INTRODUCTION TO

DENTISTRY AND PUBLIC

HEALTH
 DENTISTRY
• Dentistry is defined as the evaluation, diagnosis, prevention and
treatment of diseases, disorders and conditions of the oral
cavity, maxillofacial area and the adjacent and associated
structures and their impact on the human body, provided by the
dentist, within the scope of his/her education , training and
experience, in accordance with the ethics of the profession and
applicable law.

• By 1997 ADA House Of Deligates

 Aims of Dentistry
• To acquire adequate knowledge, necessary skills and attitudes
which are required for carrying out all the activities
appropriate to general dental practice involving the prevention,
diagnosis and treatment of anomalies and diseases of the teeth,
mouth, jaws, and associated tissues.

• To understand the concept of community oral health education

and be able to participate in rural health care delivery
programs existing in the country.
 Objective of Dentistry
 KNOWLEDGE AND UNDERSTANDING

 SKILLS

 ATTITUDES
 MEDICINE IN ANTIQUITY
• In ancient times , health
and illness were
interpreted in
cosmological and
anthropological
perspective.
 INDIAN MEDICINE
• Ayurveda
• Siddha System

• Origin Is Traced Far Back

To Vedic Times About
5000 B.C
• In Ancient, Indian
celebrated authorities in
ayurvedic medicine were;
1. Atreya
2. Charka
3. Susruta
4. Vagbhatt
Susruta Was Known As
Father Of Indian Surgery
• Ayurveda is the “Tridosha” Theory
Of Disease
• The Doshas Or Humors Are
1. Vata
2. Pitta
3. Kapha
When these 3 humors are in perfect
balance and harmony , a person is
said to be healthy.
 CHINESE CIVILIZATION
• Chinese Medicine (2700 B.C )

It was based on two principles:

1. The Yang – Active Musculine Principle
2. The Yin - Negative Feminine Principle
• Balance of these 2 opposing forces meant good
health.
• Chinese Were Early Pioneers Of Immunisation
• H Wang-ti Described About Dental And Gingival
Diseases 2500 B.C
 EGYPTIAN CIVILIZATION

• One of the oldest civilization around

2500 B.C
• They believed disease was due to
absorption from the intestine of harmful
substances, which gave rise to
putrefaction of blood and formation of
pus.
• Edwin Smith Papyrus And Ebers
Papyrus were best known medical
mauscripts belongings to egyptian
times.
 GREEK MEDICINE
• CLASSIC PERIOD OF GREEK MEDICINE
( 460-136 B.C )

• They taught men to think in terms of “why and how”.

• Greatest physician in greek medicine was Hippocrates,
who is often called “FATHER OF MEDICINE”
• Hippocrates was infact the first true epidemiologist.
Since he distinguised b/w diseases which were epidemic
and endemic.
• Greeks believed that matter was made up of 4
elements
1. EARTH
2. AIR
3. FIRE
4. WATER

• These elements were represented in the body

by 4 humors.
• PHLEGN, YELLOW BILE, BLOOD, BLACK BILE
• Greeks postulated that when the balance b/w 4
humors was disturbed , disease was the result .
 ARAB CIVILIZATION
• Period b/w ( 500 A.D -1500 A.D) is generally known as
“middle ages”

• The greatest contribution of Arabs in general was in the

field of pharmacology.

• They developed pharmaceutical chemistry introducing

a large number of herbal and chemical drugs.

• Pioneers in pharmacology, they invented the art of

writing prescriptions.

• They introduced wide range of syrups, pills, plasters,

powders, alcoholates.
 HISTORY OF DENTISTRY
• 2500 B.C – CHINESE CIVILIZATION
H WANG Ti described dental and gingiva diseases.

• 1500 B.C – EGYPT

• EBERS PAPYRUS describes oral diseases and offers oral

prescriptions for strengthning of teeth and gums.

• 480 B.C– HIPPOCRATES ( FATHER OF MODERN

MEDICINE ) discussed the function and eruption of teeth.
9th CENTURY AD– The Arabs were interested in
the care of teeth rather than extraction and
replacement. Mouth hygiene was established
with a small wodden stick called “ siwak”.

Late 1400– first modern idea of toothbrush

invented by China.

1723– Pierre Fauchard, a French surgeon publishes

“the surgeon dentist “ first to describe a
comprehensive system for the practice of
Dentistry.
• 1801– RICHARD C. SKINNER published the first dental
book in AMERICA.

• 1832 – JAMES SNELL invents first RECLINING DENTAL

CHAIR.

• 1833 – CRAWCOUR BROTHER introduced AMALGAM

IN U.S.A and advertised it as a substitute of gold restoration.
this time in dental history known as “AMALGAM WAR”

• 1839 –” AMERICAN JOURNAL OF DENTAL SCIENCE”

WORLDS FIRST DENTAL JOURNAL BEGINS
PUBLICATION
• 1840– WORLDS FIRST DENTAL SCHOOL “THE
BALTIMORE COLLEGE OF DENTAL SURGERY.

• 1884– M.L. RHEIN COINED THE TERM ORAL

HYGEINE.

• 1899– J LEON WILLIAMS INTRODUCES A SLOGAN “ A

CLEAN TOOTH NEVER DECAYS “

• 1931– FLUORIDE IS IDENTIFIED BY H.V CHURCHILL.

• 1931– “SHOE LEATHER SURVEY” BY
TRENDLEY H DEAN.

• 1948– WORLD HEALTH ORGANIZATION

(W.H.O) WAS FORMED.

• 1950– FIRST FLUORIDE TOOTHPASTE

MARKETED.
 MILESTONES IN INDIA
• 1000B.C– “INDIAN CIVILIZATION”:

SUSHRUTHA SAMITA GAVE

DESCRIPTION ABOUT SEVERE
PERIODONTAL DISEASES.

CHARKA SAMITA STRESSED ON

TOOTH BRUSHING.

• FATHER OF DENTISTRY IN
INDIA : DR. RAFIUDDIN AHMED,
LATER BECAME THE PRESIDENT
OF I.D.A

• IN 1920 HE FOUNDED THE FIRST

DENTAL COLLEGE IN INDIA IN
CALCUTTA
• IN 1971, Mr. ORONGO STARTED THE DEPARTMENT OF
COMMUNITY DENTISTRY AT THE GOVERNMENT DENTAL
COLLEGE , BANGALORE UNDER Dr. MOHANDAS BHATT.

• NATIONAL ORAL HEALTH CARE PROGRAM (NOHCP) WAS

INITIATED IN 1968 TO IMPROVE ORAL HEALTH OF
MASSES AND TO PREVENT/ REDUCE THE BURDEN OF
ORAL DISEASES IN INDIA.

• DURING 2002-2003 NATIONAL ORAL HEALTH SURVEY

WAS CARRIED OUT BY DENTAL COUNCIL OF INDIA.
• HEALTH
• WHO DEFINED HEALTH AS “ A STATE OF
COMPLETE PHYSICAL, MENTAL AND
SOCIAL WELLBEING AND NOT MERELY
THE ABSENCE OF DISEASE”.
 Changing concepts of health
• 1. Biomedical concept
• 2. Ecological concept
• 3. Psychosocial concept
• 4. Holistic concept
 Biomedical concept

• This concept viewed Health as “Absence from

disease.”
• If a person is free from disease ,he is
considered to be healthy.
 Ecological concept

• This concept views health as a dynamic

equilibrium between man and his
environment.
 Psychosocial concept
• This concept reveals that
health is not just a biomedical
phenomenon but is also
influenced by
• Social
• Psychological
• Cultural
• Economical and political
factors.
 Holistic concept
• This concept believed in all of the previous
concepts and implies that all sectors of society
have an affect on health.
 WHAT IS PUBLIC HEALTH
• Winslow in 1920 defines public health as “ the science and
art of preventing disease , prolonging life and promoting
physical and mental efficiency through organized community
effort for the sanitation of the environment, the control of
communicable infections, the education of the individual in
personal hygiene, the organization of medical and nursing
services for the early diagnosis and preventive treatment of
disease and the development of social machinery to insure
everyone a standard of living adequate for the maintenance of
health , so organizing these benefits as to enable every citizen
to realize his birthright of health and longevity”
 HISTORY OF PUBLIC HEALTH
• An Era Of Public Health Started By Another
Important Milestone i.e.
• “Great Sanitary Awakening”
• First In England In Mid–nineteenth Century
• The Industrial Revolution Of The 18th Century
Sparked Off Numerous Problems .
• The great cholera epidemic of 1832 led Edwin
Chadwick, a lawyer in England to investigate the
health of the inhabitants of the large towns with a
view to improve the conditions under which they
lived.
• Chadwick’s report focused the attention of people as
well as govt on the urgent need to improve public
health.
• Filth was recognized as man’ s greatest enemy and
with this began the “ great sanitary awakening”
which led to enactment of public health act of 1848 in
England.
 RISE OF PUBLIC HEALTH
• Sanitary awakening led to the birth of public health
concept.
• An English epidemiologist, John Snow studied the
epidemiology of cholera in London from 1848 to
1854 and established the role of polluted drinking
water in the spread of cholera.
• In 1856, William Budd, another pioneer by careful
observations concluded that the spread of typhoid
fever was by drinking water not by miasma and sewer
gas.
John Simon ( 1816- 1904) The First Medical Officer Of
Health Of London. He Built Up The System Of
Public Health .

1880-1920 Often Called “Disease Control Phase”.

While Public Health Made Rapid Strides In The

Western World, Its Progress Has Been Slow In
Developing Countries Such As India
 GERM THEORY OF DISEASE
• Theory that proposes that
microorganisms are the cause of many
diseases.
• In 1873, Pasteur advanced the germ
theory of disease.
• In 1877, Robert Koch showed that
anthrax was caused by bacteria.
• Microbe after microbe was discovered
in succession. It was the golden age of
bacteriology.
CHANGING CONCEPTS IN PUBLIC HEALTH
In the history of Public Health 4 distinct phases

A. Disease Control Phase: (1880 - 1920)

Aimed at Control of man’s physical environment. E.g.

water supply, Sewage disposal etc. These measures
were not aimed at the control of any specific disease
like Sanitary awakening in England.
 • Beginning of the 20th century, a
new concept, the concept of health
B. Health promotion, began to take shape.
• Initiated as personal health services
Promotiona such as-
l Phase: • mother and child health services,
(1920 - • school health services,
1960) • industrial health services,
• mental health & rehabilitation
services.
• The pattern of disease began to change in the
developed world.

• New health problems in the form of chronic disease

began to emerge, e.g. cancer, diabetes, cardiovascular
diseases, and alcoholism, drug addiction etc.

• These problems could not be tackled by traditional

approaches to public health like isolation,
immunization and disinfection.
 MILLENNIUM DEVELOPMENT GOALS

• In september 2000 , representatives from 189

countries, met at the millennium summit in
New York to adopt the U.N millennium
declaration.

• TOTAL 8 GOALS WERE SET IN THE SUMMIT

WHICH ARE AS FOLLOWS:
• GOAL 1: ERADICATE EXTREME POVERTY AND
HUNGER

• GOAL 2: ACHIEVE UNIVERSAL PRIMARY EDUCATION

• GOAL 3 : PROMOTE GENDER EQUALITY AND

EMPOWER WOMEN

• GOAL 4: REDUCE CHILD MORTALITY

• GOAL 5: IMPROVE MATERNAL HEALTH

• GOAL 6: COMBAT HIV/ AIDS, MALARIA AND OTHER

DISEASES.

• GOAL 7: ENSURE ENVIRONMENTAL SUSTAINAIBILITY.

• GOAL 8: DEVELOP A GLOBAL PARTNERSHIP FOR

DEVELOPMENT.
LANDMARK COMMITTEES IN THE HISTORY OF
PUBLIC HEALTH

Various national health committees formed by the

government of India since 1946 :
Bhore committee (1946):
Mudaliar committee (1962):
Kartar singh committee (1973):
Shrivastav committee (1975):
Rural health scheme (1977):
1. Bhore committee (1946):

It is also known as “the health survey and

development committee” and was appointed in 1943
with Sir. Joseph bhore
It suggests one primary health centre for a
population of 40000.
This committee used the term ‘comprehensive
health care’ for the first time.
2. Mudaliar committee (1962):

This committee known as “the health survey and

planning committee” was appointed in 1959 with Dr.
A.I Mudaliar as its chairman.

They found the quality of services at PHC inadequate

and adviced strengthing them.
3. KARTAR SINGH COMMITTEE (1973)

Known as “the committee on multipurpose workers

under health and family planning” appointed in 1972
with Mr. Kartar Singh as Chairman.

Recommended one health centre for a population of

50,000.
 4. Shrivastav committee (1975)
• known as :The group on medical education and
support manpower.

• Recommended creation of health workers from

within community itself.

• 1 male and 1 female for every 5,000 population.

 5. Rural Health scheme (1977)
• Emerged out of recommendations of the Shrivastava
committee.
• Based on 4 tier system-
• Village
• Subcentre
• Primary health centre
• Community health centre