Preventive and Community Dentistry
What this domain tests
Preventive and community dentistry tests caries risk assessment, evidence-based prevention, behaviour change, and delivery of prevention to populations as well as individuals.
Core rules
- Risk assessment drives recall and prevention: previous caries, diet, fluoride exposure, plaque, medical factors, and social factors.
- Fluoride: 1,450 ppm toothpaste for adults and at-risk children; 5% sodium fluoride varnish (22,600 ppm) two to four times yearly for high-risk patients; avoid supplements where water or bottled water already provides fluoride.
- Sealants: resin-based sealants on sound or incipient pits and fissures; do not seal over active cavitated caries.
- Diet: limit frequency of sugar exposure more than total amount; no bottle at bedtime; water between meals.
- Early childhood caries: arrest with silver diamine fluoride or fluoride varnish, restore where possible, and coach parents.
- Tobacco and areca nut cessation is part of prevention.
- Recall intervals are risk-based, not uniformly six months.
Worked example
A 3-year-old has active white-spot lesions on the upper incisors, a bedtime bottle, and a high-sugar diet. Reasoning: this is severe early childhood caries. Plan fluoride varnish, silver diamine fluoride on arresting lesions, restorative care where cavitated, parental counselling on bottle cessation and diet, and review in three months rather than six.
Traps
Sealing over active caries; prescribing fluoride supplements without checking total exposure; applying a single recall interval to every patient.