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Oral Health Promotion

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For CHO/SN

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List the risk factors associated with oral health

Have an understanding of oral health promotion

Identify the role of CHO in oral health promotion

Describe the healthy practices to maintain oral health

OBJECTIVES

At the end of the session participants will be able to:

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A risk factor is a condition or behavior that increases the chances of developing a particular disease

WHAT IS RISK FACTOR?

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Nawab is 24 years old and has been chewing tobacco since he was ten years old.

His teeth are discolored and he keeps getting ulcers in his mouth.

Prasad is always busy with his office work and in a hurry. Several times he skips his lunch and dinner due to work stress. Whenever he eat, he cleans his mouth with a tissue only and chew sweetened mouth freshener to avoid the food smell.

Juhi, a 7 months baby more often falls asleep with a feeding bottle in her mouth for a longer period.

SOME CASES: ARE THEY AT RISK? IF SO, FOR WHAT?

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- High blood pressure

- High blood glucose levels

- High blood fat levels

- Excess body fat (being overweight)

RISK FACTORS - HEALTH

Modifiable Risk Factors

- Unhealthy diets

- Lack of physical activities

- Tobacco use

- Alcohol consumption

- Environmental factors

Non Modifiable Risk Factors

- Age

- Sex

- Family history

Outcome

- Cardiovascular disease (Heart disease , stroke)

- Diabetes

- Cancers

- Chronic Respiratory Diseases (Asthma , difficulty in breathing)

- Tooth decay/cavities

Source: Adapted from WHO STEP wise approach to NCD surveillance, WHO 2003

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SIX RISK FACTORS FOR ORAL HEALTH

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RISK FACTORS FOR ORAL DISEASES

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All major NCDs including oral diseases, share the same social determinants and some common modifiable risk factors like:

    • Poor diet,
          • Tobacco use and
                • Alcohol use

REMEMBER

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HEALTH PROMOTION FOCUSES ON

Keeping people healthy

Helping people make changes in lifestyle to prevent diseases

Motivating behaviour changes to avoid complications among those with diseases

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    • Oral health promotion– Prevent oral diseases from occurring in individuals by helping them adopt healthy lifestyle practices such as proper tooth brushing.

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    • Diagnosis and treatment– Early detection of oral diseases in individuals and help them get prompt treatment so that the disease is controlled at an early stage, especially in oral cancers.

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    • Prevent complications – of the disease and its progression to late stages in the individual by facilitating complete treatment and follow-ups.

THREE PRINCIPLES

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    • Improves the health behavior of individuals and communities and makes positive changes in the habits that affect their oral health

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    • Improves the oral health status of individuals, families, communities

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    • Reduces the costs (both financial and human) that individuals and communities would spend on dental treatment

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    • Oral Health Promotion has a lifelong effect

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    • The earlier Oral Health Promotion begins, the better its effects are

IMPORTANCE OF

ORAL HEALTH PROMOTION?

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ORAL HEALTH PROMOTION: ADOPTION OF HEALTHY PRACTICES

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    • Plaque the main reason of common dental diseases

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    • It is a colourless film, which sticks to teeth at the gum line and constantly forms on teeth
    • Brushing teeth twice a day

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    • Tongue Cleaning

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    • Rinsing of mouth after meal - Use of Mouthwashes / warm saline rinses

MAINTENANCE OF ORAL HYGIENE

MAINTENANCE OF ORAL HYGIENE

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TOOTH BRUSHING

    • Brush your teeth twice daily

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    • Avoid aerated drinks sticky/sweet food; Snacking between meals

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    • Brushing and rinsing mouth with water and massage over gums

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    • Do not quit brushing during pregnancy

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BRUSHING TECHNIQUE

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The tongue should be cleaned using the toothbrush or a tongue cleaner every time along with brushing teeth.

TONGUE CLEANING

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    • Rinsing after meals is very essential. Mouth should be rinsed with plain water after every meal, especially after eating sugary and sticky foods.

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    • For small babies give water as last feed.

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MOUTH RINSING

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    • Warm saline rinses should be done for relief from common oro-dental problems like pain and swelling in gums, swelling in mouth till the time care at the nearest facility is accessed.

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    • Medicated Mouthwashes can be used as prescribed by the Dentist.

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EATING

RIGHT

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ANTICARIOGENIC DIET

    • Foods such as nuts, cheese, and onions have been shown to slow the growth of decay-causing bacteria in the mouth.

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    • Consume fresh fruits and vegetables

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    • Avoid processed foods, and sweetened beverages.

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    • Avoid snacking in between meals

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    • Stained teeth increase the risk of gum disease and oral cancer.

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    • Every person who uses tobacco should be motivated to stop

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    • Those who have not yet started should be counseled not to start.

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    • Stress often leads to increased consumption of tobacco and alcohol.

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    • Stress management techniques like yoga and meditation should be practiced.

AVOID TOBACCO USE

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A regular check-ups at the nearest facility should be advised.

Professional teeth cleaning every six months if suggested by the dentist.

Some patients might need to come in every three or four months, due to the advanced level of gum disease

REGULAR CHECK-UPS

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ORAL CANCER PREVENTION AND SCREENING

    • When found early, it can have almost a 90% survival rate.

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    • But Oral cancer is usually detected late and has a 50% mortality rate.

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    • It is mainly associated with heavy smokers or excessive alcohol use.

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    • There is a significant increase in oral cancer in non-smokers and non- drinkers.

Self Examination is beneficial for early detection of Oral Cancer

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ORAL SELF-EXAMINATION TECHNIQUE

    • First check the lips, and the inside lining of the lips

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    • Next check the inside of the cheeks on both sides

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    • Thirdly, check on the palate - the hard and soft part on the roof of the mouth

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    • Hold the tongue with a piece of gauze or a clean cloth; look in the mirror and check the tongue.

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    • Then look under the tongue

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    • Finally check both sides of the tongue.

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    • Advise people to do this examination once a month. If they find anything abnormal inform ASHA/MPW/ CHO

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Meetings of Gram Sabha

VHSNCs/MAS

Anganwadi Centers

Panchayati Raj Institutions

Self-help groups

Peers Educators

Schools

PLATFORMS FOR ORAL HEALTH PROMOTION IN THE COMMUNITY

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    • IEC activities (SHC-HWC , Anganwadi, school, VHND)

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    • Oral Health Education – Oral hygiene practices, habits, addressing myths and taboos

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    • Prevention of common oral diseases through dietary advice and tobacco cessation

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    • Screening, early detection (SHC-HWC and out patient)

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    • Ensuring Universal Screening for Oral Cancers

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    • First level management of common dental diseases, referral and follow up

ROLE OF CHO IN ORAL HEALTH PROMOTION

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    • Coordinate with RBSK and School health program

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    • Mentoring ASHA and MPW for imparting preventive and promotive oral health education, ensuring completion of CBAC for people > 30 years

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    • Participate and co-ordinate various Oral Health Care training programs

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    • Participate and co-ordinate the outreach activities of PHC

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    • Maintaining records and reports

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EVALUATION: QUESTIONS

TRUE OR FALSE-

1. THE EARLIER ORAL HEALTH PROMOTION BEGINS, THE BETTER ITS EFFECTS ARE.

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2. ORAL HEALTH PROMOTION HAS EFFECTS FOR A SHORT DURATION ONLY.

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3. PLAQUE IS THE MAIN REASON FOR COMMON DENTAL DISEASES.

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4. BRUSHING SHOULD BE QUITTED DURING PREGNANCY.

STRESS IS A MODIFIABLE RISK FACTOR

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EVALUATION: QUESTIONS

FILL IN THE BLANKS-

6. FOODS SUCH AS NUTS, CHEESE, ONIONS HAVE BEEN SHOWN TO ___________ OF DECAY-CAUSING BACTERIA IN THE MOUTH.

7.___________ IS BENEFICIAL FOR EARLY DETECTION OF ORAL CANCER.

8. DURING BRUSHING, FOR THE OUTER PORTION OF TOOTH SURFACES, PLACE THE TOOTHBRUSH AT A ___________ ANGLE TOWARD THE GUM MARGIN.

9.ORAL HYGIENE CAN BE MAINTAINED BY ___________ AFTER MEAL.

10.THREE WAYS IN WHICH ORAL DISEASES CAN BE PREVENTED ARE __________, _________ AND ______________.

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EVALUATION: ANSWERS

TRUE OR FALSE-

1. THE EARLIER ORAL HEALTH PROMOTION BEGINS, THE BETTER ITS EFFECTS ARE. TRUE

2. ORAL HEALTH PROMOTION HAS EFFECTS FOR A SHORT DURATION ONLY. FALSE

3. PLAQUE IS THE MAIN REASON FOR COMMON DENTAL DISEASES. TRUE

4. BRUSHING SHOULD BE QUITTED DURING PREGNANCY. FALSE

5. STRESS IS A MODIFIABLE RISK FACTOR. TRUE

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EVALUATION: ANSWERS

FILL IN THE BLANKS-

6. FOODS SUCH AS NUTS, CHEESE, AND ONIONS HAVE BEEN SHOWN TO SLOW GROWTH OF DECAY-CAUSING BACTERIA IN THE MOUTH.

7. SELF EXAMINATION IS BENEFICIAL FOR THE EARLY DETECTION OF ORAL CANCER.

8. DURING BRUSHING, FOR THE OUTER PORTION OF TOOTH SURFACES, PLACE THE TOOTHBRUSH AT A 45-DEGREE ANGLE TOWARD THE GUM MARGIN.

9. ORAL HYGIENE CAN BE MAINTAINED BY RINSING MOUTH AFTER A MEAL.

10. THREE WAYS IN WHICH ORAL DISEASES CAN BE PREVENTED ARE ORAL HEALTH PROMOTION, DIAGNOSIS & TREATMENT, AND PREVENTING COMPLICATIONS.

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Thank You