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Mechanical and Chemotherapeutic Home
Oral Hygiene
Powered Mechanical Plaque Removal• Significantly proven more effective and
beneficial in reducing plaque index, gingival index, percentage of sites that bled on probing, pocket depth, total gram negative bacteria in subgingval plaque than the manual tooth brushes.
• It was designed because some people lack manual dexterity in manipulation of brushes
• Uses acoustic energy
Mechanical Methods of Plaque ControlThe most accepted techniques for
plaque removal• These include:– Tooth brushing– Flossing– Disclosing agents– Oral irrigators– Tongue scrapers
• Manual toothbrush-Most common method for removing
plaque-Variable
• Bristle material• Length• Diameter• Number of fibers• Length of brush head• Number and arrangement of bristle tufts• Angulation of brush head to handle• Handle design
How to brush your teeth
• Brush at a 45 degree angle to your teeth. Direct the bristles to where your gums and teeth meet. Use a gentle, circular, massaging motion, up and down. Don't scrub. Gums that recede visibly are often a result of years of brushing too hard.
• Step 2 Clean every surface of every tooth. The chewing surface, the cheek side, and the tongue side.
• Step 3 Don't rush your brush. A thorough brushing should take at least two to three minutes. Try timing yourself.
• Step 4 Change your usual brushing pattern. Most people brush their teeth the same way all the time. That means they miss the same spots all the time. Try reversing your usual pattern.
REMINDERS
• thorough brushing is a very important step in preventing tooth decay and gum disease
• thorough brushing is a very important step in preventing tooth decay and gum disease
Floss• Flossing removes plaque and
bacteria that you cannot reach with your toothbrush. If you don't floss, you are missing more than one-third of your tooth surface..
Types of floss• Flavoured and unflavored• Waxed and unwaxed• Thin, tape and meshwork
How to floss
• Step 1 Take a length of floss equal to the distance from your hand to your shoulder
How to floss
Wrap it around your index and middle fingers, leaving about two inches between your hands.
How to floss
Step 2 Slide the floss between your teeth and wrap it into a "C" shape around the base of the tooth and gently under the gumline. Wipe the tooth from base to tip two or three times.
Step 3 Be sure to floss both sides of every tooth. Don't forget the backs of your last molars. Go to a new section of the floss as it wears and picks up particles.
Time Consideration• How often should we brush and floss
our teeth and for how long?• Answer: 1 minute brushing period
provides the greatest plaque removal.
• In Children, oral hygiene procedures must be done once or twice daily with parental supervision.
Dentrifices• Plaque and stain removing agents
through the use of abrasives and surfactants
• Composition
• Disclosing Agents• Allow visualization of plaque• Compostion– Iodine– Gentian violet– Erythrosine– Basic fuchsin– Fast green– Food agents with antimicrobial activity
Adjuncts for Plaque Control• oral irrigators (uses pulsed water or
chemotherapeutic agents to dislodge plaque)• tongue scrapers (flat, flexible plastic sticks that
are used to remove bacterial and food deposits that accumulate within the rough dorsal surface of the tongue. )
• gauze or special dental wash cloths (used in infants to massage the gums and remove the plaque in newly erupted teeth)
Techniques• roll method• Charters method• Horizontal scrubbing method• Modified stillman method
Chemotherapeutic Plaque Control
• characteristics of an ideal Chemotherapeutic plaque control agent – specificity only for the pathogenic bacteria– substantivity, the ability to attach to and be retained by oral
surfaces and then be released over time without loss of potency
– chemical stability during storage– absence of adverse reactions, such as staining or mucosal
interactions– toxicology safety– ecologic safety so as not to adversely alter the microbiotic
flora– ease of use
Different ways to administer antiplaque agents
– Mouthwashes– Dentrifices– Gels– Irrigators (provide supragingival and subgingival delivery)– Floss– Chewing gum– Lozenges– Capsules (systemic distribution)– All of these are for local, supragingival administration
except capsules and irrigators
Antiseptic Agents
• Chlorhexidine – Positively Charged Organic antiseptic agent– Reduces plaque, gingivitis, mucositis– Binds with anionic glycoproteins and
phosphoproteins on the buccal, palatal and labial mucosa and tooth-borne pellicle
– Can be of great use in immunocompromised patients esp. mental retardation and patients undergoing bone marrow transplantation
Chlorhexidine
– Antibacterial effects:• Binding well to bacterial cell membrane• Increasing their permeability• Initiating leakage• Precipitating intracellular components• Decrease levels of streptococcus mutans
Antiseptic Agents
• Listerine• Noncharged phenolic antiseptic agent• Burning sensation • Bitter taste• Highest alcohol contents (25 %)
Enzymes, Plaque- Modifying Agents and Plaque Attachment Interference Agents
• Enzyme System– Alter plaque architecture
• Urea Peroxide – Plaque modifying agent – Increased stability over hydrogen peroxide – Protein denaturation effect of urea
• Delmopinol– Binds to salivary protein and alters cohesiveness
and adhesiveness properties of films formed
Sugar Substitutes
• Incorporated in chewing gums to:– Decrease plaque accumulation and pH– Lower incidence of caries
• Examples of Sugar Substitutes– Xylitol– Mannitol– Sucralose– Aspartame
• Prenatal Counseling– Before birth of child– Discuss Pregnancy gingivitis
• Infants (0 – 1 year old)– Plaque removal activity should begin on eruption
of primary teeth– Cleaning and massaging of gums using moistened
gauze or washcloth, soft bristled infant sized toothbrush may be introduced
• Toddlers (1 to 3 years old)– Toothbrush must be introduced– Parent remains primary caregiver of hygienic
procedures– Flossing, if interproximal contacts are closed
• Preschoolers (3 to 6 years)– Fluoride dentrifice can be introduced at 3 years– Pea - sized amount of tooth paste– Daily flossing
• School-Aged Children (6-12 years)– Parents may find they only need to brush or floss their
child’s teeth in difficult to reach areas of mouth– Use of disclosing agent for parents’ inspection– Ingestion is the primary concern– Fluoridated dentrifices is necessary– Use of chemotherapeutic agents is recommended
• Adolescents (12 – 19 years)– Motivation– Poor dietary habits and pubertal hormonal changes increase
the risk for caries and gingivitis
In- office Oral Hygiene Programs
– Dental education of parent and child describing exactly the importance of oral hygiene
– Delivered in simple terms with enthusiasm and conviction
– Conveyed in a child’s age-appropriate language– Positive reassurance, not critical– “let me show you how to improve” rather than
saying “you’re doing it all wrong”– Recare intervals should be personalized with
patient’s needs
The end
Agbayani. CassieopeaDimatulac, KevinTesoro, Joseph Paulo D.