Prevention in dentistry as viewed by a dental health educator.

The concept of Prevention, in spite of recent vigorous emphasis, is not new to the practice of dentistry; for many years it has been a basic part of the practice of dental public health. The early investigations of those such as McKay’ and others in detecting an elusive fluoride ion and, the developments by Jay and his associates’ in the dietary control of dental caries are just two of the pioneering activities directed toward the prevention of dental disease. Today’s burgeoning emphasis of another preventive effort the continuous removal of plaque t o reduce carious lesions and sustain ginigval health has gained such widespread momentum that dentists and their personnel find themselves in the midst of something called the “Prevention Movement.” No attempt will be made to define this movement because the term has meanings which vary in different groups and appear to depend on the practitioners’ present orientation, their past experience, their desire t o be scientific, or their motivation t o practice economically. To the educator in dental public health, each new preventive activity poses the question: “To what extent will this current interest and activity actually influence the public’s oral health for the better, by motivating change in behavior?” The educator soon recognizes that the current movement relies on educational technics for influencing people t o perform certain procedures individually, regularly, and in their homes. The ritual has not been practiced long enough in a scientifically ordered situation t o demonstrate improved behavioral changes over a long sustained period. The health educator, hence, must ask another question: “What is the potential of this movement in the practice of public health?” This paper, then, will discuss briefly three of the programs reported in the literature to date, and examine each of thetn in the light of the five evaluative criteria developed by the American Public Health Association’s Committee on Evaluation and Standards’ : 1. Appropriateness. This criterion demands the determination of the extent t o which programs are directed toward a significant health problem of high priority. 2. Adequacy. Criterion No. 2 demands that one learn the proportion of the total problem that the program is expected to solve. 3. Effectiveness. The third criterion demands that the reader ask, “To what extent have the preestablished objectives been attained as a result of the program’s activity ? ” ~ f f i c i ~ ~ ~ ~ , The fourth criterion, so pertinent in the practice of public health, is the