«Chapter 24 Assorted Errands in Prevention of Children’s Oral Diseases and Conditions H.S. Mbawala, F.M. Machibya and F.K. Kahabuka Additional ...»
Assorted Errands in Prevention of Children’s Oral
Diseases and Conditions
H.S. Mbawala, F.M. Machibya and F.K. Kahabuka
Additional information is available at the end of the chapter
Children are young human beings; they are vulnerable to various ailments including oral
diseases and conditions. In order to prevent the various oral diseases and conditions in
children, all people responsible in looking after the children have a role to play so as to protect them from acquiring oral diseases or receive appropriate prompt management. This chapter presents responsibilities of various stakeholders in prevention of children’s oral diseases and conditions. The impact of oral diseases in children’s general health, growth and development is presented. The various oral diseases and conditions and the significance of their prevention is described. Finally, responsible stake holders and their various errands are elucidated.
2. Prevention of children’s oral diseases and conditions The word prevent comes from the Latin “praeventus”, which means anticipate or hinder.
Prevention literally implies the act of putting a stop to something from happening. It refers to measures taken to make the occurrence of something from none existence or not progressing to a worse situation . Subsequently, prevention of diseases is actions aimed at eradicating, eliminating or minimizing the impact of disease and disability, or if none of these are feasible, retarding the progress of the disease and disability. Prevention of oral diseases and conditions, therefore means to put a stop or to avoid the oral diseases and or conditions from occurring, control the already existing condition or disease not to progress further or take charge such that the impact of the condition or diseases is handled to improve quality of life of the affected individual. Disease preventive strategies are acting on the chain of disease causation where individuals who are at risk or have higher possibilities of contracting the disease or having the © 2015 The Author(s). Licensee InTech. This chapter is distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and eproduction in any medium, provided the original work is properly cited.
546 Emerging Trends in Oral Health Sciences and Dentistry stated condition are made less likely to contract the disease by decreasing their susceptibility, for example action of fluoridated dentifrices on strengthening the teeth to prevent dental caries.
3. Essence of prevention of children’s oral diseases and conditions The rationale behind prevention of oral diseases in children lays back to the sense of wide‐ spread of the common oral diseases (dental caries and periodontal conditions) among them, where about 60-90% of children worldwide are affected .
Unfortunately, these oral diseases and conditions tend to create socio-demographic gradients ; where regardless of knowledge and scientific based evidence advances and achievement for the control and treatment, globally oral diseases have tended to accumulate in the most disadvantaged populations. In these populations the affected child usually have severe and multiple conditions or diseases. It is reported that about 50 million school hours are lost annually in USA due to dental pain as a result of dental caries and that dental pain is the second common condition at medical emergencies, hence oral diseases in children are a public health problem as they impact children’s socio and psychological well being as well as restrict school activity . Table 1 summarizes a range of research findings showing the socio-psychological impact of oral diseases to children. In most developing countries, the cost of treating dental caries among children alone will require their total health care budget . Furthermore the clinical approach to dental treatment has proved to be an economic burden in industrialized countries where expenditure on oral health is about 3%-12% of total health expenditures.
is their parents or guardians who decide and act for their health care. On the other hand, prevention of oral diseases through instituting most oral health related-behaviours like tooth brushing and use of fluoridated toothpaste are determined by the family. Likewise, associated expenses are to be incurred by a family earner.
Oral health is an integral part of overall well-being and essential for eating, growth, speech, social development, learning capacity and quality of life and tooth decay has been reported to have negative impact on childhood nutrition, growth and weight gain . Additionally;
World Federation of Public Health Associations  admits that oral health problems in children can impact on many aspects of their general health and development, causing substantial pain and disruption to their lives and often altering their behaviour.
Prevention of oral diseases is relatively less costly compared to curative dental services, therefore it is considered beneficial. For example, water fluoridation may appear expensive, but because of its wider coverage and its easy application versus dental treatment for a decayed tooth in an individual, it remains a better choice. Prevention of oral diseases is cost effective particularly in middle and low income countries where resources necessary for conventional dental treatment are scarce and a substantial proportion of their financial resources for health is directed to address infectious diseases.
Another benefit of preventing oral diseases in children is to minimize pain, discomfort and suffering; enable them to eat and socialize well, avoid loss of school hours ultimately contribute into their growth and development.
5. Levels of disease prevention The concept of prevention is conveniently defined at four levels, namely primordial, primary, secondary and tertiary prevention though in reality the stages blur one into the next.
5.1. Primordial prevention This is a relatively recent classification of disease prevention. It seeks to prevent at a very early stage, often before the risk factor is present in the particular context, the activities which encourage the emergence of lifestyles, behaviours and exposure patterns that contribute to increased risk of disease. Or it is actions and measures that inhibit the emergence of risk factors in the form of environmental, economic, social, and behavioral conditions and cultural patterns of living. In primordial prevention, efforts are directed towards discouraging children from adopting harmful lifestyles, the main intervention being through individual and mass education. According to Porta , primordial prevention consists of conditions, actions, and measures that minimize hazards to health and hence inhibit the emergence and establishment of processes and factors (environmental, economic, social, behavioral, cultural) known to increase the risk of diseases. Furthermore, Porta  states that primordial prevention is accomplished through many public and private healthy public policies and intersectoral action and that it may be seen as a form of primary prevention. Primordial prevention addresses 548 Emerging Trends in Oral Health Sciences and Dentistry broad health determinants rather than preventing personal exposure to risk factors, which is the goal of primary prevention. For instance, outlawing alcohol would represent primordial prevention, whereas a campaign against drinking would be an example of primary prevention.
In dentistry primordial prevention will include enforcing a law on fluoride levels in various products and education on causes and prevention of oral diseases and conditions to individ‐ uals and to the community.
5.2. Primary prevention
Primary prevention can be defined in several ways. One of these definitions states that primary prevention is the action taken prior to the onset of disease, which removes the possibility that the disease will occur. It also can be defined as the first level of health care, designed to prevent the occurrence of disease and promote health, or as prevention of disease through the control of exposure to risk factors. Approaches for primary prevention include population-wide strategies and high-risk strategies focusing on population sub-groups. It may be accomplished by measures of “Health promotion” and “specific protection” that is; measures designed to promote general health and well-being, and quality of life of people or by specific protective measures. Examples of primary prevention in dentistry include fluoridation of public water, oral evaluation, dental prophylaxis, Fluoride use as preventive agent, fissure sealants, use of Xylitol, mouth guards, regular dental examinations and self-care such as tooth brushing, flossing, use of dental rinses and medicinal mouthwashes.
5.3. Secondary prevention
Is defined as the application of available measures to detect early departures from health and to introduce appropriate treatment and interventions. Others define secondary prevention as the second level of health care, based on the earliest possible identification of disease so that it can be more readily treated or managed and adverse sequelae can be prevented. This level of prevention is also defined as action which halts the progress of a disease at its incipient stage and prevents complications. Screening is a major component of secondary prevention.
Examples of secondary prevention in dentistry are Fluoride use on incipient caries, dental restorations, periodontal debridement, root canal treatments, serial extraction, fixed and removable appliances, installation of caps and crowns. Removal of broken or impacted teeth, especially the third molars is also a type of secondary preventive dentistry.
5.4. Tertiary prevention
Is the application of measures to reduce or eliminate long-term impairments and disabilities, minimising suffering caused by existing departures from good health and to promote the patient’s adjustments to his/her condition. In other words, it is the third phase or level of health care, concerned with promotion of independent function and prevention of further diseaserelated deterioration. It also can be defined as all the measures available to reduce or limit impairments and disabilities, and to promote the patients’ adjustment to irremediable conditions. Examples of tertiary prevention in dentistry include; denture fabrication, bridges, Assorted Errands in Prevention of Children’s Oral Diseases and Conditions 549 http://dx.doi.org/10.5772/59768 implants, oro-maxillofacial surgery, periodontal surgery, fixed prosthodontics and space maintainers. Most dental procedures aiming at children fall under the first three levels of prevention.
6. Rationale of oral disease prevention in children Although dental diseases are not among the feared killer diseases like ebola and malaria, their high prevalence inflict heavy pain in the community in terms of treatment cost, physical and physiological incapacitation and rarely death. Oral health is part and parcel of the general health in such a way that severe illness on orofacial region can lead to systemic problems like malnutrition, immunosupresion, septicaemia etc.
The rationale for preventing oral diseases and especially in children can be viewed under three areas; the disease burden inflicted by oral diseases to the community, the common risk factors shared by oral diseases and other chronic diseases and the lifelong effects to be gained if efforts for prevention are directed to children.
6.1. Disease burden
Despite great improvements in the oral health of populations in several countries, globally, oral health problems still persist . Traditional treatment of oral diseases is extremely costly;
it is the fourth most expensive disease to treat in most industrialized countries where 5–10% of public health expenditure relates to oral health [17, 18]. In most developing countries resources are primarily allocated to emergency oral care and pain relief; it is estimated that, if treatment were available in these countries, the costs of dental caries in children alone would exceed the total health care budget for children .
6.2. Relation to general health
There is a group of risk factors common to many chronic diseases and oral diseases. They include tobacco and alcohol use, frequent consumption of sugars and inadequate physical activity, especially when coupled with consumption of excess calories, [19-23]. Hence, addressing these factors will ultimately prevent other systemic diseases. The four most prominent non-communicable diseases sharing risk factors with oral diseases are cardiovas‐ cular diseases, diabetes, cancer and chronic obstructive pulmonary diseases; the factors are preventable and relate to lifestyles.
6.3. Lifelong effect in children
Children are young, easy to learn and usually what they learn at early age is retained for life.
Therefore, efforts for directing disease prevention to children who are likely to practice preventive measures and maintain good oral health throughout adulthood are justified.
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7. Oral diseases and conditions that affect children There are many oral diseases affecting children. They may be congenitally transmitted or acquired through environmental interaction. The chapter describes some of the common oral diseases and conditions in children
Dental caries or tooth decay is the disease which causes destruction of tooth material, which includes: enamel, dentin, root and pulp. It is one of the most prevalent chronic diseases worldwide . Dental caries forms over time through interaction between cariogenic bacteria and fermentable carbohydrates or cariogenic food particles left on the surface of the tooth.