Mechanical and Chemotherapeutic Home Oral Hygiene

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Mechanical and Chemotherapeutic Home Oral Hygiene

Transcript of Mechanical and Chemotherapeutic Home Oral Hygiene

Page 1: Mechanical and Chemotherapeutic Home Oral Hygiene

Mechanical and Chemotherapeutic Home

Oral Hygiene

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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

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Mechanical Methods of Plaque ControlThe most accepted techniques for

plaque removal• These include:– Tooth brushing– Flossing– Disclosing agents– Oral irrigators– Tongue scrapers

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• 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

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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.

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• Step 2 Clean every surface of every tooth. The chewing surface, the cheek side, and the tongue side.

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• Step 3 Don't rush your brush. A thorough brushing should take at least two to three minutes. Try timing yourself.

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• 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.

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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

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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

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How to floss

• Step 1 Take a length of floss equal to the distance from your hand to your shoulder

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How to floss

Wrap it around your index and middle fingers, leaving about two inches between your hands.

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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.

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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.

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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.

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Dentrifices• Plaque and stain removing agents

through the use of abrasives and surfactants

• Composition

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• Disclosing Agents• Allow visualization of plaque• Compostion– Iodine– Gentian violet– Erythrosine– Basic fuchsin– Fast green– Food agents with antimicrobial activity

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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)

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Techniques• roll method• Charters method• Horizontal scrubbing method• Modified stillman method

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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

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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

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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

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Chlorhexidine

– Antibacterial effects:• Binding well to bacterial cell membrane• Increasing their permeability• Initiating leakage• Precipitating intracellular components• Decrease levels of streptococcus mutans

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Antiseptic Agents

• Listerine• Noncharged phenolic antiseptic agent• Burning sensation • Bitter taste• Highest alcohol contents (25 %)

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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

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Sugar Substitutes

• Incorporated in chewing gums to:– Decrease plaque accumulation and pH– Lower incidence of caries

• Examples of Sugar Substitutes– Xylitol– Mannitol– Sucralose– Aspartame

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• 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

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• 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

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• 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

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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

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The end

Agbayani. CassieopeaDimatulac, KevinTesoro, Joseph Paulo D.