Denture Cleaners
Ban-A-Stain Liquid
Phosphoric Acid 25%
Dentu-Cream Paste
dicalcium phosphate dehydrate / calcium carbonate / aluminum silicate
Efferdent Plus Tablets
Sodium bicarb / perborate / potassium monopersulfate / detergents
TYPES of Detrifices
(toothpaste)
Caries Prevention / Treatment
sodium fluoride
- *Tartar Control**
- *zinc** chloride/citrate / soluble pyrophospates
- *Anti Plaque/Gingivitis**
- *Triclosan (Colgage total)** = only toothpaste accepted by the ADA for this indication
- *Whitening / Anti-Stain**
- *Baking soda** (mild abrasive) / titanium dioxide (pigment produces brightening)
Non-Rx DESENSITIZING Toothpastes
Colgate Sensitive Multi-Protection
Colgate Sensitive Enamel Protect
Crest Sensitivity
Clinical Sensitivity Relief Extra Whitening
Sensodyne Maximum Strength w/ Fluoride
Carmex Lip Balm
Ingredients / Indicaiton / Directions
Lip Balm = 1.7% CAMPHOR + 0.7% MENTHOL
Cold Sore Treatment: 10% BENZOCAINE
For the temporary relief of
Cold Sores & Chapped Lips
AAA PRN
do NOT put on cold sores for >14 days
Prevention of Caries
- *Control Dental Plaque**
- *Mechanical Removal** = brush / floss
Chemical Management = Fluoride / products that remove / prevent plaque
Non-Pharmacological
DIETARY = AVOID CARIOGENIC FOODS
cariogenic food = >15% sugar –> clings to teeth -> remains in mouth
high water content is good, need to stimulate flow of saliva
Toothbrushing GUIDELINES
Brush after each meal or BID
Gentle back & forth motion, sweep AWAY from gums
45* angle @ gumline
>2 minutes covering all surfaces
Brush tongue to reduce plaque + bacteria
rinse + spit out water
Toothache
Cavitation or Decay present in tooth
- *Intermittent SHORT / SHARP pain on stimulation**
- may indicate reversible damage*
- *Pain w/o stimulation**
- may indicate IRREVERSIBLE damage*
Requires DENTAL CARE for resolution
Medications that –> XEROSTOMA
May Decrease blood flow
Anti Histamines / Decongestants
Anti Hypertensives / Diuretics
Anti Depressants / Anti Psychotics
Sedatives
DENTIN
HARD TISSUE
located beneath the Enamel
contains microscopic tubules
(small hollow tubes or canals)
when dentin loses its protective covering = enamel
then the tubules allow for heat+cold or Acid/sticky foods to
stimulate nerves / cells INSIDE the tooth –> SENSITIVITY
Orajel
Indications
Toothaches or Teething
for temporary pain relief
Apply directly to gum area affecting the tooth
CANKER SORES
Denture Irritation/ Mouth Ulcer / Other sores
AAA AD
Oral Health Tips
- Drink fluoridated water and brush with fluoride toothpaste.
- Practice good oral hygiene. Brush teeth thoroughly.
- Flossing is just as important! Even flossing 1-2 times per week can make a difference!
•Visit your dentist on a regular basis every 6 months,
and for severe pain ASAP
Do not use any tobacco products and limit alcohol
•Control diabetes
•Know if your medications can cause dry mouth- consider an
alternative treatment, or care for dry mouth.
•See your doctor or a dentist if you have
sudden changes in taste and smell
Xerostoma
DRY MOUTH
Salivary flow is limited or completely stopped
Sjogren’s Syndrome
autoimmune disorder where salivary glands are partly/completely disfunctional
DM / Depression / Crohn’s
may also be prone to dry mouth
+medications
MINIMIZE = caffeine / acidic foods / alcohol / alcohol rinses
CHEMICAL Removal of Plaque
Fluoride
enhances development of fluoridated hydroxyapatite
resistant to De-mineralizing ACIDS
ALSO interferes w/ bacterial cariogenic process
Dentifrices (TOOTHPASTE)
enhances removel of dental plaque + stain
decreased incidence of dental caries + gum disease
less mouth odor & enhanced appreance
Mouth Rinses
Cosmetic + Therapeutic
Crown / Root
part of the tooth that is
VISIBLE IN THE MOUTH
Root is the
Part of the tooth that is
INSIDE THE BONE SOCKET
Recurrent APTHOUS STOMATITIS
(Canker Sore)
Likely causes are: Stress + Local Trauma
chemical irriatation / biting inside of cheek/lips
injury from brushing or braces
can NOT be cured, products only provide symptomatic relief
Minor Presentation
oval / flat ulcer / erythematous tissue around ulcer / usually 1 lesion
Major presentation
oval / ragged / grey or yellow ulcers / several lesions
MEDICATIONS
that INCREASE the risk of GINGIVITIS
Calcium Channel Blockers = CCBs
Cyclosporine
- *Phenytoin**
- can cause HYPERtrophy of gums*
- *AntiCholinergics / AntiDepressants**
- reduces salivary flow*
Orajel Products
Ingredients
Regular Strength Gel
10% benzocaine
Severe Toothache Pain Cream
20% benzocaine + 0.25% menthol
- *Canker Sore Gel**
- *benzocaine 15% + menthol 2%**
Mouth Sore Rinse
1.5% hydrogen peroxide
Mouth Sore GEL
benzalkonium CL 0.13% + benzocaine + zinc chloride
Mouth Rinses
Rince with plaque / calcus control properties
indicated as ADJUNCT to proper flossing / brushing w/ fluoride toothpaste
COSMETIC - freshens breath & cleans debris
Plaque control ingredients:
Aromatic Oils = Antibacterial / Local Anesthetic
4* Ammonium Compounds = Antimicrobial
Listerine
1st mouth rinse accepted by ADA as non-RX Anti-plaque/gingivitise RINSE
Pulp Chamber
Space INSIDE the tooth
for the
Nerve + Blood Vessels
Herpes Simplex Labialis
SYMPTOMS
Cold Sores or Fever Blisters
Burning / Itching / Tingling / Numbness
@
Junction of Oral Mucosa & Skin of LIP/NOSE
several number of lesions
Red / Fluid-Filled Vesicles
that may coalese, crusted when mature
Pustules or Pus under crust, may indicate secondary bacterial infection
needs to be further evaluated
ABREVA
Ingredients / Indecation / Direction
DOCOSANOL 10%
Treatment of Cold Sores or Fever Blisters
on the face or lips by shortening healing time & duration
of the tingling/pain/burning /itching
Directions:
AAA on face or lips @ the first sign of cold-sore/fever blister
Use 5x per day until healed
do NOT use for >10 days or if symptoms worsen
EX-ST
for COLD SORES / Fever Blisters
Tooth Aches / Loose Teeth
Broken / knocked out teeth
Severe Tooth Pain
hot / cold / chewing
Mouth soreness
Fever / Swelling
Bleeding Gums w/o trauma
Trauma to Mouth
bleeding / swelling / soreness
FLUORIDE PRODUCTS!!
•ACT Anticavity Flouride Rinse
- *•Gel-Kam Gel**
(0. 4% stannous fluoride) - *•Crest Pro-Health For me Anticavity Flouride Rinse**
(0. 022% fluoride rinse)
(0.05% sodium fluoride)
NonRX - Mouth Rinses
- *Therapeutic**
- *Crest PRO-Health** (cetylpriindium chloride)
- *Botanical**
- *Listerine**
Tom’s of Maine
Denture Problems
HYYGIENE RELATED
Pain UNDER Dentures
usually result of poor denture cleaning
Dentures can accumulate:
Plaque / Stain / Calculi simular to natural teeth
Chronic Atrophic Candidiasis
most common issue, often caused by candida albicans
that adheres to dental base
Biotene Oral Balance
Indication / Ingredients / Directions
Use as needed for DRY MOUTH = Xerostoma
Use 15 ml
rinse for 30 sec –> SPIT
Glucose Oxidase / Lysozyme / Lactoperoxidase
Special Population Considerations
Infants
20 primary teath, need to remove plaque + milk resedue
Advanced Age
some medications that affect oral health
Diabetes** + **Smokers
increased risk for oral health problems
Fluoride Products
- *ACT**
- *Anticavity Fluoride Rinse**
- *Gel-Kam Gel**
0. 4% stannous fluoride - *Crest Pro-health**
0. 022% fluoride rinse
Guidelines
for using Topical Fluoride
ONLY ONCE A DAY
brush teeth with fluoride dentifrice FIRST
rinse-measured amount vigorously for ONE MINUTE
GEL
brush gel onto teeth & remain for 1 minute
SPIT OUT after 1 minute, do not drink/eat for 30 minutes
SELECTED PRODUCTS
Detrifices
(toothpaste)
Caries Prevention / Treatment
FLUORIDE = Crest Cavity Protection
Tartar Control
Colgate Tartar Protection
Anti Plaque/Gingivitis
Colgate TOTAL / Crest Multicare
Whitening / Anti-Stain
Aquafresh Whitening Gel
Rembrant PLUS Premium whitening
Enamel
HARD - OUTER
covering of a tooth
covers the dentin
dentist can care for damage, since non-living cells
Flossing Guidelines
Pull 18in of floss, wrap MOST around middle finger
wrap remaining around middle finger of other hand
curve floss into C-SHAPE
gently scrabe tooth w/ floss in up/down motion
REMINDER = Floss behind LAST MOLARS
can cause bleeding / discomfort,
but will lessen w time & better gum health
Gingiva = Gums
Soft Tissue
portion of the supporting structures
protect the roots of your teeth
&
cover the teeth that have NOT yet erupted
SELECTING
a toothbrush
# Choose based on patient factors: **Manual Dexterity** / **Oral anatomy** / **Oral Health**
SOFT bristols are preferred, do not damage enamel /gum
- *Electronic = Constant efficiency**
- especially for disabled / advanced age w/ difficult dexterity*
REPLACE Q3 months due to wear + bacteria
Oral Irrigating Devices
(WaterPIK)
*NOT A SUBSTITUTE for*
TOOTHBRUSHING OR FLOSS
Adjunctto maintaingood oral hygiene
Herpes Simplex Labialis
Caused by what?
How is it spread?
Cold Sores or Fever Blisters
caused by HSV1
Contagious, spread by DIRECT CONTACT
kissing / sharing utensils / drinks
Can be REACTIVATED once virus has infected host
by cold / stress / windburn / fatigue
Gum Chewing
Indicated to CONTROL PLAQUE
Benefits:
Increased SALIVA
buffers acids in mouth
can be helpful for pts with dry mouth
recommend sugar-free
Chew 2 Pieces of gum QD AFTER EATING
What is Gingivitis?
Inflammation of GUMS, found in 20% of pop
Is the MILDEST form of PERIODONTAL DISEASE
reversible and affects nearly everyone
May progress to significant bone loss
Is from accumulation of SUPRAGINGIVAL BACTERIAL PLAQUE
can be prevented in the same wasy as caries
Tooth CARIES
Definition / Risk Factors
an infectious disease that affects calcified tissues of the teeth
Plaque bacteria –> acid -> demineralizes ENAMEL + DENTIN = CARIES
Risk factors:
Orthodontic Appliences / Dry Mouth / Gum Recession / TOBACCO
incedence is in a decline due to Fluoride
ANBESOL
Ingredients / Indication / Directions
BENZOCAINE
Gels or liquids ~ 10-20% benz
cold sore therapy = 20% benz + 1% allntoin + 3% camphor
Temporary Pain Relief of:
Toothache / Teething / Braces / Denture irritation
Sore gums / Cold + Canker Sores / Fever Blisters
AAA on or around lips or wihthin mouth
do NOT use for >2 days, except under physician direction
Halitosis
Bad Breath
90% of cases related to oral cause
dental caries / periodontal disease / infections / mucosal ulcers
- *Prevention**
- *prope**r oral hygiene to prevent tooth/gum problems
Zinc Salts** + **Chloride Dioxide
most effective in chemical prevention of malolder
Smart-Mouth / CloSYS
Tooth HYPERSensitivity
Dentin becomes exposed
& tubules become OPEN to the oral cavity
Patient experiences pain from:
hot/cold + sweet/sour + temperature air
Can be PREVENTED by:
brushing LESS vigorously + AVOIDING hypersensitivity stimuli
POTASSIUM NITRATE 5%
most widely used ingredient for teeth sensitivity
Fluoride dentrifices + Supplementation can help
contineu to use product until problem resolves