plaque control and oral hygiene aids

Question 1

plaque control =

Answer 1

disease control

Question 2

plaque - primary agent in development of:

Answer 2

dental caries and periodontal disease

Question 3

plaque control leads to

Answer 3

1. resolution of gingival inflammation in the early stages
2. reduction of calc formation

Question 4

oral health can neither be attained or preserved without

Answer 4

plaque control

Question 5

home care instructions

Answer 5

1. need to be effective/personalized
2. be none-traumatic when cleaning the teeth

Question 6

plaque control depends on YOU:

Answer 6

1. educate the patient
2. show patient disease in his/her own mouth
   -bleeding points
   -periodontal probing
   -red, bleeding gums
3. utilize disclosing agent
   -educational tool
   -motivational tool

Question 7

consider the following with home care instructions:

Answer 7

• 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

Question 8

toothbrushes most important features

Answer 8

1. able to reach all areas to be cleaned
2. size of head is appropriate for patient
3. no tissue trauma
   (bristles softer is better)

Question 9

toothbrush replacement

Answer 9

average life 3 months
-signs of bristles splaying
-consider replacing after illness

Question 10

patient’s over or under estimate the time they brush

Answer 10

over-estimate

Question 11

toothbrushing techniques

Answer 11

1. bass (modified)
   -rolling
   -stillman
   -charters
2. fones (circular)
   -leonard
   -horizontal
   -smith-modified

Question 12

-Angle bristles toward gingival
margin (approximately 45o angle) (angle towards gingival)

Answer 12

bass (modified)

Question 13

bass modified steps

Answer 13

1. gently press bristles to enter sulcus and or embrasures
   -subgingival cleansing, gingival stimulation
2. vibrates brush (or use small strokes) without disengaging bristles
3. roll the instrument toward the incisal/occlual
4. replace and repeat on next 2 or 3 teeth
5. turn brush lengthwise
6. place heel of brush along gingival margin
7. Vibrate to dislodge plaque
8. ‘Roll’ the toothbrush to
   cleanse the lingual surface

Question 14

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

Answer 14

fone’s circular

Question 15

improper toothbrushing

Answer 15

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

Question 16

• 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

Answer 16

ada guidelines for acceptance of powered toothbrushes

Question 17

mechanical action of brush

Answer 17

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

Question 18

emits soundwaves in addition to the movement of the brush filaments

Answer 18

sonic action of toothbrush

Question 19

The evidence produced shows benefits in using a powered toothbrush when
compared with a manual toothbrush

Answer 19

1. 11% reduction in plaque at 1-3 months
2. 21% reduction in plaque after 3 months
3. 6% reduction in gingivitis at 1-3 months
4. 11% reduction in gingivitis after 3 months

Question 20

choose interproximal aid based on

Answer 20

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

Question 21

The purpose of flossing is to

Answer 21

remove interproximal plaque, not to dislodge food wedged between the teeth

Question 22

Embrasure: II and III
Fixed bridge
Ortho appliances
Implant prosthesis

Answer 22

super floss

Question 23

covers more surface area
stiff end
easier to insert

Answer 23

super floss

Question 24

embrasure I
easy to insert into embrasure

Answer 24

unwaxed round floss

Question 25

embrasure I around rough tooth surfaces and restorations

Answer 25

waxed dental floss

Question 26

Embrasure: II and III Loose contact Large surface area

Answer 26

waxed dental tape

Question 27

The ‘spool’ method may be easier for someone

Answer 27

with less dexterity

Question 28

how to floss

Answer 28

* 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 (See-saw motion)

Question 29

(do/don't) pop the floss

Answer 29

DONT

Question 30

adapt floss to each interproximal surface by making

Answer 30

C shape floss should be placed into sulcus area

Question 31

Once the floss is below the contact area and wrapped around the tooth, it should be moved

Answer 31

“up and down” against the tooth

Question 32

floss holders recommended for patient's with

Answer 32

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

Question 33

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

Answer 33

floss swords/daily flossers

Question 34

* 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

Answer 34

floss threaders

Question 35

Ideal for plaque removal under pontics and ortho appliances

Answer 35

super floss

Question 36

Used for: * large embrasures * teeth with concavities * around fixed appliances * ortho appliances * Furcations ( Class III, IV)

Answer 36

interdental brushes (proxybrush)

Question 37

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

Answer 37

soft picks

Question 38

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)

Answer 38

end-tuft toothbrush

Question 39

* Primary use is for gingival massage * Limited use for removing plaque from: * exposed furcation(s) * along gingival margins * open embrasures

Answer 39

rubber-tipped stimulator

Question 40

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

Answer 40

toothpick holders (perio-aid; D-plak-R)

Question 41

* Can result in disruption of loosely attached or unattached supra/subgingival plaque * 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 * Pts with ortho appliances, bridges, or implants

Answer 41

oral irrigators

Question 42

AAP confirms supragingival irrigation with _____:

Answer 42

chlorhexidine CHZ vs water -slight clinical and microbial improvements noted in gingivitis patients only use device syringe to distribute CHX

Question 43

preventive philosophy

Answer 43

1. must be promoted by all staff members, but your role is most significant 2. treat your patients as individuals 3. provide accurate information 4. reinforce; don't assume your patient understood everything