Patient Education pp

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Patient Education:

Patient Education Victoria Kalmer & Shelby Pontera

Biofilm & Calculus:

Biofilm & Calculus Biofilm (plaque) Build-up of bacteria on the teeth Soft, gel-like form Can be removed with toothbrush Calculus (tartar) Hardened biofilm that was left untouched overtime Can only be removed by hygienist/professional

Dental Caries:

Dental Caries What are caries? A disease where the surface of the tooth or root is broken down Transmissible, can spread to others

Dental Caries continued:

Dental Caries continued How does this happen? Step 1 : Microorganisms in Biofilm -Carbohydrates like sugary foods/drinks taken into biofilm Step 2: Dental Biofilm - Acidity of biofilm drops severely with intake of carbohydrates Step 3: Acid Formation - The more sugars taken in, the more harmful acid produced Step 4: Demineralization -Tooth surface starts to dissolve, carious lesion forms Step 5: Cavitated Carious Lesion - Carious lesion is broken down further into a cavity

Contributing Factors to Caries:

Contributing Factors to Caries Time for Acid Formation Begins immediately after eating carbohydrates like sugar or starch pH (acidity) of Biofilm Normal pH levels are from 6.2-7.0 Tooth surface begins breaking down at a pH of 4.5-5.5 Tooth’s root surface begins breaking down at a pH of 6.0-6.7 Takes 1-2 hours to return pH levels back to normal (6.2-6.7) Frequency of Carbohydrate Intake The more often you eat sugary foods/drink the more times your acid levels drop, enabling the carious process Better to eat more sugar at one time than throughout the day

Gingivitis & Periodontitis:

Gingivitis & Periodontitis Gingivitis Inflammed gingival tissues (gums) Periodontitis Inflammation of the gingiva (gums), and the supporting structures of the tooth Recession of gingival tissues (movement of gum line away from tooth)

Local Contributing Factors to Disease:

Local Contributing Factors to Disease Primary contributing factor: dental biofilm Dental factors: abnormal/rough tooth surfaces, abnormally shaped teeth, tooth position, & dental appliances (ex: dentures) Gingival factors: position (ex: recession), size and abnormal shape, effective mouth breathing

Risk Factors for Periodontal Disease:

Risk Factors for Periodontal Disease Effect of medications Tobacco use Diabetes Osteoporosis (bone loss) Social strain (stress, etc.)

Manual Toothbrushes:

Manual Toothbrushes Effective characteristics Conforms to individuals needs Size, shape, texture unique to patient Easily and efficiently manipulated Easy for patient to use Readily cleaned and aerated Resistant to moisture and bacteria Durable and inexpensive Long lasting at reasonable price Flexible, soft, prime diameter of filaments; strong, rigid, light handle Gentle brush head with optimal handle function End-round filaments Edges of filaments rounded to protect gingiva Designed for utility, efficiency, and cleanliness

Manual Toothbrushes (continued):

Manual Toothbrushes (continued) Guidelines for use Grasp: light and comfortable, reduces stress on hand Handle in palm and thumb on shank Sequence Begin brushing at a new place at least once a day Equal attention to each area of the mouth Amount of brushing Count system- six strokes or slowly count to ten in each area Clock system- at least 3 to 4 minutes Timers can help to keep track of duration Ensures most complete removal of biofilm Frequency of brushing At least 2 times each day Keeps bacteria in the mouth down

Manual Toothbrush Method:

Manual Toothbrush Method Bass Removes biofilm at or beneath the gingival margin (gum line) Instructions Direct filaments up on the top teeth & down on the bottom teeth 45 degree angle of filaments Press lightly but do not bend the filaments Bent filaments tend to miss areas of biofilm Vibrate back and forth at least ten times Over 2 to 3 teeth at a time Overlap areas and cover all surfaces of teeth Ensures complete coverage of teeth Hold brush vertically at anterior linguals (back side of front teeth) Long and narrow way, up and down (INSERT VIDEO LINK)

Powered Toothbrushes:

Powered Toothbrushes Purposes & Indications for Use General application Patients with ineffective manual technique Removal of biofilm and food debris Reduce calculus and stain Special patients Orthodontic patients with braces Restorative treatment and prosthetics Aggressive brushers, prevents wearing down of tooth enamel Disabled patients who cannot perform manual brush skills Caregivers; easier to use than manual

Powered Toothbrushes (continued):

Powered Toothbrushes (continued) Description Motion Multiple different directions the brush heads can move Example: rotational- moves in a 360 degree circular motion Speed Vary from low to high Brushes with replaceable batteries get slower as they get older Brush head design Adult: variety of shapes and sizes Child: made for smaller mouth and development of teeth Interdental: similar to manual, fits in power brush handle Filaments Soft, end-rounded, nylon filaments Diameters range from extra soft to soft

Powered Toothbrushes (continued):

Powered Toothbrushes (continued) Description (continued) Power source Direct: plugs into electrical outlet from the handle Replaceable batteries: when batteries lose power, brush is slower Rechargeable: brush placed on a charging dock stand Disposable: batteries cannot be replaced or recharged

Powered Toothbrushes (continued):

Powered Toothbrushes (continued) Procedure Floss first allows access for dentifrice (toothpaste) between teeth Select soft, end-rounded filaments Prevents gingival damage Select least abrasive dentifrice Prevents enamel wear Place small amount of dentifrice on brush, spread over several teeth Vary brush position for each tooth surface Use slight, steady pressure Do not bend filaments

Supplemental Brushing:

Supplemental Brushing Problem areas Abnormally placed teeth Especially canines and premolars Inclined teeth Slanted teeth, hard to access exposed root surfaces Cementum (outer layer of root) Overlapped teeth or wide embrasures (gaps) Exposed furcation areas Space between a single tooth’s roots Canines and lateral incisors (teeth behind canines) Distal surfaces of posterior teeth Surfaces facing the back of the mouth

Supplemental Brushing (continued):

Supplemental Brushing (continued) Occlusal Brushing (chewing surface) Removes biofilm from the pits and grooves Procedure Point tips into pits without bending Vibrate in circular motion or use sharp quick strokes Precautions Long strokes tend to skip over pits and grooves, keep short Tongue Cleaning Reduces overall bacteria in the mouth Slows biofilm growth Reduces halitosis (bad breath) Procedure Can use a toothbrush or specific tongue cleaner (plastic, metal, etc.)

Care of Toothbrushes:

Care of Toothbrushes Supply of brushes 2 at home, 1 for traveling Prevent cross-contaminating Brush Replacement Every 2-3 months Replace after illness Cleaning Toothbrushes Rinse with warm water after use Tap excess particles off with handle Rinse filaments off again Tap off excess water Toothbrush Storage Keep in open air to dry Keep head upright Does not touch others Holes in travel container for aeration and drying