Plaque Control and Oral Hygiene Aids

Question 1

• Plaque control leads to:

Answer 1

o Resolution of gingival inflammation in early stages
o Reduction of calculus formation

Question 2

• Without plaque control,

Answer 2

• Without plaque control, oral health cannot be attained nor preserved

Question 3

• To have effective plaque control, you have to get your patients attention

Answer 3

o 1. Educate the patient
o 2. Show patient disease in his/her own mouth
▪ Bleeding points
▪ Periodontal probing
▪ Red, bleeding gums
▪ (Make it personal to them)

Question 4

Utilize disclosing agents

Answer 4

▪ Educational tool (Show them where they’re missing specifically)
▪ Motivational tool
▪ Plaque tinting agents (Listerine blue rinse; chewable tablets)

Question 5

• Home care instructions need to be effective and non-traumatic when cleaning the teeth; consider:

Answer 5

o Areas of plaque accumulation: Interproximal, buccal, lingual, occlusal
o Restorative dentistry: Crowns, bridges, overhangs, etc
o Anatomical features: Embrasure spaces, furcations, etc
o Patient’s dexterity and motivation

Question 6

• Toothbrushing

Answer 6

o Best type of toothbrush to use = SOFT
o ADA – brush 2X a day for 2 minutes for plaque removal

Question 7

• Bass (modified)*

Answer 7

o Angle bristles toward gingival margin (approx. 45 angle)
▪ “angle it toward the tissue”
o Gently press bristles to enter sulcus and/or embrasures
▪ Subgingival cleansing, gingival stimulation
o Vibrate brush (or use small strokes) without disengaging bristles
o ‘Roll” the instrument toward the incisal/occlusal
▪ “small circles then roll it away from the tissue”
▪ Flick that plaque away
o Replace and repeat on next 2-3 teeth
o Turn brush lengthwise
o Place ‘heel’ of brush along gingival margin
o Vibrate to dislodge plaque
o “Roll” the toothbrush to cleanse the lingual surface

Question 8

• Improper Toothbrushing

Answer 8

o Hard toothbrush
o Horizontal scrubbing
o Excessive pressure
o Toothpaste too abrasive
▪ Gingival recession
▪ Cervical abrasion

Question 9

• TopHat questions:

Answer 9

o Best floss for a rough interproximal restoration? Waxed floss
o Best interproximal aid for someone with limited dexterity? Floss holder

Question 10

• Flossing

Answer 10

o Purpose is to remove interproximal plaque, NOT dislodge food wedged between teeth
o Best type of floss = doesn’t matter! (any flossing is better than no flossing) (ALL ARE EQUAL)
▪ TABLE GTQ!!! “What would be the most appropriate floss for…”

Question 11

• Xylitol

Answer 11

o Reduces levels of strep mutans and level of lactic acid they produce
▪ Strep mutans can’t use xylitol 🡪 ↓ s. mutans levels
o Absorbed slowly by the GI (like all polyol)
o Leads to diarrhea (but in large quantities, 4-5 times more than what we need)
o Anti-caries benefit of xylitol, especially when consumed in chewing gum
▪ Xylitol therapeutic dose (exact dose not yet found)
● 3-8 grams over at least two consumptions
o Highly toxic to dogs
o Causes rapid and severe increase insulin production which leads to sustained hypoglycemia (at only .15g/kg)

Question 12

1. Describe parts of the Periodontium