primary prevention
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Primary prevention can be defined as " action taken prior to the onset of disease, which removes the possibility that a disease will ever occur'.
It signifies intervention in the prepathogenesis phase of a disease or health problem.
Primary prevention may be accomplished by measures designed to promote general health and well being, and quality of life of people or by specific protective measures.
They are called as modes of intervention.    
Primary prevention is far more than averting the occurrence of a disease and prolonging life.
It includes the concept of "positive health", a concept that encourages achievement and maintenance of " an acceptable level of health that will enable every individual to lead a socially and economically productice life".
It concerns an individual's attitude towards life and health and the initiative he takes about positive and responsible measures for himself, his vfamily and his community.
The concept of primary prevention is noe being applied to the prevention of chronic diseases such as
  • coronary heart disease
  • hypertension and cancer
based on elimination or modification of "risk factors" of disease.
The W.H.O. has recommended the following approaches for the primary prevention of chronic diseases where the risk factors are established
  • population (mass) strategy
  • high-risk strategy

POPULATION (MASS) STRATEGY

Population strategy is directed at the whole population irrespective of individual risk levels.
For example, studies have shown that even a small reduction in the average blood pressure or serum cholestrol of a population would produce a large reduction in the incidence of cardiovascular disease.
The population approach is directed towards socio-economic, behavioural and life style changes.

HIGH-RISK STRATEGY

The high rish strategy aims to bring preventive care to individuals at special risk.
This requires detection of individuals at high risk by the optimum use of clinical methods.
Primary prevention is a desirable goal.
It is worthwhile to recall the fact that the industrialized countries succeeded in eliminating a number of communicable diseases like
  • cholera
  • typhoid, and
  • dysentery
and controlling several others like
  • plaque
  • leprosy, and
  • tuberculosis
not by medical intervention but mainly by raising the standard of living (primary prevention).
And much of this success came even before immunization became universal routine.
The application of primary prevention to the prevention of chronic disease is a recent development.
To have an impact on the population, all the above three approaches (primordial prevention , population strategy and high-risk strategy) should be implemented as they are usually complementary.
In summary, primary prevention is a "holistic" approach.
It relies on measures designed to promote health or to protect against specific disease "agents" and hazards in the environment.
It utilizes knowledge of the prepathogenesis phase of disease, embracing the agent, host and environment.
The safety and low cost of primary prevention justifies its wider application.
Primary prevention has become increasingly identified with 'health education" and the concept of individual and community responsibility for health.


APPLICATION OF PREVENTIVE MEASURES TO DENTAL HEALTH

PRIMARY PREVENTION

SECONDARY PREVENTION

TERTIARY PREVENTION

Health Promotion

Specific Protection

Early Diagnosis & Treatment

Disability Limitaion

Rehabilitation

  1. Dental health education
  2. Education for periodic dental examination.
  3. Good stands of nutrition, adjusted to development phases of life.
  4. Attention to personality development
  5. Genetic cpunselling
  6. Provision of optimum living conditions
  1. Attention to personal oral hygiene
  2. Use of environmental controls, such as
    • water fluoridation
    • topical application of fluorides; and
    • other preventive measures
  3. Protection against occupational and recreational hazards, e.g. use of mouth gaurds.
  4. use of specific, essential nutrients ( of which fluorine is one )
  5. Protection from carcinogens, e.g. anti-smoking measures.
  1. case finding measures, such as radiographs
  2. screening surveys, such as oral cancer screening programmes
  3. dental recall systems
  4. treatment of decayed teeth
  5. professional cleaning of the teeth
  6. elimination of infections
  7. provision of orthodontic appliances and spaces
  1. Treatment to control dental caries and periodontal disease and to prevent further complications and sequelae.
  2. Provision of appliances to restore function and appearance
  3. Treatment of other oral diseases and conditions.
  1. Education of individuals for appropriate use of dentures
  2. Pre-surgery and post-surgery education for oral surgery patients.


PREVENTION OF PERIODONTAL DISEASES

LEVELS

PRIMARY PREVENTION

SECONDARY PREVENTION

TERTIARY PREVENTION

Preventive Services

Health Promotion

Specific Protection

Early Diagnosis & Treatment

Disability Limitaion

Rehabilitation

Services provided by the individual
  • Periodic dental visit
  • Demand for preventive services
Oral hygiene practices
  • Self examination and referral
  • Use of dental services
Use of dental services Use of dental services
Services provided by the community
  • Dental health education programs
  • Promotion of research efforts
  • Provision of oral hygiene aids
  • Lobby efforts
Supervised school brushing programs
  • Periodic screening and referral
  • Provision of dental services
 Provision of dental services Provision of dental services
Services provided by the dental professional
  • Patient education
  • Plaque control
  • recall reinforcement
  • Correction of tooth malalignment
  • prophylaxis
  • Complete examination
  • Scaling and curettage
  • Corrective restorative, and
  • occlusal services
  • Deep curettage
  • Root planing
  • Splinting
  • Periodontal surgery
  • Selective extractions
  • Removable fixed prosthodontics
  • minor tooth movement