Toothbrushing Methods & Techniques Overview - PDF

TOOTHBRUSHING DH 110  WEEKLY LEARNING OUTCOMES Explain the characteristics of manual and power toothbrushes Describe and demonstrate the six toothbrushing methods and when each is utilized Discuss considerations for particular toothbrush recommendations Discuss hard and soft tis...

TOOTHBRUSHING DH 110  WEEKLY LEARNING OUTCOMES Explain the characteristics of manual and power toothbrushes Describe and demonstrate the six toothbrushing methods and when each is utilized Discuss considerations for particular toothbrush recommendations Discuss hard and soft tissue lesions and the factors that cause them including the significance of a clean TB  BEHAVIORS: performed “to achieve, maintain, or promote health or oral health” Human needs theory, SELF CARE: evidence-based decision HOMECARE making, and motivational interviewing... How does what we’ve been learning apply? D&W (2015)  TOOTHBRUSHING No individual manual toothbrush design consistently shown to be superior in removing plaque or preventing and controlling periodontal disease.  MANUAL TOOTHBRUSHES Most commonly used device for plaque removal Well designed to remove plaque from tooth surfaces: Facial Lingual Occlusal  PARTS OF A TOOTHBRUSH Head: Contains the filaments (bristles) Handle: Used for grasping Shank: Connects the head and handle  TOOTHBRUSH FILAMENTS Usually nylon Tufts: individual filaments bundled together and secured in a hole of the toothbrush head Variations with toothbrush design  FILAMENT DESIGNS Affects toothbrush efficacy: Especially in hard to reach areas Toothbrushing ALONE cannot access interproximal areas Filament: also known as a “bristle” TOOTHBRUSH BRISTLE WEAR  POWER TOOTHBRUSHES Typically activated by electricity or battery Cochrane systematic review & meta analysis: Only the oscillating-rotating design power toothbrushes significantly outperformed the manual toothbrush in plaque (7%) and gingivitis reduction (17%) D&W (2015)  POWER TOOTHBRUSHES Shown to be safe & effective Suitable for almost anyone High level of client acceptance  TOOTHBRUSHING INSTRUCTION INDIVIDUALIZED Risk & susceptibility to disease Dexterity Personal values & preferences  COMMUNICATION Appropriate to patient’s: AGE LANGUAGE EDUCATION LEVEL CULTURE LEARNING STYLE READINESS (TO ADOPT NEW BEHAVIORS)  SYSTEMATIC APPROACH Patients need to understand the link between oral biofilm and oral & systemic diseases Patients need to understand the importance of controlling plaque and inflammation  TOOTHBRUSHING: DURATION & FREQUENCY Brush thoroughly For an adequate amount of time Goal: biofilm removal from teeth/mouth/tongue Encourage and teach a logical sequence: Helps avoid omission of an area Instill these habits: early childhood  BRUSHING TIME Research: Recommended duration is 2 minutes The average brushing time is less than 1 minute Electric toothbrushes may have built in 2 min timer Encourage the use of timers  TOOTHBRUSH FORCE Force = Pressure Research: focus on soft & hard tissue damage Recession Abrasion  TOOTHBRUSHING METHODS Bass Stillman Charter Roll Stroke Modified Bass/Stillman/Charter Fones  BASS Also known as “sulcular” Filaments directed apically at 45 degree angle to long axis of tooth Firm, vibratory strokes w/o removing filament ends from sulcus  STILLMAN Angled similar to Bass Filaments placed partly on cervical portion of teeth; partly on adjacent gingiva Short back & forth vibratory strokes; brush head moved occlusally with light pressure  CHARTER Filaments are directed toward the crown of the tooth Short back & forth vibratory stokes Bristles are directed AWAY from the gingiva  ROLL-STROKE Filaments are directed apically and rolled occlusally when in a vertical motion Used in conjunction with Bass, Stillman, and Charter methods  MODIFIED BASS/STILLMAN/CHARTER Any time a “roll” stroke is added to one of these methods it modifies it  FONES Filaments are activated in a circular motion  INSTRUCTION Toothbrushing techniques that require brush filament placement on an angle in relation to the teeth are more difficult for our patients to achieve consistently. Required for both manual and electric TB Tell, show, do (have THEM demonstrate in their mouth) SOFT & HARD TISSUE LESIONS CAUSED BY TOOTHBRUSHING Trauma from toothbrushing technique or toothbrush/paste selection  SOFT TISSUE LESIONS The cause of gingival trauma is multifactorial Toothbrushing technique has a “less-certain influence” (D&W) Other factors include: TB filament stiffness (lack of flexibility) Toothbrushing force/duration Abrasiveness of toothpaste TOOTHBRUSH TRAUMA Gingival abrasions Redness Scuffing Punctate lesions (marked with points/dots; having minute spots of depressions) Recession Clefts Festooning  TOOTHBRUSH TRAUMA festooning stillmans recessio n  HARD TISSUE LESIONS Abrasion Abfraction Non-carious cervical lesion  TONGUE CLEANSING The dorsum of the tongue is a bacterial habitat Tongue cleaning reduces the number of organisms Helps control oral malodor Decreases chance of bacterial translocation Improves taste perception TOOTHBRUSH CONTAMINATION Toothbrushes can be a mode of indirect transmission for pathogenic organisms Toothbrush acts as a fomite (inanimate object that houses & transmits potentially infectious agents) Air drying is recommended Plastic caps & covers encourages microbial growth  DH PROCESS OF CARE As part of oral hygiene instruction (OHI), the patient should be asked to DEMONSTRATE their toothbrushing method, so that the RDH can observe the client’s technique, skill, and dexterity  TOOTHBRUSH DESIGN Countless variations on TB design Consumer preferences based on market research Specific needs After gingival surgeries (extra soft) In hospital (sponge-type) Convenience (travel, etc) Style CASE STUDIES FROM TEXT