Plaque Contral

Question 1

What are methods of plaque control 2

Answer 1

Plaque control includes:

1. Mechanical plaque control
2. Chemical plaque control
3. Mechanical plaque control, seems to be the most dependable form of plaque control method
   a) By individuals daily and
   b) By professionals such as periodontal health education periodically or scaling, polishing and root planing. Professional support is essential both to maintain good plaque control and intercept recurrent disease while still at an early stage.
4. Chemical plaque control, has been used only as an adjunct to mechanical means and not a substitute.

• Both, further enhances the efficiency of the plaque control program.

Question 2

What are types of tooth brush? Based an what

Answer 2

Tooth brush Are the most widely used oral hygiene aids. It is the principle instruments in general use for accomplishing the goals of plaque control.

Types of tooth brushes.

1. Manual.
2. Powered.
3. 3.Sonic and ultrasonic.
   ‘
4. ionic.

Question 3

What’s ideal character of Manual Tooth Brushes?

Answer 3

• It should confirm to individual patient requirement in size, shape and texture.
• Be easily and effectively manipulated.
• Be readily cleaned and aerated, impervious to
• moisture.
• Be durable and inexpensive.
• Be designed for utility efficiency and cleanliness.

Question 4

What are parts of tooth brush

Answer 4

Parts of a tooth brush

1. Handle: The part grasped in the hand during tooth brushing.
2. Head: The working end of a tooth brush that holds the bristles or filaments. Toe: The extreme end of the head.
3. Heel :The part which is closet to the handle.
4. Shank: The section that connects head and handle.
5. Handle: The part grasped in the hand during tooth brushing.
6. Head: The working end of a tooth brush that holds the bristles or filaments.
7. Tufts: Clusters of bristles or filaments secured into head.
8. Brushing plane: The surface formed by the free ends of the bristles or filaments.
9. Shank: The section that connects head and handle.

Question 5

What are type of bristles and what the nigga recommend r

Answer 5

Types of bristles

1. Hard & Soft
2. Multitufted & Space tufted
3. Natural & Synthetic

Artificial: nylon plastic is Uniform in size & elasticity Resistant to fracture, does not get contaminated Natural: hogs and horses is fray, soft and break easily also loss of elasticity and contaminate faster

There is no clear cut evidence that one particular type of tooth brush is superior to others however many authors recommended:

• Soft filament brushes are better in view of the damage the hard filaments may cause.
• Multitufted brushes show better cleaning ability.
• Rounded ends produce fewer lacerations.

Question 6

Talk about Powered tooth brushes

Answer 6

• Electrically Powered tooth brushes were inverted to make plaque control easier.
• Theheadoftheelectrictoothbrushissmallerthanmanual and is removable for replacements.
• The 3 basic patterns that the head follows when the motor is started are:

o o o

Reciprocating: a back and forth motion. Arcuate: up and down motion. Elliptical: a combination of both motion.

Question 7

Indication of Powered tooth brushes

Answer 7

• Young children
• Handicapped patients
• Individuals lacking manual dexterity
• Patients with prosthodontic or endosseous implants
• Orthodontic patients
• Institutionalized patients including the elderly who are dependent on care providers
• Patients on supportive periodontal therapy

Question 8

Advantages of Powered tooth brushes?

Answer 8

• It increases patient motivation resulting in better patient compliance
• Increased accessibility in interproximal and lingual tooth surfaces
• Nospecificbrushingtechniquerequired
• Useslessbrushingforcethanmanualtoothbrushes
• Brushing timer is incorporated in some brushes to help the patient in brushing for the required duration.

Question 9

Talk about Sonic and ultrasonic tooth brushes and Ionic tooth brushes

Answer 9

Sonic and ultrasonic tooth brushes

• These types produce high frequency vibrations (1.6 MHz), which lead to the phenomenon of cavitation and acoustic micro streaming.
• This phenonomenon aids in stain removal as well as disruption of the bacterial cell wall (bactericidal)

Ionic tooth brushes

• Ionic tooth brushes change the surface charge of a tooth by an influx of positively charged ions.
• The plaque with a similar charge is thus repelled from the tooth surface and is attracted by the negatively charged bristles of the tooth brush.

Question 10

How a nigh can maintain tooth brushes?

Answer 10

• Most investigators have observed that, the tooth brush may act as a vehicle in breeding and transmitting various organisms in the oral cavity.
• Parts of a toothbrush that can become contaminated with micro-organisms
• Experts therefore advice cleaning the tooth brush daily in antiseptic mouthwashes such as phenolic derivatives.
• Storing toothbrushes in dry areas in a necessity, as, wet surfaces may allow bacterial proliferation.
• Toothbrushes should be kept in open air with the head in an upright position with no contact with other brushes.
• Toothbrushes have an average life span of 3 to 6 months. However, they should be replaced as soon as there is any evidence of fraying, as frayed tooth brushes do not clean teeth efficiently and may cause wearing of teeth or gingival recession

Question 11

What are Objectives of tooth brushing

Answer 11

1. To clean teeth and interdental spaces of food remnants debris and stain ect…
2. To prevent plaque formation
3. To disturb and remove plaque
4. To stimulate and massage gingival tissue
5. To clean the tongue

Question 12

What are Tooth brushing methods

Answer 12

1. The Roll technique.
2. The Vibratory technique.
3. The Circular technique.
4. The Vertical technique.
5. The Horizontal technique.
6. The Physiological technique.

Question 13

Tooth electric brush technique

Answer 13

Question 14

Mechanical plaque control aids: siwak

Answer 14

x

Research has proven that the Miswak contains more than 10 different natural chemical compounds considered essential for good oral and dental hygiene.

Some of these components are stain removers and teeth whiteners, some protect teeth against cavities, some are bactericidal and antiseptic, some help in healing and repairing tissue, among others.

How to use Miswak:

x

Fresh Miswaak is brown in color, with a hot, pleasant taste. People usually strip off some of the Miswaak’s thin bark from one end, then chew that end a little to separate the fibers so that they become like the fibers of a normal toothbrush. They then use it to brush their teeth.

Question 15

What are Interdental cleaning aids

Answer 15

Are adjunctive devices, which are used to remove plaque and debris that are adherent to the teeth, restorations, orthodontic appliances, and gingiva in the interproximal embrasures. It polishes the surfaces as it removes the debris. It also massaging the inter-dental papillae and reduce gingival bleeding

. x

Interdental cleaning aids contribute to general oral sanitation and the control of halitosis

Question 16

Factors in selection of an interdental cleaning aids:

Answer 16

x Typeofgingivalembrasures.

x Alignment of teeth.

x Fixed prosthesis/orthodontic appliances. x Open furcation areas.

x Contact areas.

Question 17

Talk about Dental flossing

Answer 17

Dental flossing is the most widely recommended method of removing plaque from proximal tooth surfaces with type 1 gingival embrasures.

Dental floss may be available in various forms:

x x x x

Multifilament - twisted/ non twisted. Bonded/ non bonded.

Thick/ thin.

Waxed/ non waxed.

Question 18

What are Functions of Dental Floss

Answer 18

1. Removal of adherent plaque and food debris from the interproximal embrasure and under the pontics of the fixed partial denture.
2. Polishing of the tooth surface during removal of the plaque and debris.
3. Stimulating and massaging the interdental papillae.
4. Helping in locating the following
   a. Subgingival calculus deposits
   b. Overhanging margins of the restorations
   c. Proximal carious lesions
5. Improving oral hygiene.
6. Reducing gingival bleeding.
7. Vehicle for application of polishing or therapeutic agents to interproximal and subgingival area.

For this purpose tapes are better than floss. Before the advent of nylon, dental floss and tape were made of silk.

Question 19

Talk about methods of floss

Answer 19

Methods of using dental floss

1. The spool method used by adults and teenagers with mental maturity.
2. The circle or loop method used by handicapped and mentally retarded patients.

Spool method

x

x

x

About 45cms (18 inches) long floss is taken and about 10cms (4 inches) from each end is wound around the middle finger of the each hand.

In both the hands the last three fingers are folded and closed and both the hands are moved apart.

In this way about 5 cms (2 inches) long floss is held between the index fingers of both the hands. Circle or loop method

x

x

In this method the floss is made from about 45cms (18 inches) long piece and both ends are tied securely with the three knots.

All the fingers except the thumbs of both the hands are placed within the loop and the floss is held by both the hands having about 2.5 cms (1 inch) floss between fingers of both the hands.

Question 20

Talk about Wooden Tips (Tooth picks):

Answer 20

x x

x

In type 2 gingival embrasures an ideal substitute for the dental floss would be the wooden type. Triangular are superior to round or rectangular ones, which are ineffective on lingual aspects of proximal surfaces.

Their use is however is restricted to the facial aspects of anterior teeth. However, specific handles have been designed, attached to which the wooden tips may be used throughout the oral cavity.

Question 21

Talk about Interproximal/ Interdental brushes

Answer 21

Interproximal/ Interdental brushes

x

x x x

In case of type 2 gingival embrasure interdental brushes have proven to be the best choice for plaque removal from interproximal tooth surfaces.

They may also be used to clean furcation areas and root concavities.

Powered interdental brushes requires less dexterity and makes access to gingival areas easily. Their design is similar to that of bottle brush, which may be mounted onto specifically designed handles, to make its use in the posterior areas of the mouth more comfortable.

Question 22

Talk about Uni-tufted/ Single tufted brushes

Answer 22

Uni-tufted/ Single tufted brushes are basically employed in type 3 gingival embrasures.

Beside plaque removal these brushes may also be used to carry antimicrobial agents (Chlorhexidine) in to the proximal areas.

Depending on the type of embrasures, the kind of interdental cleaner most frequently recommended:

Type 1 (where no gingival recession)- Dental floss Type 2 (moderate papillary recession)- Interdental brush, wooden tips Type 3 (complete loss of papillae)- Uni-tufted brush

Question 23

Talk about Oral irrigation devices and types

Answer 23

Oral irrigation devices clean non-adherent bacteria and debris from the oral cavity more effectively than do toothbrushes and mouth rinses, especially from inaccessible areas around orthodontic appliances and fixed prosthesis.

Type 1 (where no gingival recession)- Dental floss Type 2 (moderate papillary recession)- Interdental brush, wooden tips Type 3 (complete loss of papillae)- Uni-tufted brush Types of irrigation devices

1. Home irrigations, the spray which provides an aerosol
   a. Supragingival home irrigation device
   b. Subgingival
   c. Marginal
2. Professional subgingival irrigation devices, which provides a steady or pulsating stream of fluid.

Question 24

Three situations in which an irrigating device are used

Answer 24

1. To help remove accumulated debris from interdental areas where there is difficult access.
2. The aids in personal oral hygiene program of individuals with orthodontic devices, complex restorations, crowns and fixed bridges, splints.
3. To irrigate deeper gingival sulci

It has been shown to disrupt and detoxify sub gingival plaque and can be useful in delivering antimicrobial agents in to periodontal pockets.

Question 25

Talk about Gingival physiotherapy

Answer 25

Gingival physiotherapy The rationale behind gingival physiotherapy is the fact that mechanical stimulation of the gingiva either by tooth brushing or interdental cleansing with various aids and devices such as rubber tape stimulator or single finger massage, leads to:

1. Increased keratinization
2. Increased blood flow
3. Increased flow of GCF within gingival sulcus.

This resulted in an overall improvement in the gingival health duo to modulation of the gingival host defense mechanism.

Question 26

Talk about Tongue scraping?

Answer 26

Tongue scraping

x Is the process of removing debris from the surface of the tongue with some form of scraper designed for this purpose

x

x

Most tongue scrapers are made of soft flexible plastic. However, a soft tooth brush my also be used for this purpose.

Tongue cleaning devices can be recommended for patients when they have elongated papillae, deep fissures or surface coating.

Question 27

Denture & Partial Clasp brushes Frequency of plaque removal

Answer 27

Frequency of plaque removal

x Cleaning once a day with all necessary tools is sufficient if it is performed meticulously.

x However poor performance of plaque removal can be improved by brushing twice per day. x Cleaning 3 or 4 times per day does not appear to further improve periodontal conditions.