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Plaque control for the prevention of oral diseases

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  1. Plaque control for the prevention of oral diseases Libyan International Medical University 2nd Year First Semester D Caroline Mohamed D Caroline Mohamed

  2. Objectives • At the end of this topic you should be able to explain and describe: • Mechanical plaque control by: Self-care • Professional mechanical tooth cleaning D Caroline Mohamed

  3. Remember……..!!! • Plaque: • Plaque is a white, sticky substance that builds up every day around your teeth and gums, and on dental appliances. • Plaque can be removed with daily brushing, flossing, and rinsing with an antiseptic mouthwash. • If plaque is not removed it hardens into calculus. • Calculus: • Once plaque has been allowed to remain it calcifies. Onlya dental professional can then remove calculus. D Caroline Mohamed

  4. The objective of mechanical plaque control • Complete daily removal of dental plaque with a minimum of effort, time, and devices, using the simplest methods possible. • Primary role in removal of soft deposits on teeth and gingival tissue. • Helps in increasingly gingival tone, surface keratinization, gingival vascularity and gingival circulation. D Caroline Mohamed

  5. What can we use to clean our teeth? D Caroline Mohamed

  6. Mechanical plaque control Self Care (a)Toothbrush manual electrical ionic sonic and ultrassonic (b) Dentifrice (c) Interdental cleaning aids dental floss tooth pick interdental brushes gauze strips pipe cleaner yarns D Caroline Mohamed

  7. (d) Aids for gingival stimulation Rubber tip stimulator (e) Oral irrigation (f)Salvadorapersica –Miswak (g) Aids for Completely or Partially Edentulous Patients Denture & Partial Clasp Brushes/Cleansing Solutions D Caroline Mohamed

  8. The dental cleaning instrument most used: The toothbrush • The efficacy of brushing with regards to plaque removal depends upon 3 main factors: • The design of the brush. • The skill of individual using the brush. • The frequency and duration of use. D Caroline Mohamed

  9. Objectives of toothbrushing • To clean teeth of food, stains and debris, • To disturb and remove plaque formation, • To stimulate and message the gingival tissue, • To aply fluoride dentifrice. • Cleaning of tongue and palate. D Caroline Mohamed

  10. Ideals requisites of a toothbrush • Handle size appropriate to user age and dexterity. • Head size appropriate to the size of the patients mouth. • Use of end-rounded nylon or polyester filaments not larger than 0.009 inches in diameter. • Bristles should be of even lengh, so that, they can function simultaneously. • Use of soft bristle configuration as defined by the international industries standards. • Bristle pattern which enhances plaque removal in the approximal spaces and along gum line. • Causing minimum damage to soft and hard dental tissue. • The brush should be easy to keep and clean. • Should be nontoxic. • Having a reasonable lifespan. D Caroline Mohamed

  11. Morphology of a ToothbrushComponents/DimensionsStructurally, the toothbrush has four components � the body, the neck, the head and the bristles.  D Caroline Mohamed

  12. The Toothbrush • Generally toothbrushes vary in size, design as well as in length and arrangements of bristles hardness to overcome this variation ADA given specification of toothbrushes. • --------------------------------------------------- • Length : 1,5 child to 12,5 cm adults • Width : 5/16 to 3/8 inches • Surface area : 2.54 to 3.2 cm • No. of rows : 2 to 4 rows of brushes • No. of tufts : 5 to 12 per row • No. of bristles : 80 to 85 per tuft D Caroline Mohamed

  13. Lateral profile of a toothbrushFlat, rippled, dome, multilevel. D Caroline Mohamed

  14. Baby´s Toothbrush D Caroline Mohamed

  15. Bristles Polyester or nylon • Nylon wear less and is more hygienic- antistatics Classified: • Soft 0.15-0.18 mm • Medium 0.18-0.23mm • Hard/Extra hard 0.230.28mm D Caroline Mohamed

  16. The use of hard toothbrush, vigorous horizontal brushing, the use of extremely abrasive dentifrices may lead to cervical abrasion of teeth and recession of the gingiva. ( Jepson ,1998) If you think the economy has been in a recession, just look what can happen to your gum tissue! D Caroline Mohamed

  17. Toothbrushes need to be replaced every 3 months, when the bristles flare or you have an infective high respiratory disease. D Caroline Mohamed

  18. Electric toothbrush ( powered) • Its mainly recommended for : • Individual lacking motor skills ( Aged persons, arthritic patients) • Hospitalized patients whose teeth are cleaned by the caregivers. • Special needs patient ( physical and mental disability) • Patient with orthodontic applied • Whosoever wants to use D Caroline Mohamed

  19. There are many powered tooth brushes some with back and forth, rotating, oscillating-pulsating motions . Some are circular and elliptical motion. Round head. • Powered tooth cleaner resembles a dental prophylaxis and hand piece with rotary rubber cap. • Patient should be oriented for proper use. Care if the bristles are not soft. D Caroline Mohamed

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  21. Electrical toothbrush X Manual toothbrush D Caroline Mohamed

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  23. Sonic Toothbrush • The motion of these agitated fluid is capable of dislodging dental laque, even beyond where the bristles of the toothbrush actually touch. Only a sonic toohbrush can make this claim. D Caroline Mohamed

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  26. Ionic Toothbrush D Caroline Mohamed

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  28. Sonic X Ionic • Both sonic and ionic toothbrushes are capable of removing plaque and reducing gingivitis and bleeding effectively. • The results show that the sonic toothbrush showed better results as compared with the ionic toothbrush, though the difference was statistically insignificant. • Guljot Singh, D. S. Mehta,1Shruti Chopra, and Manish Khatri.Comparison of sonic and ionic toothbrush in reduction in plaque and gingivitisJ Indian Soc Periodontol. 2011 Jul-Sep; 15(3): 210–214. D Caroline Mohamed

  29. Soladey ionic with light activated titanium rod (semicondutor) D Caroline Mohamed

  30. No significant difference in dental plaque removal between a conventional toothbrush and the Soladey-2. • Soladey toothbrush had significant reduction in plaque over a conventional toothbrush in the front portions of the mouth, but the removal effects on other areas were similar in comparison. Niwa et al. Clinical study on the control of dental plaque using a photo energy conversion toothbrush equipped with a TiO2 semiconductor. Shigaku Vol. 77 No 2, 1989. D Caroline Mohamed

  31. Take care with your power brush • Some problems with the children’s electric toothbrush have been reported, including cut lips, battery burns and bristles that fell off and lodged in the child’s tonsils. • Should change the toothbrush’s head every three months – or sooner, especially if the head is loose. • "Extended usage, loose parts or excessive wear could lead to brush head breakage, generation of small parts and possible choking hazard," according to the website. "Inspect brush for loose parts before use."Read more: D Caroline Mohamed

  32. Tooth Brushing Techniques • Vertical (Leonard´n method) • Horizontal • Roll technique (Modified Stillman// rolling stroke) • Vibrating technique (Charter´s/Stillman and Bass) • Circular technique (Fones method) • Physiological technique (Smiths method) • Scrub Brush method D Caroline Mohamed

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  34. Requirement of a satisfactory Method of tooth brushing • The technique should clean all tooth surfaces specially the area of gingival crevice and the interdental region. • The movment of the brush should not injure the soft or hard tissues. Certain methods, e.g. Vertical and horizontal scrubbing methods can produce gingival recession and tooth abrasion. • The technique should be simple to use and simple to learn. • The method most be well organized so that, each part of the dentition is brushed in turn and no area over looked. D Caroline Mohamed

  35. Bass method Charters method D Caroline Mohamed

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  37. Charter[s enphasizes bristle action in the interproximal area D Caroline Mohamed

  38. Stillman method provides better gingival stimulation D Caroline Mohamed

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  42. Abutment teeth cleaning: Charter´s techn. along with floss threaders. D Caroline Mohamed

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  44. Be sure:Use disclosing solutions! [ [ [ [ [ [ D Caroline Mohamed

  45. It is clean, isn´t it? [ D Caroline Mohamed

  46. Dentist should be noted that a plaque control devices should be tailored to the individual, similarly to his or her plaque control program. • Controlled studied evaluating the most common brushing technique have shown that no one method is superior. D Caroline Mohamed

  47. Handicapped patient • Toothbrush adaptations • The most common tool for effective mechanical control of dental plaque is a toothbrush. The presence of physical and/or cognitive disabilities can create difficulties both in holding and manipulating a toothbrush.  D Caroline Mohamed

  48. Grasp, manipulation and control • Grasp– for people who cannot grasp and hold, the objective is to fasten the brush handle to the hand. velcro strap with a pocket on the palm side into which the toothbrush can be inserted. • Fixed fingers – for a patient with fingers permanently flexed or fixed in a fist. The handle of some brushes can be modified by immersion in hot water. no spill beaker' D Caroline Mohamed

  49. Limited hand closure or reduced manual dexterity – here, the objective is to enlarge the diameter of the brush handle to fit the hand. Plastazote tubing and silicone putty the use of sponges plastazote tubing bicycle handlebar grips wrapping the handle of the brush in tape or pushing it into a soft rubber D Caroline Mohamed

  50. Carers D Caroline Mohamed