PREVENTION OF PERIODONTAL DISEASES Department of Therapeutic Dentistry TSMU 4th year of study
Preventive dentistry This is the area of dentistry that focuses on those procedures and life practices that help people to prevent the beginning or progression of oral disease. It includes: • at-home dental care performed by patients, • dental care and education by professional dental staff in the office or clinic.
Purpose of Preventive dentistry Preventive dentistry includes two aspects of dental careto help patients avoid dental disease or to catch it in its early, more treatable stages. It is the oral hygiene care performed • by the patient at home • by the dental staff in their offices to help patients maintain healthy teeth and gums. Dental health professionals can stop the development of oral disease or to find it at an early stage
Preventive care in a dental office includes: • Prophylaxis-cleaning of the teeth, which removes accumulation of calculus • Examination of the teeth and soft tissue, using visual and tactile exams, x-rays, oral cancer screening • Newer techniques to diagnose periodontal or gum disease, include computerized measurement devices that measure the bacterial content in the mouth • Prescribing medications (anti-inflammatory mouthwashes) to help prevent dental disease
The brushing techniqueshould be gentle and in a rolling back-and-forth motion, with two to three teeth being brushed at a time. Patients should: • use a soft nylon toothbrush with round-ended bristles • place the bristles along the gum line at a 45-degree angle to cover the tooth surface and gum line. • use a back-and-forth motion to brush the biting surface of the teeth and the tongue.
Types of toothbrush Fundamental to the use of electric or manual toothbrushes is the consistency, quality and duration of your efforts. Soft bristle brushes are best to avoid unnecessary abrasion of the periodontal tissues and teeth.
. Two minutes of brushing twice daily with gentle strokes is better than aggressive brushing for a shorter duration.
Flossing removes plaque from between teeth and at the gum line. • It should be done with an 18-inch strip of floss wrapped around the middle fingers of each hand • The remaining one to two inches of floss that is inserted between the teeth should be directed by the thumbs • By keeping the floss taut, use index fingers to guide the floss between the lower teeth with a gentle zig-zag motion, while contouring the floss around the sides of the teeth • Need floss each tooth with a clean section of the floss and ensure that the floss goes under the gum line.
BASS METHOD Importance • 1) Most effective in cleaning cervical 1/3 & beneath gingival margins • 2) Suitable for everyone – Periodontally healthy & periodontally disease • 3) Periodontal maintenance • 4) Cleanses sulcus (space between tooth and gums)
BASS METHOD • Direct bristles apically to sulcus at 45° to the long axis of the tooth. Use gentle force to insert bristles into sulcus. • Apply firm but gentle 10 back-and-forth strokes of vibratory motion without removing bristle ends from sulcus. Move brush head to the next group of teeth by overlapping with the completed area. • On the lingual surfaces of front teeth, brush is placed vertically and apply gentle vibratory motion of up-and-down strokes. • On the chewing surface apply a motion of back-and-forth brushing strokes.
STILLMAN’S METHOD Importance 1) Provides gingival stimulation (vibratory motion) 2) Suitable for gingival recession (Toothbrush bristle ends not directed into sulcus) 3) Less traumatic to the gingiva 4) Who should use this? People with continuous gingival recession
STILLMAN’S METHOD • Direct bristles apically to sulcus at 45° to the long axis of the tooth . Place bristles partly on the cervical part and on the gingiva. Apply vibratory motion with slight pressure to stimulate gingiva. • Repeat for the lingual surface of the tooth • Use short back-and-forth strokes on the occlusal surfaces gently. Place toothbrush perpendicular to the tooth surface.
CHARTER’S METHODImportance 1) Efficiently cleans interproximal areas 2) Able to clean areas between fixed appliances (prosthetic and orthodontic) and gingival margins 3) Who should use this? People with orthodontic and fixed prosthetic appliances People who have just undergone periodontal surgery (temporary cleaning of surgical wounds)
CHARTER’S METHOD • Place bristles horizontally and parallel to the arch at 45°at the gingival margin. Direct bristles toward the crown of the tooth rather than the root. • Bristles are directed occlusally and vibrate into the interdental spaces. Use short back-and-forth strokes for activation. Repeat for other parts of the mouth until all areas are cleaned.
Types of toothpaste • fluoride toothpaste • desensitizing toothpaste • anti-calculus toothpaste • anti-plaque toothpaste • whitening toothpaste. Their various functions depend on the active ingredients they contain.
Ingredients contained in toothpastes may include: ----------Fluoride: • strengthens tooth enamel against decay and enhances remineralization of the enamel • inhibits acid-loving bacteria, especially after eating, when the mouth is more acidic. This antibacterial activity may help control plaque. ----------Triclosanis an anti-bacterial substance that may help reduce mild gingivitis. ----------Metal salts such as stannous and zinc, serve as anti-bacterial substances in toothpastes do not reduce plaque, even though they have some effect against the bacteria that cause it, but slightly reduce gingivitis ----------Peroxide and baking soda have a whitening action, but while they may help remove stains there is little evidence they whiten the actual color of the teeth. In addition, these substances appear to offer no benefits against gum disease. ----------Antibacterial sugar substitutes (xylitol), and detergents (delmopinol)
Oral Rinses • Mouth rinses do not replace brushing or flossing. Certain brands have more scientific support and may be a helpful adjunct in maintaining good oral health. Please ask us about the best product for your individual care.
An important part of preventive dentistry performed by dental professionals is educating patients about at-home care nutrition smoking cessation.