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HPDP 2
toothbrushing and dental floss
Question | Answer |
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Explain the rationale for daily plaque removal by the patient. | -Applying dentifrice (toothpaste) -Removal of plaque/biofilm -Removal of food/stain -Stimulate the gingiva |
Bass Method Indications | - Biofilm removal adjacent and directly beneath the gingival margin - Open interproximal areas - Exposed root surfaces - Abutments - Periodontal surgical patients |
Bass Method Contraindictions | - Difficult for children |
Bass Method Technique | - Focus on the sulcus - Intrasulcular position 45 degree angle - strokes: - 10 strokes each area - press lightly without flexing - vibrate the brush - reposition and repeat |
Modified Bass Technique | same as Bass method plus a sweeping motion following the vibratory strokes in each section |
Stillman's Method Indications | Message and stimulation as well as cleaning the cervical areas of the teeth |
Stillman's Method Contraindictions | Excessive pressure can lead to tissue blanching |
Stillman's Method Technique | - Brush located partly on the gingival and partly on the cervical area of the tooth directed apically. - Circular motion is given to the brush |
Modified Stillman Method Indications | - Minimize gingival trauma - Massage gingival tissue - Increase biofilm removal effects - Cervical areas and exposed proximal surfaces |
Modified Stillman Method Technique | - Combination of the Rolling Stroke and Bass Methods - Great for someone with a lot of inflammation |
Rolling Stroke Method Indications | - Emphasis not on gingival sulcus - children with healthy gingiva - Sulcular technique too difficult - General cleaning |
Rolling Stroke Method Contraindicitons | - brushing too high during initial placement can lacerate the alveolar mucosa |
Rolling Stroke Method Technique | - Brush is rolled from cervical third to incisal third |
Circular (Fones) Method Indications | - Easy to learn for young children |
Circular (Fones) Method contraindicitons | - Can be detrimental if paired with vigorous brushing |
Circular (Fones) Method Technique | - Teeth closed - Circular Motion - Fast wide sweeping from maz to mand finfiva - Light pressure - Anterior teeth: edge to edge - Lingual and palatal - In and out stroke |
Charters Method Indications | - Orthodontic appliances - Loosen debris and biofilm - Abutments - Post-perio surgery - Stimulate marginal and interdental gingiva |
Charters Method Technique | - Accomplish rolling stroke method first - Press lightly - Vibrate brush - Use rotary motion of handle - Bristles toward - occlusal plane - Incisal plane - 45 degree angle |
Horizontal Method Contraindicitons | - Considered detrimental - with use of abrasive dentifrice, such brushing may produce tooth abrasion - dental biofilm can remain undisturbed on proximal surfaces |
Horizontal Method Technique | - Unlimited sweep with a horizontal scrubbing motion |
Powered toothbrushes Indications | - More effective than manual - Many improve compliance - Useful for patients - in orthodontic-prosthodontic-restorative treatment - with dental implants - who are aggressive brushers - with disabilities - Variety of motion, speeds |
Methods for removing plaque from occlusal surfaces | - Handle parallel - Filaments in pits - Toe covers most posterior tooth - Procedure - vibrate slightly circular - Maintain tips on surface OR - Sharp quick strokes - lift off, repeat 10x |
Methods for removing plaque from the tongue | -Toothbrush is inferior to tongue cleaners in removing debris and microorganisms - Start posterior, handle 90 degrees - Roll filaments towards anterior - at least 2x daily to control halitosis and anaerobes |
Proximal Cleaning Aid Indications | - Unwaxed vs Waxed Floss - Waxed: tight proximal contacts - Unwaxed: normal tooth contacts - Dental tape - preferred if surface area is large - PTFE (polytetrafluoroethylene) ex. Glide - no fraying -Braided - implants - Tufted |
Spool Method Flossing Technique | - Arm length floss - wrap around middle fingers - Use index fingers and thumbs to control movement between teeth - floss wrapped c-shaped around proximal tooth surface |
Loop Method Flossing Techinque | - Great for children and patients with limited dexterity - 2 ends tied together in a knot - same technique as spool method |
Trauma caused by improper flossing | - Too long a piece between fingers when inserting between teeth - Snapping floss - no c-shape - failure to use finger rest for control - shoeshine motion |
Patient Education " My gums bleed when I floss" | - Gingival bleeding during flossing - indicative of inflammation - Ulcerations in the sulcular lining - Will subside with daily removal of biofilm - Flossing shouldn't be avoided -Active disease needs to be controlled by more frequent flo |
Proximal | Distal or Mesial surfaces |
Occlusal | Chewing surface of posterior teeth |
Facial | Includes labial and buccal surfaces |
Lingual | surfaces towards the tongue |
Buccal | Posterior teeth surface toward the cheek |
Labial | Anterior teeth surface toward the lip |
Embrasure spaces | a space continuous with an interproximal space, produced by curvatures of teeth in contact in the same arch; it provides a passage through which food escapes from the occlusal surfaces during mastication. |
Furcation | The region of a multirooted tooth at which the root divides |
Abrasion (tooth) | The pathological wearing away of tooth substance by mechanical means; grinding |
Abrasion (Gingival) | The wearing down or rubbing away or removal of the superficial layers of skin or mucous membrane in a limited area |
Tuft | part of the toothbrush head, refers to the small, individual clusters of bristles that proceed from a single opening. |