Oral hygiene Oral hygiene Aim - Prevention of dental caries - Prevention of periodontitis - Keeping therapeutical results Dental plaque = biofilm  Comunity  Primitive circulation More species Higher metabolic activity Higher resistance (S. sobrinus CHX 300x, AF 75x) better conditions to survive higher virulence Can it be recognised and removed easily? Biofilm  Adherence  Colonisation  Maturation Plaque detection  Special liquids  Tablets  Gels Dental calculus Oral hygiene  Individual - Everybody  Professional - Dentist - Dental hygienist Individual oral hygiene Removal of rests of food - Toth brush - Tooth paste - Dental floss - Dental stick - Mouthwash - Movement of soft tissues Individual oral hygiene Removal of dental biofilm - Toth brush - Tooth paste - Tools for interdental hygiene - Chemicals decreasing of plaque formation - Individual oral hygiene MUST BE INDIVIDUALIZED! For each patient individual approach. General recommendation  Tooth brushing 2x daily 3 – 4 min  Mouth wash after meal 30 s  Mouth wash after acidic or sweet drinks Local factors  Bad made crowns and prothesis  Mucosal disorders – frenum  Trauma (bad occlusion)- high fillings Tooth brushing  Short head, dense fitting fibers, soft. (hard, medium, soft, super soft, ultrasoft, smart) Tooth brushing - methods  Horizontal method  Fones method – circuar movement )for children) Tooth brushing - methods  Stillman method – movement from gingiva to tooth in vertical direction Tooth brushing - methods  Bass method Tooth brushing - methods  Charters method movement of the toothbrush from gingiva to teeth, fibers are pressed into interdental spaces and smal vibration are recpommended Tooth brushing - methods  Single (solo) technique Single toothbrush. Each tooth is brushed separately System of tooth brushing 1. Oral sïde 2. Vestibular side 3. Occlusal side Interdental hygiene  1. Interdental brushes Interdental hygiene  Floss: waxed, non waxed. Expanded  Superfloss or brush and floss Flossing Interdental hygiene Stimulator Interdental tooth brush Professional oral hygiene  Investigation – history, extraoral and introral examination, indexes, plaque visualization  Motivation  Professional care  Individual programm PBI – papilla bleeding index  0  1  2  3  4 No bleeding Point Line Triangl Drop Importance  Sume divided with number of investigated points - figure 1 2 3 2 3 1 2 2 1 0 0 2 2 3 12 14 1 1 2 2 0 4 0 3 3 4 2 3 1 0 9 17 52:28= 1,8 52/28 CPITN (Comunity periodontal index of treatment needs) CPITN WHO probe Slight pressure Around the teeth Wait 1 min CPITN  0 no bleeding  1 bleeding  2 dental calculus  3 periodontal pocket 3 – 5 mm  4periodontal pocker deeper than 5 mm CPITN  0 -no therapy  1 bleeding – improve oral hygiene  2 dental calculus – professional oral hygiene, home care  3 periodontal pocket 3 – 5 mm complex periodontal therapy – more conservative  4periodontal pocker deeper than 5 mm – complex periodontal therapy including surgical Plaque visualization Calculus and plaque removal  Hand instruments (scalers, curretes)  Power driven instruments (sonic, ultrasonic)  Polishing using rotary brushes and pastes  Air flow Scalers sharp pointed instruments removal supragingival calculus only Scalers sharp pointed instruments removal supragingival calculus only Sonic and ultrasonic scalers lenka.roubalikova@tiscali.cz 40 Air flow Currettes  Sharp spoons for subgingival treatment  Not pointed  Two sharp blades - universal  One sharp blade - special Universal and special currette Universal Working part and shaft 90° Cut also soft tissue Special Working part and shaft 70° Clean only root of the tooth Scaling, root planing  Action of the currette