Disease prevention in dentistry can be categorized based on scientific findings in the literature and on the oral health of the patient. To help mitigate the need for more invasive procedures, preventive measures can be a more conservative alternative that allows the patient and the practitioner to work together to achieve optimal oral health. A THE NEXTDDS webinar presentation from Dr. Kenneth Markowitz entitled, “Clinical Application of Disease Detection and Management for Preventive Dentistry” outlines several factors to consider planning such an approach for your patients.
Prevention applies to all stages of the disease process, but in primary prevention, the dentist is looking at the earliest stages of disease, or even before evidence of any disease occurs to begin the necessary protocols. Primary prevention is about developing a healthy “dental career” in individual patients. This is achieved through oral health promotion, enabling individuals to adopt healthy behaviors from birth.1
Instilling a proactive approach (a brush-floss-rinse regimen, education on power and manual toothbrushes, etc.) improves the oral health and quality of life of patients in a way that is not costly and before any serious issues develop. Here, there is also the possibility of detecting other early-stage issues, such as oral cancer, that will lead to immediate treatment planning and intervention.
In secondary prevention, the goal is to limit the complications of an already established disease. Secondary prevention focuses on interfering with the disease process before signs and symptoms appear.2 Using a minimally invasive approach, a practitioner hopes to repair or stop further damage once the disease has already occurred.
Various visualization and detection tools are available to the dentist seeking to apply secondary prevention, including digital radiography, intraoral scanners, and digital cameras. This type of preventive care is harder to implement consistently in the philosophy of a modern practice. For example, despite these efforts in primary and secondary prevention, millions of people are still affected by chronic periodontitis and/or caries disease.3 However, methods such as the CAMBRA look to manage causative factors of disease in at-risk patients.
In tertiary prevention, the clinical focus is on the progression of disease with complications. Tertiary prevention is the management of patients with chronic periodontitis through nonsurgical and surgical therapy and maintenance to avoid further damage by the disease process.3 A key factor in this type of prevention is managing the disease when it has reached an advanced stage.
Tertiary prevention encompasses methods and measures that should remove existing complications and prevent their further possible progression. Treatments for the dental pulp, periodontium, and dental prosthetics fall into this tertiary category.4 Dentists who treat populations with high levels of dental disease often implement a tertiary prevention approach.1
Dentists are granted the opportunity to work together with patients, allowing them to significantly alter oral health for the better by regularly treating and managing. Instead of relying on the operatory and surgical approach to dentistry, an emphasis for patient education and intervention should be the first priority. New dentists should aspire for a minimally invasive type of practice that has its roots in communication and conservative care, leaning on the goals of primary as well as secondary prevention if necessary. Learn more about what specific things you can do during prevention by listening to the full webinar.
1. Richards W. Prevention in practice. British Dental Journal. https://www.ncbi.nlm.nih.gov/pubmed/18690167. 2008 Aug 9;205(3):111. Accessed September 14, 2017.
2. Stedman's Medical Dictionary. 28th ed. Baltimore: Lippincott Williams & Wilkins; 2006.
3. Kumar S. Exploring prevalence and prevention. Dimensions of Dental Hygiene. http://www.dimensionsofdentalhygiene.com/2015/05_May/Features/Exploring_Prevalence_And_Prevention.aspx. May 2015;13(5):53–59. Accessed September 14, 2017.
4. Dostálová TCA, ed. Dentistry and Oral Diseases. Prague, Czech Republic: Grada Publishing; 2010.