Plaque Control and Oral Hygiene Aids Flashcards
Plaque is the primary agent in development of…
- Dental Caries
- Periodontal Disease
- Plaque Control leads to:
- Resolution of gingival inflammation in the early stages
- Reduction of calculus formation
How can you teach the importance of plaque control?
- 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)
What is important about home care instructions?
- Need to be effective/personalized
- Be non-traumatic when cleaning the teeth
What do you need to consider before giving home care instructions?
- 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
What is the most important features of toothbrushes?
- Able to reach all areas to be cleaned
- Size of head is appropriate for patient
- No tissue trauma (Bristles – SOFTER is better)
What is the average life of the toothbrush?
3 months
When do you need to replace toothbrush?
- Average life of toothbrush – 3 months
- Signs of bristles splaying
- Consider replacing after illness
Patients usually ____ estimate the time they brush and spend more time on the _____ surfaces
over; facial
What is the ADA’s position on toothbrushing?
brush regularly
Patient’s ____ completely remove plaque
rarely
What is the important things to mention for toothbrushing?
- Daily fluoride use
- Routine brushing pattern
- Emphasis on all areas
What are the toothbrushing techniques?
- Bass (modified)*
- Rolling
- Stillman
- Charters
- Fones (circular)*
- Leonard
- Horizontal
- Smith-Modified
What is the bass (modified) toothbrushing technique?
- Angle bristles toward gingival margin (approximately 45o angle)
- Gently press bristles to enter sulcus and/or embrasures
- Vibrate brush (or use small strokes) without disengaging bristles
- ‘Roll’ the instrument toward the incisal/occlusal
- Replace and repeat on next 2-3 teeth
- Turn brush lengthwise
- Place ‘heel’ of brush along gingival margin
- Vibrate to dislodge plaque
- ‘Roll’ the toothbrush to cleanse the lingual surface
What is the fone’s (circular) toothbrushing technique?
- 90 Degrees to tooth
- Larger circles over teeth and gingiva
- Easy for children to pick up
- Option for those with limited dexterity
What is improper toothbrushing?
- Hard toothbrush
- Horizontal scrubbing
- Excessive pressure
- Toothpaste too abrasive (Gingival recession, Cervical abrasion)
What are the ADA guidelines for acceptance of powered toothbrushes?
- 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
What is the mechanical action of a powered toothbrush?
- Uses the motion of the bristles to remove plaque and debris
- Rotation oscillation
What is the sonic action of a powered toothbrush?
Emits soundwaves in addition to the movement of the brush filaments
Is a powered toothbrush or manual toothbrush better?
The evidence produced shows benefits in using a powered toothbrush when compared with a manual toothbrush
What evidence was provided to show benefits of powered toothbrush over manual?
- 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
You should choose an interproximal aid base on…
- Size of interdental spaces
- Presence of furcation(s)
- Ortho or fixed appliance
- Tooth alignment
What is the purpose of flossing?
The purpose of flossing is to remove interproximal plaque….not to dislodge food wedged between the teeth.
What are the different types of floss?
- waxed dental tape
- waxed dental floss
- unwaxed round floss
- super floss
- colored floss
- flavored floss
How should you floss?
- Tear off an adequate amount of dental floss
- Wrap floss around middle fingers
- Floss is maneuvered between thumb and index finger
- The floss is moved back and forth until it is through/broken the contact
- Adapt to each interproximal surface by making C-shape.
- Floss should be placed into sulcus area
- Once the floss is below the contact area and wrapped around the tooth, it should be moved “up and down” against the tooth
When do you use the ‘spool’ method for flossing?
someone with less dexterity
What is this showing?
floss cuts
What patients are floss holders recommended for?
- Physical disabilities
- Poor manual dexterity
- Limited mouth opening
- Large hands
- Sensitive gag reflex
- Difficulty with manual flossing
What is the disadvantage of floss swords/daily flossers?
floss cannot be changed as it gets used
What are floss swords/daily flossers?
Plastic toothpick on one end, floss on the other
What are floss threaders?
- Floss is threaded through loop
- Used to carry floss interproximally
What are floss threaders ideal for?
- abutment teeth
- beneath pontics
- ortho appliances
- teeth that are splinted together
- tight contact
What is super floss used for?
Ideal for plaque removal under pontics and ortho appliances
What are interdental brushes (proxybrush) used for?
- large embrasures
- teeth with concavities
- around fixed appliances
- ortho appliances
- Furcations (Class III, IV)
What are the characteristics of soft picks?
- Soft, flexible bristles
- Tapered to work around appliances
- Easy to use for patients who find flossing cumbersome
- Latex free
What patients do you recommend to use end-tuft toothbrush?
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)
What is the primary use of the rubber-tipped stimulator?
gingival massage
What does the rubber-tipped stimulator remove plaque from?
- exposed furcation(s)
- along gingival margins
- open embrasures
What are toothpick holders (perio-aid; D-PLAK-R)?
Trace along gingival margins to remove plaque in sulcus/pockets
Where can toothpick holders (perio-aid; D-PLAK-R) be used?
- crown margins
- accessible furcations
- concave proximal surfaces
- orthodontic appliances
What do oral irrigators do?
Can result in disruption of loosely attached or unattached supra/subgingival plaque
What are the negatives for oral irrigators?
- Irrigation not indicated for pts who have effective HC or no inflammation
- Irrigation alone is ineffective in reducing inflammation
Best benefit is seen when irrigation is combined with ________________
toothbrushing
What patients are oral irrigators used for?
ortho appliances
bridges
implants
What does irrigation with chlorhexidine (CHX) do (according to AAP)?
Slight clinical and microbial improvements noted in gingivitis patients only
What is the preventive philosophy?
- Must be promoted by all staff members, but your role is most significant
- Treat your patients as individuals
- Provide accurate information
- Reinforce; don’t assume your patient understood everything
What are the indications for waxed dental tape?
- Embrasure: II and III
- Loose contact
- Large surface area
What are the indications for waxed dental floss?
- Embrasure: I
- Around rough tooth surfaces and restorations
What are the indications for unwaxed round floss?
Embrasure: I
What are the indications for super floss?
- Embrasure: II and III
- Fixed bridge
- Ortho appliances
- Implant prosthesis
What are the indications for colored floss?
- Visual cue for plaque/debris
- Beginners or individuals with weak eyesight
What are the indications for flavored floss?
- Appealing
- Patients lacking motivation
What are the advantages of waxed dental tape?
Tear resistant
What are the advantages of waxed dental floss?
- Strength/Durable
- Shred resistant
- Prevents tissue trauma
What are the advantages of unwaxed round floss?
Easy to insert into embrasure space
What are the advantages of super floss?
- Covers more surface area
- Stiff end
- Easier to insert
What are the advantages of colored floss?
- Motivational and educational
- Increases compliance
What are the advantages of flavored floss?
Motivational
What are the disadvantages of waxed dental tape?
Difficult for tight contacts
What are the disadvantages of waxed dental floss?
Patient comfort
What are the disadvantages of unwaxed round floss?
Tears easily on contact with calculus and defective restorations
What are the disadvantages of super floss?
Requires coordination and can get caught on rough surfaces
What are the disadvantages of colored floss?
None
What are the disadvantages of flavored floss?
None
