing once daily.Use of mouthwash.Healthy snack habit.Proper brushing method
55Prevention of gingivitis. Maintain good oral hygiene.Cleaning of teeth.Interruption of bad habit.[smoking , mouthbreathing.]Proper brushing technique .
56Prevention of periodontitis. Scaling.Maintenance of oral hygiene.Flap operation.Bone grafting.
57Replacement of tooth loss. EDENTULISM- Loss of one or more teeth.Restore it by-RPD[Removal partial denture.]FPD[Fixed partial denture.]CD[Complete denture.]Implant
58A lifetime of proper hygiene improves quality of life
59FOOD FACTSLearn how to read labels on food products
61Type of toothbrush –Soft to Medium bristles with small head.How often should I replace my toothbrush?When it begins to wear or every three months ,whichever comes first.How important is the toothpaste?According to the need and choice.
62Mouth Care Involves the teeth, gums, palate and tongue Patients should be encouraged to:Brush teeth, at least twice daily or after meals (45minutes to 1hr)Use toothpaste that contains fluorideFloss after mealsMoisturize and lubricate lips and mucosa as needed .
63Tooth brushing Techniques There are several different acceptable tooth brushing methods because each patient has different needs.Not one method is perfect for all patients. Some patients may use more than one method.
64Toothbrush MethodsThe important thing is to brush thoroughly for at least two minutes each time and two times a day….
65Quote from Soupy Sales“Be true to your teeth or they will be false to you”
77Arrested CariesThis is a carious lesion that has become inactive and has stopped progressing; they may exhibit changes in color and consistency.This occurs when the carious process starts but remineralisation exceeds deminersalisation and the process stops.