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pt care III > plaque control and hygiene aids- boles > Flashcards

plaque control and hygiene aids- boles Flashcards

1
Q

 Plaque – primary agent in development of:

A

 Dental Caries
 Periodontal Disease

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2
Q

 Plaque Control leads to:

A

 Resolution of gingival inflammation in the early stages
 Reduction of calculus formation

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3
Q

 Oral health can neither be attained or preserved without:

A

 Oral health can neither be attained or preserved without
plaque control

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4
Q

must get what for effective plaque control?

A

pt attention

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5
Q

how we can get pt attention for plaque control?

A

 Educate the patient
 Show patient disease in his/her
own mouth
 Bleeding points
 Periodontal probing
 Red, bleeding gums
 Utilize disclosing agent
 Educational tool
 Motivational tool

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6
Q

home care instructions should be?

A

 Need to be effective/personalized
 Be non-traumatic when cleaning the teeth

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7
Q

what to consider with home care instructions

A

 Areas of plaque accumulation: Interproximal, buccal, lingual, occlusal
 Restorative dentistry: Crowns, bridges, overhangs, etc.
 Anatomical features: Embrasure spaces, furcation involvement, etc.
 Patient’s dexterity
 Patient’s motivation

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8
Q

most important features of toothbrushes

A

 Able to reach all areas to be cleaned
 Size of head is appropriate for patient
 No tissue trauma

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9
Q

possible bristle materials

A

natural and nylon

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10
Q

natural bristles

A

Made of wild boar or hog hair
 Bristles vary greatly in each
filament
 Varies texture, size, flexibility
 Absorbs water, bristles soften
 Hollow bristles
 May harbor bacteria

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11
Q

nylon bristles

A

 Flex 10x’s more before breaking
 Do not split or abrade
 Easier to clean and dry more
rapidly
 Shape, stiffness of bristles more
standardized: Manufactured according to federal specifications

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12
Q

bristle shape round vs blunt

A

End rounded vs. blunt cut
 Researched determined:
 Rounded, tapered, or smooth bristles
were less abrasive
 Rounded bristle tips are recommended

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13
Q

bristle texture

A

 Bristle resistance to pressure
 Firmness, stiffness, hardness
 Thinner filaments = softer, more resilient
 Soft: .007-.009 inches
 Medium: .010-.012 inches
 Hard: .013-.015 inches
recomend softer, less abrasive

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14
Q

toothbrush replacement

A

 Average life of toothbrush – 3 months
 Signs of bristles splaying
 Consider replacing after illness

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15
Q

ADA positions on brushing freq/ our recomendation

A

ADA: brush regularly
us: 2x for 2 min

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16
Q

can pt completely remove plaque

A

rarely completely remove plaque

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17
Q

can pt estimate time they brush? spend most time where?

A

 Patients over-estimate time they brush
 Spend most of time on the facial surfaces

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18
Q

toothbrushing techniques

A

bass and fones

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19
Q

bass technique for sulcus

A

 Angle bristles toward gingival
margin (approximately 45o angle)
 Gently press bristles to enter sulcus and/or embrasures= Subgingival cleansing, gingival stimulation

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20
Q

bass technique for facial

A

 Vibrate brush (or use small strokes) without disengaging bristles
 ‘Roll’ the instrument toward the incisal/occlusal
 Replace and repeat on next 2 or 3 teeth

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21
Q

bass technique for lingual

A

 Turn brush lengthwise
 Place ‘heel’ of brush along gingival margin
 Vibrate to dislodge plaque
 ‘Roll’ the toothbrush to cleanse the lingual surface

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22
Q

fones technique

A

 90 Degrees to tooth
 Larger circles over teeth and gingiva
 Easy for children to pick up
 Option for those with limited dexterity

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23
Q

common forms of improper brushing

A

 Hard toothbrush
 Horizontal scrubbing
 Excessive pressure
 Toothpaste too abrasive= Gingival recession and Cervical abrasion

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24
Q

ADA guidelines for acceptance of powered toothbrushes
safety?
efficacy of?
labeling?

A

 Laboratory evidence of electrical
safety
 Clinical evidence of hard/soft tissue
safety under unsupervised conditions
 Clinical evidence of plaque and
gingivitis efficacy when compared to
other ADA accepted toothbrush
 Evidence of proper labeling and
advertising claims

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25
Q

mechanical actions of powered brushes

A

 Uses the motion of the bristles to
remove plaque and debris via Rotation oscillation

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26
Q

sonic actions of powered brush

A

 Emits soundwaves in addition to the movement of the brush filaments

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27
Q

ionic brushes

A

 Temporarily reverses the negative ionic charge of a tooth to positive
 Portion of toothbrush that is also positively charge “attracts” the plaque and food particles away from the tooth
 Allows bristles the brush the loosened
particles away

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28
Q

mechanical vs manual brush reductions in plaque and gingivitis

A

benefits for mechanical
 11% reduction in plaque at 1-3 months
 21% reduction in plaque after 3 months
 6% reduction in gingivitis at 1-3 months
 11% reduction in gingivitis after 3 months

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29
Q

choose interprox aid based on:

A

 Size of interdental spaces
 Presence of furcation(s)
 Ortho or fixed appliance
 Tooth alignment

30
Q

purpose of flossing

A

The purpose of flossing is to remove interproximal plaque….not to
dislodge food wedged between the teeth.

31
Q

waxed tape indications

A

embrasure II and III
loose contact
large SA

32
Q

wax tape pros

A

tear resistant

33
Q

wax tape cons

A

no good for tight contacts

34
Q

wax dental floss indications

A

embrasure I
tight contacts with rough surfaces

35
Q

waxed floss pros

A

strong
shred resistant
no tissue trauma

36
Q

waxed floss cons

A

pt comfort

37
Q

unwaxed round floss infications

A

embrasure I

38
Q

unwaxed round floss pros

A

easy insertion

39
Q

unwaxed round floss cons

A

easy tears with calculus/defective restorations

40
Q

super floss indications

A

embrasure I and II
fixed bridges
ortho
implant prothesis

41
Q

super floss pros

A

cover more SA
easy to insert

42
Q

super floss cons

A

req coordination
caught on rough surfaces

43
Q

colored floss indication

A

beginners/weak eye sight

44
Q

colors floss pros

A

motivation/education
increased compliance

45
Q

colored floss cons

A

none

46
Q

flavored floss indications

A

pts without motivation

47
Q

flavored floss pros

A

motivational

48
Q

flavored floss cons

A

none

49
Q

what if limited dexterity?

prepparing floss for flossing

A

 Tear off an adequate amount of
dental floss
 Wrap floss around middle fingers
Floss is maneuvered between
thumb and index finger
 The ‘spool’ method may be
easier for someone with less
dexterity.**

50
Q

insertion of floss into contact

A

The floss is moved back and
forth until it is through the
contact
 See-saw motion
 Do NOT ‘pop’ the floss

51
Q

adapting floss to tooth surface

A

 Adapt to each interproximal surface by making C-shape.
 Floss should be placed into sulcus area

52
Q

flossing motion

A

 Once the floss is below the contact
area and wrapped around the tooth,
it should be moved “up and down”
against the tooth

53
Q

floss cuts

A

can occur if going too fast or hard

54
Q

floss holders recommended for:
 Physical?
 Poor what?
 Limited?
 Large?
 Sensitive?
difficulty with?

A

 Physical disabilities
 Poor manual dexterity
 Limited mouth opening
 Large hands
 Sensitive gag reflex
 Difficulty with manual flossing

55
Q

Floss Swords/Daily Flossers

 Disadvantage?

A

 Plastic toothpick on one end, floss
on the other
 Disadvantage: floss cannot be
changed as it gets used

56
Q

helpful for?

automated flossers

A

 May help with patient motivation
 Helpful for patients who need handle with larger diameter

57
Q

Floss Threaders
 Used to?
 Ideal for:

A

 Floss is threaded through loop
 Used to carry floss interproximally

 Ideal for:
 abutment teeth
 beneath pontics
 ortho appliances
 teeth that are splinted together
 tight contact

58
Q

Super Floss
 Ideal for:

A

 Ideal for plaque removal under pontics and ortho appliances

59
Q

Platypus Ortho Flosser

A

Created to floss around orthodontic brackets
- Floss spread between two “spatula” ends
- Bracket brush on the opposite end

60
Q

Interdental Brushes(Proxybrush)
 Used for:

A

 large embrasures
 teeth with concavities
 around fixed appliances
 ortho appliances
 Furcations ( Class III, IV)

61
Q

Soft Picks
 work around appliances?
 Easy to use for what patients?
 Latex?

A

 Soft, flexible bristles
 Tapered to work around appliances
 Easy to use for patients who find flossing cumbersome
 Latex free

62
Q

Rubber-tipped stimulator
 Primary use?
 Limited use for?

A

 Primary use is for gingival massage
 Limited use for removing plaque from exposed furcation(s), along gingival margins, and open embrasures

63
Q

End-tuft toothbrush
 Useful for?
around what appliances?
lingual of?
distal of most?
embrasure spaces?
exposed ?

A

 Useful for difficult to reach places:
around ortho appliances
around pontic(s)
lingual of crowded lower anterior teeth
distal of most posterior teeth
wide embrasure spaces
exposed furcation(s)

64
Q

Sulcus Brush

A

More narrowed brush head
Fits along the gumline
Softer bristles for inflamed gums

65
Q

Toothpick Holders(Perio-aid; D-PLAK-R)
Trace along?
May be used along?

A

 Trace along gingival margins to remove plaque in sulcus/pockets
 May be used along:
crown margins
accessible furcations
concave proximal surfaces
orthodontic appliances

66
Q

Wooden or Plastic Triangular Sticks
(Stim-U-Dent)
 most common material?
 cross-section shape?
 Stick is inserted from?
 Moved from?

A

 Balsa or birchwood most common
 Triangular in cross-section
 Stick is inserted from the facial, with
flat surface resting on gingiva
 Moved from buccal to lingual

67
Q

Other aids

A

 Pipe cleaners
 Yarn
 Gauze

68
Q

Oral Irrigators
 Can result in?
 Irrigation not indicated for pts who?
 Irrigation alone is ineffective in?

A

 Can result in disruption of loosely attached or unattachedc supra/subgingival plaque
 Irrigation not indicated for pts who have effective OH or no inflammation
 Irrigation alone is ineffective in reducing inflammation

69
Q

best benefots of irrigation seen in?

A

 Best benefit is seen when irrigation is
combined with toothbrushing
 Pts with ortho appliances, bridges, or
implants

70
Q

Irrigation with antimicrobials

A

 Some clinical and microbial improvements noted in gingivitis patients with Irrigation with chlorhexidine vs irrigation with water

pt care III (14 decks)

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