Principles of prevention and health

Prevention: The act or practice of stopping something bad from happening

Prevention in Public Health: Any measure or act that allows the reduction of the probability of
illness happening, and also any measure that stops the illness or slows its progression.

Illness natural history: “Is the course that an illness has when no treatment is applied”

Stages in Natural History:

•Prepathogenic stage:

– Environmental factors

– Behavioural factors

– Endogen factors (age, sex, genetics…)

– Mixed origin

•Pathogenic stage:

– Pre –symptomatic

– Clinical illness

•Result:

– Recovery

– Chronicity

– Inability

– Death

Prevention levels:

•Primary prevention:

– Aim: to decrease the probability of illness ocurrency

– It is done in the pre-pathogenic stage

– Sublevels:

- Non –specific prevention: Measures taken in order to prevent illness in general.

o Ex: healthy food, dental hygiene, smoking prevention…
- Specific prevention: measures taken in order to prevent a specific illness
o Ex: vaccination…
Primary prevention in dentistry: examples: oral examination, scale and polish, fluoridation,
fissure sealants, health habits education, dental health promotion…

•Secondary prevention:

- Illness interruption by administering early treatment

- It acts whenever the primary prevention has either failed or was non-existent

Aim:

- Early diagnosis / screening

- Healing

- To avoid sequels

Secondary prevention in dentistry: examples: restorative dentistry, periodontal treatments,

fluoridation of early decay, root canal therapy…

•Tertiary prevention:

– It acts when illness is fully established

– Aim: to limit the lesion and to avoid a bigger problem.

Tertiary prevention in dentistry: examples: prosthodontics, implants, maxillofacial surgery…

HEALTH

“Health is a state of complete physical, mental and social well-being and not merely the
absence of disease or infirmity” WHO (1948)

Multidimensional health model:

-Physic

-Mental

-Social

-Emotional

-Spiritual

Welfare state:

A social system in which a government is responsible for the economic and social welfare of its
citizens and has policies to provide free health care, money for people without jobs, etc.
Health Promotion:

“The process of enabling people to increase control over, and to improve, their health” Ottawa
Charter for Health Promotion 1986 (WHO)

Health determinants according to Lalonde model:

-Environment

-Lifestyle

-Human biology

-Health systems

(esquema)

Social determinants of health

• Individual behaviour determines:

– Oral hygiene habits

– Diet

– Dentist visits

– Etc…

• These depend on cultural, familiar and social aspects.

• Also depend on health policies and the health system.

Levels of preventive action:

“Actions destined to improve:

- the social and economic aspects of society

- as well as those related to public health policies

in order to achieve better environmental factors and also better individual behaviours”

Prevention strategies (1992 WHO)

1. High risk strategy:

– Target: visible aspects of the disease and its risk

– Aim: identify and protect susceptible individuals

2. Population strategy:

– Aim: to avoid the incidence of a disease in the population as a whole.

– Target: lifestyles, economic and environmental factors…