Chapter 26: oral infection control. Toothbrush and toothbrushing Flashcards
he described many aspects of oral health. He was critical of the toothbrush made of horse’s hair because it was too soft and advised the use of sponges to vigorously rub the teeth.
pierre fauchard
Characteristics of an Effective Manual Toothbrush
-Conforms to individual patient requirements in size, shape, and texture.
-Easily and efficiently manipulated.
Readily cleaned and aerated; impervious to moisture.
-Durable and inexpensive.
-Soft bristles.
-End-rounded filaments free of sharp or jagged edges.
-Designed for utility, efficiency, and cleanliness.
different shapes of brush head
- flat
- rippled
- tapered filament
- multilevel
- angled
- bilevel-orthodontic
There is moderate evidence that power toothbrushes result in a __%–__% reduction in plaque and about a 10% reduction in gingivitis whe
10-20%
compared to manual toothbrushes, why are power toothbrushes less damaging to gingival tissues?
they have mechanisms to alert the patient when they apply excessive force.
Indications for Use of Power Toothbrush
- Those with a history of failed attempts at more traditional biofilm removal methods.
- Those undergoing orthodontic treatment.
- Those undergoing complex restorative and prosthodontic treatment.
- Aggressive brushers
- Patients with disabilities
- For caregivers that must brush for the patient.
in what motion do power toothbrushes move
- Rotation oscillation.
- Counter oscillation.
- Sonic or ultrasonic motion.
- Side to side.
- Circular.
Some research suggests angled tufted designs of manual toothbrush heads and rotating, oscillating round power brush heads are most effective.
t or f
true
Toothbrush bristles are typically classified as ___ , ____ , ____ , or _____ .
hard
medium
soft
extra soft
An extra soft toothbrush may be indicated in conditions such as :
necrotizing ulcerative
or
following periodontal surgery
Manual toothbrushing methods include the following:
Sulcular: modified Bass.
Roll: rolling stroke, modified Stillman.
Vibratory: Stillman, Charters, Bass.
Horizontal (or scrub).
Circular: Fones.
Vertical: Leonard.
what method of brushing is this
Dental biofilm removal adjacent to and directly beneath the gingival margin.
Open embrasures, cervical areas beneath the height of contour of the enamel, and exposed root surfaces.
Adaptation to abutment teeth or implants, under the gingival border of a fixed partial denture.
Filament tips are directed into the gingival sulcus at approximately 45° to the long axis of the tooth.
modified bass
this method is designed for massage and stimulation, as well as for cleaning the cervical areas. This method adds a rolling stroke to the vibratory stroke to clean the crown of the tooth
THE STILLMAN AND MODIFIED STILLMAN METHODS
Removing biofilm, materia alba, and food debris from the teeth WITHOUT emphasis on GINGIVAL SULCUS.
Used in conjunction with a vibratory technique such as modified Bass, Charters, and Stillman methods.
Can be particularly helpful when there is a question about the patient’s ability to master and practice a more complex method.
roll or rolling stroke method
Loosen debris and dental biofilm.
Stimulate marginal and INTERDENTAL gingiva.
Aid in biofilm removal from proximal tooth surfaces when interproximal tissue is missing creating open embrasures, for example, following periodontal surgery.
Remove dental biofilm from abutment teeth and under the gingival border of a fixed partial denture (bridge) or implant-supported bridge or partial denture.
charters method
A systematic review suggested the most effective method for toothbrushing in children is this method up to the age of 6 or 7 years.
Once the child reaches the late mixed dentition stage, modification to another technique can be initiated as the this method has limitations in terms of thorough plaque biofilm removal.
horizontal or scrub method
This method is EASY for children to learn.
Bristles are moved in a circular motion several times in each area and then the brush is moved to a new area
fones (circular method)
MAY work well for small children.
Bristles move in an up and down motion with light pressure on the tooth surfaces. Move systematically from area to area around the mouth.
leonards or VERTICAL method
_________ bacteria involved in the production of volatile sulfur compounds related to oral malodor (bad breath) or halitosis reside on the tongue
anaerobic
Tongue coating is a white-brownish layer on the dorsum of the tongue and is made up of:
desquamated epithelial cells,
blood cells and metabolites,
food debris
bacteria.
instructions for patients with Acute Oral Inflammatory or Traumatic Lesions
- Brush all areas of the mouth not affected and if tolerable clean the affected area with an extra soft toothbrush.
- Rinse with a warm, mild saline solution to encourage healing and debris removal.
- Consider prescribing an antimicrobial rinse like chlorhexidine to aid in the reduction of bacterial load until normal oral self-care can resume.
- Resume regular biofilm control measures on the affected area as soon as possible.
instructions for patients Following Periodontal Surgery
Perform oral self-care in the areas not involved in the surgery as usual.
Follow directions provided by the periodontal office for care of the surgical area.
no rinsing or brushing until at least 24 hours after surgery
If gingival grafting was done, do not brush until next appointment
An antimicrobial rinse like chlorhexidine may be prescribed to aid with reducing the bactera and healing
instructions for patients Following dental extraction
Clean the teeth adjacent to the extraction site the day following surgery.
Brush areas not involved in the surgery as usual to reduce biofilm and promote healing.
Beginning hours after surgery, rinse the mouth with a warm, mild saline solution after each meal or snack to help remove food debris from the extraction site.
low white blood cell count (<500 absolute neutrophil count) occurs during treatment such as chemotherapy, radiotherapy, and bone marrow transplant associated with many cancers.
**this condition puts the patient at risk for life threatening infection
neutropenia
