mechanical plaque control PHD PPT.pptx in public health dentistry

mechanical plaque control PHD PPT.pptx in public health dentistry

1. MECHANICAL PLAQUE CONTROL SEMINAR BY:YUKTA RAJESH KOTTEWAR[4 TH Yr]

2. CONTENTS Introduction Methods of plaque control Objectives Classification Tooth brushes and types Dentrifices Toothbrushing techniques interdental aids Conclusion references

3. INTRODUCTION   There are various kinds of dental diseases, of which dental caries and disease of periodontal origin are the most common. According to the recent evidences, it is evident that there is a very strong connection between oral inflammation and general health of an individual Dental plaque also alters the ecology of the oral cavity by accumulation of microbes and may lead to advancement or formation of new carious lesions 

4. This dental plaque may also be referred to as microbial plaque that consists of highly organized structures of different microbiotas attached to the hard tooth structure, which may be bound by salivary glycoproteins. Plaque biofilm formation is a gradual process that includes following steps: (1) formation of pellicle, (2) primary colonization, (3) secondary colonization, and (4) biofilm maturation  Plaque control is a term that refers to removal of already formed or the control of formation of this microbial biofilm .

5. METHODS OF PLAQUE CONTROL MECHANICAL CHEMICAL

6. MECHANICAL PLAQUE CONTROL OBJECTIVES Physical clearing away of microorganisms and their pathogenic products Prevent dental and periodontal infections

7. CLASSIFICATION OF MECHANICAL PLAQUE CONTROL

8. TOOTH BRUSHES HISTORY Earlier, twigs were used in place of toothbrushes. In India, before toothbrushes were invented, a twig of Neem plant, which is said to be having medicinal properties, was widely used for toothbrushing. An Aromatic twig of plant called Miswak was also in wide use as a toothbrush in Middle eastern region. A twig of plant from the Salvadoraceae family of plants was also used commonly as an alternative to Neem

9. Manual toothbrushes These are the most commonly used toothbrushes. In 1980s, a single type of manual brush was marketed, which had a multitufted toothbrush head shape. Then, in 1990s, a varied type of toothbrushes was invented, which had different types of head designs, angulations, shapes, sizes, and different types of bristles.  TYPES

10. According to American Dental Association (ADA), a toothbrush should have a set of specifications, which are as follows: 1) length of the toothbrush should be 1-1.25 inches, (2) width of the toothbrush should be 5/16 to 3/8 inches, (3) surface area of the toothbrush head should be 2.54 to 3.2 cm (4) there should be two to four rows of bristles, (5) it should have 5-12 tufts per row, and (6) there should be 80-85 bristles per tuft 

11. 2. CONVENTIONAL FLATE TRIMED This is the gold standard and the most commonly used toothbrush to maintain oral hygiene. This toothbrush complies with the ADA specifications and contains bristles placed at the same level, which may compromise tooth cleaning and plague removal due to difference in tooth placement in every individual [ 4 - 6 ]. Modifications are made in the bristle designs and mechanism to overcome the drawbacks of this toothbrush, which are elaborated further.

12. 3. SMART TOOTHBRUSHES Toothbrushes since the time they were invented are continuously been modified to increase their efficiency [ 5 ]. Continuous research and development have led to development and modifications of toothbrushes such as power-driven toothbrushes, rotating and oscillating toothbrushes, sonic and ultrasonic toothbrushes, solar-powered toothbrushes, and disposable toothbrushes [ 2 ]. Tooth brushe 4. POWER-DRIVEN Power-driven toothbrushes were first invented in 1960s, which were the first alternative to manual toothbrushes [ 2 ].These electric toothbrushes have been found to be efficient in removing plaque as compared to other manual toothbrushes in various studies carried out across the globe. They were proved to be useful for the handicapped and for people with some or the other mental dexterity. Studies also claimed these to be efficient in removal of the plaque in children .

13. 5. SONIC AND ULTRASONIC Toothbrushes Ultrasonic toothbrushes are manual toothbrushes with embedded pizoelectric emitter in the brush head. Emmi®-dent was the first ultrasonic toothbrush that used nano paste technology [ 2 ]. The core technology used in ultrasonic toothbrushes is the ultrasonic vibration of the bristles 

14. DENTIFRICES Dentifrices Dentifrices aid in cleaning and polishing tooth surfaces. Primarily, toothbrushes are used with pastes, although powders and gels are alternatives. Abrasives, which are insoluble inorganic salts, significantly boost the abrasive effects of brushing, sometimes by upto 40% COMPOSITIONS:

15. Anticaries agents in toothpastes • Fluoride: Different types of fluoride, including amine fluoride, stannous fluoride, sodium fluoride, and sodium monofluorophosphate , have been incorporated into toothpaste formulations. Dentifrices containing fluorides in concentrations >1500ppm are classed as prescription only medicines (POM) and should be used only above the age of 10 years and for the management of high caries risk individuals such as those with xerostomia or root surface caries.6 • Non-fluoride: Non-fluoride anti-caries agents within toothpaste formulations include agents containing calcium, phosphorus (phosphate, tri metaphosphates, pyrophosphates, glycerophosphates), metals (zinc, tin, aluminium, iron, manganese, molybdenum) and various antimicrobials. Although many agents have been identified in various models few have been taken forward to clinical trials in humans.

16. TOOTH BRUSHING TECHNIQUES Toothbrushing methods Many methods for brushing the teeth have been described and promoted as being efficient and effective. These techniques are mainly classified based on the brushing motion pattern and are primarily of historical significance, as follows . • Roll: Roll or modified Stillman technique • Vibratory: Stillman, Charters, and Bass techniques • Circular: Fone’ S technique • Vertical: Leonard technique • Horizontal: Scrub technique

17. TOOTH BRUSHING TECHNIQUES

18. ROLL METHOD Rolling method of tooth-brushing is world-wide spread method recommending for general peoples who have not specific oral problems. It had been once recommended by World Health Organization as well as the Ministry of Health and Welfare in Korean government for general people. It has been suggested the movement of rolling through wrist the hand which had hold a tooth-brush. Sweep the tooth surface from up to down movement with rolling the hand-wrist in upper teeth, and from down to up in lower teeth. Insert the tooth-brush straight with obliquely at inner side of frontal teeth, both in upper and lower teeth, and sweep the brush from inside to outside and horizontal movement as back and forth for occlusal surface of posterior teeth, both upper and lower. Rolling technique is known as comparatively easy for learning and effective for removal of plaque even at proximal area.

19. HORIZONTAL METHOD It has been the most popular motion for tooth-brushing technique by uneducated people. It is a motion for scrub tooth-surface with horizontal movement as back and forth ward. It can be occurred the accumulation of micro-debris at the inter-dental area and happen the cervical abrasion or hyper sensitive dentin through the using this motion for a long time as 20 or 30 years

20. FONES BRUSHING TECHNIQUE circle on the teeth with closing the mouth slightly. It could be easier to change the rolling method after school aging than in horizontal scrub method. Horizontal scrub action would be accomplished on brushing on occlusal site and lingual site Dr. Fones was a pediatric dentist and try to supply the proper and easy method for tooth-brushing for preschool child as sweeping with small sized kids tooth-brush with motion as drawing continues

21. BASS METHOD Bass technique of tooth-brushing has been recommended for periodontal problem dental patient, even though it had been some difficult to perform. It needed for soft and 1 or 2 lane tooth-brush to vibrate shortly and lightly with holding tooth-brush handle with lightly. Short and light vibration would be needed inserting one lane of tooth-brush into the gingival sulcus or periodontal pocket which had been some inflammatory tissues. Vibratory action could induce the plaque removal and gingival massage effect at the gingival sulcus, in order to subsid the gingivitis. Recent years, the modification of Bass method as adding the rolling motion together to Bass method has been recommended for subsid gingivitis as well as plaque removal effectively

22. MODIFIED BASS METHOD

23. STILLMAN METHOD Stillman method would be applied for gingival inflam-mation area with relatively wide spread. Short zig-zag movement with soft bristled and 3 or 4 lane tooth-brush holding with lightly, from up to down ward sweep with short vibration on the gingiva at the upper jaw and from down to up at the lower jaw. Gingival massage effect would be great to increase the blood circulation on the inflammatory gingival area. Also modification would be performed by adding the rolling motion after zig-zag vibration at gingiva

24. CHARTERS METHOD This method of tooth-brushing is emphasize to clean the interdental area especially. Insert tooth-brush tip with perpendicular direction to longitudinal tooth axis at the proximal area or revers 45 degrees from the gingiva to tooth direction. And then, short vibration would be needed focusing on the proximal area. But, this method is a little bit hard to perform at lingual side of the tooth surface. This method is effective for bridge wearer and well done at the bottom of the artificial tooth on bridge area. Of course, it could be applied as modified method by adding the rolling motion

25. CHARTERS METHOD

26. INTERDENTAL AIDES INTRODUCTION: Oral hygiene is important for the preservation of oral health, whereby microbial plaque is removed and prevented from accumulating on teeth and gingival tissues. Interdental aids are important as they can remove food trapped in between the teeth which can turn into plaque and then calculus in around 48 hours. This review focuses on the various interdental cleaning aids as an adjunct to tooth brushing habits in maintaining interdental hygiene which promotes healthy tissues and offers protection against bacterial and other oral infections.

27. INTERDENTAL AIDS

28. DENTAL FLOSS Reports of the benefits of flossing date back to the early 19thcentury, when it was believed that irritating matter between teeth was the source of dental disease .Over the years, it has been generally accepted that dental floss has a positive effect on removing plaque. Even subgingival plaque can be removed, since dental floss can be introduced 2 to 3.5 mm below the tip of the papilla.

29. THE Dental floss is available in various forms a) Waxed / Non waxed b)Orthodontics floss with holder c) Material- silk, nylon, expanded Polytetrafluoroethylene d)Twisted/non-twisted e) Thick/thin f) Bonded / Non bonded

30. INTERDENTAL BRUSHES Interdental brushes were introduced in the 1960s as an alternative to wood sticks. The interdental brush consists of soft nylon filaments twisted into a fine stainless steel wire. The support wire is continuous or inserted into a metal/plastic handle. Interdental brushes are manufactured in different sizes and forms. The most common forms are cylindrical or conical/ tapered (like a Christmas tree). The length of the bristles in cross - section should be tailored to the interdental space.

31. Appropriate interdental brushes are currently available for the smallest to the largest interdental space which ranges from 1.9 to 14 mm in diameter. Interdental brushes have the added advantage of serving as vehicles for the local application of antibacterial agents or desensitizing agents to exposed sensitive root areas. Interdental brushes are frequently recommended by dental professionals to patients with sufficient space between their teeth [8]. They are also available as single and multitufted brushes.

32. WOODSTICK Wood sticks are one of the earliest and most persistent “tools” used to “pick teeth.” It dates back to the days of the cave people, who probably used sticks to pick food from between their teeth. Originally, dental wood sticks were advocated by dental professionals as ‘gum massagers’ used to massage inflamed gingival tissue in the interdental areas to reduce inflammation and encourage keratinization of the gingival tissue. They are fabricated from soft wood to improve adaptation into the interdental space and to prevent injury to the gingiva. A triangular wood stick seems to have the correct shape to fit the interdental space. Wood sticks are inserted interdentally with the base of the triangle resting on the gingival side. The tip should point occlusally or incisally and the sides against the adjacent tooth surfaces. The tapered form makes it possible for the patient to angle the wood stick interdentally and even clean the lingually localized interdental surfaces

33. GINGIVAL MASSAGE

34. WATER IRRIGATION DEVICES Oral Irrigators These irrigation tools deliver a pulsating fluid flow between teeth, effectively reaching the spaces between them. Moreover, they have the capability to administer medications such as chlorhexidine, antibiotics, and 5% tetracycline. Oral irrigation devices are available in different forms, including both powered and manual models, designed for use at home or in profess Additional oral hygiene aids have been developed in an attempt to augment the effect of tooth brushing on reducing interdental plaque. The adjunctive aid of the oral irrigator is designed to remove plaque and soft debris through the mechanical action of a jet stream of water. Oral irrigator devices can also be used with antimicrobial agents. The oral irrigator facilitates the removal of food debris in posterior areas, especially in cases of fixed bridges or orthodontic appliances, when the proper use of interdental cleaning devices is difficult

35. TONGUE CLEANER

36. RUBBER TIPS Conical or pyramidal flexible rubber tip attached to handle. Uses: a) For cleaning debris from interdental areas b) Biofilm removal at and just below gingival margin

37. CONCLUSION A central focus of dentistry practice revolves around managing plaque effectively. Dentists advocate for patients to assume daily responsibility for their oral health. Periodontal therapy is indispensable for achieving and sustaining optimal oral health. In all dental procedures, it is essential to instruct and motivate every patient to maintain consistent plaque control. While mechanical plaque control forms the foundation for preventing oral diseases, it necessitates significant patient cooperation and motivation. Consequently, chemical plaque control agents serve as valuable supplements in achieving the desired outcomes. Antimicrobial and antiplaque agents in dentifrices and oral rinses act in several ways To reduce and inhibit bacterial growth.

38. As seen in the review above, interdental aids are an important adjunct to daily tooth brushing procedures. They effectively disrupt the microbial biofilm which is the main causative factor of dental caries and periodontal disease. Although there is a plethora of devices available

39. REFERENCES ASDS-08-1867 .PDFhttps:// share.google /RtFWSHgaXs94DhTXj Status Quo in Mechanical Plaque Control Then and Now: A Review – PMC https://pmc.ncbi.nlm.nih.gov/articles/PMC9523496/ https://journals.lww.com/ijcm/fulltext/2025/01000/a_novel_classification_system_of_smart_mechanical.27.aspx New Dimensions in Mechanical Plaque Control: An Overview https://share.google/yXmjIRJ4dfg9EAaqV Medwinpublishers.com/OAJDS/OAJDS16000182.