2. ICEBERG
• An iceberg is a large piece of ice that has
broken off from a snow-formed glacier or ice
shelf and is floating in open water.
• only one-ninth of the volume of an iceberg is
above water.
• The shape of the underwater portion can be
difficult to judge by looking at the portion
above the surface
3. CONCEPT OF CAUSATION OF DISEASE
• EPIDEMIOLOGICAL TRIAD
• MULTIFACTORIAL CAUSATION
• NATURAL HISTORY OF DISEASE
• WEB OF CAUSATION
• RISK FACTORS & RISK GROUPS
• SPECTRUM OF DISEASE
• ICEBERG OF DISEASE
4. ICEBERG PHENOMENON
• The iceberg phenomenon is a metaphor
emphasizing that every health problem the
number of known cases of disease is
outweighed by those that remain
undiscovered, much as the unseen part of an
iceberg is much larger than the part that is
visible above the water.
5. • Floating tip of iceberg represents what the
physician sees in the community – Clinical cases
• Submerged portion of the iceberg represents the
hidden mass of disease- like Pre-symptomatic and
undiagnosed cases or The carriers in the
community.
• Waterline represents the demarcation between
apparent and unapparent disease.
• Patients who are at the tip of the iceberg are
more likely to have multiple health problems
than other
6. The iceberg concept in the form of a pyramid
1 Diseased, diagnosed & controlled
Diagnosed
2 Diagnosed, uncontrolled disease
3 Undiagnosed or wrongly
diagnosed disease
Undiagnosed or
wrongly diagnosed disease
4 Risk factors for disease
5 Free of risk factors
Blocks 1 and 2 correspond to the iceberg
above the sea-level and 3 to 5 below sea level.
7. • Unidentified cases may be different from
identified ones, both in terms of the natural
history or spectrum of disease.
• Where symptoms and disease progression are
related, the undiagnosed cases are likely to be
less severe.
8. • When symptoms and signs are not evident in
the early stages of disease, as in high blood
pressure or diabetes , undiagnosed cases may
be just as severe as diagnosed ones.
• Epidemiological studies based on selected
cases from the tip of the iceberg may give an
incorrect view.
9. CARIES
• Dental caries, also known as tooth decay or
a cavity,it is an irreversible microbial disease
of the calcified tissue of teeth characterized by
demineralization of inorganic portion &
destruction of organic substance of tooth
which often lead to cavitation
13. • Periodontits is an
PERIODONTITIS inflammatory diseases
affecting
the periodontium, Periodo
ntitis involves progressive
loss of the alveolar
bone around the teeth, and
if left untreated, can lead
to the loosening and
subsequent loss of teeth.
14. Signs & Symptom
• Redness or bleeding of gums while
brushing teeth, using dental floss or biting into hard
food
• Gum swelling.
• Halitosis, or bad breath, and a persistent metallic
taste in the mouth.
• Gingival recession, resulting in apparent lengthening
of teeth.
• Deep pockets between the teeth and the gums
• Loose teeth, in the later stages .
15. ICEBERG OF PERIODONTITIS
• Gingival inflammation and bone destruction
are largely painless. Hence, people may
wrongly assume that painless bleeding after
teeth cleaning is insignificant, although this
may be a symptom of progressing
periodontitis in that patient.
16. diagnosed
Loose tooth &
tooth
elongation
Gingival recession
Bleeding gums Radiographic and
Clinical aids
pockets
Sub clinical initial Bone destruction &
gingival inflammation Un diagnosed
17. ORAL CANCER
• Oral cancer is cancer of the mouth
• Oral cancer most commonly involves the lips or
the tongue.
It may also occur on the:
• Cheek lining
• Floor of the mouth
• gingiva
• palate
• Most oral cancers are a type called squamous
cell carcinomas
18. Factors
• Smoking and tobacco use are linked to most
cases of oral cancer. Alcohol also increases risk
for oral cancer.
• Other factors :
o Chronic irritation
o Human papilloma virus (HPV) infection
o Taking medications that weaken the immune
system (immunosuppressant)
o Poor dental and oral hygiene.
19. Signs & Symptoms
Sore, lump, or ulcer in the mouth:
• May be a deep, hard-edged crack in the tissue & Most often pale
colored, but may be dark or discolored.
• Usually painless at first (may develop a burning sensation or pain when
the tumor is advanced)
Other symptoms that may occur with oral cancer
include:
• Chewing problems
• Speech difficulties
• Swallowing difficulty
• Swollen lymph nodes in the neck
• Woody tongue
• Weight loss
20. Woody tongue,
diagnosed
Chewing
problems,
Difficulty in
swallowing
Sore ,leukoplakia
Lichen planus, Aspiration & biopsy
lump,ulcers
Lymph node enlargement
Un diagnosed
Weight loss or
Wrong diagnosed
21. CONCLUSION
• The ultimate purpose of iceberg phenomena is
to spread awareness in people that disease may
not look as sever as they are & thus iceberg
phenomenon contribute to form a uniform
classification that can be used throughout the
world to make accurate comparisons of
morbidity and mortality data for decision
making in prevention , management and in
facilitating research on particular health
problems.
