 Hello everyone welcome back to a new session on dentistry and more so today's class will be on modes of intervention. So in the last sessions we had covered causes concepts of causation and then comes the concepts of prevention. So it is like a continuum it is all goes in the same line so when the disease is happening it comes under concept of causation there are various theories and how do we prevent it so what are the preventive strategies that is levels and concepts of prevention and the next one is modes of intervention so that is how do we apply these preventive strategies that's what we are discussing today modes of intervention so it is nothing but the levels of prevention but what are the measures we take what are the particular steps in levels of prevention. So modes of intervention basically has five steps which is five steps which will be into three levels of prevention. The first two steps that is health promotion and specific protection it comes under primary prevention. The second prevention is early diagnosis and treatment and the tertiary prevention is disability limitation and rehabilitation. So let's go into detail about the health promotion that is coming under primary prevention. So primordial prevention is not mentioning here so the primary prevention that is the truest sense of prevention whether the disease is not yet occurred. Okay so let's see what is health promotion. So health promotion is just like promoting so we need to promote health just like we promote our products we promote people promote their movies their books their songs just like we need to promote health so health promotion is nothing but they're all together compiled movement of the social health administrative political and all together come into action to promote health not a single factor can alone do this promotion. So it has to be a multi-sectoral or intersectoral coordination for this health promotion activities. So let's see what is in health promotion the steps are the activities are health education environmental modifications nutritional interventions lifestyle and behavioral changes so all of the life sectors has to be coming to the action for promoting health. So what is health education it's nothing but educating people about health why you need to keep hygiene all the time you need to get the profile access what are the causes of this disease now this disease spreads so that you can prevent the disease why you need to wash your hands before and after food or washroom so all these things we need to teach them so then only they can follow it so if they know the pathogenesis the etiology of particular disease they can prevent the disease so educating people about health is a part of health promotion and that comes under primary prevention so the second part is environmental modification even if we keep ourself very hygiene very aware of the health what if the water we drink or we get from outside is very filthy and it's containing coliform bacteria so we can't help it so the environment also should be very health promoting so we should be able to get safe drinking water there should be proper sanitary latrines and there should be control of insects and rodents and there should be a good housing facilities so that's why I was saying it should be a multifactorial or intersectoral approach as a individual as a person I cannot be always healthy if my environment my surroundings is very filthy or it is polluted so even if I being very conscious or very aware of the health there's no point so environmental modification is must that the nutritional interventions that's why government is providing nutrients for under 5 age in various schemes like mid-day male scheme ICDS schemes through Angan bodies and all this that is to prevent certain diseases like malnourishment and protein nutrients and vitamin deficiencies so we give it at a very early stage so that they don't develop the disease at all so nutritional intervention is part of health promotion it's just like vulnerable groups there are programs for vulnerable groups like pregnant women lactating women and under age under 5 age children's so food fortification nutrition education child feeding program all these are coming under health promotion the second part of health promotion is specific protection in first part we are doing everything in general aspect but the second part is specific protection we have to be very specific just like immunization we know immunization in seconds to polio mmr vaccine mums measles rubella then the hepatitis vaccine Japanese and cephalitis vaccine so all these are particularly or specifically against a particular disease so that is a specific protection and use of specific nutrients to prevent a specific disease we are providing vitamin B to prevent anemia or iron and calcium tablet to prevent anemia so such things nutrients and cream of profile axis and protection against occupational hazards we know we wear the helmets when go to a work site protection against accidents we promote using helmets and seat belts similarly avoidance of callogens allergens and protection from carcinogens so it comes into help promotion also under primary prevention and it is a part of health promotion that is specific protection we are specifically doing works against certain diseases or certain injuries or certain accidents to prevent such accidents or diseases so this comes under secondary prevention that is early diagnosis and so the secondary prevention is we cannot say that it is twist sense because I had mentioned in the last class that the truest prevention is primary and primordial because the diseases not yet occurred but in secondary prevention diseases just started or diseases going the progress we need to halt we need to stop the progress of disease so as early as we need to find out the disease okay so the screening of disease is very much important in this section we should find out the disease people or the disease at very early stage so that it won't result much of the mobility so it won't create much of the problem for people so if it is a cancer we need to go to population and we need to do active screening of various types of cancer so that we can find out cancers in very apparently healthy people so that they get a better treatment at a very early stage and they'll have a very good prognosis what if it goes a very late stage and we diagnose it at a very late stage the prognosis will be very poor so early diagnosis and adequate or prompt treatment is a part of secondary prevention so that is secondary prevention it comes early diagnosis and treatment the number three this is part of the first one was health promotion and specific protection it comes under primary prevention early diagnosis and treatment the three comes under secondary prevention and the last part is tertiary prevention it has two section one is disability limitation and rehabilitation the tertiary prevention in the sense the disease has caused its full effect the person is suffering person is disabled if we take dental caries tooth is non vital tooth has lost tooth is not able to do amastication people has lost a limb people has lost eye has lost something like that so we need to limit the disability okay so here it is reported at very late pathogen is faced the pathogen or the particular problem has shown as full effect now only available option is limiting the disability so objective is to prevent the transition of disease from impairment to handicap so let it not go to a stage of handicap okay so handicap means a socially is not able to perform the duties if he's a let if he lose his leg means his socially is his job is completely stopped if he's a like surgeon he lost his fingers due to some accident he can't do a search anymore so that handicap should not happen so it should be stopped at every real transition stage that impairment to handicap so let's take an example we'll get an idea this is a concept of disability disease happens then there will be impairment then disability handicap let's see an example the disease is frostbite okay so when comes in contact with very low temperature what happens is the person lost his two fingers okay so frostbite is a disease impairment is losing two fingers so disabilities is cannot do surgery that is his disability is not able to do the surgery happened the handicapped thing is he can't become a surgeon so that surgeon what is missing here can't become surgeon so that is the handicap portion of the cycle so we need to stop it at least this stage let not become a socially handicap if it's become handicapped he need to be rehabilitated with with artificial processes and he need to be accompanied with helpers so that stage should not happen so tertiary prevention is always aiming at disability limitation so we need to limit the disability and let it not go to the handicapped stage so rehabilitation is nothing but we need to rehabilitate the people or the person who has suffered a severe injury or severe disease so rehabilitation comes under many heading it's like medical rehabilitation we need to replace the food he has lost vocational rehabilitation we need to get him a livelihood because he was an athlete he lost his leg so he can't do any job so we need to give him a livelihood we need to socially rehabilitate so we need to get him back to his the family and social relationship because he might have isolation isolated feeling so we need to get him back to the family circle and we need to psychologically rehabilitate we need to get back to restore his personal dignity and his confidence so all this comes under rehabilitation so this is the last part so if disability limitation is not possible it goes to the rehabilitative phase so rehabilitative phase is nothing but restoration of his medical social educational and vocational measures so that is able to leave a highest possible level of functional with functional ability so it has all these sectors like medical, vocational, social and psychological rehabilitation okay so that's all about the modes of intervention so we have seen health promotion the various measures used in health promotion that is health education, environmental modification, nutrition, and behavioral changes next one was specific protection we had seen it comes under immunization protection against hazards accidents and consonants and the secondary prevention it is early diagnosed we need to give proper active screening and finding out the disease at a very high stage then the tertiary prevention it has disability limitation so we can see the example of disability limitation we need to stop at this disability limit and let it go to the handicap so if it is not possible then we have to rehabilitate so rehabilitation in the sense medical, vocational, social and psychological okay that's all about the various intervention of prevention so this is nothing but the prevention but how do we apply the preventative measures so we have covered the concept of disease concept of prevention and the modes of intervention in prevention so I'll come up with a new session