5. Mechanical Plaque Control
• A-Patient information
•
•
2-information about the causes & the
symptomes of periodontal disease.
stage 1:-allow the patient to participitate in the
examination of his oral cavity
• stage 2:-understanding the patient that the bacteria
is the main causes of the periodontal disease
• Stage 3:-location of plaque by using disclosing agent.
10. Tooth brush : the best tooth brush is :
1- straight ,with short head
2- multitufted with medium or soft nylon
bristles
3- rounded end to prevent damage of gingiva
11.
12.
13.
14. The Objective of tooth brushing
• 1-Removed the plaque .
• 2-Clean the teeth of food debris & stain.
• 3-Stimulate the gingival tissue.
• 4- Apply flouride dentifrice.
15. Interdental aids
• 1- Dexterity of the patient.
• 2-Morphology of the teeth.
• 3-Spaces between the teeth
Dental floss Tooth picks interdental brush
18. Electric brushes
Electric brushes can motivate some patients to improve their oral hygiene
Electric brushes used for patients with poor manual dexterity
21. Use of gauze to clean distal surface of teeth
adjacent to edentulous areas
22. Control of breath malodor
Plaque control is most predictable way to reduce
oral malodor together with daily tongue
scarping to reduce bacterial load of oral cavity.
23. The disadvantage of mechanical
plaque control
•
•
•
•
1- depend on the dexterity of the patient
2-need effort
3-time consuming
4-need continuity and follow up.
24. Frequency of plaque removal
• 1-every 24-48 hrs
• 2-improved periodontal health associated
with increase the frequency of the tooth
brush up to twice / daily
• 3-cleaning 3 or more/daily do not appeare to
further improve periodontal health
• 4-cleaning once a day with all necessary tools
is sufficient if it is performed correctly.
26. Antiseptic
• Chlorhexidine
Chlorhexidine is available in three forms,
the diglu-conate, acetate and hydrochloride salts.
Most studies and most oral formulations and
products have used the digluconate salt, which is
manufactured as a 20% concentrate. Digluconate
and acetate salts are water-soluble but
hydrochloride is very sparingly soluble in water.
27. • Chlorhexidine was developed in the 1940s by
Imperial Chemical Industries, England, and
marketed in 1954 as an antiseptic for skin
wounds. Later, the antiseptic was more
widely used in medicine and surgery
including obstetrics, gynecology, urology and
presurgical skin preparation for both patient
and surgeon. Use in dentistry was initially for
presurgical disinfection of the mouth and in
endodontics(1962)
28. Brown discoloration of the teeth of an individual rinsing
twice a day for 3 weeks with a 0.2% chlor-hexidine
mouthrinse.
29. Brown discoloration of the tongue of an
Brown discoloration of the tongue of an
individual rinsing twice aaday for 22weeks with
individual rinsing twice day for weeks with
aa0.2% chlorhexidine mouthrinse.
0.2% chlorhexidine mouthrinse.
31. Mechansim of action
Both bacteria and tooth surfaces are
negatively charged and are bidged by calcium
ions.
CHX has a competitive ion for saliva calcium so
will prevent bacteria from attachment to the
tooth and to each other so it will prevent
plaque formation.
32. Clinical uses of Chlorohexidine
1. As adjunct to oral hygiene and professional prophylaxis.
2. Post oral surgery including periodontal surgery and root
planning.
3. In patient with jaw fixation.
4. For oral hygiene and gingival health benefits in mentally and
physically handicapped patient as spray of 0.2% solutin.
5. In high risk patient chlorohexidine rinse or gel can reduce the
streptococcus mutans count and it is synergistic with fluoride.
6. In treatment Recurrent oral ulceration.
7. In treatment of denture stomatitis.