mechanicalplaquecontrol[ppt].ppt

1、,MECHANICAL PLAQUE CONTROL,OBJECTIVES,Background Mechanical plaque control(a)Toothbrush(b)Dentifrice(c)Interdental cleaning aids-Dental floss-Interdental brushes-tooth pik(d)Oral irrigation,IMPORTANT CHAPTERCLINICALLY VERY RELEVANT REQUIREMENT FOR PATIENT TEACHING,Plaque as etiologic factor,Experime

2、ntal gingivitis study(1965 Le et al.),The cause and effect relationship between supragingival plaque and gingivitis was demonstrated by Loe et al(1965).When plaque was allowed to accumulate,gingivitis developed within 21 days.When plaque control was initiated,the gingivitis was reversed(by means of

3、efficient plaque control,i.e.,brushing and flossing)to clinical gingival healthThe removal of microbial plaque leads to cessation of gingival inflammation,and cessation of plaque control measure leads to recurrence of inflammation,The removal of plaque also decreased the rate of formation of calculu

4、s.(Sanders,1962)Thus eliminating plaque is the key to prevent the occurrence of periodontal disease or halting the progression of the disease.,Masses of plaque first develop(Lang,1973),PLAQUE CONTROL,Plaque control:The removal of dental plaque on a regular basis and the prevention of its accumulatio

5、n on the teeth and adjacent gingival surfaces.Position:supra-&sub-gingival plaque controlMethods:mechanical&chemical,MECHANICAL PLAQUE CONTROL,OBJECTIVE:Complete Daily Removal Of Dental Plaque With A Minimum OfEffort,Time,And Devices,Using The Simplest Methods Possible.,Self-performed,Tooth brushing

6、Interdental aidsDental floss and tapeToothpicksInterproximal brushesSingle-tufted brushAdjunctive aidsDental irrigation devicesTongue scrapersDentifrices,TOOTH BRUSH,Toothbrush DesignMethods of toothbrushingFrequency and effectiveness of toothbrushingToothbrush wear and replacementElectric toothbrus

7、hes,The Toothbrush,First“toothbrush”-15th Century in ChinaFirst modern toothbrush-England in 1780 by William Addis mass produced,The Toothbrush,Nylon toothbrush bristles-1938 in USA(Du Pont)First electric toothbrush-1960s(Broxodent)1987 first rotary action electric toothbrush,Generally toothbrushes

8、vary in size,design as well as in length and arrangements of bristles hardness.To overcome this variation ADA given specification of toothbrushes.-,The Toothbrush,Toothbrush design,American Dental Association(ADA)Length:1 to 1.25 inches Width:5/16 to 3/8 inchesSurface area:2.54 to 3.2 cmNo.of rows:2

9、 to 4 rows of brushes No.of tufts:5 to 12 per rowNo.of bristles:80 to 85 per tuft,Toothbrush bristles,Natural:hogArtificial filaments:nylon,Bristle hardness,Proportional to the square of the diameter and inversely proportional to the square of bristle lengthSoft brush:0.007 inch(0.2 mm)Medium brush:

10、0.012 inch(0.3 mm)Hard brush:0.014 inch(0.4 mm),For most patients:,short-headed brushes with straight-cut,round-ended,soft to medium nylon bristles arranged in three or four rows of tufts ARE RECOMMENDED.,TOOTH BRUSHING TECHNIQUES,Various toothbrushing technique have achieved acceptance by the denta

11、l profession.Each technique has been designed to achieve a definite goal.Depending on the individual cases,the techniques of toothbrusing may have to be altered to achieve the maximum beneficial effects.,The efficacy of brushing with regard to plaque removal is dictated by three main factors:The des

12、ign of the brushThe skill of the individual using the brushThe frequency and duration of use 1986 Frandsen,Effects and sequel of the incorrect use of toothbrush,Toothbrushing methods,Horizontal brushing(scrub)Leonard method(vertical)Bass method(Sulcular cleaning)Modified Bass methodsStillman methos(

13、vibratory)Modified Stillman method(roll)Charters methodMethods of cleaning with powered toothbrushes,How to brush?,Patient is instructed to start with molar region of one arch around the opposite side than continue back around the lingual or facial surfaces of the same archLast surface to be brushed

14、 are occlusal.Patient instructed to stroke each area ten time or spend 10 seconds per area then move on to next area.Time:2 minutes(30 sec per quadrant),Tooth Brushing,Three methods widely accepted:the modified bass method,the modified stillman method(stillman 1932),and the charters method(Carters 1

15、948).Controlled studied evaluating the most common brushing technique have shown that no one method is superiorRecommended is Bass technique,because it emphasize sulcular placement of the bristles.Plaque control devices should be tailored according to individual plaque control needs.,BASS OR SULCUS

16、CLEANING METHOD,Most accepted and effective method for the removal of dental plaque present adjacent to and underneath the gingival margin.INDICATIONSinterproximal areascervical areas beneath the height of contour of enamel.exposed root surfaces.,TECHNIQUE,The bristles are placed at a 45 degree angle to the gingiva and moved in small circular motions.Strokes are repeated around 20 times,3 teeth at a time.On the lingual aspect of the anterior teeth,the brush is pressed into the gingival sulci and