plaque scores Flashcards
what is plaque and what tooth surfaces may it be found on
diverse community of microorganisms found on a tooth surface as a biofilm, embedded in an extracellular matrix of polymers of host and microbial origin
dentures
orthodontic appliances
implants
tongue
why do we carry out plaque scores
- prevent dental disease as their aeitiology is directly linked to plaque ((epidemiological) studies related to caries like hopewood house study provide direct correlation)
- measure effectiveness of oral hygiene advice
- motivate the patient, pt and clinician work together to achieve aim of 80% plaque free
how may plaque appear
- corn cob (central rod-shaped bacterium becomes surrounded by mini round cocci)
- bacteria in mature biofilm forms complex patterns
- corn cob plaque can be seen covering a toothbrush filament from microscopy
what is a plaque free score a basis for
- further treatment + planning
- monitors the response to ongoing therapy and identifies local plaque retentive sites
what is a plaque score
an index
measurable
objective
which plaque indices is used at leeds
what others exist
O’LEARY PLAQUE CONTROL INDEX
- Vermillion & Green
- Silness & Loe
what armamentarium is required to carry out a plaque score
- examination kit (dental mirror, BP probe, dental tweezers)
- disclosing solution in dappen dish
- vaseline on cotton wool roll for pts lips
- small paint brush
- mouth wash, tissues, patient bib to protect their clothing
- record sheet (on SALUD)
what is used instead of disclosing tablets and why
- 2 tone disclosing solution
- much more effective
- only need a few drops in a dappen dish
how is disclosing solution put into mouth
painted on with a paint brush
it will colour the plaque pink/purple
pink = new plaque
purple = mature plaque
what is plaque recorded at
at 6 points for all teeth
1) commence on maxillary
2) upper right quadrant buccal (recording for distal buccal mesial etc)
3) then work way back round commencing on palatal surface of upper left quadrant (record distal, midline, palatal, mesial)
4) then move to mandible
5) lower right quadrant buccal
6) lower left lingual quadrant
if plaque present = record 1
if not = record 0
plaque free score automatically worked out for us by salud
why is a plaque free score given
- it is a positive to motivate patients
- they get higher score as mouth becomes cleaner
what do clinicians have to look at
- interpret plaque free score
- look where plaque is present and tailor oral hygiene advice to the individual
- BUT do not overload the patient with too much info (small steps, build on these to enable pt to successfully carry out the home care)
what is overgrow of gum tissue around the teeth called
gingival hyperplasia overgrowth
seen as inflammed gingiva
where does plaque build up in fixed orthodontic appliances (braces)
- around the orthodontic brackets and underneath wire
- plaque stagnating here can cause demineralisation of the enamel progressing to cavitation of enamel (irreversible)
- if plaque not removed daily gingivitis may progress to periodontitis
- show pt how to remove plaque around the brackets
- if pt doesnt carry out this advice daily the appliances may have to be removed
what evidence based science for prevention relates to the oral health toolkit
1) brush 2x a day with a fluoride toothpaste
2) spit don’t rinse
3) carry out daily interdental cleaning
what is the method for carrying out a plaque free score?
- Cross infection control = wiping down unit and setting it up for procedure
- Check medical history
- Explain and gain consent for procedure
- once pt is in dental chair place a patient bib on them to protect their clothing
- patient must also wear patient goggles
- can then lay the patient back and begin
what is the method for disclosing the teeth
- Apply petroleum jelly to ps lips w cotton wool
- Paint on disclosing solution with paint brush
- ask pt to sit up and rinse gently around once
- lay pt back + record plaque present on salud
- plaque will be coloured pink/purple (depends on age of the plaque; pink is fairly new; purple is mature)
- once recorded the plaque on salud sit the pt up and tell them the plaque free score
- give them a hand held mirror and show them the presence of plaque in their own mouth
how is a plaque score generated
no of plaque sites is expressed as a % of total no of sites in the mouth
