2 - nonsurgical at home mechanical and chemical Flashcards

1
Q

plaque biofilm cannot be completely eliminated

plaque biofilm can be managed thru effective oral hygiene measures like

A

proper diet`- watch carbs/sugar frequency

toothbrushing 2X with ADA Fl toothpaste - 3x recommended

interdental cleaning

use of ada-accepted antimicrobial mouthrinse 2X

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2
Q

role of personal oral hygiene

~on the quantity and composition of _

~on longterm outcomes of _ tx

A

~on the quantity and composition of subgingival plaque

~on longterm outcomes of periodontal and surgical tx

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3
Q

ideal tooth brush features

handle size
head size
use of _ filaments
use of soft bristle configurations
bristle patterns which enhance interdental plaque removal
A

small size handle and head to reach posterior areas

use of end-rounded nylon or polyester filaments

we want soft brushes because somestimes too aggressive on the gingiva

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4
Q

6 brushing methods

A
stillmann's method
roll and sweep method (modified stillmann's method)
Bass Method
Rotational Scrub
Charters Method
Horizontal Scrub
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5
Q

_ tooth brushing method

30 degree angle with bristles pointing toward the gingiva

movement in coronal direction with a vibrating and rolling stroke

half on gums half on tooth

A

Stillmann’s Method

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6
Q

_ brushing method

30 degree angle with bristles pointing toward the gingiva

movement in coronal direction with a rolling stroke

A

Roll or Sweet Method
Modified Stillman -

more coronal surface same angle to stillmans method

angle because trying to get bristles in sockets

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7
Q

_ brushing method

45 degree angle with the bristles pointing toward the gingiva

movement with a vibratory, circular motion

A

Bass Method

we have prob heard of this method

Modified Bass method
-additional sweeping motion following vibratory, circular motion - only one we can recommend

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8
Q

_ brushing Method

brush is positioned on the tooth surface

bristles are perpendicular to tooth and gingival surfaces

movement is in small circulatory motions

A

rotational scrub

no angle - perpendicular

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9
Q

_ brushing method

45 degree angle with bristles pointing toward the occlusal surface

movement back and forth in a circular motion

best method for patients with open interpoximal spaces

most difficult method to do correctly

A

Charters Method

angle is totally opposite of Bass

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10
Q

_ brushing Method

90 degree angle between brush and teeth

movement in horizontal motion

this method should be used occlusal surfaces

can cause both soft and hard tissue damage at cerical area

A

horizontal scrub

only good for occlusal surfaces

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11
Q

really no difference in tooth brushing methods as long as the patients are brushing

_ plaque removal with a toothbrush is ineffective

A

interproximal plaque

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12
Q

difference between waxed and unwaxed floss?

A

no difference

might use waxed in really tight contacts

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13
Q

when do we recommend using proxybrushes

A

where there are large interproximal spaces to clean

change every 2 weeks

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14
Q

explain in general toothbrushing frequency and duration study

A

for 6 weeks following a patient
12-48 hours of not brushing for 2 minutes didn’t really make a difference

we still recommend 3x a day because patients don’t brush for the full 2 minutes

2 minutes accepted to get big reduction in plqaue but after 2 minutes it slows

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15
Q

_ brush for distal of posterior molar - ortho brackets

A

end tufted brush

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16
Q

2 rows of bristles for gum line

A

sulcus brush

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17
Q

we use tongue brushers/scrapers especially for _

A

halitosis

bacteria on the tongue big cause of bad breath

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18
Q

3 things associated with trauma from brushing

A

gingival erosion
cervical abrasion
gingival recession

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19
Q

rounded or cut ended filaments for brush

A

rounded ends produce less trauma to gingival tissues

20
Q

toothbrushes can effectively remove plaque for at least _ months and that after _ weeks one should consider replacement

A

2 months
9 weeks

2 weeks for interproximal brushes

21
Q

big picture about powered toothbrushes

A

powered brushes with a rotation oscillation action provice slightly better plaque removal and may provide better protection against gingival inflammation than manual

Rotation and oscillation action are better

Not recommended for every patient because costly - we give to patients that have manual brushing problems - also for too aggressive brushing

22
Q

Dentifrice(toothpaste) effects on periodontal health

Supragingival plaque control is necessary to reduce _

A

gingival inflammation

appropriate brushing and flossing can reduce supragingival plaque

23
Q

toothpaste ingredients

for plaque and stain removal - can cause root sensitivity

make up 10-50%

A
abrasives
~Ca-phosphates
~Ca-pyrophosphates
~Hydrated Silica
~Alumina
~Ca-Carbonate
~Na-Bicarbonate

abrasion depends on particle hardness, size, and shape

24
Q

toothpaste ingredients

therapeutic 0.2-1.5%

replace Ca in hydroxyappatite

A

fluorides

sodium fluoride
monofluoro-phosphate MFP
stabilized stannous fluoride

25
toothpaste ingredients therapeutic 0.2-1.5% _ only thing in toothpaste to help control inflammation or bleeding
Triclosan Triclosan - only thing in toothpaste to help control inflammation Patient has bleeding gums - we might want to give them a toothpaste with Triclosan
26
toothpaste ingredients 40-70%, act to retain moisture and prevent the toothpaste from hardening on exposure to air. Glycerol, sorbitol, Xylitol and propylene glycol are commonly used. also sweeten the toothpaste, though this is not their main function.
humectants
27
toothpaste ingredients foaming agents thickening agents 0-12% flavoring agents 0.8-1.5% _0.5-2% mainly a foaming agent, which enables uniform distribution of toothpaste, improving its cleansing power.
surfactants Na-lauryl-sulfate - Irium - SLS Na-N-lauroyl sarcosinate 0 - Gardol
28
which is more statistically and clinically effective in reducing plaque triclosan/copolymer dentifrice or fluoride dentifrice
- flouride better - tricolsan for bledding gumms more effective at reducing gingival inflammation too
29
compare stannous fluoride to triclosan
stannous fluoride has anti-inflammatory effects but it causes staining triclosan does not cause staining, only thing to activly reduce bleeding,
30
why use mouth rinse?
teeth only make up 25% of the oral cavity biofilms cover the entire mouth, not just teeth liquid carries actives to all areas of the mouth plaque biofilm cannot be managed by tooth brushing and flossing alone
31
Phenols, quaternary ammonium compounds, bisbiguanides, herbal extracts are examples of _
supragingical anti plaque and gingivitis agents
32
Mouth Rinses EO - Essestial Oils fixed combo of 1. Eucalyptol 0.092% 2. Menthol 0.042% 3. Methyl salicylate 0.060% 4. Thymol 0.064%
LESTERINE need alcohol as solution
33
mouth rinses CPC cetylpridinium chloride - active ingredient quaternanry ammonium compound
crest prohealth
34
mouth rinses 0.12% CHX chlorhexidine a _ Peridex and PerioGard
it is a bisbiguanide antiseptic only one that needs a prescription
35
EO - Essential Oils - Listerine 26.9% alcohol _compound has ADA seal of acceptance for plaque and gingivitis 1st OTC mouthwash in 1914
phenolic compound ~might want to watch for history of alcoholism
36
EO - Essential oils exhibits broad spectrum of activity against gram positive or negative bacteria? how?
both gram positive nand negative bacteria EO non-selectively and rapidly disrupts bacteria cell wall reduces plaque endotoxin levels and pathogencity for gingivitis plaque reductions of up 56.3% and gingivitis reductions of up to 35.9% when used as directed
37
CPC - Cepacol 14% alcohol _compound has ADA seal
quaternary ammonium compound plaque - 15-25% gingivitis - 20% ruptures bacteria cell membrane, leading to rapid leakage of cell contents and cell death may alter bacterial metabolism inhibitiing cell growth
38
what kind of mouthwash? ruptures bacteria cell membrane, leading to rapid leakage of cell contents and cell death may alter bacterial metabolism inhibitiing cell growth
cpc cepacol
39
what kind of mouthwash? non-selectively and rapidly disrupts bacteria cell wall reduces plaque endotoxin levels and pathogencity for gingivitis
EO essential oils - listerine
40
what kind of mouthwash? kills bacteria by altering the permeability of the cell membrane of the bacteria. this alteration causes the bacteria cell to leak. which eventually kills the bacteria used to treat gingivitis and bleeding gums
peridex - chlorhexidine 0.12% chlorhexidine gluconate Used to treated gingivitis and bleeding gums Can't brush teeth very well so always give CHX after surgery for post-op care
41
which mouthwash may cause tooth discoloration or increase in calculus formation?
peridex - CHX
42
which mouthwash may cause local hypersensitivity and sometimes generalized allergic reactions have also been reported bitter taste and can cause taste interference
peridex - CHX
43
which mouthwash? binds salivary mucins, reducing pellicle formation which in turn inhibits plaque bacteria colonization plaque reduction up to 60.9% and gingivitis reduction up to 42.5% when used as directed
CHX ruptures bacteria cell wall membrane leading to rapid leakage of cell contents and cell death binds bacteria. inhibiting absorption onto the teeth
44
``` bacteria and bacterial by products like H2S CH3SH CH3SCH3 short chain fatty acids polyamines (cadeverin. putrecine) Nitrogen byproducts (urea) Keton byproducts Alkalines Phenyl byproducts ```
halitosis malodor - bad breath we need to eliminate etiological factors review oral hygiene habits recommend dietary changes
45
only herbal extract we use - may work. coat the sutures may have antimicrobial properties
Chitosan derived from Chitin
46
how can products get the ADA seal of acceptance
across two 6 month studies an average minimum of 20% gingivitis reduction is demonstrated in order to award the seal