Oral Infection Control: Interdental Care

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Questions and Answers

Which type of dental floss is primarily recommended for Type I embrasures?

Tufted dental floss

Gauze strips

Silk dental floss

Waxed dental floss (correct)

What is a primary use of tufted dental floss?

To remove biofilm from teeth adjacent to wide embrasures (correct)

To polish teeth effectively

To access deep pockets between gums and teeth

To clean the large surface area of molars

What is a common cause of flossing injuries?

Applying flavored floss

Using too short a piece of floss

Not curving the floss in a C-shape (correct)

Flossing too infrequently

Which of the following devices is NOT considered a flossing aid?

Interdental brush Signup and view all the answers

Gauze strips are best used for cleaning which of the following?

Widely spaced teeth Signup and view all the answers

Which enhancement is NOT typically found in dental floss?

Fluoride treatment Signup and view all the answers

When using dental floss, which technique helps prevent excess pressure and potential injuries?

Curving the floss in a C-shape Signup and view all the answers

Which of the following statements about 'super floss' is true?

It comes in both precut and roll forms. Signup and view all the answers

Which type of interdental aid is specifically indicated for patients with gingivitis and deeper pockets?

Water flosser/irrigation Signup and view all the answers

What is a primary requirement for effective use of traditional floss?

Must have a healthy sulcus Signup and view all the answers

What is the main purpose of tufted dental floss?

To clean around braces and wide spaces Signup and view all the answers

Which of the following is NOT a characteristic of rubber interdental cleaners?

Strictly for use on orthodontic appliances Signup and view all the answers

What is essential for the care of interdental brushes after use?

Rinsing and storing properly Signup and view all the answers

Which cleaning technique is recommended for open embrasures?

Interdental brushes or cleaners Signup and view all the answers

What is a common injury associated with improper flossing techniques?

Gum recession Signup and view all the answers

Which device is most suitable for someone with dexterity problems looking to maintain interdental cleanliness?

Floss holder Signup and view all the answers

What is one of the main benefits of oral irrigation?

Reduction of gingivitis and bleeding Signup and view all the answers

Which statement about oral irrigation's effectiveness is true?

Can deliver solution to 50% of the pocket depth Signup and view all the answers

Which of the following is NOT an indication for using oral irrigation?

Fluoride treatment Signup and view all the answers

What is a recommended technique for using a water irrigator effectively?

Sweep across the gingival margin for 3 seconds per tooth Signup and view all the answers

What common misconception exists about the effects of oral irrigation?

It eliminates the need for flossing entirely Signup and view all the answers

Why is there a concern regarding the research on oral irrigation claims?

Most funding comes from a single manufacturer, indicating potential bias Signup and view all the answers

What should documentation for a patient’s interdental care progress include?

All interdental aid recommendations and demonstrations Signup and view all the answers

Which of the following is a true statement about the application of antimicrobial agents in oral irrigation?

They can be delivered subgingivally to target microorganisms Signup and view all the answers

Study Notes

Chapter 27: Oral Infection Control: Interdental Care

Learning Objectives (1 of 2):
- Review interdental anatomy; explain why brushing alone is insufficient for periodontal infection prevention.
- Assess embrasure size and patient health to select appropriate interdental tools.
- Describe different interdental brush types and their suitability for various patients.
Learning Objectives (2 of 2):
- Describe dental floss types and flossing techniques.
- Identify various floss aids, their purposes, and rationales for selection.
- Demonstrate and recommend alternative biofilm removal devices.
Interdental Care: Removal of biofilm from the proximal surfaces.

Patient Assessment & Planning Interdental Care

Personal Oral Care History
Dental and Gingival Anatomy (including embrasure spaces, CAL: Periodontal condition, prostheses)
Extent and Location of Biofilm (using biofilm scores and plaque records)
Personal factors (dexterity, health literature (Dental IQ)

Embrasure Types

Type I: No gingival recession
Type II: Moderate papillary recession
Type III: Complete loss of papilla or extensive recession
Unitufted brush

Selective Interdental Biofilm Removal

Relation to toothbrushing techniques
Brushing vertically for access
Floss (healthy sulcus, good dexterity): slides through contacts
Floss Holder (problems with dexterity): slides through contacts
Water Flosser/Irrigation (gingivitis, implants, deep pockets)
Interdental brushes (embrasure spaces II & III, periodontitis patients, exposed roots)
Wood Sticks (embrasure spaces II & III, periodontitis patients, exposed roots)

Interdental Brushes

Types:
- Small insert brushes with reusable handles
- Travel interdental brushes
- Rubber interdental cleaners
Procedure: Gently move brush into the embrasure space, emphasizing proximal surfaces.
Care: Rinse and store or dispose of as disposable.

Indications for Use (Interdental Brushes)

Proximal surfaces adjacent to open embrasures
Orthodontic appliances
Fixed prostheses
Implants
Exposed furcations
Application of chemotherapeutic agents

Dental Floss and Tape

Common interdental aids for Type I embrasures
Waxed and unwaxed floss
Flossing tape
Materials: Silk, Nylon, PTFE
Enhancements: Color, flavor, therapeutics

Use of Dental Floss

Illustrated steps for correct flossing technique.

Tufted Dental Floss

Single precut or roll ("Super Floss")
Used to clean teeth with wide embrasures (loss of papilla)
Abutment teeth, pontics, orthodontics.
Illustrated method of use.

Gauze Strips

Used for widely spaced teeth, areas near edentulous areas, abutment teeth

Flossing Injury

Cuts or clefts beside or in the middle of papilla
Too long of floss
Snapping floss through contacts
Improper C-shape curve
Excessive pressure without rest

Flossing Aids

Power flossing instruments
Floss holders
Floss threaders

Use of a Floss Holder

illustrated technique

Use of Floss Threader

Illustrated technique

Disposable Single-Use and Two-Handle Floss Aid

Illustrated examples

Air Flosser using bursts of air and water

Uses a stream of water or other agent
Purpose: reduce biofilm bacteria
Effective alternative to floss
Delivers solution to 50% of pocket depth

Oral Irrigation

Benefits:
- Reducing gingivitis and bleeding
- Reducing/altering biofilm
- Access to pathogenic microorganisms
- Subgingival delivery of antimicrobials or water.
Other indications
- Orthodontics
- Crowns and bridges
- Removal of food debris

Tips for Water Irrigator

Placement in interproximal areas for 3 seconds, followed by a sweep across gingival margins.

Documentation

Includes all interdental aid recommendations and demonstrations for the patient.

Factors to Teach the Patient (1 of 2)

Use disclosing solution for visual understanding of toothbrush limitations in interdental cleaning.
Explain biofilm accumulation on proximal surfaces.
Explain the interdental area's vulnerability to infection.

Factors to Teach the Patient (2 of 2)

Demonstrate interdental aid usage.
Emphasize the need for patients to discuss any new products with dental professionals.

Single Tuft Brush (End-Tuft)

Single or multiple small tufts for interproximal use.
Used for fixed prostheses, orthodontics, implant abutments.

Interdental Tip

Conical, flexible rubber/plastic tip
Cleans interdental areas, just below the gingival margin.
Useful for furcations, and recontouring after periodontal surgery.

Wooden Interdental Cleaner

Bass/birch wood stick
Triangular cross-section.
Used for proximal surfaces where papilla are missing.

Tooth Pick Holder

Perio-Aid: Round toothpicks
Used by patients with periodontitis and orthodontic patients

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Description

This quiz covers the principles of interdental care and its importance in oral infection control. Learn about various interdental tools, floss types, and techniques for effective biofilm removal. Assess patient needs and suitable care options for optimal dental health.