Oral Hygiene Measures PDF

ORAL HYGIENE MEASURES Associate Prof. Dr. Nurul Asyikin Yahya BDS, MSc, DDPHRCS, PhD Faculty of Dentistry, UKM January 2024 1 NAY23 Characteristics of toothbrush Soft-bristled brush...

ORAL HYGIENE MEASURES Associate Prof. Dr. Nurul Asyikin Yahya BDS, MSc, DDPHRCS, PhD Faculty of Dentistry, UKM January 2024 1 NAY23 Characteristics of toothbrush Soft-bristled brush Small headed brushes: tapered or rectangular Long handle with non-slip grip What determine the efficacy of plaque removal is The individual’s manual dexterity Thoroughness in cleaning, concentrate on the cervical and interproximal area Brushing method Bass’ Most effective in 1. Direct bristles apically to sulcus at 45° to the Method cleaning cervical 1/3 long axis of the tooth. Use gentle force & beneath gingival removing bristle ends from sulcus. B margins 2. Apply firm but gentle 10 back-and-forth strokes Cleanses sulcus of vibratory motion without removing bristle (space between tooth ends from sulcus. Move brush head to the next and group of teeth by overlapping with the gums-recommended completed area. for periodontal 3. On the lingual surfaces of front teeth, brush is patients) placed vertically and applies gentle vibratory motion of up-and-down strokes.  4. On the chewing surface apply a motion of back-and-forth brushing strokes. Stillman’s Provides gingival 1. Direct bristles apically to sulcus at 45° to Method stimulation vertical axis of tooth. Place bristles partly on the (vibratory motion) cervical part of teeth and partly on the gingiva Suitable for and apply vibratory motion with slight pressure S individuals with to stimulate gingiva. gingival recession (toothbrush bristle 2. Repeat for the lingual surface of the tooth ends not directed into 3. Place toothbrush perpendicular to the tooth sulcus surface and use short back-and-forth strokes on Less traumatic to the occlusal surfaces gently. gingiva Charter’s Efficiently cleans 1. Place bristles at gingival margin, 45° to the Method interproximal areas occlusal plane rather than the roots and pt Useful to clean areas vertical axis of tooth. Direct bristles towards C between fixed vibrate into the interdental spaces, using short appliances and back and forth strokes. gingival margins Suitable for those 2. Repeat for other parts of the mouth. just undergo perio 3. Place toothbrush perpendicular to the tooth surgery surface and use short back-and-forth strokes on the occlusal surfaces gently. al margins Dental Floss For removing interdental plaque & reducing interdental gingival inflammation. Waxed or unwaxed, fluoridated. Requires greater dexterity and motivation than toothbrushing. Parents should floss for children under 8 years old. Not effective for wide interdental spaces, root surfaces or concavities. Incorrect flossing can cause gingival inflammation, trauma, ulceration. Interdental Brush Single tufted brush Toothpaste/ Dentifrices Potassium nitrate > strontium chloride → blk nerve pathway (potassium nitrate) Mouthwash Common mouth rinse : 225ppm Lecture outline toothbrush Dental floss Mechanical Interdental brush Oral hygiene Single tufted brush measures Dentifrices Chemotherapeutic Mouthrinses Chewing gum 2 NAY23  MECHANICAL ORAL HYGIENE MEASURES 3 NAY23 In the beginning…. Ancient people Chinese European history Twigs & woods Hog(pig) bristles A piece of rag cloth Baking soda, chalk embedded in bone handles 1961 1950’s Du Pont 1938 1st electric Softer nylon bristles Nylon bristles (harsh toothbrush & stiff) Broxodent (USA) 4 NAY23  Toothbrush beat out cars and computers as the invention Americans can't live without, according to the Lemelson-MIT Survey. January 2003  While it may seem that cell phones, computers, and other technological gadgets are Americans' most coveted items, teens and adults agree that the toothbrush is the one invention they cannot live without.  The 2003 Lemelson-MIT Invention Index, an annual survey of Americans' perceptions about inventing and innovating, found that technologically advanced items significantly lag in importance behind the toothbrush developed in the 15th century. 5 NAY23  The right toothbrush: what you should look for… 1. Soft-bristled brush 2. Small headed brushes: tapered or rectangular 3. Long handle with non-slip grip …..Whichever is comfortable to use. The BEST… One that fits in your mouth and allows you to reach all teeth easily. 6 NAY23 No one manual toothbrush design appears superior for plaque removal What determine the efficacy of plaque removal is… The individual’s manual dexterity Thoroughness in cleaning, concentrate on the cervical and interproximal area. 7 NAY23  Why do we brush our teeth? To REMOVE PLAQUE or To DELIVER FLUORIDE interfere with its formation (chemotherapeutic agents) to prevent it from from dentifrice to provide becoming pathogenic, at anticaries effect. least 48 hrs interval. 8 NAY23  1 2 5 4 3 Brushing technique 9 NAY23 Techniques of toothbrushing  Modified Bass Technique:  Dentists and dental hygienists widely recommend this technique for its effectiveness in cleaning the teeth and along the gumline.  Modified Stillman Technique:  This technique is another effective method for cleaning teeth and gums, particularly in cases of gum recession or when there is a need for gentle brushing. 10 NAY23 Tooth brushing for children  An adult should perform tooth brushing until the child is about six years old.  Start as soon as the first tooth erupts. 11 NAY23 Toothbrushing in adults  Chronic marginal gingivitis suggests poor toothbrushing compliance or low-performance dexterity.  Improper brushing can damage teeth and surrounding tissues, causing abrasion and gum recession.  It is important to re-educate the toothbrushing technique. 12 NAY23 Toothbrushing in the elderly  Diminished cognition and medical conditions may hinder toothbrushing.  Poor manual dexterity: decreased visual acuity and physical ability  Institutionalized elderly: inadequate brushing by carers.  Need to modify handle or use electric toothbrush by individual or carer. 13 NAY23 Dental Floss  For removing interdental  Parents should floss for plaque & reducing children under 8 years old. interdental gingival  Not effective for wide inflammation. interdental spaces, root  Waxed or unwaxed, surfaces or concavities. fluoridated.  Incorrect flossing can  Requires greater dexterity cause gingival and motivation than inflammation, trauma, toothbrushing. ulceration. 14 NAY23 CARA MEMFLOS 1 GIGI Mulakan dengan sehelai flos gigi sepanjang 18 inci panjangnya. Lilitkan benang flos pada jari tengah pada satu tangan. Lilitkan hujung satu lagi pada jari tengah pada tangan yang sebelah pula. 15 NAY23 CARA MEMFLOS 2 GIGI Untuk membersihkan gigi atas pegang flos diantara ibu jari dan jari telunjuk dan masukkan flos di celah- celah gigi. Lalukan flos mengikut garisan gusi dengan pergerakan atas dan kebawah berulang kali. Ulangi pada setiap gigi. 16 NAY23 Interdental brush  To remove plaque and  In areas such as… accumulated food debris 1. Proximal tooth surfaces from… 2. Wide interdental spaces 1. Areas inaccessible to 3. Exposed root surfaces, toothbrushes concavities and furca in 2. Deliver periodontally involved chemotherapeutic dentitions. agents 4. Between proximal tooth 3. Reduce interdental surfaces and ortho gingivitis brackets. 17 NAY23 18 NAY23 Interdental brush  ….needs… good manual dexterity and visual acuity for effective usage.  Not suitable for children and elderly. 19 NAY23 Single tufted toothbrush  A single-tufted toothbrush is a specialised dental tool designed with a small, isolated cluster of bristles at the tip.  This unique design serves specific purposes and has various applications in oral care. 20 NAY23 Common uses of single-tufted toothbrushes  Orthodontic Care  Post-surgery oral care  Difficult-to-Reach Areas  Special Needs Patients  Wisdom teeth  Children's Oral Care  Implant Care  Travel and On-the-Go  Periodontal Pockets  Post-Operative Care  Interdental Spaces  Post-dental procedures 21 NAY23 22 NAY23 Toothpaste/ dentifrice  Toothpaste is a gel or paste used in conjunction with a toothbrush to clean and maintain the health of teeth. 23 NAY23 The key uses of toothpaste: 1. Removal of Plaque and Bacteria:  Toothpaste contains abrasive particles that aid in removing plaque, a sticky film of bacteria that forms on teeth.  The mechanical action of brushing, combined with toothpaste, helps to eliminate bacteria prevent the formation of dental plaque and contribute to gum health.  This can aid in preventing gum diseases such as gingivitis and periodontitis. 24 NAY23 The key uses of toothpaste: 2. Prevention of Cavities:  Fluoride, a common ingredient in toothpaste, helps prevent tooth decay by strengthening tooth enamel.  It promotes remineralisation, making teeth more resistant to acid attacks from bacteria and acids produced by sugars in the mouth. 25 NAY23 The key uses of toothpaste: 3. Freshening Breath:  Many toothpaste formulations include flavouring agents such as mint to leave a fresh taste in the mouth and combat bad breath.  Additionally, removing bacteria and plaque contributes to improved breath odour. 26 NAY23 The key uses of toothpaste: 4. Reduction of Tooth Sensitivity:  Some toothpaste varieties are formulated with desensitising agents to help reduce tooth sensitivity.  These agents block the microscopic channels (dentinal tubules) that transmit sensations from the tooth surface to the nerves. 27 NAY23 The key uses of toothpaste: 5. Stain Removal:  Abrasive particles in toothpaste assist in removing surface stains from teeth.  This is particularly helpful in countering stains caused by beverages like coffee, tea, or red wine, as well as tobacco use. 28 NAY23 The key uses of toothpaste: 6. Therapeutic effect  The consistency of toothpaste also helps distribute the active ingredients, such as Fluoride, evenly across the teeth.  There are various specialised toothpaste formulations targeting specific oral health concerns, such as tartar control, whitening, and natural or herbal options.  These cater to individual preferences and needs. 29 NAY23 Chemotherapeutic Agents in toothpaste 1. Anti-calculus agents (pyrophosphate) 2. Antibacterials (Triclosan TM and chlorhexidine) 3. Anticaries agents (fluoride) 4. Whitening agents (alumina) 5. Desensitizing agents (strontium chloride) 30 NAY23 31 NAY23 Fluoride content in dentifrices. Children* Risk of dental fluorosis if Adults ingested  Concentration:  Concentration: - - Parts per million 1,000-1,500 ppm F as sodium 600ppm or less fluoride or sodium  Use only a smear of children’s monofluorophosphate toothpaste for young children ( the under-2 )  Use a small quantity of children’s fluoridated toothpaste, i.e. 0.25 to 0.5g or the equivalent of a groundnut-size or strip less than 5mm long* 32 NAY23 Mouthrinses  Adjunct to mechanical plaque control  Does not replace brushing & flossing  Generally, regular brushing and proper flossing is enough  May be prescribed for certain patients  Not suitable for young children 33 NAY23 Mouthrinses CHILDREN ELDERLY  Few benefits.  May replace mechanical  Indicated for those plaque control. wearing orthodontic  Address poor oral hygiene appliances. and periodontal disease.  Not advised for preschool  Prevent root caries. children due to toxicity. 34 NAY23 35 NAY23 36 NAY23 Sugar-Free Chewing Gums  Sugar-free gum as a mechanical salivary stimulant after eating can…  accelerate the clearance of dietary substances and microorganisms,  Promote buffers to neutralise plaque acids,  Provide antibacterial substances.  Promote salivation and require hydration to release chemotherapeutic agents, which can be effective for longer periods than rinses or dentifrices. 37 NAY23 REFERENCES 1. A Choo, D M Delac, L B Messer. Oral hygiene measures and promotion: Review and considerations. Australian Dental Journal 2001; 46 (3): 166-173. 2. Textbook of preventive dentistry. SS Hiremath. Elsevier 2007. 3. Prevention of oral disease. JJ Murray Oxford Press 4th Edition. 38 NAY23  THANK YOU 39 NAY23