Dental Health Education
Lec 1-1st sem3334
CHS 483
By Dr. Ebtisam Fetohy
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:
1. inadequate home care, and
2. 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:
1. Decreased school performance,
2. Poor social relationships and
3. Less success later in life.
•
 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:
1. Are economically disadvantaged,
2. Lack insurance and
3. 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.
Oral diseases
Even in adults, can affect:
1. one's overall health,
2. one's ability to eat healthy food, and
3. 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:
1. cardiovascular diseases (heart disease),
2. respiratory ailments (pulmonary or lung disease), and
3. poor pregnancy outcomes (babies born too small and too
soon).
Persons with diabetes are also at increased risk for periodontal
infections.
Programs and Initiatives
• Preventive Dentistry for High-Risk Underserved Children's
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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
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
Dental Health Educator
 Must have knowledge of:
-Available resources
- Demographic Changes affecting dental health (socioeconomic-Health services and weigh (external-Internal)
variables in relation to clinical and behavioural reasrch
findings
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 generationschool health education, community activities
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
Oral screening and risk factors for oral
cancer dental health education
 Efforts are done by:
1. Dentists
2. Oral health care professionals
3. Community health educators
4. Class room Teachers
Baby Bottle Tooth Decay
 Efforts of Dental Health Educators are targeted to:
1. Doctors
2. Pediatricians
3. Nurses
4. Parents and caregivers
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
 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
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
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
 Dental Fluorosis: Excessive intake of Fluoride: leads to:
1. hypo-mineralization and
2. disruption of enamel developments
It is caused by:
A. Prolonged use of formula milk and
B. Tooth paste ingestion (younger than 6 years)

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
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
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.
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.
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.
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.
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.
Tooth Structure
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.
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
away ‫ يبلى‬due to:
1. Attrition (abrasion) (‫ )الحك‬or
2. Erosion (be dissolved by acid) (‫ )التآكل‬and
fractured due to:
A. Stress, and or
B. Affected by dental decay.
it may be

1.
2.
3.
4.
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.
1. It is made up of blood vessels, cellular substance and nerves.
2. It supplies nutrients to the tooth and
3. Its nerve endings transmit sensations such as pain and
temperature.

Tooth structure
 Cementum forms a very thin layer over the root of the
tooth
1. It is similar to bone.
2. It is yellowish in color and also
3. It carries sensations such as temperature and pain to the pulp.
4. 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)
Tooth types
Deciduous teeth: are also known as baby teeth, milk teeth,

1.
2.



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
worn ‫ بالي‬due to grinding (‫ )الطحن‬and normal wear ‫الحك‬
through eating.
The incisors are used for cutting,
The canines for tearing and
The molars for chewing
 In the upper arch (maxilla)
there are ten deciduous
teeth:
 2 central incisors
 2 lateral incisors
 2 canines
 2 first molars
 2 second molars
In the lower arch (mandible)
there are ten deciduous teeth:
 2 central incisors
 2 lateral incisors
 2 canines
 2 first molars
 2 second molars
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.
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
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.
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 17-21
years
Baby Teeth
 Front Teeth:
A. Central incisor
B. Lateral incisor
C. Canine or eye tooth
 Back Teeth:
D. First molar
E. Second molar
Permanent Teeth
 Tooth Names
 Front Teeth:
1. Central incisor
2. Lateral incisor
3. Canine or eye tooth
i. Back Teeth:
4. First premolar
5. Second premolar
6. First Molar
7. Second Molar
8. Third Molar Or Wisdom Tooth
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.