Preventive Care and Health Promotion
Preventive Care and Health Promotion
This domain tests risk-based prevention and behavior change: caries risk assessment, fluoride, sealants, diet, tobacco cessation, oral hygiene instruction, and motivational interviewing.
Core rules
- Caries risk assessment combines disease indicators (white spots, restorations), biological factors (diet, saliva, bacteria), and protective factors (fluoride, sealants). Risk determines recall and intensity.
- Topical fluoride: varnish for high-risk children and adults; 5,000 ppm dentifrice for high-risk adults; avoid swallowing; know the water fluoridation level (0.7 mg/L is optimal in the U.S.).
- Sealants prevent pit and fissure caries; they do not replace fluoride.
- Tobacco cessation uses the 5 A’s: Ask, Advise, Assess, Assist, Arrange. Motivational interviewing uses open questions, affirmations, reflections, and summaries.
- Health literacy: plain language, teach-back, and culturally appropriate materials.
Worked example
A 7-year-old has one incipient occlusal lesion, frequent juice intake, and no sealants. Plan: fluoride varnish every 3–6 months, seal the permanent molars, counsel water instead of juice, and recheck in 3 months. Reasoning: the child is high risk because of active disease plus dietary exposure; varnish and sealants add protection, while diet counseling addresses cause.
Traps
- Giving a “prophy and fluoride” without risk assessment.
- Recommending systemic fluoride supplements without checking water.
- Telling patients to “floss more” without demonstrating or negotiating behavior.
- Confusing sealant failure with caries progression.
- Ignoring tobacco or vaping use because the patient is young.