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Clinical Manual for Public Health Dentistry and Practical Record Book
DP Narayan
SECTION 1: CLINICAL MANUAL FOR PUBLIC HEALTH DENTISTRY
CHAPTER 1:
Introduction
PUBLIC HEALTH DENTISTRY
Definitions
Health
Public Health
Dental Public Health
Science of Dental Public Health
Art of Dental Public Health
Determining a Public Health Problem
Objectives/Functions of Public Health Dentistry
Dental Public Health Programs
COMMUNITY DENTISTRY
What is Community?
What is Dentistry?
Community Oral Health
What is Community Dentistry?
Simple Definition of Community Dentistry
What is Community Diagnosis?
What is Community Treatment?
PREVENTIVE DENTISTRY
What is Preventive Dentistry?
What is “Prevention”?
Why should we Prevent Dental and Oral Diseases?
Avoidance of Pain
Justification for Oral and General Health
Economy of Dental Treatment
Principles of Prevention of Disease
CHAPTER 2:
Comprehensive Oral Health Care Planning
COMPREHENSIVE ORAL HEALTH CARE
Preventive Services
Primary Prevention
Secondary Prevention
Tertiary Prevention
Educational Services
Therapeutic Services
PROCESS OF COMPREHENSIVE ORAL HEALTH CARE
Assessment
Dental Diagnosis
Data Processing
Classification
Interpretation
Validation
Dental Care Planning
Objectives
Mechanism of Planning
Establishing Priorities
Setting Goals
Determining Interventions
Identify Expected Outcome
Presenting the Dental Care Plan to the Patient
Obtaining Informed Consent
Implementation Phase
Objectives
Evaluation Phase
Objectives
Maintenance Phase
CHAPTER 3:
Evaluation of the Patient for Comprehensive Oral Health Care
CASE HISTORY
Definition (WHO)
DEMOGRAPHIC DATA
Hospital Registration Number
Date
Name
Date of Birth
In Child Patient
Gender–Sex
Occupations
For Child
Martial Status
Address, Telephone Numbers, Place of Birth and Residence in Early Years
Race
Physician
CHIEF COMPLAINT
SIGNIFICANCE
Purpose of the History
History Preparations
Brief History
Complete History
The Questionnaire
Types of Questions
History of Present Illness
Location of Pain
Inception
Provoking Factors or Aggravating Factors
Attenuating Factors or Relieving Factors
Duration
Intensity and Quality
Radiation
COMPLETE PATIENT HISTORY
Past Dental History
Past Medical History
Objectives
Serious or Significant Illness
CARDIOVASCULAR DISEASES
Congenital and Rheumatic Heart Diseases
Record Notes
Medications and Treatment Modalities
Considerations for Dental Appointment Procedures
Hypertension
Record Notes
Medications and Treatment Modalities
Considerations for Dental Appointment Procedures
Angina Pectoris
Record Notes
Medications and Treatment Modalities
Considerations for Dental Appointment Procedures
Heart Diseases
Record Notes
Medications and Treatment Modalities
Considerations for Dental Appointment Procedures
Surgically Corrected Cardiovascular Lesions
Record Notes
Medications and Treatment Modalities
Considerations for Dental Appointment Procedures
Cerebrovascular Accident (Stroke)
Record Notes
Medications and Treatment Modalities
Considerations for Dental Appointment Procedures
LIVER
KIDNEY
RESPIRATION AND LUNG DISEASES
DIABETES OR HORMONAL PROBLEMS
Diabetes Mellitus
Record Notes
Medications and Treatment Modalities
Considerations for Dental Appointment Procedures
Endocrinal or Hormonal Problems
Record Notes
Medications and Treatment Modalities
Considerations for Dental Appointment Procedures
CANCER RADIATION AND CANCER CHEMOTHERAPY
BLOOD DISORDER
BLEEDING DISORDER
INFECTIOUS DISEASES
Communicable Diseases
Record Notes
Medications and Treatment Modalities
Considerations for Dental Appointment Procedures
HEPATITIS B
TUBERCULOSIS
SEXUALLY TRANSMITTED INFECTIONS
HERPES
HIV INFECTION AIDS
ARTHRITIS
MENTAL AND PSYCHIATRIC
PHYSICAL DISABILITIES
EPILEPSY
GASTROINTESTINAL
FAMILY HISTORY
PERSONAL HISTORY
SOCIAL HISTORY
DIET AND DIETARY ANALYSIS
Dietary Assessment
Purposes of Dietary Assessment
Forms used for Assessment
Presentation of Food Diary form to the Patient
Food Diary Instructions
FOOD DIARY
Analysis of Dietary Intake
Analysis of Cariogenic Foods
Identify Physical form of Carbohydrate
Nutritional Analysis for Adequacy of 24 Hour Recall Intake
Nutritional Analysis for Adequacy of Food Intake from the Food Diary
Analysis of Diet Consistency
Benefits of Food Dairy Analysis
DIET COUNSELING
Objectives
Planning
Teaching Materials
Diet Counseling Procedures
GENERAL EXAMINATION
VITAL SIGNS
Instructions for Patient
New Vital Signs
BODY TEMPERATURE
Indications
Maintenance of Body Temperature
Body Temperature Variations
Methods to Determining Temperature
Location for Measurement
Types of Thermometers
PULSE
Maintenance of Normal Pulse
Normal Pulse Rate
Factors that Influence Pulse Rate
Procedure for Determining Pulse Rate
BLOOD PRESSURE
Components of Blood Pressure
Factors that Influence Blood Pressure
Maintenance of Blood Pressure
Factors that Increase Blood Pressure
Factors that Decrease Blood Pressure
LOCAL EXAMINATION
Objectives
Types of Dental Examinations
Type I: Complete Examination
Type II: Limited Examination
Type III: Inspection
Type IV: Screening
Serial Examinations
Periodic Examinations
Maintenance/Re-evaluation
Examination Methods
EXTRAORAL AND INTRAORAL EXAMINATIONS
Overall Appraisal of Patient
To Observe
Indication and Influence on Appointment
Head
Hydrocephalic
Face
To Observe
Indication and Influence of Appointment
Skin
To Observe
Indications and Influences on Appointment
Eyes
To Observe
Indications and Influences on Dental Appointments
Nose
To Observe
Lymph Nodes—Palpate
To Observe
Indication and Influences on Dental Appointments
Temporomandibular Joint (Palpate)
To Observe
Examination of Temporomandibular Joint
Indication and Influences on Dental Appointments
Lips
To Observe
Indication and Influences on Dental Appointments
Labial and Buccal Mucosa: Left and Right Examined Systematically
To Observe
Indication and Influences on Dental Appointments
Tongue
To Observe
Indication and Influences on Dental Appointments
Floor of the Mouth
To Observe
Indication and Influences on Dental Appointments
Breath Odor—Halitosis
To Observe
Indication and Influences on Dental Appointments
Saliva
To Observe
Indication and Influences on Dental Appointments
Hard Palate
To Observe
Indication and Influences on Dental Appointments
Soft Palate, Uvula
To Observe
Indication and Influences on Dental Appointments
Tonsillar Region and Oropharynx
Gingiva
Indication and Influences on Dental Appointments
BASIC TERMINOLOGY IN TOOTH NUMBERING SYSTEM
The FDI—Two Digit Tooth Numbering System
Permanent Teeth
Primary Teeth
UNIVERSAL OR CONTINUOUS SYSTEM NUMBER 1 THROUGH 32 SYSTEM
Permanent Teeth
Primary Tooth
PALMER OR QUADRANT OR CHEVRON NUMBERING 1 THROUGH 8 SYSTEM
Permanent Teeth
Primary Teeth
THE EUROPEAN TOOTH NUMBERING SYSTEM
Permanent Teeth
Primary Teeth
EXAMINATION OF TEETH
Morphology
To Observe
Dental Care Implications
Development
To Observe
Dental Care Implications
Eruption
To Observe
Dental Care Implications
Deposits
To Observe
Dental Care Implications
Stains
To Observe
Dental Care Implications
Regressive Changes
To Observe
Dental Care Implications
Exposed Cementum
To Observe
Dental Care Implications
Dental Caries
To Observe
Dental Care Implications
Restorations
To Observe
Factors Related to Occlusion
To Observe
Dental Care Implications
Tooth Wear
To Observe
Dental Care Implications
Proximal Contacts
To Observe
Dental Care Implications
MOBILITY
To Observe
Dental Care Implications
Classification
To Observe
Dental Care Implications
Habits
To Observe
Dental Care Implications
Edentulous Areas
To Observe
Dental Care Implications
Replacement for Missing Teeth
To Observe
Dental Care Implications
Dentures
To Observe
Dental Care Implication
PROVISIONAL DIAGNOSIS
Differential Diagnosis
Diagnosis of A Specific Problem
INVESTIGATIONS
Chairside Investigations
Identifying Cracked Tooth
RADIOGRAPHS
Extra Oral Views
Periapical Radiography
Bitewing Radiographs
Occlusal Radiography
TREATMENT PLAN
LEVELS OF PREVENTION
Primary Prevention
Secondary Prevention
Tertiary Prevention
CHAPTER 4:
Assessment of Oral Health Status Using Dental Indices
DENTAL INDEX
What is Dental Index?
Ideal Requirements of a Dental Index
Clarity, Simplicity and Objectivity
Validity
Reliability
Quantifiability
Sensitivity
Acceptability
Comfort
Uses of Dental Index in Dental Practice
Individual Oral Health Assessment Score
Clinical Trial in Research
Community Health Epidemiologic Survey
Classification of Dental Indices
General Categories
Selection of a Dental Index
ARMAMENTARIUM USED IN EXAMINATION OF PATIENT TO RECORD DENTAL INDICES
Examination Instruments and Procedures
Precautions
The Mouth Mirror
Types of Mouth Mirror Surfaces
Purpose and Uses
Probe
Types of Probes
Purpose and Uses
Probing Procedures
Probe Insertion
Advance Probe to Base of Pocket
Read the Probe
Circumferential Probing
Explorers
General Purposes and Uses
Basic Procedures for use of Explorers
Use of Sensory Stimuli
Tooth Surface Irregularities
Types of Stimuli
ORAL HYGIENE INDEX
Introduction
Oral Hygiene Index (John C Greene and Jack R Vermillion 1960)
Purpose
Examination Method
Rules for Oral Hygiene Index
Criteria and Scoring for DI and CI in OHI
Calculation
Advantages
Limitations
Why Original Oral Hygiene Index is Simplified
Differences Between OHI and OHI-S
Uses, Advantages and Drawbacks of OHI-S
Uses
Advantages
Drawbacks
Definitions for Oral Hygiene Index
ORAL HYGIENE INDEX-SIMPLIFIED (OHI-S) (Greene and Vermillion 1964)
Examination Criteria and Rules for Coding
Selection for Teeth and Surfaces
Exclusions
Substitutions
General Rules
Components of OHI-S
Examination Procedure
ORAL HYGIENE INDEX-SIMPLIFIED (OHI-S) (Greene and Vermillion 1964)
Debris Index-Simplified (DI-S)
Calculus Index-simplified (CI-S)
Scoring: OHI-S for an Individual
Suggested Range of Scores for Evaluation
Computing Instructions for Selected Statistics
ASSESSMENT OF PERIODONTAL DISEASES
Introduction
RUSSELL'S PERIODONTAL INDEX
Purpose
Examination Procedure
Instrument Used
Russell's Periodontal Index
Calculation
For Individual (Table 4.9)
Suggested Nominal Scale
Drawbacks of Periodontal Index
Uses of Periodontal Index
Advantages
Limitations
COMMUNITY PERIODONTAL INDEX OF TREATMENT NEEDS (CPITN)
Purpose
Methodology
Uses of Index Teeth
Adults: (20 Years and above)
Children and Adolescents: (Below 19 Years)
Procedure
The WHO Periodontal Examination Probe
Types of CPITN Probe
The Probing Procedure
Objectives
Probing Force
Recording of Findings
Classification of Treatment Needs
Examples of Cpitn Recordings: Treatment Planning
Case 1
COMMUNITY PERIODONTAL INDEX (CPI)
Purpose
Indicators
Selection of Teeth
Index Teeth
Adult 20 Years and Older
Children and Adolescents (Less than 20 Years)
Procedure
Instrument
Examination
Loss of Attachment (Figure 4.9 and Table 4.14)
DECAYED MISSING FILLED (DMF) INDEX
Introduction
Concept of DMF Index
What Does Dmf Index Describe?
Definition
Decayed missing filled-surfaces (DMFS) Index
Mixed Dentition
Assessment of Caries in Primary Teeth
What does “DEF-Index” describe?
Modification of DEF Index
Decayed missing filled Index
Decayed filled (DF) Index
The DMF Classification System
Rational for the DMFT Classification
Examination Criteria and Rule for Coding
Special Rules
General Rules
Exclusions
Permanent Tooth Present
Primary Tooth Present
Primary or Permanent Tooth Absent
Extracted Permanent Tooth
The DMFT Examination Procedure
Do's and Don'ts for the Examiner
The Selection and Arrangement of the Examination area
CALCULATIONS FOR DMF INDEX
Instructions for Data Summary
The Number of DMF Teeth (DMFT)
The Number of DMF Surfaces (DMFS)
The Number of DF Teeth (DFT)
The Number of DF Surfaces (DFS)
The Number of Decayed Permanent Teeth
The Number of Permanent Teeth Missing Because of Caries
The Number of Sound Permanent Teeth Present
The Number of Filled Permanent Teeth
The Number of Permanent Teeth Present
Computing Instructions for Selected DMFT Statistics
Number and Percentage of Persons by DMF Statistics
Specific Treatment Need of a Group
Percentage of Permanent Teeth Decayed
Percentage of Persons Needing Care for Carious Permanent Teeth
Percentage of Persons with no Previous Caries Experience
Ratio of filled teeth to DMF teeth
The Average Number of df Teeth Per Child
Limitations of DMF Index
DEAN'S FLUOROSIS INDEX (1942)
Procedures
CHAPTER 5:
Assessment of Oral Health Status Using WHO Assessment Form
GENERAL
STANDARD CODES
ORAL HEALTH ASSESSMENT FORM
IDENTIFICATION AND GENERAL INFORMATION SECTIONS OF THE FORM
Date of Examination (Boxes 5–10)
Identification Number (Boxes 11–14)
Examiner (Box 15)
Original/Duplicate Examinations (Box 16)
Name
Date of Birth (Boxes 17–20)
Age (Boxes 21 and 22)
Sex (Box 23)
Ethnic Group (Box 24)
Occupation (Box 25)
Geographical Location (Boxes 26 and 27)
Location Type (Box 28)
Other Data (Boxes 29 and 30)
Contraindication to Examination (Box 31)
CLINICAL ASSESSMENT
Extraoral Examination (Box 32)
Temporomandibular Joint Assessment (Boxes 33–36)
Oral Mucosa (Boxes 37–42)
Enamel Opacities/Hypoplasia (Boxes 43–52)
Clinical Examination
Dental Fluorosis (Box 53)
Community Periodontal Index (CPI) (Boxes 54–59)
Indicators
Sextants
Index Teeth
Sensing Gingival Pockets and Calculus
Examination and Recording
Loss of Attachment (Boxes 60–65)
Dentition Status and Treatment Need (Boxes 66–161)
Dentition Status
Treatment Needs of Individual Teeth
Prosthetic Status (Boxes 162 And 163)
Prosthetic Need (Boxes 164 And 165)
Dentofacial Anomalies (Boxes 166–176)
Need For Immediate Care and Referral (Boxes 177–180)
CHAPTER 6:
Preventive Dentistry
PROFESSIONAL TOPICAL APPLICATION OF FLUORIDE
Repeated Series of Four Fluoride Treatment
Topical Fluoride Therapy on Incipient Caries Lesion
Topical Fluoride Therapy upon Plaque and Bacterial Metabolism
KNUTSON TECHNIQUE: SODIUM FLUORIDE 2%
Preparation of 2% NaF
Method of Application
Isolation
Application of Fluoride Solution
Advice to the Patient
Mechanism of Action
Disadvantages of Knutson Technique
STANNOUS FLUORIDE 8% (MUHLER'S TECHNIQUE)
Method of Preparation
Method of Application
Mechanism of Action
Advantages
Disadvantages
ACIDULATED PHOSPHATE FLUORIDE (APF): BRUDEVOLD'S TECHNIQUE
Critical Appraisal of APF as a Cariostatic Agent
Brudevold's Apf Solution Composition
Practical Difficulties in Topical Application of Apf Solution
Acidulated phosphate fluoride (Apf) Gels/Foam
Thixotropic Gels
Method of Preparation
Method of Application
Acidulated Phosphate Fluoride: Fluoride Gel Application
Tray Application Technique: Professional Application of APF Gel
Mechanism of Action of Acidulated Phosphate Fluoride
Advantages
Disadvantages
Precautions for Professional Topical Application of Fluorides
Indication for Professional Topical Fluoride Application (Patient at Risk of Dental Caries)
FLUORIDE VARNISHES
Indications
Duraphat
Fluorprotector
Carex
Steps Involved in the Application of Varnish
TOXICITY OF FLUORIDE
Signs and Symptoms of Acute Toxic Dose
Emergency Treatment
Chronic Toxicity
PIT AND FISSURE SEALANTS (The Acid Etch Technique in Caries Prevention Sealants)
Introduction
Why Pit and Fissure are More Susceptible to Caries?
Pit and Fissure Anatomy
A Unique Process of Caries Formation in Pits and Fissures
Why Fluoride is Less Efective in Preventing Caries in Pits and Fissures?
Historical Perspective
Polyurethanes
Cyanoacrylates
Bisphenol A-Glycidyl Methacrylate (BIS-GMA)
Polymineralization of the Sealants
Why Ultraviolet Light Curing Sealants Abandoned?
Benefits of Light Cured Chemical Cured
Laser-Curing of Visible Light-Activated Sealant Resin Materials
Advantages
Disadvantages
How Sealants Work?
The Acid Etch Technique—“Scientific Basis” “Phosphoric Acid”
First Level: A Narrow Zone of Enamel is Removed by Etching
Second Level: The Qualitative Porous Zone
Third Level: The Quantitative Process
Requisites for Sealant Retention
Maximum Surface Area or Increasing the Surface Area
Pit and Fissure Anatomy
Surface Cleanliness
Dryness
Clinical Technique
Sealant Application
Patient Preparation
Clinical Procedures (Figure 6.5)
Step 1: Isolation
Step 2: Cleanse the Tooth Surface
Step 3: Acid Etching Tooth Surface
Step 4: Completion of Etching Rinse and Dry Etched Tooth Surface
Step 5: Apply Sealant to the Etched Tooth Surface
Step 6: Explore the Sealed Tooth Surface
Step 7: Evaluate the Occlusion of the Sealed Tooth Surface
Step 8: Periodically Reevaluate and Reapply Sealant as Necessary
ATRAUMATIC RESTORATIVE TREATMENT
What is ART?
Specific uses of ART
History
Advantages
Indications
Contraindications
Principles of ART
Purpose of Hand Instruments Only in ART
Steps in Preparing the Cavity for ART
ART Training
Introduction
Educational Approach of ART Training
Rationale for Application of ART
Structure for a Basic ART Training
Module 1: Dentin Caries: (Its Progression and how Best to Stop it)
Structure of Dentin
Progression of Dentin Caries Bacterial Invasion
Defence Reaction in Dentin
Two Layers of Carious Dentin
Remineralization of Inner Carious Dentin
External Souces for Remineralization
Characteristics of Occlusal and Approximal Caries
Stages of Dentin Lesion Formation and Progression in an Occlusal Fossa
Characteristics of Progression of Approximal Caries
Traditional Concepts of Cavity Design
Reasons for Failure
Outcomes of Traditional Treatment Approach
Biological Principles of Cavity Preparation
What Kind of Instrumentation is Required to Remove Demineralized Tooth Tissues?
Most Appropriate Instrument
Why Hand Instruments?
Why Does the Cleaned Cavity Need to be Restored?
How is this Best Achieved?
Which Material Best Offer for this?
Tooth Preservation Versus Cavity Preparation
Effect of Sealed Versus Non-sealed Restorations
Summary
Module 2: Adhesive Restorative Materials for Minimal Intervantion Apporaches for Caries Management
Adhesive Material for Minimal Cavity Preparations
Glass Ionomer (Self Cure)
How Does Glass Ionomer Harden?
What are the Main Characteristics of Glass Ionomer?
How does Glass Ionomer Bound to Tooth Tissue?
What about Microleakage of Glass Ionomer?
What does the Tooth Tissue—Glass Ionomer Interface Look Like?
What if Glass Ionomer Fracture?
What is the Function of a Surface Conditioner?
Bond Strength of Glass Ionomer to Enamel and Dentin with or without Dentin Conditioners
What is the Role of Water in Glass Ionomer?
What does Fluoride do in Glass Ionomer?
Pattern of Fluoride Release from Glass Ionomer
What happens to the Fluoride that is Released from Glass Ionomer?
What is Known About Fluoride in Plaque?
Has Glass Ionomer the Potential to Remineralize Carious Lesions in Adjacent Tooth Surfaces?
Overview of Carious Inhibition Zone Adjacent to Resin Modified Glass Ionomer and Composite Resin Restoration
How Pulpal-friendly is Glass Ionomer?
What can be said About the Physical Characteristics of Glass Ionomer?
Pattern of Wear In-vitro
Conclusions
Resin Modified Glass Ionomer
Composite Resin
Polyacid Modified Composite Resin (Compomers)
Comment
Summary
Module 3: Equipments and Materials Required for the ART Approach
General Introductory Statement to the Module
Appropriate Support for the Patient and the Operator
Dental Instruments Required for Art
Restorative Materials Required for Art
Miscellaneous Consumable Materials Required for ART
Operating Light
Sterilization of Instruments
Sharpening of ART Instruments
Module 4
Selection of Cases for ART
Step-by-Step Guide to the ART Approach
Restoring Multiple-surface Cavities
Module 5
Survival of Single Surface ART Restoration
Appicability of ART
How Well are Hand Instrument Accepted by Care Receivers?
What can be Said About Discomfort Felt During Treatment with ART?
Have Changes in Treatment Pattern Occurred due to the Introduction of ART?
Module 6
What are the Perceived Reason for the Failure of ART Restorations?
What are the Reasons for Replacement of Amalgam and Composite Resin Restoration in General Practice?
Conclusions about Restoration Failure
Principles of doing Replacements
Module 7: Practical Experience in the Handling and Mixing of Adhesive Materials for use in the ART Approach
Module Objectives
General Introductory Statements to the Module
Salient Points to Note
Module 8: Practice of Cavity Cleaning and Restoration Placement using the ART Approach on Extracted Teeth
ART Restorations on Extracted Teeth
Sharpening Hand Instruments
Module 9: Practice of the ART Approach on Patients
Module 10: Free Format Discussion
Private Practice
Module 11: Course Evaluation
BIOFILM CONTROL
Plaque as Biofilm
Plaque Metabolism
Plaque Acidification due to Fermentation or Glycolysis
Plaque Alkalinization by Ammonia Production
Synthesis of Polysaccharides (Polymers)
Phlogogenic Substances
ORAL HEALTH EDUCATION TO CONTROL BIOFILM USING PHP INDEX
Purpose
Substitutions for Missing Teeth
Procedures
Scoring
Debri Score for Individual Tooth
PHP Index Value for the Individual
PHP Index Value for a Group
Nominal Scale for Evaluation of Scores
Rating Scores
PLAQUE CONTROL
Procedures for the Control of Plaque and Calculus
Mechanical Methods for the Control of Plaque
Traditional Tooth Sticks
Toothbrushes
Toothbrush Design
ADA Specification for Toothbrushes
Bristle Shape
Electric Toothbrush
Special Uses
Toothbrushing Methods
Supplemental Brushing
Supplemental Oral Hygiene Care
Purposes
Classification of Chemical Plaque Control Agents
First Generation Antiplaque Agents
Second Generation Antiplaque Agents
Third Generation Antiplaque Agents
CHAPTER 7:
Diet Counseling
INTRODUCTION
DIETARY COUNSELING
Dietary Counseling
Requirements for Dietary Counseling
Communication
3 Rules for Effective Communication
Interviewing
Purpose
Goals
How to Interview a Patient?
Counseling
Guidelines for Counseling
Principles of Diet Management
Application to Caries Prevention
Step by Step Dietary Counseling for Caries Prevention
General Principles to be Applied for Prevention of Dental Caries
How to Assist the Patient to Select an Adequate Noncariogenic Diet?
Dietary Advice for Particular Groups
CHAPTER 8:
Management of Physically and Mentally Challenged Children
DEFINITION
CLASSIFICATION
Treatment Factors to be Considered
PREVENTIVE MEASURES
Plaque Control
Diet
Fluorides
Preventive Restorations
MENTAL RETARDATION
Dental Problems
Treatment Considerations
LEARNING DISABILITY
Dental Treatment Considerations
EPILEPSY
Oral Manifestations of Epilepsy
Dental Management
DEAFNESS
Dental Problems and Treatments
BLINDNESS
Dental Problems and Treatments
CHAPTER 9:
Management of Medically Compromised Patients
ISCHEMIC HEART DISEASES
Angina Pectoris and MI
Symptoms
Underlying Pathology
Drug of Choice
Unstable Angina
Stable Angina
Cardiac Pacemakers
Common Causative Organism
Risk Group
High Risk
Moderate Risk
Signs and Symptoms
Dental Aspects
Aim
Preventions
Objective of Antibiotic Prophylaxis
Rheumatic Fever
Signs and Symptoms
Medical Management
Dental Aspect
DISORDERS OF BLOOD
Clinical Signs and Symptoms
Laboratory Tests
HEMOPHILIA
Hemophilia A
Medical Management
Dental Aspects
INR—Prothrombin Time
HEMOPHILIA B—CHRISTMAS DISEASE
VON WILLEBRAND DISEASE
THROMBOCYTOPENIA
ANEMIA
RESPIRATORY DISORDERS
Asthma—Panting/Gasping in Greek
Symptoms
Cystic Fibrosis
Dental Aspects
RENAL DISORDERS
Nephrotic Syndrome
Dental Aspect
Chronic Renal Failure
Dental Aspects
Immunosuppression
Dental Aspects
METABOLIC AND ENDOCRINE DISORDERS
Diabetes Mellitus
Type I—IDDM
Type II—NIDDM
Common Symptoms and Signs
Common Medications
Symptoms of Diabetes
HYPOGLYCEMIA
INFECTIONS
HIV, AIDS, HTLV III
Goals of Treatment
Precautions
CHAPTER 10:
Preparation of Oral Health Education Material
ORAL HEALTH EDUCATION MATERIALS
DENTAL POSTER OR CHART
Effective Poster Design
Steps in Poster Design
Design of the Poster
Layout
Color
Text size
Style and Type
Paragraph Formatting
Visuals
Space
Criteria of a Good Poster
Clarity
Relevance
Concussion
Appeal
Readability
How to Write Easy to Read Health Materials?
What are Easy-to-Read (Etr) Materials?
How can you Create Easy-to-Read Health Materials?
Step 1: Plan and Research
Know your Target Audience
Include your Target Audience
Research your Target Audience
Determine Objective and Outcomes
Step 2: Organize and Write
General Points
Language and Writing Style
Visual Presentations and Representations
Step 3: Evaluate and Improve
Step 4: Readability
What is Readability?
A Brief Historical Overview
How and Why were they Developed?
Readability Formulas Today
What Factors do they Measure?
Measuring a Readability of a Text
Readability Tests
Reading Level Algorithms
What you can do to Improve Readability?
Should you use Readability Formula?
Things they can do
Things they cannot Tell you why?
GUNNING FOG INDEX
Calculating the Gunning Fog Index
SMOG Index
Fry Readability Formula
Coleman Lian Index
SAM Index
Flesch Reading Ease/Flesch-Kincaid Grade Level
CHAPTER 11:
Field Program—A Visit to School
A VISIT TO SCHOOL
Objectives of School Dental Services
School Based Dental Health Program
Elements of School—Based Dental Health Program
Assessment of Oral Health Status of School Children
Trial for Calibrating Examiners
Single Examiner
A Group of Examiners
Recording Clerk
Organizing Clerk
Instruments and Supplies
Examination Area
Emergency Care
Courtesy Reporting
School Based Preventive Dental Health Programs
Classroom Based Tooth Brushing Programs
Limitations
CLASSROOM BASED FLUORIDE PROGRAMS
Method of Preparation and Dispensing
Method of Use
School Based Pit and Fissure Sealant Program
FIELD PROGRAM AFTER FIELD PROGRAM
Field Visits
Anti-Tobacco Cell
Milk Dairy
Primary Health Center
Public Health Institute
Sewage Treatment Plant
Slum Survey
Water treatment Plant
CHAPTER 12:
Early Detection of Oral Cancer
PRIMARY PREVENTION
SECONDARY PREVENTION
TERTIARY PREVENTION
Primary Prevention of Oral Cancer
Risk Factors
Prevention and Early Detection
Factors Delaying the Diagnosis
Screening Exam Requires
Supravital Staining with Toluidine Blue for Oral Cancer (Figure 12.1)
DIAGNOSTIC PROTOCOL FOR ORAL CANCER
CONCLUSION
CHAPTER 13:
Early Detection of Dental Caries
CONCEPTS OF RISK FACTOR, RISK INDICATOR, RISK PREDICTION AND RISK ASSESSMENT
Risk Factor
Risk Indicator
Risk Assessment vs Prediction
Purpose of Risk Prediction
RISK FACTORS TO DENTAL CARIES
Etiologic Factors
External Modifying Risk Indicators, Risk Factors, and Prognostic Risk Factors
Internal Modifying Risk Indicators, Risk factors, and Prognostic Risk Factors
Preventive Factors
Approaches to Risk Prediction
RISK GROUPS
Risk Age Groups
Other Risk Groups
Individual Risk
Key-Risk Teeth and Surfaces
CHAPTER 14:
Setting up of a Private Dental Clinic
FINANCIAL RESOURCES
DESIGNING OF THE DENTAL OFFICE
DESIGNING OF THE WORK AREA
SELECTION OF THE EQUIPMENTS AND INSTRUMENTS
PATIENTS IN PRACTICE
Factors Responsible for a Successful Dental Practice
Relationship with Other Professionals
Updating Knowledge and Skills
Personal Qualities Related to Dentist
Tips and Guidelines for Proper Management of Dental Office
Practice Image
Time Management
Appointments
Recall Systems
Patient Management
Patient Communication
Improving Verbal Images
Managing the Patients Special Needs
Waiting Patients
Forms to be used in Dental Practice
Finance Control
Payment
Stock Control Materials
Records and Accounting
Insurance
Administrative Applications of Computers
Dental Assistants
Infection Control
Guidelines for Control
Space out Professional Work
CONCLUSION
CHAPTER 15:
Consent Letter
CHAPTER 16:
Public Health Laboratory
PUBLIC HEALTH LABORATORIES
Core Functions of Public Health Laboratories
Role as Central Food Laboratory
SECTION 2: PRACTICAL RECORD BOOK
CHAPTER 17:
List of Armamentarium Required in Department of Public Health Dentistry
CHAPTER 18:
Assessment of Oral Health Status Using Dental Indices
ORAL HYGIENE INDEX (GREENE AND VERMILLION, 1960)
Purpose
Examination Method
Rules for Oral Hygiene Index
Criteria and Scoring for DI and CI in OHI
Calculation
ORAL HYGIENE INDEX – SIMPLIFIED (GREENE AND VERMILLION, 1964)
Purpose
General Rules
Examination Procedure
Criteria for Coding
Simplified Debri Index (DI-S)
Simplified Calculus Index (CI-S)
Scoring
OHI-S for an individual
Suggested Range of Scores for Evaluation
PATIENT HYGIENE PERFORMANCE INDEX
Purpose
Selection of Teeth and Surfaces
Substitutions for Missing Teeth
Procedure
Scoring
Debri Score for Individual Tooth
PHP Index Value for The Indivual
PHP Index Value for a Group
Nominal Scale for Evaluation of Scores
DMF INDEX (KLEIN, PALMER AND KNUTSON 1938)
What does Dmf Index Describe?
Definition
DMFS INDEX
MIXED DENTITION
Assessment of Caries in Primary Teeth
“def-index”
Definition
MODIFICATION OF DEF INDEX
DMF Index
Definition
DF Index
Definition
RATIONALE FOR THE DMFT CLASSIFICATION
For Each of the 28 Tooth Spaces
EXAMINATION CRITERIA AND RULE FOR CODING
Rules
Speicial Rules
General Rules
EXCLUSIONS
Excluded Tooth or Tooth Space
PERMANENT TOOTH PRESENT
Sound Permanent Tooth
Filled Permanent Tooth
Decayed Tooth
PRIMARY TOOTH PRESENT
PRIMARY OR PERMANENT TOOTH ABSENT
EXTRACTED PERMANENT TOOTH
THE DMFT EXAMINATION PROCEDURE
DO'S AND DONT'S FOR THE EXAMINER
RUSSEL'S PERIODONTAL INDEX
Purpose
Examination Procedure
Instruments Used
Rule
Criteria and Scoring for the Periodontal Index
Suggested Nominal Scale
Group Periodontal Index (PI) Score and Clinical Manifestations
Individual Periodontal Index (Pi) and Clinical Conditions
COMMUNITY PERIODONTAL INDEX OF TREATMENT NEEDS (CPITN)
Purpose
Methodology
Sextants
Uses of Index Teeth
Adults (20 Years and Above)
B. Children and Adolescents (Below 19 Years)
Procedure
The WHO Periodontal Examination Probe
Types of CPITN Probes
The Probing Procedure
Objective
Probing Force
A Practical Test for Probing Force
Recording of Findings
Classification of Treatment Needs
Treatment Needs (Tn)
COMMUNITY PERIODONTAL INDEX (CPI)
Purpose
Indicators
Selection of Teeth
Index Teeth
Adult 20 Years and Older
Children and Adolescents (Less than 20 Years)
Procedure
Instrument
Examination
Criteria: CPI Score
Loss of Attachment
Criteria: Loss of Attachment
DEAN'S FLUOROSIS INDEX 1942
Procedure
Scores and Criteria
CHAPTER 19:
Assessment of Oral Health Status Using Who Basic Oral Health Survey Form
SURVEY FORM
Purpose
Standard Codes
Tissues/Areas Examined
Procedures
Scoring
CHAPTER 20:
Comprehensive Oral Health Care Planning
COMPREHENSIVE ORAL HEALTH CARE
Definition
EVALUATION OF DENTAL PATIENT
Chief Complaint
History of Present Illness
Past Dental History
Medical History
Family History
Personal History
General Physical Examination
Vital Signs
Local Examination
1. Extraoral Examination
2. Intraoral Examination
Indices
Provisional Diagnosis
Recommended Investigations
Diagnosis
Comprehensive Treatment Plan
Emergency Treatment
Patient Education and Motivation and Oral Prophylaxis
Restorative Treatment
Surgical Treatment
Prosthetic Treatment
Maintenance Phase
Levels of Prevention
Primary Prevention
Health Promotion
Specific Protection
Secondary Prevention
Early diagnosis
Prompt treatment
Tertiary Prevention
Disability limitation
Rehabilitation
CHAPTER 21:
Preventive Dentistry
KNUTSON'S TECHNIQUE: SODIUM FLUORIDE 2%
Preparation of 2% NaF
Method of Application
Isolation
Application of Fluoride Solution
Advice to the Patient
MUHLER'S TECHNIQUE: STANNOUS FLUORIDE 8%
Method of Preparation
Method of Application
BRUDEVOLD'S TECHNIQUE: ACIDULATED PHOSPHATE FLUORIDE (APF)
Method of Preparation
Tray Application Technique: Professional Application of APF Gel
Precautions for Professional Topical Application of Fluorides
Fluoride Varnishes
Steps Involved in The Application of Varnish
Topical Fluoride Application Exercise
PROCEDURE
PIT AND FISSURE SEALANTS
STEPS IN PREPARING THE CAVITY FOR ART
ATRAUMATIC RESTORATIVE TECHNIQUE
CHAPTER 22:
Oral Health Education Materials
DESCRIPTION OF ORAL HEALTH TALK AND PRESENTATION OF ORAL HEALTH EDUCATION MATERIAL
CHAPTER 23:
Field Programs (Submission of Reports)
A VISIT TO SCHOOL
Place of Visit ______________________________________________________________
Date of Visit _______________________________________________________________
VISIT TO PRIMARY HEALTH CENTER
Place of Visit ______________________________________________________________
Date of Visit _______________________________________________________________
VISIT TO WATER PURIFICATION PLANT
Place of Visit ______________________________________________________________
Date of Visit _______________________________________________________________
VISIT TO SEWAGE TREATMENT PLANT
Place of Visit ______________________________________________________________
Date of Visit _______________________________________________________________
VISIT TO MILK DAIRY
Place of Visit ______________________________________________________________
Date of Visit _______________________________________________________________
VISIT TO PHARMACEUTICAL COMPANY
Place of Visit ___________________________________________________________
Date of Visit ___________________________________________________________
VISIT TO INSTITUTION FOR HANDICAPPED PEOPLE
Place of Visit ___________________________________________________________
Date of Visit ___________________________________________________________
CARIES DETECTION PROGRAM
CANCER DETECTION PROGRAM
CHAPTER 24:
Comprehensive Report on Setting up a Private Dental Clinic
COMPREHENSIVE REPORT ON CLINICAL PRACTICE
CHAPTER 25:
Proforma for Indices
PROFORMA FOR RUSSEL'S PERIODONTAL INDEX
PROFORMA FOR COMMUNITY PERIODONTAL INDEX OF TREATMENT NEEDS
PROFORMA FOR COMMUNITY PERIODONTAL INDEX
PROFORMA FOR CARIES INDICES (DMFT, DMFS, DFT, DFS)
PROFORMA FOR ORAL HYGIENE INDEX
PROFORMA FOR ORAL HYGIENE INDEX-SIMPLIFIED
PROFORMA FOR DEAN'S FLUOROSIS INDEX
References
INDEX
TOC
Index
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