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ODDR- Periodontal disease treatment > Plaque control and patient advice > Flashcards

Plaque control and patient advice Flashcards

1
Q

Name the toothbrush that the ancient Egyptians used 5000 years ago

A

The meswak

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2
Q

Why should we worry about plaque?

A

Because there is ample evidence linking plaque and gingivitis and periodontal disease

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3
Q

What is the most important strategy for preventing periodontal disease?

A

Preventing the build up of plaque from an early stage

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4
Q

How can we prevent the build up of plaque?

A

By Brushing, flossing and having regular periodic dental visits are associated with better periodontal health

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5
Q

What type of manual toothbrushes the most effective

A

Tooth brushes with multilevel profiles were consistently more effective
than flat brushes, especially when interproximal efficacy was monitored

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6
Q

What type of tooth brush is general is he most effective?

A

An electric toothbrush

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7
Q

What is the objectives of tooth brushing?

A
  1. To remove plaque biofilm and disturb reformation
  2. To clean teeth from food, debris and stain
  3. To maintain the health of the gingival/periodontal tissues
  4. To apply dentifrice with specific active ingredients to address dental caries, periodontal disease, or sensitivity
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8
Q

How can we asses and improve a patients tooth brushing technique?

A
  1. Disclose the plaque using a plaque disclosing tablet or solution
  2. Record the plaque free score
    3, Show the patient the disclosed plaque in a mirror
  3. Let the patient brush their teeth with their own toothbrush
  4. Modify their technique as necessary
  5. Let the patient try the new technique
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9
Q

What plaque free score should patients have?

A

The goal is to try and achieve a plaque free score of >70%

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10
Q

What are the key points we should remember when giving oral hygiene advice?

A
  1. The OHI must be tailored to each individual patient’s needs
  2. Don’t expect the patient to change more than one thing during a single session
  3. Set and agree targets
  4. Evaluate the patient’s progress from session to session
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11
Q

Why is a multi level tooth brush favoured to a flat headed manual toothbrush?

A

Because they can reach the inter dental areas and they can displace the plaque from those areas

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12
Q

What technique should we use when brushing out teeth?

A

The modified bass technique

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13
Q

What are the ingredients of toothpaste?

A
  1. Abrasives (20-40%)
  2. Water (20-40%)
  3. Humectants (20-40%)
  4. Foaming agent (soap or detergent 1-2%)
  5. Binding agent (up to 2%)
  6. Flavouring agent (up to 2%)
  7. Sweetening agent (up to 2%)
  8. Therapeutic agent (up to 5%)
  9. Colouring or preservative (less than 1%)
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14
Q

What are some chemical compounds used to to supplement the usual brushing and flossing?

A
  1. Triclosan and co-polymer (eg Colgate Total)
  2. Stannous salts
  3. Sodium hexametaphosphate to reduce tartar and staining potential
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15
Q

What is triclosan?

A

Broad-spectrum antibacterial agent
It is effective again a wide variety of bacteria
Broad-spectrum antibacterial agent

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16
Q

How can triclosan be used to improve oral health?

A

Oral retention can be improved by copolymer of methoxyethylene and maleic acid (Gantrex) and triclosan

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17
Q

What are stannous salts used again?

A

Stannous fluoride (SnF2 ) has reported activity against caries, plaque, and gingivitis30

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18
Q

What are anti-calculus dentifrices designed to do?

A

Designed to interrupt the process of mineralisation of plaque to calculus due to the super saturation of saliva with calcium and phosphate ions

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19
Q

What do some anti hypersensitivity products contain?

A
  1. Potassium nitrate (Sensodyne Total Care F)
  2. Strontium chloride (Sensodyne Original)
  3. Strontium acetate (Sensodyne Rapid Relief)
  4. Calcium sodium phosphosilicate (Sensodyne Repair & Protect)
  5. Potassium citrate (Colgate Sensitive)
  6. Arginine (Colgate Pro Relief)
  7. Stannous fluoride (Colgate Gel Kam Sensitive)
  8. Sodium citrate (Rembrandt Sensitive)
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20
Q

What do whitening tooth paste contain?

A

Dentifrices marketed as ‘whitening’ or ‘stain control’ control extrinsic stain via physical and chemical methods

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21
Q

Name some inter dental aids

A
  1. Floss
  2. Interdental brushes
  3. Automated inter proximal cleaners
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22
Q

What can be used by patients who have bridges but need to clean inter dentally?

A

They can use superfluous

23
Q

What is more effective: dental floss or interproximal brushes?

A

Interproximal brushed are , more efficacious in interdental plaque removal than dental floss

24
Q

Describe the different types of interdental papillae

A

Type 1 : Intact interdental papillae; narrow interdental space
Type 2: Moderate papillary recession; slightly open interdental space
Type 3: Complete loss of papillae; wide open interdental space
Type 4: Wide embrasure space; diastema, furcation, posterior surface of the most distal molar

25
Q

What is a type 1 interdental papillae and what would you recommend to a patient that has this?

A

Type 1 : Intact interdental papillae; narrow interdental space

Use:
Dental floss

26
Q

What is a type 2 interdental papillae and what would you recommend to a patient that has this?

A

Type 2: Moderate papillary recession; slightly open interdental space

Use: Dental floss /small ID brush

27
Q

What is a type 3 interdental papillae and what would you recommend to a patient that has this?

A

Type 3: Complete loss of papillae; wide open interdental space

Use: Tepes /ID brushes

28
Q

What is a type 4 interdental papillae and what would you recommend to a patient that has this?

A

Type 4: Wide embrasure space; diastema, furcation, posterior surface of the most distal molar

Use: Single tufted /end tufted or gauze strip

29
Q

What can we use to clean our tongues?

A

Tongue cleaners like brushes or scrapers

30
Q

When should we use tongue cleaners?

31
Q

Where is the most bacteria found in the mouth?

A

Many bacteria can be found on the posterior - dorsum of the tongue, which can cause bad breath

32
Q

Are oral irrigators useful?

A

There is some evidence to suggest that oral irrigators can be effective to reduce gingivitis but not plaque accumulation

33
Q

Name the most effective anti plaque agents

A

Chlorhexidine

34
Q

Which toothpaste has chlorhexidine?

A

Corsodyl contains 0.2% w/v chlorhexidine digluconate and 7% alcohol

35
Q

What can chlorhexidine do?

A

Can cause:
staining of teeth,
altered taste sensation,
evidence of increased deposition of supragingival calculus,
mucosal erosion
parotid swelling.
In some individuals even life threatening anaphylaxis

36
Q

What can be prescribed to some patients with bad oral hygiene?

A

0.2% 10 ml volume per rinse delivers about 20 mg of chlorhexidine
Only for a short period of time up yo 2 weeks

37
Q

What are the active ingredients in essential oils like listerine?

A 
Thymol
Menthol
Eucalyptol
Methyl salicylate
Contains 21.7% alcohol
38
Q

What is smoking?

A

Smoking is a major risk factor for periodontal disease

The prevalence, incidence and severity of periodontal disease is greater in smokers

39
Q

What is smoking a etiological factor of?

A

Smoking is heavily implicated in the aetiology of Necrotising Ulcerative Gingivitis (NUG)

40
Q

How much more likely are tobacco users in developing periodontal disease than non smokers?

A

2.5 to 6 times more likely to develop periodontal disease

41
Q

What increases as the number of cigarettes smoked?

A

As the number of cigarettes smoked increases so does the severity of the periodontal disease

42
Q

What ingredients are found in mouthwashes to help tackle supra-gingival plaque

A
  1. Enzymes
  2. Bisbiguanide antiseptics
  3. Quarternary ammonium antiseptics
  4. Phenolic antiseptics
  5. Other antiseptics
  6. Oxygenating agents
  7. Metal ions
  8. Natural products
43
Q

What is a problem with treating smokers?

A

The response of smokers to periodontal therapy is not as favourable as for non-smokers

44
Q

What can happen to your bones and oral hygiene if you smoke?

A

There is a strong association between smoking and alveolar bone and tooth loss

There is more pocketing in the anterior segments of teeth than for non-smokers

45
Q

Define plaque inhibitory

A

Inhibits the plaque formation but does not necessarily brings down the inflammation

46
Q

define Antiplaque

A

Prevents plaque formations

47
Q

Define antigingivits

A

Brings down inflammation

48
Q

What are some Non-pharmacological aids in smoking cessation?

A
  1. Will-power
  2. Advice and counselling from a healthcare professional
  3. Hypnosis
  4. Acupuncture
  5. Behavioural therapy
49
Q

Define Substantivity

A

The ability of the drug to adsorb on and to bind to hard and soft tissues =

50
Q

What does the substantivity of a drug depend on?

A

depends on concentration of the drug, pH, temperature and length of time of contact of the solution

51
Q

What are some Non-pharmacological aids in smoking cessation?

A
  1. Nicotine Replacement Therapy
  2. Zyban and Champix tablets
  3. E- cigarettes
52
Q

Why is chlorohexidine so effective?

A

It slowly releases its active form over 12-24 hours (so has a high substantivity)

53
Q

Give examples of nicotine replacement therapy

A
  1. Nicotine gum and Nicotine patches
  2. Lozenges
  3. Inhalators
  4. Nicotine nasal spray

ODDR- Periodontal disease treatment (9 decks)

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