Plaque control for handicap children

Plaque control for handicap children

1. PLAQUE CONTROL FOR HANDICAP CHILDREN Presented by: Dr.Shadman Zakir Department of paediatric dentistry Sapporo Dental College & hospital

2. W hat is dental plaque Dental plaque is a specific but highly variable structural entity resulting from colonization and growth of microorganism consisting of various species and strains embedded on extracellular matrix.

3. IMPORTANCE OF PLAQUE CONTROL: Plaque control is the removal of plaque and the prevention of its accumulation on teeth and adjacent gingival surface.Plaque control is the key to prevention and successful treatment of periodontal disease.Removal of microbial plaque leads to resolution of gingival inflammation in its early stage,and cessation of plaque control measures leads to its recurrence.Plaque control measures leads to its recurraence.Plaque control is accomplished by professional plaque removal and by patient performed oral hygiene practice or both.

4. The purpose of preventive dental survice for person with disabilities Including personal oral hygiene procedures,are no different than those of the general population.However te physical,cognitive and behavioral Limitations presented by severe disabled individuals require modification Of usual preventive practices including the choice of material and Techniques utilized.Although the dentist ,maintains overall responsibility for preventive as well as restorative services.

5. Oral hygiene aids: Devices used in the mouth to control Plaque should be selected on an individual basis and training in their use is necessary to prevent damage to oral tissues.There ase a wide variety of oral care products available for use.When deciding on the appropriate devices to be tried,the following should be considerd : Ability of the idividual performing daily oral hygiene. Time constraints placed on staff or caregiver. Level of personal cooperation. Physical and environmental condition where oral care is provided. Degree of patient involvement.

6. TOOTH BRUSH: The choice of a toothbrush for persons with often the same as for the general population. Usually a soft nylon bristle,rounded end,multi-tuftted brush with long strong neck is prefered choice. As with the individual the proper application of toothbrush is far more important than toothbrush choice. Several studies have found the autometic toothbrush to be superior to manual brushes for some individual. Autometic toothbrush

7. T ooth brush modification: The most common tool for effective mechanical control of dental plaque is a toothbrush but the presence of physical or cognitive disabilities can create deficulities in both holding and manipulating the thoothbrush,that’s why it should be adjusted or adapted. The aim of toothbrush adaptation is to provide a handle with a stable grip,whilst its shape enables the person to feel how to manipulate the brush in the mouth adequately during cleaning. Grasp: For people who cannot grasp and hold,the objective is to fasten the brush handle to the hand.this can be achieved by using a velcro strap with a pocket on the palm side into which the toothbrush can be inserted.

8. F ixed finger: For a patient whos finger is permanently fixed or fixed with the fist,toothbrushes with variation in the grip and handle in all size and shape are available comercialy . Gripped toothbrush

9. Limited hand clouser: Objective is to enlarge the diameter of the brush handle to fit in the hand.the simplest method of improving the grip is to inserting the handle in another material to improving its size shape and characteristics.

10. Manipulation: Those patient who can position the toothbrush but can not manipulate it sufficiently to clean all the surface of the tooth,double or tripple headed brushes are useful.such as super brush.

11. Limited arm movement: For the group of people with limited arm and hand movement.the objective is to lengthen the handle of the brush with a material strong enough to maintain the contact with tooth surface.

12. Dentifrices: For many severely disabled patients,the foaming caused by toothpaste with saliva obstructs visualization of the areas to be brushed and can stimulate gagging. Some individual may ingest excessive amount of toothpaste. An alternative way is the toothbrush can simply be moistened with water or flavorful mouthwash. Some comercially available dentifrice are non foaming with a pleasant taste.

13. M outh wash: The use of antimicrobial agents,especially chlorhexidine mouth rinse,has been proven effective in reducing the severity of plaque accumulation and gingivities . Since the usual method of rinsing and expectorating is difficult for the person with severe disabilities,alternative methods such as a spray or applicationby swab is oftern indicated.

14. mouthwash

15. Flossing: flossing is very essential for maintaining oral hygiene.Its the best interdental cleaning aid.there are two methods for flossing one is spool method and another is loop method.the loop method is the method of choice for handicap patient.

16. Flouride application: Professionally prescribed stanous flouride gels are more effective anti plaque agent the comercially available flouride mouthwash. Foam or plastic tray is contraindicated due to lack of patient co-operation and frequent bruxism . The application of flouride gel by tooth brush after normal brushing is method of choice.

17. CONCLUSION: Controlling dental plaque is very much essential for maintaining a good oral health. the handicap children often cant control the plaque by their own so the parents have to be extra careful in this case.The dental surgeons role is to properly educate the parents and train them so then they can perform accordingly. REFERENCE: Text book of paediatric dentistry,nikhil marwah