mechanicalplaquecontrol[ppt].ppt

mechanicalplaquecontrol[ppt].ppt

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,MECHANICALPLAQUECONTROL,OBJECTIVES,BackgroundMechanicalplaquecontrol（a）Toothbrush（b）Dentifrice（c）Interdentalcleaningaids-Dentalfloss-Interdentalbrushes-toothpik（d）Oralirrigation,IMPORTANTCHAPTERCLINICALLYVERYRELEVANTREQUIREMENTFORPATIENTTEACHING,Plaqueasetiologicfactor,Experimentalgingivitisstudy（1965Leetal.）,ThecauseandeffectrelationshipbetweensupragingivalplaqueandgingivitiswasdemonstratedbyLoeetal（1965）.Whenplaquewasallowedtoaccumulate,gingivitisdevelopedwithin21days.Whenplaquecontrolwasinitiated,thegingivitiswasreversed（bymeansofefficientplaquecontrol,i.e.,brushingandflossing）toclinicalgingivalhealthTheremovalofmicrobialplaqueleadstocessationofgingivalinflammation,andcessationofplaquecontrolmeasureleadstorecurrenceofinflammation,Theremovalofplaquealsodecreasedtherateofformationofcalculus.（Sanders,1962）Thuseliminatingplaqueisthekeytopreventtheoccurrenceofperiodontaldiseaseorhaltingtheprogressionofthedisease.,Massesofplaquefirstdevelop（Lang,1973）,PLAQUECONTROL,Plaquecontrol:

Theremovalofdentalplaqueonaregularbasisandthepreventionofitsaccumulationontheteethandadjacentgingivalsurfaces.Position:

supra-&sub-gingivalplaquecontrolMethods:

mechanical&chemical,MECHANICALPLAQUECONTROL,OBJECTIVE:

CompleteDailyRemovalOfDentalPlaqueWithAMinimumOfEffort,Time,AndDevices,UsingTheSimplestMethodsPossible.,Self-performed,ToothbrushingInterdentalaidsDentalflossandtapeToothpicksInterproximalbrushesSingle-tuftedbrushAdjunctiveaidsDentalirrigationdevicesTonguescrapersDentifrices,TOOTHBRUSH,ToothbrushDesignMethodsoftoothbrushingFrequencyandeffectivenessoftoothbrushingToothbrushwearandreplacementElectrictoothbrushes,TheToothbrush,First“toothbrush”-15thCenturyinChinaFirstmoderntoothbrush-Englandin1780byWilliamAddismassproduced,TheToothbrush,Nylontoothbrushbristles-1938inUSA（DuPont）Firstelectrictoothbrush-1960s（Broxodent）1987firstrotaryactionelectrictoothbrush,Generallytoothbrushesvaryinsize,designaswellasinlengthandarrangementsofbristleshardness.ToovercomethisvariationADAgivenspecificationoftoothbrushes.-,TheToothbrush,Toothbrushdesign,AmericanDentalAssociation（ADA）Length:

1to1.25inchesWidth:

5/16to3/8inchesSurfacearea:

2.54to3.2cmNo.ofrows:

2to4rowsofbrushesNo.oftufts:

5to12perrowNo.ofbristles:

80to85pertuft,Toothbrushbristles,Natural:

hogArtificialfilaments:

nylon,Bristlehardness,ProportionaltothesquareofthediameterandinverselyproportionaltothesquareofbristlelengthSoftbrush:

0.007inch（0.2mm）Mediumbrush:

0.012inch（0.3mm）Hardbrush:

0.014inch（0.4mm）,Formostpatients:

short-headedbrusheswithstraight-cut,round-ended,softtomediumnylonbristlesarrangedinthreeorfourrowsoftuftsARERECOMMENDED.,TOOTHBRUSHINGTECHNIQUES,Varioustoothbrushingtechniquehaveachievedacceptancebythedentalprofession.Eachtechniquehasbeendesignedtoachieveadefinitegoal.Dependingontheindividualcases,thetechniquesoftoothbrusingmayhavetobealteredtoachievethemaximumbeneficialeffects.,Theefficacyofbrushingwithregardtoplaqueremovalisdictatedbythreemainfactors:

ThedesignofthebrushTheskilloftheindividualusingthebrushThefrequencyanddurationofuse1986Frandsen,Effectsandsequeloftheincorrectuseoftoothbrush,Toothbrushingmethods,Horizontalbrushing（scrub）Leonardmethod（vertical）Bassmethod（Sulcularcleaning）ModifiedBassmethodsStillmanmethos（vibratory）ModifiedStillmanmethod（roll）ChartersmethodMethodsofcleaningwithpoweredtoothbrushes,Howtobrush?

PatientisinstructedtostartwithmolarregionofonearcharoundtheoppositesidethancontinuebackaroundthelingualorfacialsurfacesofthesamearchLastsurfacetobebrushedareocclusal.Patientinstructedtostrokeeachareatentimeorspend10secondsperareathenmoveontonextarea.Time:

2minutes（30secperquadrant）,ToothBrushing,Threemethodswidelyaccepted:

themodifiedbassmethod,themodifiedstillmanmethod（stillman1932）,andthechartersmethod（Carters1948）.ControlledstudiedevaluatingthemostcommonbrushingtechniquehaveshownthatnoonemethodissuperiorRecommendedisBasstechnique,becauseitemphasizesulcularplacementofthebristles.Plaquecontroldevicesshouldbetailoredaccordingtoindividualplaquecontrolneeds.,BASSORSULCUSCLEANINGMETHOD,Mostacceptedandeffectivemethodfortheremovalofdentalplaquepresentadjacenttoandunderneaththegingivalmargin.INDICATIONSinterproximalareascervicalareasbeneaththeheightofcontourofenamel.exposedrootsurfaces.,TECHNIQUE,Thebristlesareplacedata45degreeangletothegingivaandmovedinsmallcircularmotions.Strokesarerepeatedaround20times,3teethatatime.Onthelingualaspectoftheanteriorteeth,thebrushispressedintothegingivalsulciand