#Terminology
#Cariouslesions
#OralCavity
#PPT
#POWERPOINTPRESENTATION
#OperativeDentistry
#ConservativeDentistry
#DENTALNOTES
Dentin Hypersensitivity PPT
#DentinHypersensitivity
#PPT
#POWERPOINTPRESENTATION
#OperativeDentistry
#ConservativeDentistry
#DENTALNOTES
Terminology related to Non-Carious lesions of Oral Cavity NOTES
Attrition – the mechanical wear of the incisal or occlusal surface of the teeth due to frictional forces between the opposing teeth is attrition (includes wear of the proximal surfaces due to physiologic movement).
Abrasion – this is abnormal tooth surface loss because of direct frictional forces between teeth and external forces (brushing force or frictional force between contacting teething presence of an abrasive) Eg. Tooth brush abrasion, abrasion due to tobacco chewing.
Erosion: the loss or wear of tooth due to chemico-mechanical action is erosion especially by frequent consumption of citrus juices, gastric regurgitation etc.
Abfraction – the micro-fractures seen in cervical areas of the teeth due to abnormal tooth flexure (m. bent or curved part)
Fracture – any break in the continuity of tooth surface as a result of traumatic injuries.
Enamel hypoplasia – the defective formation or calcification of enamel due to injury to ameloblasts during enamel formation.
Terminology related to Carious lesions of Oral Cavity NOTES
Primary caries – first attack of caries on a tooth
Secondary caries or recurrent caries – the subsequent attack of caries on the restored tooth is secondary caries. This is usually seen at the junction of tooth and restoration.
Incipient caries or reversible caries – an early carious lesion which in the initial stages, which can be reversed by the use of remineralizing agents.
Cavitated caries or irreversible caries – the carious lesion that has cavitated the enamel and progressed into dentin where restoration is definitely needed.
Pit and fissure caries – this type of caries involves the pit and fissure areas of the tooth. They are the most common sites for caries as they are potential sites for food entrapment.
Smooth surface caries – this caries involves the smooth areas of teeth ( eg. proximal surfaces of teeth, gingival one-third of the facial and lingual surfaces of teeth) that are covered by a plaque for a prolonged period of time.
Root surface caries or senile caries (as it is generally seen in elderly people)– this caries involves the exposed areas of root following the gingival recession. Root surface caries spread more rapidly and needs immediate treatment.
Acute caries – this caries is of rapid onset and spread. The carious lesion is light yellow in color, soft in texture and highly infectious.
Chronic caries – this caries is of slower onset and spread. The carious lesion is hard in consistency and dark brown to black in color.
Forward caries – if the carious cone in enamel is larger or same as that in dentinal caries zone, then it is referred to as forward caries.
Backward caries – when the spread of caries along the dentinoenamel junction exceeds caries in contiguous enamel, caries extends backward into this enamel from the junction, then it is backward caries.
Residual caries – caries that is left over in a completed tooth preparation either by operator’s neglect or intention is residual caries. Caries may be left intentionally when it is very close to the pulp while performing indirect pulp capping procedures.
Milestones in Dental Public Health NOTES
INTRODUCTION
The history of man's fight for health begins with his earliest existence when he was completely at the mercy of nature with no effective means of combating its hazards.
Ancient Egyptians used a variety of ways to treats the diseases of the mouth whereas efforts related to prevention of oral diseases dates back to Hippocrates
Then came to the process of learning and research in medical and dental field has resulted in a dramatic acceleration in health knowledge but dental diseases continue to be most common diseases and are still progressing
This is because conventional dentistry has traditionally been curative rather than preventive. The need of the hour is the application of evidence based Dentistry at the community level
In public health dentistry, the individual patient is not the sole object of study. The entire community is in focus
DEFINITION
1.DENTISTRY
Dentistry is defined as the evaluation, diagnosis, prevention and/or treatment [non surgical, surgical or related procedures] of diseases, disorders and/or conditions of the oral cavity, maxillofacial area and/or the adjacent associated structures and their impact on the human body; provided by a dentist within his/her scope of education, training and experience, in accordance with the ethics of the profession and applicable law.
2. DENTAL PUBLIC HEALTH
“The science and art of preventing and controlling dental diseases and promoting dental health through organized community efforts. It's that form of dental practice which serves the community as a patient rather than the individual. It's concerned with dental health education of the public, with applied dental research and with the administration of group dental care programs as well as the prevention and control of dental diseases on a community basis.”
3. ORAL HEALTH
The World Health Organization (1982) defined oral health as “ The retention throughout the life of a functional, aesthetic and natural dentition of not less than 20 teeth and not requiring a prosthesis.”
An alternative definition of oral health given by U.K Department of Health (1994) is “Oral health is a standard of health of the oral and related tissues which enables an individual to eat, speak and socialize without active disease, discomfort or embarrassment and which contributes to general well being.”
HISTORY OF DENTISTRY
STAGES OF EVOLUTION OF DENTISTRY
Stage-1 Undifferentiated occupation
-Folk medicine was used in the treatment of toothache n infections
-A few individuals denote some time to perform simple dental procedures
-None depended solely on dentistry for their livelihood
Stage-2 Differentiated occupation
-Indigenous practitioners emerged without any formal training
-Devotion of entire time to dentistry profession
-Fabrication of dental prosthesis was done
-No restriction of govt for the practice of dentistry
Stage-3 Initial professionalization
-Dentists form a guild/association
-Formal training of 6months-2years was organized
-Restrictive legislation is enacted
-Profession comes into being
Stage-4 Intermediate professionalization
-Independent dental schools were established with increased course n duration
-Minimum requirement for admission was secondary education
-Dental education stresses on technical aspects of profession
-Professional associations became stronger due to increase in dental professionals
-Unqualified professionals strived due to deficiencies in laws n their enforcements
Stage-5 Advanced professionalization
-Dentistry becomes recognized as health profession
-It becomes strongly organized n institutionalized
-Post graduation studies develop
-Dental practice by unqualified personnel disappears
MILESTONES IN DENTAL PUBLIC HEALTH
Efforts towards the prevention of dental disease date back to 2600 years before Christ where an inscription on the tomb of Hesy-Re, an Egyptian scribe reads that he was “the greatest of those who deal with teeth and of physicians.” This is the earliest known reference to a person identified as a dental practitioner and is often called “the first dentist.”
2500 BC – H Wang Ti from China devotes a chapter in his book to dental and gingival diseases
1500 BC – Ebers papyrus from Egypt describes oral diseases and offers a number of prescriptions for strengthening of teeth and gums
480 BC – Hippocrates of Cos, the father of modern medicine, discussed the functions and eruptions of teeth and also the etiology of periodontal diseases
15 BC – Aulus Cornelius Celsus (Roman) refers to the disease that affects the soft parts of the mouth and their treatment. Paul of Aegina (Roman) differentiated between Epulis and Parulis
9th century AD – The Arabs were interested in the care of the teeth rather than in their extraction and replacement and mouth hygiene was a well-established technique. They used a small wooden stick, the end of which was often chewed, the wooden fibers being used as a brush called “Siwak”
Late 10th century AD – The first recognition for removal of calcareous deposits as important in control of periodontal diseases was mentioned by Abulcasis
14th century AD – Guy de Chauliac records a fairly definite set of rules for oral hygiene based on Arab writings involving a number of dietary prohibitions including viscous food such as figs and confectionery made with honey and also directions for cleansing the teeth with a dentrifice
Late 1440’s – The first modern idea of a toothbrush was invented in China by the Chinese
1640 – Toothbrush is introduced into the western world
1723 – Pierre Fauchard , a French surgeon publishes “The Surgeon Dentist”, a treatise on teeth. Fauchard is credited as being the Father of the Modern Dentistry because his book was the first to describe a comprehensive system for the practice of dentistry including basic oral anatomy and function, operative and restorative techniques and denture reconstruction
1776 – The first modern known case of post-mortem dental forensics. Paul Revere, a dentist, verifies the death of his friend, Dr. Joseph Warren in the Battle of Breed’s Hill, when he identifies the bridge that he constructed for Warren
1789 – Frenchman Nicolas Dubois de Chemant receives the first patent for porcelain teeth
1790 – John Greenwood, son of Issac Greenwood and one of George Washington’s dentists, constructs the first known dental foot engine. He adopts his mother’s foot treadle spinning wheel to rotate a drill
1790 – Josaiah Flagg, a prominent American Dentist, constructs the first dental chair made specially for dental patients. To a wooden Windson chair, Flagg attached an adjustable headrest plus an arm extension to hold the instruments
1791 – The first dispensary for the treatment of poor was established by Skinner in NYC. Dental services were also offered there.
1801 – Richard C Skinner writes the Treatise on the human teeth, the first dental book published in America
1825 – Samuel Stockton begins commercial manufacture of porcelain teeth. His SS White Dental Manufacturing Company establishes and dominates the dental supply market throughout the 19th century
1832 – James Snell invents the first reclining dental chair
1833 – The Crawcour brothers introduce amalgam in the US and advertise it as a substitute for gold restorations
1839 – The American Journal of Dental Science, the world’s first dental journal begins its publication
1839 – Charles Goodyear invents the vulcanization process for hardening rubber. The resulting Vulcanite, an inexpensive material easily moulded, makes an excellent base for false teeth.
1840 – The American Society of Dental Surgeons, the world’s first national dental organization is founded
1844 – Horace Wells, a Connecticut dentist discovers that nitrous oxide can be used as an anesthesia and successfully uses it to conduct several extractions in his clinic. In 1845 the public demonstration of the same failed after the patient cried out during the operation. In 1846, another dentist, William Mortan (student of Wells) takes the credit for the discovery when he conducts the first successful public demonstration of the use of ether as an anesthesia for surgery
1849 – The Society of Dental Surgeons of the state of New York founded its own dental infirmary
1854 – The earliest known lab in the US., Sutton & Raynor, opens in NYC
1857 – The first patent for toothbrush by HN Wadsworth in the US
1859 – 26 dentists meet in Niagara Falls and forms American Dental Association
1861 – Dental service became a part of charity hospital of Philadelphia
1864 – Sanford C Barnum develops the rubber dam which solves the problem of isolating a tooth
1865 – The first children’s dental clinic was established in Strasbourg, Germany
1866 – Lucy Hobbs graduated from Ohio College of Dental Surgery, becoming the first woman to earn a dental degree
1867 – The Harvard University Dental School, the first university-affiliated dental institution is founded. The school calls its degree Dentariae Medicinae Doctorae (DMD)
1867 – Small dental clinic for low income people was opened in Boston
1871 – James B Morrison patents the first commercially manufactured foot-treadle dental engine. This inexpensive mechanized tool supplies dental burs with enough speed to cut enamel n dentin smoothly and quickly, revolutionizing the practice of dentistry
1871 – George F Green receives the patent for the first electric dental engine, a self contained motor and handpiece
1877 – The Wilkerson chair, the first pump type hydraulic dental chair is introduced
1884 – ML Rhein of NYC urges dentists to teach their patients proper tooth brushing method. He coins the term “Oral Hygiene”
1885 – Dr. C Edmung Kells of New Orleans hires his first lady dental assistant in assisting his lady patients
1890 – In England through the stimulation of W Mac Pherson Fisher of Dundee, a committee was appointed to carry on oral hygiene work in schools which led to the appointment of dentists in many elementary schools
1892 – Dr. Washington Sheffield of New London, Connecticut manufactures toothpaste in a collapsible tube and names it Dr. Sheffield’s Crème Dentifrice
1895 – Wilhelm Conrad Rontgen a German physicist discovers the X-ray
1896 – A prominent New Orleans dentist C Edmond Kells takes the first dental radiograph of a living person in US
1898 – J Leon Williams, a dental histologist gave a slogan “A clean tooth never decays” which led to higher standards of mouth hygiene
1899 – Edward Hartley Angle classifies the various forms of malocclusion
1900 – FDI is formed
1901 – Dr Federick Mckay discovers Colorado stains in Colorado springs, US
1905 – Alfred C Fones of Bridgeport trains Mrs. Irene Newman to undertake oral prophylaxis
1908 – Epidemiologic studies related to mottled enamel was done
1913 - Alfred C Fones opens the Fones Clinic For Dental Hygienists in Bridgeport, Connecticut, the world’s first oral hygiene school. Dr. Fones uses the term dental hygienist to become known as the Father of Dental Hygiene
1921 – The first training school for dental nurses come into existence in New Zealand in Willington at the urging of T A Hunter
1926 – The Carnegie Foundation-sponsored Gies report, the first comprehensive report on the state of dental education, is published and has an immediate impact on dental profession
1931 – Fluoride is identified by H V Churchill in New Kensington, Pennsylvania , Smith MC, Lantz EM, Smith HV in Arizona and Velu H, Balozet L in France
1938 – The nylon toothbrush made with synthetic bristles is introduced by DuPoint
1945 – The water fluoridation era begins when the city of Grand Rapids, Michigan, add sodium fluoride to their public water systems
1948 – WHO was formed
1955 – Michael Buonocore describes the acid etch technique, a simple method of increasing the adhesion of acrylic filings to enamel
1956 – The Oral Health Unit was established in WHO
1957 – John Borden introduces a high speed air driven contra-angle handpiece. The airotor obtains speed upto 300,000 rotations per minute
1958 – A fully reclining dental chair is introduced
1959 – The first electric toothbrush, the Broxodent is introduced by Bristol-Myers company at the centennial of ADA
1960s – Lasers are developed and approved for soft tissue procedures
1969 – WHO establishes the WHO epidemilogical data bank which collects data on dental health and dental needs in many countries around the globe
1982 – International conference on the declining prevalence of dental carried is organized by Forsyth Dental Centre, Boston in June
1996 – WHO establishes an internet online oral health database, supported by the WHO Collaborating Centre in oral health at Malmo University, Sweden and the University of Niigata, Japan. The WHO Oral health Country/Area Profile Program (CAPP) aims at presenting information on oral diseases in individual countries, including data on oral health services, programs, dental education and human resources
MILESTONES IN THE INDIAN CONTEXT
1000 BC – Sushrutha Samhita-numerous descriptions of severe periodontal disease with loose teeth and purulent discharge
Charaka Samhita – Stressed on tooth brushing-the stick for tooth brushing, should be bitter, pungent or astringent. One of its ends should be cleaned in the form of a brush and should be used twice a day taking care that gums are not injured. Neem twigs are used even today
The father of Dentistry in India is considered to be Dr. Rafiuddin Ahmed, who was born on December 24, 1890, and later became the first president of Indian Dental Association (then known as All India Dental Association)
1920 – Dr. Ahmed founded the first dental college in India which was financed by starting the New York Soda Foundation in Calcutta
1925 – Dr. Ahmed establishes the Bengal Dental Association and establishes the Indian Dental Journal
1939 – Dr. Ahmed helps to form the Bengal Dentists Act, which was the first governmental regulation in India
1948 – Dentists act is passed by the Indian Parliament in close association with All India Dental Association on the 29th of March. This Act was introduced to regulate the profession of dentistry in India. The Act was amended on 1st July 1955 to make the law applicable to the state of Jammu and Kashmir
1971 – Mr. Orango started the department of Community Dentistry at Government Dental College, Bangalore under Dr. Mohandas Bhat
1988 – National Oral Health Care Program, (NOHCP) project of DGHS and Ministry of Health and Family Welfare is initiated to improve the oral health of the masses and to prevent or reduce the burden of oral disease in the country
1995 – The re-drafted Oral Health Policy is accepted in principle as a part of the National Health Policy during the Fourth Conference of Central Council of Health and Family Welfare
2002-2003 – National oral health survey was carried out by the Dental Council of India
REFERENCES
• Soben Peter
• Hiremath
Theories of Child Psychology NOTES
DEFINITIONS
PSYCHOLOGY is the science dealing with human nature, function and phenomenon of his soul in the main.
CHILD PSYCHOLOGY is the science that deals with the mental power or an interaction between the conscious and subconscious element in a child.
BEHAVIOUR MANAGEMENT: The means by which dental health team effectively and efficiently perform treatment for a child and simultaneously instills a positive dental attitude in the child.
THEORIES OF CHILD PSYCHOLOGY
It is classified into two groups
Psychodynamic theories:
Psychosexual theory-Freud
Psycho social theory-Eric Erickson
Cognitive theory-Piaget
Behavioral Theories:
Hierarchy of needs-Maslow
Social learning theory-Bandura
Classical conditioning-Pavlov
Operant conditioning-Skinner
Psychoanalytical theory (Sigmond Freud) :
He described the five psychosexual stages.
Psychic structure proposed by Freud in psycho dynamic theory composed of three parts
Id: It is the basic structure of personality, which serves as a reservoir of instincts or their mental representative. It is present at birth, impulse ridden and strives for immediate pleasure and gratification(pleasure principle)
Ego: It develops out of Id in the second to sixth month of life when the infant begins to distinguish between itself and the outside world. It is the mediation between Id and Super Ego. Unlike Id, Ego is governed by the reality principle. It is concerned with memory and judgment. It is developed after birth, expands with age and it delays, modifies and controls Id impulses on a realistic level
Super Ego: it is the prohibition learned from the environment. It acts as a censor of acceptability of thoughts, feelings, and behavior.It is determined by regulations imposed upon the child by parents society, and culture. It is the internalized control which produces the feeling of shame and guilt.
Freud’s stages of development:
• Birth
• Oral stage
• Anal stage
• Urethral stage
• Phallic stage
• Latency stage
• Genital stage
Classical Conditioning (Pavlov)
The more frequent pairing of the conditioned and unconditioned stimulus, the stronger is the conditioning.
The principles involved in the process are:
1. Generalization where in the process of conditioning is evoked by a band of stimuli centered around a specific conditioned stimulus e.g., a child who has had a painful experience with a doctor in white coat always associates any doctor in a white coat with pain.
2. Extinction of the conditioned behavior results if the association between the conditioned and the unconditioned response is not reinforced.
3. Discrimination is the opposite of generalization
Skinner described four basic types of operant conditioning
- Positive reinforcement: occurs if a pleasant consequence follows the response e.g., a child rewarded for good behavior following dental treatment
- Negative Reinforcement: involves removal of unpleasant stimuli following a response e.g., if the parent gives into the temper tantrums thrown by the child, he reinforces this behavior
- Omission: refers to removal of the pleasant response of a particular response e.g., if the child misbehaves during the dental procedure, his favorite toy is taken away for a short time resulting in the omission of the undesirable behavior
- Punishment: involves the introduction of an aversive stimulus into a situation to decrease the undesirable behavior e.g., use of palatal rake in the correction of tongue thrusting habit.
Cognitive theory (Piaget)
Piaget formulated his theory on how children and adolescents think and acquire knowledge. The process of adaptation is made up of 3 functional variants-
1. Assimilation
2. Accommodation
3. Equilibration
The sequence of development has been categorized into 4 major stages
1. Sensory motor stage (0 to 2 years): Every child is born with certain strategies for interacting with environment
2. Pre-operational stage (2 to 6 years): Primitive strategies change as a child assimilates new experiences and accommodates original strategies
3. Concrete operation stage (6 to 12 years): The thinking process become logical
4. Formal operation stage (11 to 15 years): The child now a teenager is able to think still more abstractly
Hierarchy of Needs (Masler)
Masler believed in the self-actualization theory, i.e., the need to understand the totality of a person.
Psychosocial theory (Eric Erickson)
Erickson concentrated on child’s development covering the entire span of the life cycle from infancy to childhood through old age.
Erickson’s psychological stages:-
Erickson’s psychological stages:-
- Basic trust versus mistrust (0 to 1 yr)
- Autonomy versus shame, doubt (2 to 3 yrs)
- Initiative versus guilt (4 to 5 yr)
- Industry versus inferiority (6 to 12 yrs)
- Identity versus role confusion (13 to 18 yrs)
- Intimacy versus isolation (19 to 25 yrs)
- Generativity versus stagnation (26 to 50 yrs)
- Ego integrity versus despair (50 +yrs)
Social learning theory (Bandura)
It is the most complete, clinically useful and theoretically a sophisticated form of behavior therapy. As compared to operant and classical conditioning this theory is
• Less reductionistic
• Provides more explanatory concepts
• Encompasses a broader range of phenomena
The learning of behavior is affected by four principal elements
1. Antecedent determinants
2. Consequent determinants
3. Modeling
It involves four processes which are
It involves four processes which are
• Attention process
• Retention process
• Reproduction process
• Motivation
4. Self-regulation
REFERENCE
SHOBHA TANDON
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