Toothbrushes and toothbrushing Flashcards
(37 cards)
1
Q
early toothbrushes
A
- made from horse hair
2
Q
characteristics of an effective manual toothbrush
A
- proper size, shape and texture for the patient’s needs
- easy to manipulate
- easy to clean
- durable and inexpensive
- flexible, soft, strong and light to hold
- has rounded ends of filaments (bristles)
- designed for use, efficiency and cleanliness
3
Q
general description of a manual toothbrush
A
- handle, shank, head (toe, heel)
- dimensions total brush length (15-19 cm) - children’s are shorter
- heads large enough to accommodate the tufts length of plane 25.4-31.8 mm, width 7.9-9.5 mm. bristle height is 11 mm
4
Q
handle of manual toothbrush
A
- composition plastics
- easy to grasp, won’t slip, not sharp, light weight
- variations include a bend or twist at the shank
- larger handles are available for limited dexterity
5
Q
basic design of toothbrush
A
- handle
- shank
- head
6
Q
manual toothbrush brush head
A
- 5-12 tufts long and 2-4 wide
- wide spaced allows easy cleaning of the head
- closely spaced bristles allows a smooth brushing plane and support for each other
7
Q
manual toothbrush brushing plane (profile)
A
- variously shaped filament profiles
- equal lengths (flat plane), rippled domed, multi leveled, bileveled, angled
- soft bristled, rounded ends for safety
- efficient in biofilm removal ie. malpositioned teeth, posterior areas, root surfaces, etc
8
Q
manual toothbrush bristle and filaments
A
- most are nylon filaments
factors influencing stiffness: - diameter: thinner filaments are softer
- length: shorter are stiffer with less flexibility
- number of filaments: increased number gives added support
- angled filaments: may be more flexible than straight filaments of equal length and diameter
9
Q
end rounding
A
- filaments should be rounded at the ends to protect against gingival and tooth damage
10
Q
influencing factors for selection of toothbrushes
A
patient:
- ability to use the brush without causing damage
- dexterity
- motivation, ability to follow directions
- age of patient and the differences between dentition and dexterity
- gingival: status of the gingival tissues and anatomic features of the tissues
- position of the teeth: crowing and open contacts
- shape of teeth and exposed roots
- personal preference: patient may resist change, to our suggestions and preferred brush
11
Q
toothbrush size and shape:
A
- must be adaptable to all surfaces
12
Q
soft nylon brush advantages:
A
- more effective alone cervical area
- less traumatic
- can be directed into sulcus and interproximal areas
- TB abrasion/gingival recession can be prevented or less severe
- more effective for sensitive gingiva or healing gingiva
- small is ideal for young children
13
Q
abrasion:
A
1 - amount of pressure exerted 2 - toothbrush method 3 - hard vs soft bristles 4 - natural vs. nylon bristles 5 - abrasivity of dentifrice (toothpaste): pastes, powders, gels, whitening
14
Q
review:
A
strongly recommend:
- soft, nylon, multitufted bristles with rounded ends
1. easier to adapt in proximal and sulcus
2. less abrasion/irritation to soft tissues
3. better adaption/flexibility
4. easier for child - softer
15
Q
watch for gimmicks like:
A
- super tip: unequal length, can increase trauma
16
Q
grasp of brush and sequencing
A
- grasp: light palm grasp
- sequence: ensure complete coverage of all surfaces, start at the back as it is more difficult and easily missed
17
Q
amount of brushing:
A
- main consideration is the removal of biofilm
- all surfaces need to be cleaned well
- number of strokes and length of time depends on the patient’s ability
18
Q
the count system
A
- count 5-10 strokes in each area (modified stillman, or other stroke methods)
- count slowly to 10 for each brush position while the brush is vibrated and filaments are held in position (bass, charters and vibratory methods)
19
Q
clock system
A
- time your brushing with an egg timer of a watch for 3-4 minutes
- this does not ensure thorough coverage
20
Q
combination systems
A
- works well for a lot of patients count and time
- some power toothbrushes have built in timers that allow for more effective time management
21
Q
frequency of brushing
A
- based on an individual basis, one set rule cannot apply to all patients
- complete biofilm removal is the key to success
- for biofilm and halitosis control and it is recommended brushing twice a day accompanied with interdental care
- am and before bed are the suggested times
22
Q
5 acceptable methods for manual brushing
A
1 - modified/bass sulcular 2 - fones 3 - modified stillman 4 - rolling stroke 5 - charters
23
Q
bass sulcular / modified bass
A
- widely accepted
purpose and indications for use: - to remove biofilm at and below gingival margin
- open and interproximal areas, exposed roots
- patient who has had periodontal surgery
- adaptation around bridge abutments or ortho appliances
24
Q
rolling stroke
A
purpose and indications:
- cleaning gingiva without the focus being on the sulcus
- for children with healthy gingiva
- meant for general cleaning in conjunction with a vibratory stroke ie bass or stillman
- useful for first instruction on a patient with little dexterity or understanding
25
stillman / modified stillman
- originally designed by Mr Stillman with a purpose of massage and stimulation, a well as for cervical areas
- modified Stillman: was to incorporate a rolling stroke with a vibratory component
purposes and indications:
- removal of biofilm from cervical area below the height
- general application for cleaning the tooth as well as stimulation of gingival tissues
26
charters
- applies the importance of cleaning at the gingiva and interproximal areas
- one angle at 90 degrees to the long axis of the tooth (Stillman) and the other at 45 degree angle with the tip filaments angled towards the occlusal plane (Charters)
purpose and indications:
- loosen debris and biofilm
- massage and stimulate margin and interdental papilla
- aid in the removal or interproximal biofilm ie following surgery, under bridge abutment
- cleaning around ortho brackets and appliances
27
fones (circular stroke)
- alfred fones: founder of the first dental hygiene course
- purpose: for children as an easy to learn method. not recommended for adults as can be done too vigorously and damage tissues
28
another 3 brushing techniques (we don't use much)
- Leonard: TV commercials, teeth together up and down motion
- horizontal: cross wise brushing, too much press with abrasive can cause tooth and gingival trauma
- scrub brush: most widely used, mixture of vibratory, circular and horizontal that can cause tissue and tooth abrasion
29
power toothbrushes: purposes and indications
- to facilitate removal or biofilm and food
- to reduce calculus and stain accumulation
- can be useful for patients undergoing ortho
- undergoing complex restorative and prosthodontic tx
- implants
- aggressive brushers, dexterity issues and disabilities
- patients that are unable to brush and a caregiver can help out
30
descriptions:
- motion
- brush head
- filaments
- power source
31
supplemental brushing:
- problem areas: malaligned teeth, exposed roots, open contacts (use toe of brush endtufts works well)
- occlusal brushing: vibrate brush in a slight circular motion over surfaces keeping filaments in place or force the brush on occlusal surface short quick lifted strokes
32
effects of cleaning tongue:
- slows biofilm formation
- reduces microorganisms
- reduces halitosis
- helps with overall cleanliness
33
how to clean the tongue:
brush with manual or powered: place the brush tips angled towards the throat
- with the tongue extruded brush forward over the tip of tongue, repeat 3 or 4 times. do not scrub the papilla
- tongue cleaner: commonly made from plastic, place the cleaner at posterior of tongue and pull forward repeat a few times to ensure cleanliness
34
supply of toothbrushes:
- 2 at home and 1 for work or school
35
brush replacements
- 2-3 months or immediately post illness
36
cleaning of brushes
- clean thoroughly remove food and debris
- can use another brush to clean
- remove as much excess water as possible
37
brush storage
- keep in open air to dry away from other brushes
- portable containers need sufficient dry holes
- closed containers harbour bacteria and are not recommended
