1. Dental Health Education
Lec 1-1st sem3334
CHS 483
By Dr. Ebtisam Fetohy

2. Impact of oral disease
Dental decay (cavities) is one of the most common chronic illnesses among children. Although most dental diseases are preventable, many children unnecessarily suffer from dental disease because of:
inadequate home care, and
lack of access to dental services.
An estimated 51 million school hours per year are lost in the U.S. because of dental-related illness.
Poor oral health has been related to:
Decreased school performance,
Poor social relationships and
Less success later in life.

3. Employed adults in the United States lose more than 164 million hours of work each year as a result of oral health problems or dental visits.
About 30 % of adults 65 years old and older have lost all of their natural teeth.
Older Americans with the poorest oral health are those who:
Are economically disadvantaged,
Lack insurance and
Are members of racial and ethnic minorities.
As the nation ages, oral health issues related to gum disease and the impact of medical treatments and medicines will increase.
Maintaining good oral health throughout a person's life is important.

4. Oral diseases Even in adults, can affect: one's overall health,
one's ability to eat healthy food, and
one's ability to get and keep a job.
Several reports link low-grade infection in the mouth (periodontal disease) to systemic illnesses such as:
cardiovascular diseases (heart disease),
respiratory ailments (pulmonary or lung disease), and
poor pregnancy outcomes (babies born too small and too soon).
Persons with diabetes are also at increased risk for periodontal infections.

5. Programs and Initiatives
Preventive Dentistry for High-Risk Underserved Children's Program
Physically Handicapped Children's Program
Dental Rehabilitation Program
Preventive Dentistry Program for Deaf/Adolescent Children
Prenatal programs
Senior oral health programs
Special needs persons Health Program
Water Fluoridation
School Fluoride Program: The Self-Applied Fluoride & Education Rinsing Program (SAFER)
School-Based Health Center Dental Program (SBHC-D)
Preventive Dental Services

6. Dental Health Education
Process that informs, motivates, and helps persons to adopt and maintain health practices and lifestyles, advocates environmental changes as needed to facilitate this goal and conducts professional training and research to the same end.
Refers to actions that are intended either to alter lifestyles or the living environment of persons to improve health:
Water Fluoridation
Reducing or eliminating access barriers
Removing financial barriers

7. Dental Health Educator
Must have knowledge of:
-Available resources
- Demographic Changes affecting dental health (socio- economic-Health services and weigh (external-Internal) variables in relation to clinical and behavioural reasrch findings

8. Designing a Community Program
When designing a community program that will be effective in achieving long term results and knowledge of program planning and community organization and skill development.
All mothers and infant caretakers need to know how to prevent oral diseases.
Reinforcing good oral health habits of future generation- school health education, community activities

9. Possible Future Dental Health Problems:
Health education should address:
Water (fluoridation to prevent caries)
Oral self care behaviours
Oral screening and risk factors
Baby Bottle tooth decay
Oral health effects of anorexia nervosa and Bulimia
Oral health effects of HIV/AIDS
Cultural issues inherent in dental health education (swak)
Dental health education for older adults (xerostomia and nutrition)
Dental Health Education for special needs population
Domestic violence, identification and referral

10. Oral screening and risk factors for oral cancer dental health education
Efforts are done by:
Dentists
Oral health care professionals
Community health educators
Class room Teachers

11. Baby Bottle Tooth Decay
Efforts of Dental Health Educators are targeted to:
Doctors
Pediatricians
Nurses
Parents and caregivers

12. Basic Concepts of dental Health Education
A person’s behavior is the result of both internal and external forces
Beliefs , attitudes, interests, values, needs, motives, personality, expectations, perceptions and biologic factors (internal forces) plus.
The influence of family, peer groups, education and media, (external forces) shape and affect actions.
Socio- demographic factors such as age, race , culture, gender, occupation, and income

13. To develop effective dental health education program, the educator must be aware of the interaction of all forces on the learners to develop and implement a rational educational program that will result in a sustained behavioural changes

14. Effective Preventive community Program
Community water fluoridation: single most effective and efficient means for preventing dental caries in children and adults regardless of race or income level
It s defined as the adjustment of the concentration of fluoride of the community water supply for optimal oral health
It ranges from 0.7 to 1.2 part per million (ppm) fluoride depending on the mean maximum daily air temperature over a 5 year period
1ppm fluoride=1mg fluoride per litre of water

15. Natural Fluoridation
All water contains at least trace amount of fluoride
Adjusted fluoridation is by adding fluoride chemicals to fluoride deficient water
Safety falsely attributed: Allergies- AIDS, Alzheimer’s disease, cancer, heart disease, kidney disease, bone disease
50-70% of caries was prevented by adjusted fluoridation (early studies)
In USA: 30-60% in children (3-5y)
20-40% in children (6-12 y)
25-35% for adolescents and adults
17-35% root caries in seniors
Cost effective: for every dollar spent on water fluoridation ,$80 saving in treatment

16. Dental Fluorosis: Excessive intake of Fluoride: leads to:
hypo-mineralization and
disruption of enamel developments
It is caused by:
Prolonged use of formula milk and
Tooth paste ingestion (younger than 6 years)

17. Deciduous Teeth Start 5th or 6th week in Utero Lower first
Continue after birth until full set (10 upper maxillary and 10 lower mandibular)
Take 2-3 years to form

18. Permanent Teeth Start during 4-5th month in Utero First lower
Development continue till after birth until 16 upper and 16 lower form
Take9-10 yrs to form

19. Bud stage
Tooth development starts with the formation of a germ which produces the different layers of the tooth.
This stage is often referred to as “the bud stage” because the tooth layers thicken and grow downwards resembling the shape of a bud.

20. Cap stage
The cells multiply at a rapid rate and take on the shape of a “cap”.
The tooth buds of the permanent teeth begin to form.

21. Bell stage
As the cells increase in number, they assume the shape of a bell.
Latter the cells become specialized and form the different layers of the tooth.

22. How does a tooth form?
While the tooth germ is developing, the surrounding area of the jaw also continues to develop.
The bone cells form the upper jaw (maxilla) and the lower jaw (mandible).
The tooth takes on the shape of a crown and a root.
During the final stage of tooth formation, the enamel and dentine increase in layers until the tooth is completely shaped.
However, when the eruption of a tooth occurs, only a small portion of the root has formed.

23. How does a tooth form?/2
The tooth will be fully erupted for approximately 2 years before the full root length is attained.
In the final stage of tooth development, the different layers calcify. Once a tooth is formed it cannot repair itself (if damaged) like bone or skin. Damage at this point can have a great impact on the health of teeth.

24. Tooth Structure

25. Tooth structure
The portion of the tooth visible in the mouth is called the crown.
The crown is covered with enamel which is a hard, white, shiny substance. Enamel is a highly calcified bone and is the protective layer of the tooth.
Enamel is made up of millions of tiny rods which form the framework of the tooth. It is thickest at the biting surface of the tooth and very thin near the gum line.

26. The color of enamel ranges from yellow to white depending upon its translucency-the more translucent the enamel, the more yellow color of the underlying dentine is apparent.
The enamel portion of the tooth has no feeling.
Even though the enamel is very hard, it can wear awayيبلى due to:
Attrition (abrasion) (الحك) or
Erosion (be dissolved by acid) (التآكل) and it may be fractured due to:
Stress, and or
Affected by dental decay.

27. The layer found under the enamel is the dentine,
It forms the bulk of the crown and the roots,
It is yellowish in color.
Dentine is softer than enamel and
It carries sensations such as temperature and pain to the pulp.
The pulp is the innermost portion of the tooth and is the only soft tissue of the tooth.
It is made up of blood vessels, cellular substance and nerves.
It supplies nutrients to the tooth and
Its nerve endings transmit sensations such as pain and temperature.

28. Tooth structure
Cementum forms a very thin layer over the root of the tooth
It is similar to bone.
It is yellowish in color and also
It carries sensations such as temperature and pain to the pulp.
If the gum recedes from the tooth and the cementum is exposed, there may be a sharp sensation when brushing the teeth or eating food (this is usually an adult condition)

29. Tooth types
Deciduous teeth: are also known as baby teeth, milk teeth, primary teeth or first teeth.
They are shed and replaced by permanent teeth-this process is called exfoliation.
deciduous teeth are much whiter than permanent teeth and
They are softer. Therefore, deciduous teeth can appear very wornبالي due to grinding (الطحن) and normal wear الحك through eating.
The incisors are used for cutting,
The canines for tearing and
The molars for chewing

30. In the lower arch (mandible) there are ten deciduous teeth:
2 central incisors
2 lateral incisors
2 canines
2 first molars
2 second molars
In the upper arch (maxilla) there are ten deciduous teeth:
2 central incisors
2 lateral incisors
2 canines
2 first molars
2 second molars

31. Healthy deciduous teeth are important for
Efficient mastication of food.
Maintaining normal facial appearance.
Formulating clear speech.
Maintaining a proper diet-missing or badly decayed teeth may cause young children to reject foods that are difficult to chew.
Maintaining space for the permanent teeth.
Jaw development
Self-esteem.

32. Tooth eruption Deciduous teeth
Although deciduous teeth begin to form in utero, they don’t usually begin to erupt till 6 months of age.
Eruption times vary from child to child just as the individual growth rate varies.
Normally no teeth are visible in the mouth at birth.
Occasionally, however, some babies are born with an erupted incisor tooth (neonatal tooth), but these are not true teeth and are usually lost after birth. They don’t usually begin to erupt until 6 months of age

33. Eruption patterns Lower teeth usually erupted before the upper teeth
Girls usually precede boys in tooth eruption
The teeth in both jaws usually erupt in pairs-one on the right and one on the left.
By the time the child reaches the age of 2 to 3 years of age, all the deciduous teeth should have erupted.

34. Permanent teeth
At about 6 years of age, the first permanent molars and lower permanent incisors begin to erupt.
-Between the age of approximately 6 and 12 years, children have mixture of permanent and deciduous teeth. This is known as mixed dentitions.
-By the age of 12, most children have all their permanent teeth except the third molars, which erupt between the age of years

35. Baby Teeth
Front Teeth: A. Central incisor B. Lateral incisor C. Canine or eye tooth
Back Teeth: D. First molar E. Second molar

36. Permanent Teeth Tooth Names
Front Teeth: 1. Central incisor 2. Lateral incisor 3. Canine or eye tooth
Back Teeth: 4. First premolar 5. Second premolar 6. First Molar 7. Second Molar 8. Third Molar Or Wisdom Tooth

37. The temporomandibular
The temporomandibular joints are the two jaw joints, one at each side of the face.
Movement of the lower jaw is made possible by this joint.
The upper jaw is called the maxilla and is joined to the temporal bone.
The lower jaw is called the mandible or mandibular bone.
The term "temporomandibular" refers to the connection between these two bones.
Chewing and speech would not be possible without this joint.

38. Thank You