Assessing & Monitoring Patient's Dental Biofilms

Question 1

How do disclosing agents work?

Answer 1

They change the colour of dental biofilm in order to provide a contrast with the tooth surface

Question 2

How does the biofilm interact with disclosing agents and retain the dye?

Answer 2

Electrostatic interactions (proteins)and hydrogen bonds (polysaccharides- these are secreted by the bacteria) bind the particles together

Question 3

Give 3 examples of disclosing agents that can be used (possible 9 answers)

Answer 3

iodine
mercurochrome

bismark brown

fast green 
fluorescein 
two tone 
basic fuchsin
Merbromin 
erythrosine

Question 4

What is the purpose of two-tone dye?

Answer 4

It differentiates between early biofilm formation and mature biofilm.

Early- stained red/pink

Mature- stained blue (over 3 days old)

Question 5

What are the advantages of a disclosing agent for the clinician?

Answer 5

1. visualise the biofilm
2. color guides biofilm removal
3. take plaque indices

Question 6

What are the advantages of a disclosing agent for the patient?

Answer 6

1. Motivation and education on OH (e.g. show where to brush better)
2. Personalised pt instruction and motivation
3. Self-evaluation by pt
4. Maintenance

Question 7

Outline the criteria for plaque index (0-3)

Answer 7

0 = following air drying, plaque is NOT visible nor cannot be wiped off with explorer

1 = following air drying, plaque is NOT visible but CAN be wiped off with explorer

2= plaque IS visible along gingival margin, with or without air drying (no need to probe)

3 = THICK plaque is visible along gingival margin (no need to probe)

Question 8

How is the plaque index scored?

Answer 8

The overall score is the sum of the 12 surface scores (max of 36- max 18 buccal, 18 lingual)

Question 9

How does the O’Leary plaque score measure plaque?

Answer 9

Qualitative answer- yes or no presence. Measured across all 4 tooth surfaces. Overall score is a % - up to 20% is considered inappropriate oral hygiene