Textbook of Preventive and Community Dentistry

This book provides a comprehensive yet simple presentation of Preventive and Community Dentistry. Based on the syllabus prescribed by Dental Council of India, the book covers various aspects of public health, dental public health, preventive dentistry, and research methodology. An important feature of the book is inclusion of additional chapters on Forensic dentistry, Hospital administration, Occupational hazards, Nutrition and oral Health, Minimal invasive dentistry and Dental Practice management. These chapters are vital for richer understanding of community dentistry. Further, some useful information like facts about tobacco, fluorides and clinical cases proforma are included separately under the Appendices. All these features make the book quite comprehensive in scope and contemporary in approach.

Table of Contents:
PART 1: PUBLIC HEALTH 1 Concepts of Health and Disease and Prevention, 3 Introduction, 3 Changing concepts of health, 3 Definitions of health, 4 Dimensions of health, 4 Concept of wellbeing, 5 Spectrum of health, 6 Determinants of health, 6 Responsibility for health, 7 Indicators of health, 8 Health service philosophies, 10 Strategies for the MDG, 13 Concept of disease, 14 Concept of causation, 14 Natural history of disease, 15 Disease classification, 17 Changing pattern of disease, 17 Community diagnosis and treatment, 17 Concepts of control, 17 Concepts of prevention, 18 Modes of intervention, 19 2 General Epidemiology, 22 Introduction, 22 Epidemiology and clinical medicine, 23 Scope of epidemiology, 23 Varieties of epidemiology, 23 The epidemiologic triad, 24 Measurements in epidemiology, 25 Epidemiological methods, 28 Analytical studies, 30 Association, relationship and causation, 33 Uses of epidemiology, 34 Screening for dental disease, 35 Investigation of an epidemic, 39 3 Environmental Health, 42 Definition of environmental health, 42 Components of environmental health, 42 General impact of environment on health, 42 Specific environmental health effects, 42 Methods of identifying environmental pollution/contamination, 43 Differences between eradication, control and elimination of environmental health hazards, 43 POLLUTION CONTROL Air pollution, 43 Noise pollution, 46 Water pollution, 49 SOLID WASTE MANAGEMENT Introduction, 58 Disposal of wastes, 58 Solid wastes, 59 Occupational hazards associated with waste handling, 64 Public education, 65 4 Health Education, 67 Introduction, 67 Definition, 67 Approaches to public health, 67 People participation in health education, 68 Concepts of health education, 68 Nature of learning, 68 Principles of health education, 68 Levels of health education, 70 Methods of health education, 70 Types of communication, 74 Barriers to communication, 75 Planning and evaluation of health education programme, 75 Health education and propaganda, 76 5 Primary Health Care, 78 Introduction, 78 Declaration of Alma Ata, 78 Primary health care, 80 Principles of primary health care, 80 Core activities, 81 Strategic imperatives, 81 Perceptions and commitment, 81 Problems with implementation of primary health care, 82 Reasons for lack of implementation of primary dental health care in India, 82 Primary health care in India, 82 Staffing pattern, 85 Functions of PHC, 86 6 National Health Programmes, 87 Introduction, 87 National health programmes in india, 88 Nutritional programme, 92 Pilot project on control of cardiovascular diseases and stroke, 94 National programme for prevention and control of diabetes, cardiovascular disease and stroke (NPDCS), 95 7 International and National Health Agencies, 97 Introduction, 97 Objectives, 97 Quarantine, 97 PAN American sanitary bureau (PASB 1902), 98 Office international d'hygiene publique (1907), 98 The health organization of the league of nations (1923), 98 The united nations relief and rehabilitation administration (UNRRA 1943), 99 International health agencies, 99 Indian voluntary health agencies, 111 8 Hospital Administration, 114 Introduction, 114 What is hospital administration?, 114 Services offered by the hospital, 115 Hospital as a system, 115 Hospital organization, 115 Categories of hospitals, 115 Human relation in hospitals, 118 Major areas of conflicts in hospital, 118 Quality assurance in health care, 118 Medicolegal aspects of hospital care, 119 9 Behavioural Sciences, 122 Introduction, 122 Definition, 122 Components, 122 Scope and use of behavioural science in dental health, 122 Sociology, 123 Psychology, 124 Anthropology, 126 PART 2: DENTAL PUBLIC HEALTH 10 Introduction to Dental Public Health, 131 Introduction, 131 History of dentistry, 131 Definition of practice of dentistry, 134 Aims and objectives in planning dental care, 134 Scope of dental care, 134 Public health, 134 Dental public health, 136 Functions of public health dentist, 138 Roles of dental public health workers, 139 Achievements of dental public health professional, 139 11 Epidemiology of Dental Caries, 141 Introduction, 141 Epidemiological studies, 141 Indian scenario, 142 Global scenario and current trends in caries incidence, 142 Epidemiological factors of dental caries, 143 Host factors (demographic factors), 143 Agent factors, 146 Environmental factors, 146 12 Epidemiology of Periodontal Diseases, 148 Introduction, 148 Aetiology of periodontal disease, 148 Pathogenesis of periodontal disease, 152 Epidemiology of periodontal disease, 152 Epidemiologic studies, 152 National oral health survey and fluoride mapping 2002-2003 (conducted by dental council of India), 153 Epidemiologic factors, 154 13 Epidemiology of Oral Cancer, 157 Introduction, 157 Global scenario of oral cancer, 157 Spectrum of oral cancer in India, 158 Age distribution, 159 Gender distribution, 159 Ethnic basis, 159 Site distribution, 159 Trends, 159 Aetiology and risk factors, 160 Classification of oral cancer, 162 Clinical presentations of cancer of oral mucosa, 163 Diagnosis of oral cancer, 164 Treatment of oral cancer, 164 Prevention and control of oral cancer, 164 Role of dentist in detecting and preventing oral cancer, 168 Population-based cancer registries: invisible key to cancer control, 168 14 Oral Health Education, 172 Introduction, 172 Considerations in oral health education, 172 Nature of learning, 173 Educational process, 174 One-to-one communication, 175 General educational theories, 176 Basic concepts of oral health education, 176 Approaches in oral health education and health promotion, 180 15 Nutrition and Oral Health, 182 Introduction, 182 Nutrition, 182 Classification of nutrients, 182 Assessment of patient's nutritional status, 187 Dietary history and evaluation, 187 Diet counselling and dietary advice, 188 16 Surveying and Oral Health Surveys, 190 SURVEYING Introduction, 190 Steps in survey, 190 ORAL HEALTH SURVEYS Pathfinder surveys, 194 Subgroups, 194 Index ages and age groups, 194 Number of subjects, 195 Organizing the survey, 195 Reliability and validity of data, 196 Implementing the survey, 196 Survey form, 196 17 Indices, 198 Introduction, 198 Definition of index, 198 Objective of an index, 198 Properties of an ideal index, 199 Purpose and uses of an index, 199 Selection of an index, 199 Types of indices, 200 18 Dental Auxiliaries, 222 Introduction, 222 Rationale for training and use of dental auxiliary, 222 Definition, 223 Classification, 223 Effects of auxiliaries on dental education, 224 Dental manpower planning, 225 Benefits of using auxiliaries, 227 Impact of auxiliaries in Indian scenario, 227 19 Financing Dental Care, 229 Introduction, 229 Structure of dental practice, 229 Dental plan standards, 230 Classification of payment plans, 232 State children's health insurance programme (SCHIP), 238 Indian scenario, 238 20 Dental Needs and Resources, 241 Introduction, 241 Dental needs, 241 Demand for treatment, 243 Manpower, 243 Scope of service, 243 Matching programmes to need and demand, 244 21 Planning and Evaluation in Oral Health, 246 Introduction, 246 Types of health planning, 246 Planning of dental health services, 246 Planning for community dental programmes, 248 Rational planning model, 251 Evaluation, 251 Framework for programme evaluation in public health, 253 22 School Dental Health Programmes, 257 Introduction, 257 Health promoting school, 257 Importance of oral health, 258 Importance of schools in promoting oral health, 258 Planning a school dental health programme, 259 Oral health education programmes, 261 School based preventive programmes, 264 Referral for dental care, 265 School lunch programme, 265 Incremental dental care, 266 Evaluation, 266 23 Dental Practice Management, 268 Introduction, 268 Factors associated with successful dental practice, 26 24 Ethics in Dentistry, 272 Introduction, 272 Ethics and human conduct, 272 Ethics and social sciences, 272 Evolution of medical ethics, 273 Basis for medical ethics, 273 Principles of ethics, 274 Ethical rules for dentists prescribed by DCI, 275 25 Dentist Act-1948, 278 Introduction, 278 Effect of registration, 282 Miscellaneous, 283 The dentists (amendment) act, 1993, 285 26 Dental Council of India (DCI) and Indian Dental Association (IDA), 288 COUNCIL The dentists act, 1948, 288 Introductory, 288 Dental council of India, 289 The executive committee, 290 Recognition of dental qualification, 290 Qualification of dental hygienists, 291 Qualification of dental mechanics, 291 Qualification of dental hygienist, 291 Mode of declaration, 293 Preparation and maintenance of register, 294 The Indian Dental Association (IDA), 295 Management of the association, 296 27 Consumer Protection Act, 298 Introduction, 298 Supreme court decisions on the consumer protection act, 299 Authorities for filing complaints based on amounts of compensation, 300 Powers of consumer redressal forums and commissions, 300 Who can sue the doctor under CPA?, 301 Against whom can a complaint be filed?, 301 Who are exempted?, 301 When the doctor can be sued?, 301 What you should do when you receive a complaint?, 301 What is a complaint?, 302 Time limit to file a complaint, 302 Guidelines to be adopted to avoid needless litigations, 302 Consent, 303 Salient features of consumer courts, 303 Consumer protection act and patients, 304 Consumer protection act and doctors, 304 Limitation of consumer forum, 304 28 Forensic Odontology, 306 Introduction, 306 History, 307 Common reasons for identification of found human remains, 307 Principles of dental identification, 307 Dental identification, 308 PART 3: PREVENTIVE DENTISTRY 29 Introduction and Principles of Preventive Dentistry, 317 Concepts of preventive dentistry, 320 Scope of preventive dentistry, 320 Principles of preventive dentistry, 320 30 Dental Caries, 321 Introduction, 321 Early theories of caries aetiology, 322 Current concepts of caries aetiology, 323 Clinical manifestations of dental caries process, 328 Caries of enamel, 330 Dentinal caries, 332 Root caries, 335 Microbiology of dental caries, 335 Mechanism of adherence of microorganisms to tooth surface, 336 Formation of plaque, 336 Role of saliva in dental caries, 337 31 Diet and Dental Caries, 340 Introduction, 340 Food, 340 Diet, 340 Nutrition, 340 Components of foods, 340 Classification of carbohydrates, 341 Evidence linking diet and dental caries, 341 Cariogenicity of sucrose, 342 Stephan curve (1940), 343 Oral clearance of carbohydrates, 344 Preventive dietary programme, 344 Dietary counselling, 345 Tooth-friendly snack or ideal snack, 345 Sugar substitutes, 345 Functions of sugar in food technology, 346 Classification, 346 Difficulties in substitution of sucrose, 346 32 Caries Risk Assessment, 348 Introduction, 348 Risk group, 348 Factors relevant for assessment of caries risk, 349 Clinical evidence, 349 Identifying relevant risk factors, 349 Caries diagnosis, 350 33 Caries Activity Tests, 352 Introduction, 352 Caries activity tests, 352 Mutans group of streptococci screening tests, 354 Uses, 355 34 Cariogram, 357 Cariogram-the five sectors, 357 Chance to avoid caries, 358 Principles of caries risk estimation based on "cariogram" concept, 358 Using the cariogram for evaluation of caries risk, 361 35 Dental Caries Vaccine, 363 Introduction, 363 Prospects for vaccination against dental caries, 364 Route of administration of vaccine, 365 Effective molecular targets for dental caries vaccine, 365 Synthetic peptide vaccines, 366 Risk factors, 367 Past, present and future human applications, 367 36 Fluorides, 370 Introduction, 370 Water fluoridation, 371 Physiology and chemistry of fluoride, 373 Fluoride homeostasis, 373 Fluoride biomarkers, 376 Mechanism of action of fluoride, 377 Classification of fluoride therapy, 380 Dental fluorosis, 393 Defluoridation, 398 37 Fluoride Technology: A Global Perspective, 403 Global variation in exposure to fluoride, 403 Balancing benefits and risks of fluoride, 403 Water fluoridation globally, 404 Salt fluoridation in the world, 406 Milk fluoridation in the world, 406 Global fluoride toothpaste usage, 406 Inequality in oral health and fluoride policy, 407 Developing policy on fluoride, 409 38 Oral Hygiene Aids, 412 Introduction, 412 Manual toothbrush, 412 Powered toothbrushes, 415 Dental floss, 418 Interproximal and unitufted brushes, 419 Wooden or plastic triangular sticks, 420 Tongue cleaners, 421 Rinsing, 421 Irrigation devices, 422 Dentifrices and mouth rinses, 423 39 Pit and Fissure Sealants, 428 Introduction, 428 Definition, 429 Types of pit and fissure sealants, 429 A type of fissure sealant, 430 B type of fissures, 431 Patient and tooth selection, 432 Technique for sealant application, 432 Follow-up and review, 435 Minimally invasive preventive restorations (preventive resin restoration-PRR), 435 Sealing of carious fissures, 436 Sealants versus amalgams, 436 Cost effectiveness of fissure sealants, 437 Sealant as part of a total preventive package, 437 Present status of pit and fissure sealants, 437 40 Atraumatic Restorative Treatment, 440 Introduction, 440 Principles, 440 Contraindications, 441 Rationale for application of ART, 441 Tips on working, 441 ART: important guidelines, 447 41 Minimal Invasive Dentistry (MID), 449 Introduction, 449 Definition, 449 Principles of minimally invasive dentistry, 449 Early caries detection, 450 42 Prevention of Dental Caries, 455 Introduction, 455 Caries preventive methods and means, 455 Dietary measures, 456 Oral hygiene measures, 458 Fluoride and different vehicles to provide fluoride, 458 Antimicrobial agents and treatments, 460 Salivary stimulation, 461 Fissure sealants, 462 General recommendations for prevention of dental caries with respect to use of sugars, 462 Recommendations (for children at high risk of dental caries), 463 43 Prevention of Periodontal Diseases, 465 Introduction, 465 Implications for prevention, 465 Factors predisposing to plaque accumulation, 465 Oral hygiene aids, 468 Chemical plaque control, 469 44 Prevention of Malocclusion, 474 Introduction, 474 Aetiology of malocclusion, 474 Preventive measures, 476 Interceptive measures, 477 Scope and limitations of interceptive orthodontics, 479 45 Prevention of Dental Trauma, 481 Introduction, 481 Primary protection, 482 Secondary prevention, 483 Tertiary prevention, 485 46 Occupational Hazards in Dentistry, 486 Introduction, 486 Occupational hazards, 486 Musculoskeletal disorders and diseases of the PNS, 490 Recommendations, 490 Hospital waste management in dental care setting, 490 47 Infection Control in Dental Care Setting, 493 Introduction, 493 Infection control procedures, 494 Disinfection and dental laboratory, 500 48 Evidence Based Dentistry, 502 How to search for the right evidence, 503 PART 4: RESEARCH METHODOLOGY AND BIOSTATISTICS 49 Research Methodology, 507 Introduction to research, 507 Research methodology, 508 Research design and types, 508 Research questions and formulation of hypotheses, 509 Ethical consideration in research, 509 Presenting results and basic nuances of publishing, 509 50 Biostatistics, 511 Introduction, 511 Presentation of data, 511 Sampling techniques, 513 Statistical inference, 516 Correlation and regression, 517 APPENDICES 1 Definitions and Glossary, 521 2 Oral Health Assessment Proforma (1997), 532 3 Case History Proforma, 537 4 Levels of Prevention, 542 5 Tobacco use, Effects on Health and Management, 544 6 Fluoride Facts, 551 Index, 553