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Alison Chapman. Basic Guide to Oral Health Education and Promotion
Table of Contents
List of Tables
List of Illustrations
Guide
Pages
BASIC GUIDE TO ORAL HEALTH EDUCATION AND PROMOTION
Dedication
Foreword
Preface
Acknowledgements
About the Companion Website
Section 1 Structure and Functions of the Oral Cavity. INTRODUCTION
Chapter 1 The oral cavity in health. Learning outcomes
INTRODUCTION
ORAL EMBRYOLOGY
Development of the face
Development of the palate and nasal cavities. Week 5
Week 6
Week 8
Development of the jaws (mandible and maxilla) Week 6
Week 7
Week 8
Tooth germ development in the foetus
MAIN FUNCTIONS OF THE ORAL CAVITY
TEETH
Primary dentition
Secondary dentition
Structure of the tooth
Organic and inorganic tooth matter
Enamel
Properties of enamel
Dentine
Properties of dentine
Cementum
Properties of cementum
Pulp
Properties of pulp
Supporting structures of the tooth
The periodontal ligament
Cementum
Alveolar bone (also known as the alveolar ridge)
Gingivae
THE TONGUE AND THE FLOOR OF THE MOUTH
Muscles of the tongue
Functions of the tongue
Taste
Mastication
Deglutition
Speech
Natural cleansing
Protection
Conditions affecting the tongue
The floor of the mouth
SALIVA
Major salivary glands
Composition of saliva
Functions of saliva
Facts about saliva
Other additives within the mouth
REFERENCES
Section 2 Diseases and Conditions of the Oral Cavity. INTRODUCTION
What causes oral disease?
Chapter 2 Plaque, calculus, and staining. Learning outcomes
INTRODUCTION
PLAQUE
Biofilms
Bacteria
Aerobic bacteria
Anaerobic bacteria
Other microorganisms found in plaque
Fungi
Viruses
The matrix
Stages in plaque formation. Stage 1
Stage 2
Stage 3
Stage 4
Local risk factors in the retention of plaque
Plaque control
CALCULUS
Types of Calculus
Supragingival calculus
Subgingival calculus
TOOTH STAINING
Intrinsic staining
Extrinsic staining
Teeth whitening
Teeth whitening in the practice
REFERENCE
Chapter 3 Dental plaque‐induced gingivitis. Learning outcomes
DENTAL PLAQUE‐INDUCED GINGIVITIS
Who does it affect?
Primary cause of dental plaque‐induced gingivitis
Secondary causes of dental plaque‐induced gingivitis
Inflammation
Stages of inflammation (also signs of gingivitis)
Other signs and symptoms of gingivitis
Signs
Symptoms
Treatment of gingivitis
REFERENCE
Chapter 4 Periodontal disease. Learning outcomes
WHAT IS PERIODONTITIS?
Who does it affect?
Primary causes of periodontitis
Secondary risk factors in the development of periodontitis
Features of periodontitis
Signs of periodontitis
Symptoms of periodontitis
Treatment and management
Classification of Periodontal diseases (Figure 4.5 a,b)
NECROTISING ULCERATIVE GINGIVITIS
Aetiology of NUG
Clinical features of NUG
Treatment of NUG
PERI‐IMPLANT MUCOSITIS AND PERI‐IMPLANTITIS
Oral hygiene aids for peri‐implant mucositis and peri‐implantitis
REFERENCES
Chapter 5 Caries. Learning outcomes
WHAT IS CARIES?
History of caries
Global incidence
UK incidence (Dental Health Surveys)
Types of caries
Development of caries
Aetiology of caries
Acid attack
The Stephan curve
Stages of caries
Common sites where caries occurs
Prevention of caries (Figure 5.8)
Simple experiments to demonstrate an acid attack
‘Coins‐in‐acid’ experiment
‘Egg‐in‐fluoride’ experiment
Epidemiology and caries
The Vipeholm study
Conclusions of Vipeholm study
Hopewood House study
Conclusions of Hopewood House study
Other evidence‐based studies
REFERENCES
Chapter 6 Tooth surface loss and sensitivity. Learning outcomes
WHAT IS TOOTH SURFACE LOSS?
Incidence of TSL
Erosion
Aetiology
Features
Patients commonly affected by erosion
Management/treatment
Attrition
Aetiology
Features
Patients commonly affected by attrition
Management/treatment
Abrasion
Aetiology
Features
Patients commonly affected by abrasion
Management/treatment
SENSITIVITY (DENTINE HYPERSENSITIVITY)
Aetiology
Symptoms
Where does dentine hypersensitivity occur?
Patients commonly affected by dentine hypersensitivity
Treatment
REFERENCES
Chapter 7 Xerostomia. Learning outcomes
WHAT IS XEROSTOMIA?
Aetiology
Permanently dry mouth
Management
Management for radiotherapy/chemotherapy (and very ill) patients
REFERENCE
Chapter 8 Other diseases and disorders affecting the oral cavity. Learning outcomes
INTRODUCTION
PERIODONTAL ABSCESS
Aetiology (causes)
Clinical features
Treatment
APHTHOUS ULCERS (MINOR AND MAJOR)
Aetiology
Clinical features
Minor aphthous ulcer
Major aphthous ulcer
Treatment
COLD SORES (HERPES LABIALIS)
Aetiology
Clinical features
What reactivates the virus?
Treatment
PRIMARY (ACUTE) HERPETIC GINGIVOSTOMATITIS
Aetiology
Clinical features
Treatment
TOOTH ANOMALIES. Hypodontia
Anodontia
Hyperdontia
Teeth size
Tooth morphology anomalies
BURNING MOUTH SYNDROME
Aetiology
Symptoms
Treatment
GLOSSITIS
Clinical features
Symptoms
Aetiology
Treatment
GEOGRAPHIC TONGUE
Clinical features
Symptoms
Aetiology
Treatment
BLACK HAIRY TONGUE
Aetiology and clinical features
Treatment
ORAL CANDIDOSIS
Oral thrush. Clinical features
Treatment
Stomatitis
Clinical features
Treatment
Angular cheilitis
Clinical features
Treatment
WHITE PATCHES (LEUKOPLAKIA)
ORAL CANCER (CARCINOMA)
Aetiology
Clinical features
Treatment
Prevention
SQUAMOUS CELL PAPILLOMA
Aetiology
Clinical features
Treatment
MUCOCELE
Clinical features
Aetiology
Treatment
TORI
BURNS
Aetiology
Clinical features
Treatment
RECREATIONAL DRUG USERS
SYSTEMIC DISEASES WITH ORAL IMPLICATIONS
Diabetes
Type 1 diabetes
Type 2 diabetes
Oral implications of diabetes
Patients with epilepsy
Lichen planus
Aetiology
Clinical features
Treatment
Acquired immune deficiency syndrome (AIDS) Aetiology
Oral manifestations
Treatment
Crohn’s disease and colitis
Sjögren's syndrome (pronounced show‐grins) Aetiology
Clinical features
Treatment
REFERENCES
Section 3 Oral Disease Prevention. INTRODUCTION
Chapter 9 Nutrition, diet, and exercise. Learning outcomes
INTRODUCTION
ROLE OF THE OHE
A HEALTHY BALANCED DIET (THE EATWELL GUIDE)
NUTRITION
Carbohydrates
Proteins
Fats
Vitamins
Vitamin classification
Fat‐soluble vitamins
Water‐soluble vitamins
Minerals
Fibre
Water
FOOD ADDITIVES
FOOD LABELLING
PHYSICAL EXERCISE AND GENERAL WELLBEING
Exercise recommendations for adults
Exercise recommendations for children. Children under 5 years old
Children and young people aged 5–18 years old
REFERENCES
Chapter 10 Sugars in the diet. Learning outcomes
INTRODUCTION
UK CONSUMPTION
CLASSIFICATION OF SUGARS
Free sugars
SACN free sugar recommendations
WHO Public Health Recommendations
Intrinsic sugars
Milk sugars
OHE ADVICE TO PATIENTS ON SUGAR CONSUMPTION
Reduce daily sugar consumption
Identify hidden sugars (read the label)
Reduce frequency of sugar intake
Reduce unhealthy snacks
Find healthy alternatives
Sugar‐free medicines
Consider using sugar substitutes
SUGAR SUBSTITUTES
Bulk sweeteners
Xylitol (E967)
Intense sweeteners
REFERENCES
Chapter 11 Fluoride. Learning outcomes
WHAT IS FLUORIDE?
Facts about fluoride
History of fluoride
1892 (UK)
1901 (Colorado Springs, USA)
1930s (USA)
1945 (Michigan, USA)
1955 (UK)
1964 (UK)
1978 (UK)
1985 (UK)
2000 (UK)
2005 (UK)
2006 (Global)
2012 (UK)
2014 (UK)
2015 (UK)
2016 (UK)
2018 (UK)
How fluoride works
Sources of fluoride
Water
Benefits of water fluoridation
Opposition to water fluoridation
Toothpastes
Mouthwash
Fluoride varnish
Fluoride varnish application
Tablets or drops
Fluoridated milk
Fluoridated salt
Points to consider when recommending supplements
Patients recommended for fluoride supplements
Dental fluorosis
REFERENCES
Chapter 12 Fissure sealants. Learning outcomes
WHAT IS A FISSURE SEALANT?
Reasons for using fissure sealants
When and where to seal
Fissure sealant materials/systems
Sealant placement
Tips on fissure sealing in children
Further advice
Clinical trials
REFERENCES
Chapter 13 Smoking cessation and substance misuse. Learning outcomes
SMOKING AND TOBACCO USE
Effects of tobacco on oral health
Effects of tobacco on general health
Reasons why people use tobacco
Helping patients change their habits
Guidelines for brief intervention
Harm reduction
Recommended harm reduction products
Advice on vaping (e‐cigarettes)
Summary of advice
The process of change
Prochaska and DiClemente’s Process of Change
OTHER DRUG MISUSE AND SUPPORT
Alcohol
What is a unit of alcohol?
Recommended limit
Guidelines for a brief intervention
Further advice and support
Illegal drug misuse
Opiates (heroin, morphine) and methadone
Cannabis
Cocaine
Amphetamines and ecstasy
Hallucinogens (LSD, magic mushrooms, angel dust)
Solvent abuse
REFERENCES
Chapter 14 Anti‐plaque agents. Learning outcomes
INTRODUCTION
Toothpaste
Constituents of toothpaste
Functions of toothpaste
Advising on toothpastes
Homeopathic toothpastes
Anti‐plaque mouthwashes
Chlorhexidine gluconate
Forms of chlorhexidine gluconate
Chlorhexidine gluconate usage
Side effects of chlorhexidine gluconate usage
Delmopinol mouthwash
Essential oil mouthwash
Fluoride mouthwashes (see Chapter 11)
Fluoride mouthwash usage
Hydrogen peroxide mouthwashes
Sodium bicarbonate
Benzydamine hydrochloride
Cetylpyridinium chloride
Sugar‐free chewing gum
REFERENCES
Section 4 Delivering Oral Health Messages. INTRODUCTION
Chapter 15 Communication. Learning outcomes
WHAT IS COMMUNICATION?
The three rules of communication
COMMUNICATION IN THE DENTAL SURGERY
Effective communication
Warmth
Empathy
Respect
Communication barriers
Social/cultural barriers
Limited receptiveness of patient
Negative attitude towards the OHE
Limited understanding or poor memory
Insufficient emphasis on education by the professional
Contradictory messages
Information fade
Paralinguistic communication
Neuro‐linguistic programming training
MEDIA INFLUENCE
TECHNOLOGY AND ORAL HEALTH EDUCATION
REFERENCE
Chapter 16 Education and planning sessions. Learning outcomes
INTRODUCTION
EDUCATIONAL THEORISTS
THE THREE DOMAINS OF LEARNING
STRUCTURING A SESSION
Decide upon the topic
Obtain background information about the patient/group
Aims
Objectives
Lesson plan
Teaching methods and aids
Rehearse the session
Evaluation
Evaluation types
Outcome evaluation
Process evaluation
Peer evaluation
Self‐evaluation (reflective practice)
Evaluation methods
SO WHAT IS A QUESTIONNAIRE?
Open and closed questions
Questionnaire design
REFERENCE
Chapter 17 Setting up a preventive dental unit. Learning outcomes
INTRODUCTION
SETTING UP A PDU
A suitable location
Business, marketing plan and budget
Enthusiasm from employers and colleagues
PDU design
SETTING UP DISPLAYS
Planning a display
Items to display
OTHER CONSIDERATIONS
REFERENCES
Chapter 18 Planning an oral hygiene presentation to a group. Learning outcomes
INTRODUCTION
PLANNING A TALK TO A GROUP OUTSIDE OF THE PRACTICE
DELIVERING THE TALK (CHECKLIST)
SETTING UP AN EXHIBITION OR DISPLAY
POSTER DESIGN AND DISPLAYING WRITTEN INFORMATION
Chapter 19 Practical oral hygiene instruction. Learning outcomes
INTRODUCTION
TEACHING PLAQUE CONTROL SKILLS
Patient motivation
Disclosing
Disclosing exercises
Exercise 1
Exercise 2
Exercise 3
Plaque indicator kits
Toothbrushes
Power brushes
Manual toothbrushing
Brushing techniques
Bass technique/modified Bass (Figure 19.3)
Simple scrub
Fones (circular) technique (Figure 19.4)
Brushing with a power brush (Figure 19.5)
When to brush
Interdental cleaning methods
Floss and tape
How to use floss and tape
Interdental brushes
Rubber toothpicks (Figure 19.12)
Interspace brushes (Figure 19.13)
Implant, braces, and bridge cleaning
Implants
Bridges
Fixed braces
Water irrigation units
Tongue cleaning
Advice to orthodontic appliance wearers
Advice to denture wearers
COMPLEMENTARY AND ALTERNATIVE THERAPIES
Acupuncture
Herbal remedies
Aromatherapy
Homeopathy
EXAMPLE OHE APPOINTMENT [1]
REFERENCES
Section 5 Oral Health Target Groups and Case Studies. INTRODUCTION
Chapter 20 Pregnant patients. Learning outcomes
INTRODUCTION
Lifestyle advice during pregnancy
Questions on the developing embryo and foetus
SUSCEPTIBILITY TO ORAL DISEASES AND CONDITIONS
Erosion (see also Chapter 6)
Prevention/management
Caries (see Chapter 5)
Prevention/management
Gingival problems (see Chapter 3)
Pregnancy gingivitis
Symptoms of pregnancy gingivitis
Signs of pregnancy gingivitis
Management of pregnancy gingivitis
Periodontal infection
Smoking‐related conditions and diseases (see also Chapter 13)
Alcohol advice (see also Chapter 13)
SUMMARY OF ADVICE FOR PREGNANT WOMEN
REFERENCES
Chapter 21 Parents and guardiansof pre‐11 year olds. Learning outcomes
INTRODUCTION
Visiting schools and clubs
GENERAL ADVICE. Sugar‐free medicines
‘One hour before bed’ rule
Passive smoking (see Chapter 13)
SPECIFIC ADVICE TO PARENTS OF 0–3 YEAR OLDS
Babies born with teeth
Eruption dates (see Chapter 1)
Teething
Advice on relieving teething pain
Effective cleaning of newly erupted teeth (see Chapter 11)
Fluoride toothpaste (see Chapter 11)
Toothbrushing (see Chapter 19)
Interdental cleaning (see Chapter 19)
Fluoride supplements (see Chapters 11 and 14)
Comforters (dummies)
Bottles and drinking cups
Breastfeeding
Breast milk substitutes
Weaning
Visiting the dentist
SPECIFIC ADVICE TO PARENTS OF CHILDREN AGED 4–6 YEARS
Eruption dates (see Chapter 1)
Fluoride toothpaste (see Chapters 11 and 14)
Toothbrushing (see Chapter 19)
Interdental cleaning (see Chapter 19)
Fluoride supplements (see Chapters 11 and 14)
Diet and sugar intake (see also Chapters 9 and 10)
SPECIFIC ADVICE TO PARENTS OF CHILDREN AGED 7–11 YEARS
Eruption dates (see Chapter 1)
Fluoride supplements (see Chapters 11 and 14)
Toothbrushing (see Chapter 19)
Interdental cleaning (see Chapter 19)
Fluoride mouthwash (see Chapters 11 and 14)
Diet and sugar intake (see Chapters 9 and 10)
Gum disease prevention
REFERENCES
Chapter 22 Adolescent and orthodontic patients. Learning outcomes
ADOLESCENTS
Treating adolescents
Consent
Advice for adolescents
Regular dental/orthodontic check‐ups
Effective cleaning (see also Chapters 14 and 19)
Dietary advice (see also Chapters 9 and 10)
Anti‐smoking/alcohol/drug advice (see Chapter 13)
Oral piercing advice
Sports mouthguards
Stock mouthguards
Mouth‐formed mouthguards
Custom‐fit mouthguards
THE ORTHODONTIC PATIENT
Deciding on orthodontic treatment
Angle’s classification
Class I
Class II
Class III
Advice for the orthodontic patient
Fixed appliances
Removable appliances
REFERENCES
Chapter 23 Older people. Learning outcomes
WHO ARE OLDER PEOPLE?
British Dental Association classification of older people
UK adult dental surveys
Benefits of a healthy mouth
Diet and nutrition (see Chapter 9)
Barriers to a good diet
Advising on sugar‐free options (see Chapter 10)
Fluoride (see Chapters 11 and 14)
Barriers to dental treatment
Breaking down the barriers
Oral problems of older people
DENTURE CARE
Advice to full denture wearers
Advice to partial denture wearers
Advice to carers of patients with full or partial dentures
OBTURATORS
ADDITIONAL INFORMATION FOR CARE HOME MANAGERS
Smiling Matters: oral health care in care homes (CQC report)
DEMENTIA
OTHER CONSIDERATIONS
REFERENCES
Chapter 24 At‐risk patients and people with special needs. Learning outcomes
WHO ARE AT‐RISK PATIENTS?
Medically compromised patients (see also Chapter 8)
Patients with diabetes
Patients with epilepsy
Epileptic seizures
Patients with haemophilia and Von Willebrand disease (VWD)
Patients with physical and mental impairment
Patients with physical impairment
Arthritis
Patients with mental impairment
People of low socioeconomic status
People who misuse alcohol and illegal drugs (see also Chapter 13)
Patients with dental phobia
Severely compromised patients
Patients with heart valve defects
PHRASES USED FOR PATIENTS WITH SPECIAL NEEDS
REFERENCES
Chapter 25 Minority cultural and ethnic populations in the United Kingdom. Learning outcomes
INTRODUCTION
BARRIERS TO DENTAL TREATMENT
Breaking down the barriers
Meet with community leaders
Contact other professionals
Diet/nutrition (see Chapter 9)
Diabetes and heart disease (see Chapter 8)
Betel nut (paan) chewing (see Chapter 13)
Suitable oral health products
Language custom/how to address people
Produce suitable promotional material
REFERENCES
Chapter 26 Other health professionals. LEARNING OUTCOMES
INTRODUCTION
WHO ELSE PROVIDES ORAL HEALTH EDUCATION?
TEAM UP WITH OTHER PROFESSIONALS
GIVING ADVICE TO INDIVIDUAL HEALTH EDUCATION PROFESSIONALS
Chapter 27 Planning education case studies, exhibitions, and record of competence. Learning outcomes
INTRODUCTION
Choosing oral health subjects
Plan ahead
Putting yourself and the patient at ease (see also Chapter 15)
Do not expect miracles
Dealing with difficult patients
Patient records
Case study examples
The patient with a number of things to improve
The patient with a special reason for improving oral health
Exhibition or display (see also Chapter 18)
Choosing a topic
Examples of exhibitions/displays
Exhibition plan (also see Chapter 18)
REFERENCE
Section 6 Oral Health and Society. INTRODUCTION
Chapter 28 Sociology. Learning outcomes
SOCIOLOGY
Socialisation
Values
Norms
Social classes
Psychological theories
THE ICEBERG EFFECT
Victim blaming
An example of how to close the performance gap. The problem
The solution
REFERENCES
Chapter 29 Epidemiology. Learning outcomes
WHAT IS EPIDEMIOLOGY?
SURVEYS
Survey terminology
INDICES
Examples of where indices can be used
DMFT caries index (1930s)
Oral hygiene index (1960)
Silness and Löe plaque index (1964)
Turesky plaque index (1970) (Figure 29.1)
Basic periodontal examination (BPE) index (1982)
Children 12 years and younger
REFERENCES
Chapter 30 Evidence‐based prevention. Learning outcomes
PREVENTION IS BETTER THAN CURE
EVIDENCE‐BASED PREVENTION
Primary prevention
Secondary prevention
Tertiary prevention
The Cochrane Collaboration
RISK MANAGEMENT STRATEGIES
NICE recommendations on patient recall
DENTAL CONTRACT REFORM: PROTOTYPES SCHEME
REFERENCES
Chapter 31 UK dental services. Learning outcomes
NHS DENTAL SERVICE
PRIVATE DENTAL PRACTICES
REVIEW OF NHS DENTAL SERVICES IN ENGLAND
THE HEALTH AND SOCIAL CARE ACT 2012
CLINICAL GOVERNANCE AND DONABEDIAN’S MODEL
Donabedian’s three principles
THE GENERAL DENTAL COUNCIL
GDC Preparing for practice
GDC Scope of Practice
GDC Standards
CARE QUALITY COMMISSION
COMMUNITY DENTAL SERVICE
HOSPITAL DENTAL SERVICES
REFERENCES
Chapter 32 Oral health promotion. Learning outcomes
WHAT IS ORAL HEALTH PROMOTION?
DEFINING PEOPLE’S NEEDS
INTERNATIONAL ORAL HEALTH PROMOTION. The Ottawa Charter
WHO’s Global Oral Health Programme
WHO oral health priority action areas
WHO public health recommendations (see Chapter 10)
UK NATIONALLY‐LED ORAL HEALTH PROMOTION INITIATIVES
Oral health promotion services
Annual promotion events
Promotion publications
Department of health guidance
GETTING INVOLVED WITH LOCAL ORAL HEALTH PROMOTION INITIATIVES
BARRIERS TO PROMOTION
FUTURE PROMOTION
REFERENCES
Chapter 33 Dental research. Learning outcomes
KEEPING UP TO DATE WITH RESEARCH
Significance of research papers
Terminology
Abstract
Qualitative research
Quantitative research
Epidemiology
Incidence
Prevalence
Control group
Cross‐sectional study
Case‐control study
Cohort study
Matching
In situ research
In vitro research
In vivo research
CLINICAL TRIALS
Randomised controlled trial/study
Cohort study
Single‐blind and double‐blind studies
Crossover study
Parallel study
SOURCING RESEARCH PAPERS
Index
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