Plaque Control and Oral Hygiene Aids Flashcards

1
Q

plaque control =

A

disease control

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2
Q

plaque is the primary agent in development of:

A
  • dental caries
  • periodontal disease
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3
Q

plaque control leads to:

A
  • resolution of gingival inflammation in early stages
  • reduction of calculus formation
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4
Q

how do you educate the patient

A
  • show patient disease in his/her own mouth
  • utilize disclosing agent
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5
Q

how do you show patients disease in their mouth

A
  • bleeding points
  • periodontal probing
  • red, bleeding gums
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6
Q

what is disclosing agent used for

A
  • educational tool
  • motivational tool
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7
Q

how should home care instructions be given

A
  • need to be effective/personalized
  • be non traumatic when cleaning the teeth
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8
Q

what should you consider when giving home care instructions

A
  • areas of plaque accumulation
  • restorative dentistry
  • anatomical features
  • patients dexterity
  • patients motivation
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9
Q

what are the areas of plaque accumulation

A

interproximal, buccal, lingual, occlusal

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10
Q

what anatomical features should be considered

A

embrasure spaces
- furcation involvement

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11
Q

what are the 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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12
Q

what are the types of toothbrush bristles

A
  • natural
  • nylon
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13
Q

describe natural toothbrush bristles

A
  • made of wild boar or hog hair
  • bristles vary greatly in each filament
  • various texture, size and flexibility
  • absorbs water, bristles soften
  • hollow bristles - may harbor bacteria
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14
Q

describe nylon toothrbush bristles

A
  • flex 10 x’s more before breaking
  • do not split or abrade
  • easier to clean and dry more rapidly
  • shape, stiffness of bristles more standardized
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15
Q

what are the types of bristle shape and what is better

A
  • end rounded vs blunt cut
  • rounded, tapered or smooth bristles are less abrasive
  • rounded bristle tips are recommended
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16
Q

what are the bristle textures

A
  • soft: 0.007-0.009 inches
  • medium 0.01-0.02 inches
  • hard: 0.13- 0.15 inches
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17
Q

thinner filaments of bristles are:

A

softer and more resilient

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18
Q

what is the average life of a toothbrush

A

3 months

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19
Q

when should you replace a toothbrush

A
  • signs of bristles splaying
  • consider replacing after illness
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20
Q

pateints ______remove plaque

A

rarely completely

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21
Q

ADA’s position on brushing:

A

regularly

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22
Q

patients _____ time they brush

A

over estimate

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23
Q

where do patients spend most time brushing

A

facial surfaces

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24
Q

what is the importance in brushing

A
  • daily fluoride use
  • routine brushing pattern
  • emphasis on all areas
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25
Q

what are the toothbrushing techniques

A
  • Brass ( modified)
  • rolling
  • stillman
  • charters
  • Fones (circular)
  • leonard
  • horizontal
  • smith- modified
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26
Q

describe the brass (modified) technique

A
  • angle bristles toward gingival margin (approximately 45 degrees angle)
  • gently press bristles to enter sulcus and/or embrasures
  • subgingival cleansing, gingival stimulation
  • vibrate brush without disengaging bristles
  • roll the instrument toward the incisal/occlusal
  • replace and repeat on next 2 or 3 teeth
  • turn brush lengthwise
  • place heel of brush on gingival margin
  • vibrate to dislodge plaque
  • roll the toothbrush to cleanse the lingual surface
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27
Q

describe Fone’s (circular)

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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28
Q

describe improper toothbrushing

A
  • hard toothbrush
  • horizontal scrubbing
  • excessive pressure
  • toothpaste too abrasive: gingival recession and cervical abrasion
29
Q

what are the ADA guidelines for acceptance of powered toothbrushes

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
30
Q

describe the mechanical action of brush

A
  • uses the motion of the bristles to remove plaque and debris
  • rotation oscillation
31
Q

describe the sonic action of toothbrush

A

emits soundwaves in addition to the movement of the brush filaments

32
Q

describe the ionic action of toothbrush

A
  • temporarily reverses the negative ionic charge of a tooth to positive
  • portion of tootbrush that is also positively charge “attracts” the plaque and food particles away from the tooth
  • allows bristles the brush the loosened particles away
33
Q

what are the benefits of using a powered toothbrush when compared to manual

A
  • 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
34
Q

choose interproximal aid based on:

A
  • size of interdental spaces
  • presence of furcation
  • ortho or fixed appliance
  • tooth alignment
35
Q

what is the purpose of flossing

A

to remove interproximal plaque

36
Q

what are the types of floss

A
  • waxed
  • unwaxed
  • tape
  • colored
  • flavored
37
Q

how should you floss

A
  • tear off an adequate amount of dental floss
  • wrap floss around middle fingers
  • floss is maneuvered between thumb and index finger
  • adapt to each interproximal surface by making C shape
  • floss should be placed into sulcus area
  • do not pop the floss
  • see- saw motion
38
Q

what flossing method is better for someone with less dexterity

A

the spool method

39
Q

once the floss is below the contact area and wrapped around the tooth:

A

it should be moved up and down against the tooth

40
Q

floss holders are recommended for patients with

A
  • physical disabilities
  • poor manual dexterity
  • large hands
  • sensitive gag reflex
  • difficulty with manual flossing
41
Q

what are floss swords/daily flossers

A

plastic toothpick on one end, floss on the other

42
Q

what is the disadvantage of floss words/ daily flossers

A

floss cannot be changed as it gets used

43
Q

what are automated flossers useful for

A
  • patient motivation
  • patient who need handle with large diameter
44
Q

what are floss threaders ideal for

A
  • abutment teeth
  • beneath pontics
  • ortho appliances
  • teeth that are splinted together
  • tight contact
45
Q

what is superfloss ideal for

A

plaque removal under pontics and ortho appliances

46
Q

what is the platypus ortho flosser and what is it used for

A
  • created to floss around ortho brackets
  • floss spread between two spatula ends
  • bracket brush on the opposite end
47
Q

what are interdental brushes/proxybrush used for

A
  • large embrasures
  • teeth with concavities
  • around fixed appliances
  • ortho appliances
  • furcations - class III, IV
48
Q

describe soft picks and what they are used for

A
  • soft, flexible bristles
  • latex free
  • tapered to work around appliances
  • easy to use for patients who find flossing cumbersome
49
Q

what are rubber tipped stimulators used for

A

for gingival massage

50
Q

rubber tipped stimulator has limited use for removing plaque from:

A
  • exposed furcations
  • along gingival margins
  • open embrasures
51
Q

what is the end-tuft toothbrush used for

A
  • difficult to reach places such as:
  • around ortho appliances
  • around pontics
  • lingual or crowded lower anterior teeth
  • distal of most posterior teeth
  • wide embrasure spaces
  • exposed furcations
52
Q

describe the sulcus brush

A
  • more narrowed brush head
  • fits along the gumline
  • softer bristles for inflamed gums
53
Q

where are toothpick holders used

A
  • along gingival margins to remove plaque in sulus/pockets
  • crown margins
  • accessible furcations
  • concave proximal surfaces
  • orthodontic appliances
54
Q

describe wooden or plastic triangular sticks (Stim- U- Dent) and how is it used

A
  • balsa or birchwood most common
  • triangular in cross section
  • stick is inserted from the facial with flat surface resting on gingiva
  • move from buccal to lingual
55
Q

what are other aids

A
  • pipe cleaners
  • yarn
  • gauze
56
Q

what can oral irrigators result in

A

disruption of loosely attached or unattached supra/subgingival plaque

57
Q

irrigation not indicated for pts who have:

A

effective HC or no inflammation

58
Q

irrigation alone is ________ in reducing inflammation

A

ineffective

59
Q

best benefit of irrigation is seen when:

A

combined with toothbrushing

60
Q

what patients really benefit from water picks

A

those with ortho appliances, bridges or implants

61
Q

what agent is used as irrigation with antimicrobials

A

chlorhexidine

62
Q

how is irrigation with antimicrobials done

A

must use device to distribute CHX
- no rinsing/swishing

63
Q

what is the preventative philosophy

A
  • must be promoted by all staff members but your role is most significant
  • treat your patients as individuals
  • provide accurate information
  • reinforce: dont assume your patient understood everything
64
Q

what are the indications, advantages, disadvantages of waxed dental tape

A
  • indications: embrasure: II and III, loos contact, large surface area
  • advantages: tear resistant
  • disadvantages: difficult for tight contacts
65
Q

what are the indications, advantages, disadvantages of waxed dental floss

A
  • indications: embrasure: I, around rough tooth surfaces and restorations
  • advantages: strength/durable, shred resistant, prevents tissue trauma
  • disadvantages: patient comfort
66
Q

what are the indications, advantages, disadvantages of unwaxed round floss

A
  • indications: embrasure: I
  • advantages: easy to insert into embrasure space
  • disadvantages: tears easily on contact with calculus and defective restorations
67
Q

what are the indications, advantages, disadvantages of super floss

A
  • indications: embrasure II and III, fixed bridge, ortho appliances, implant prosthesis
  • advantages: covers more surface area, stiff end, easier to insert
  • disadvantages: requires coordination and can get caught on rough surfaces
68
Q

what are the indications, advantages, disadvantages of colored floss

A
  • indications: visual cue for plaque/debris, beginners or individuals with weak eyesight
  • advantages: motivational and educational, increases compliance
  • disadvantages: none indicated
69
Q

what are the indications, advantages, disadvantages of flavored floss

A
  • indications: appealing, patients lacking motivation
  • advantages: motivational
  • disadvantages: none indicated