Why is oral hygiene performed?
- Prevent periodontal diseases
- Treatment of periodontal diseases to arrest progression
- Prevent development and progression of caries
- Social reasons (fresh breath, attractiveness)
What are two ways Kings commonly use to assess oral hygiene?
- Plaque disclosing (liquid or disclosing)
- Plaque control record (accesses presence/absence on 4 surfaces of the teeth)
What are the main factors when giving oral hygiene advice?
- Dedicated time
- Clear and concise
- Alignment with current best practice
- Correct misconceptions
- Observe patients technique
- Emphasise positive messages from improved oral hygiene
- Provide a specific programme to each patient
- Promote self - efficacy and responsibility
- Guide rather than direct
What is the best type of goal to set a patient?
What are the main instruments for tooth brushing?
- tooth brush
- interdental brush
- interdental silicone stick
- dental floss and tape
What are toothbrushes not good for reaching?
Fissures or normal interproximal areas
Give some details on menaul toothbrushing
- compact arrangement of medium, round end nylon filaments (different stiffness)
- appropriate handle size needed
- twice daily
- need 2 minutes
- correct and systematic technique needed
What is the name of the technique used for brushing?
Give details of the bass technique for toothbrushing
- objective is to penetrate gingival crevice
- bristles point apically at 45 degree to gingival margin
- pressed against tooth and gingival margin
- short vibratory stroked moved in circles
- brush moved along to next tooth without losing contact
- be systematic
What are the common toothbrushing errors?
- not enough time
- too infrequent
- leaving areas untouched
- inadequate pressure
- new brushes every 3 months
What are the main reasons to use a toothpaste?
- prevention of decay & long term tooth retention
- stain removal
- freshen breath
- cleaner mouth
What are the constituents of toothpaste and their purpose?
- Abrasives to remove staining
- Surfactants to help the toothpaste foam
- Humectants to prevent toothpaste drying out
- Binding agents to help tooth stay together
- Preservatives to increase shelf life
- Film agents to make it shiny
- Fluoride to prevent decay
- Anti-plaque and anti-calculus agents
- Desensitising agents
- Whitening agents (higher abrasivity)
Why do we wait 30 mins after eating to brush?
To allow remineralisation and to ensure no soft enamel is brushed off
What are the main interdental devices?
- Interdental brushes
- Interdental silicone sticks
When only should floss be used instead of interdental brushes?
Give some details on interdental brushes
- First choice for interdental cleaning
- Removes plaque supra and sub gingivally
- Can be cylindrical or tapered
- Better engagement of interproximal spaces after disease
- Good for engaging root concavities
- Ranges of size
- Handles to get to back of mouth
- Toothpaste on interdental brushes is not recommended as toothpaste has abrasive agents and the interdental brushes can go sub-gingivally and access cementum which is less mineralised and this can be worn out.
What is some advice on using interdental brushes?
- use 2-3 different sizes
- brushes replaced after a week
- appropriate size goes into inter-proximal space with some resistant but is not too tight so you are struggling to get the brush in and engaging the wire
- spaces between teeth get larger as use progresses as the inflammation will get less. Use of the brushes needs to be revised.
- Should be done at least once a day before brushing so that the interdental space is cleaned and then the toothpaste fluoride can have access to the interdental areas.
Give some details on flossing
For spaces too tight for interdental brushes
Requires skill and manual dexterity (to get to back of mouth)
Time consuming compared to interdental brushes
Waxed/unwaxed (wax can pass through contact point of tooth and is less likely to fray)
Flossests / floss holders (can be held in)
Superfloss for bridgework
How do you floss?
Vertical motion used
20-30cm wrapped around middle fingers.
Small length left between thumb and forefinger and passed through contact point of teeth to be cleaned.
Floss engages tooth surface by making it into a C shape and goes vertically up and slightly sublingually in order for the gingival crevice to be engaged. Done 2/3 times. Small floss is then used on the next surface.
Wind floss along to use a new bit on a different tooth.
When is super floss used?
Super floss is used for bridges where there is a thicker component in the middle of the floss that passes under the false tooth to remove and plaque.
When are single tufted brushes used?
What technique is used?
- crowding, rotated or tipped teeth
- localised gingival recession
- lone standing teeth
- partially erupted wisdom teeth (operculum)
- implants, furcation areas, fixed orthodontic retainers
- root exposure
Place bristles into gingival margin area and apply medium pressure while moving in a small circular motion.
What is the main role of oral irrigators?
To dislodge food particles.