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This document discusses strategies for preventing periodontal disease as a public health problem in the UK. It argues that current approaches focus too much on downstream treatment rather than upstream prevention. It advocates for whole population prevention strategies like reducing risk factors through public health measures, health education and policy changes. These include integrating oral hygiene education into schools, using media campaigns, and making oral hygiene products more affordable. A combination of population-level interventions and some targeted high-risk approaches is recommended over just clinical treatment to more effectively address periodontal disease on a public health scale.
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- 1. Prevention Strategy of Periodontal Disease as a Public Health Problem in UK An ounce of prevention is worth a pound of cure IBRAHIM BHAMJI POST GRADUATE STUDENT MSC DENTAL PUBLIC HEALTH (2015 -2016)
- 2. Why do we fail in tackling periodontal disease? Focus on downstream approaches. Inappropriate delivery of interventions. Focus on treatment rather than prevention. Lack of integration and isolation of the mouth from the rest of the body. Lack of community-based approaches.
- 3. Preventative strategies Aim for prevention If the overall aim of the dental public health strategy is focus on individualistic approach then it wont be feasible strategy. Whole population strategy and using upstream approach.
- 5. High risk vs whole-population strategies Two approaches for tackling periodontal disease: high risk or population approaches. High-risk approach: In which individuals at high risk of disease are identified and targeted for preventive treatment. This is the most natural and traditional way of dental professional use as a preventive strategy. It relies on screening of individuals and providing an intervention for those at high risk.
- 6. There is no strong evidence or study which can recommend any clinical research to be implemented in a clinical setting or population setting. With this limitation highlighted, it needs to focus on population strategy.
- 7. Population approach: In which population-wide changes in risk factors are made. This addresses the determinants and lowers the mean level of risk factors by shifting the whole population distribution to a favorable position. For example, addressing the underlying cause plaque level and smoking which reduces the risk and therefore produces a greater benefit.(rose 2008). Rose G. (2008). Rose strategy for preventive medicine. Oxford, oxford university press.
- 8. Modified risk approach, the targeted population strategy can also be used to direct action at particular high risk group within the population but not individual. To control periodontal condition a combined approach is needed.
- 9. Prevention in clinical practice Health promotion for prevention of periodontal diseases progression. To be effective it should be based on scientific and evident based. Basic periodontal examination should be used routinely for assessing and examine the periodontal health. Oral health care professional should impart knowledge, skills and demonstration of brushing for effective oral hygiene self practice.
- 10. Key health education messages to promote periodontal health (Department of Health 2012) Children under 7 years should be supervised with their brushing. Using manual or powered tooth brushed. Gentle pressure hold brush with pen grip Use of of interdental cleaning aides. Tooth brush size use a small head with a medium texture. Replace tooth brush when bristles become excessively slayed. Chlorhexidine is most effective chemical plaque suppressant. Do not smoke. L旦e, H. (2000), Oral hygiene in the prevention of caries and periodontal disease. International Dental Journal, 50: 129139. doi: 10.1111/j.1875- 595X.2000.tb00553.x Department of Health (2012). Delivering better oral health an evidence based tool kit for prevention, 3rd edition, London, Department of Health.
- 11. Smoking cessation advice It is a major etiological factor for periodontal disease and other chronic condition. If a patient is smoker should be given advice in regards to effect of smoking on oral and general health. Patient who wish should be refer to local NHS stop smoking service are available and provide a evidence based support and treatment.
- 12. Public health approaches Clinical preventive measure is not alone sufficient, public health measures are essential elements in preventive strategy (Watt and Peterson, 2012) Watt,R.G and petersen, P.E. (2012). Periodontal health through public health --- the case for oral health promotion. Periodontology 2000, 60, 147-155
- 13. Public health measures to reduce periodontal disease A community wide approach incorporating the principle of integration with general health education, diversity of educational approaches, and community participation. Community leader education. Mass media intervention. Integrate oral hygiene into body cleanliness education in nurseries and school. Incorporate the importance and skills of oral hygiene into training of health, education and social care professional. Use fiscal policy to reduce cost of oral hygiene aids and toothpaste; remove VAT at national level sell the products at cost price in NHS premises. Dorri, M ., Sheiham , A., and watt , R.G (2009). Relationship between general hygiene behaviours and oral hygiene in Iranian adolscents. Europe journal of oral sciences, 117, 407-12 Kay, L. and Locker, D (1996). Is dental health education effective? A systematic review of current evidence. Community dentistry and epidemiology, 24, 231-5. Watt,R.G. and Marinho, V. (2005). Does oral health promotion improved oral hygiene and gingival health? Periodontology 2000, 60, 147-55
- 14. Environmental change : Organizational policy; ensure oral hygiene is placed on health promoting schools agendas structural change within school provision and design of toilet facilities. Comprehensive public health strategies to reduce smoking, epically among low income groups. Sheiham, A. and Netuveli, G. S. (2002), Periodontal diseases in Europe. Periodontology 2000, 29: 104 121. doi: 10.1034/j.1600-0757.2002.290106.x
- 15. Conclusion As a clinical approach alone is not sufficient to achieve a feasible periodontal care modalities. So it is best to adopt upper stream approach and public health approach in getting a success to prevent a periodontal disease as a public health problem. Improve a periodontal health of population Smoking cessation in population.
- 16. Thank you for listening An ounce of prevention is worth a pound of cure Any questions?
Editor's Notes
- #2: Today I am going to tell you about preventive startegy of periodontal disease in UK. As before we start we preventive strtaegty let me go through some important issue which are reason for the failure of tackling periodontal disease.
- #3: Current concept of periodontal care
- #4: Care modalities and what is periodontal disease?
- #5: Upstream actions : legislative and fiscal policies building healthy public polic and creating supportive enviorments No smoking policy in public spaces.
- #8: What is population approach? With am at promoting self care practices and in particular, effective oral hygiene practice need to reduce plaQue levels in the community and reduction in tobacco use.
- #10: Health promotion is enabling indiviual and communities to increase control over the determinants of health and thee by improve their their health. It is advocates through social and enviormant change to improve health based on Building health public policies. Creating supporttive enviorments. Strnghtening community action Developing personal skills Re orientating health services toward prevention. There are some key messsages
- #11: Which can be benefical in delivery a message for beeter periodontal health.
- #14: Mouth cleaning is a part of personal hugiene and gromming behaviour, and therfore it has a strong social motivation rather than a purely healthy focus. This education theory will be far more effectivein imparting knowledge Proffesional education on influential professional groups such as health visitors, pharmacist, and teachers may be effective in deliverying a positive message to general public.
- #15: Marketing practices that promote high quality, low-cost oral hygiene product could be particuraly important in area of deprivation. Frame work convention and tobacco control by who 2003.