Question | Answer |
Explain the rationale for daily plaque removal by the patient. | -Applying dentifrice (toothpaste)
-Removal of plaque/biofilm
-Removal of food/stain
-Stimulate the gingiva |
Bass Method Indications | - Biofilm removal adjacent and directly beneath the gingival margin
- Open interproximal areas
- Exposed root surfaces
- Abutments
- Periodontal surgical patients |
Bass Method Contraindictions | - Difficult for children |
Bass Method Technique | - Focus on the sulcus
- Intrasulcular position 45 degree angle
- strokes:
- 10 strokes each area
- press lightly without flexing
- vibrate the brush
- reposition and repeat |
Modified Bass Technique | same as Bass method plus a sweeping motion following the vibratory strokes in each section |
Stillman's Method Indications | Message and stimulation as well as cleaning the cervical areas of the teeth |
Stillman's Method Contraindictions | Excessive pressure can lead to tissue blanching |
Stillman's Method Technique | - Brush located partly on the gingival and partly on the cervical area of the tooth directed apically.
- Circular motion is given to the brush |
Modified Stillman Method Indications | - Minimize gingival trauma
- Massage gingival tissue
- Increase biofilm removal effects
- Cervical areas and exposed proximal surfaces |
Modified Stillman Method Technique | - Combination of the Rolling Stroke and Bass Methods
- Great for someone with a lot of inflammation |
Rolling Stroke Method Indications | - Emphasis not on gingival sulcus
- children with healthy gingiva
- Sulcular technique too difficult
- General cleaning |
Rolling Stroke Method Contraindicitons | - brushing too high during initial placement can lacerate the alveolar mucosa |
Rolling Stroke Method Technique | - Brush is rolled from cervical third to incisal third |
Circular (Fones) Method Indications | - Easy to learn for young children |
Circular (Fones) Method contraindicitons | - Can be detrimental if paired with vigorous brushing |
Circular (Fones) Method Technique | - Teeth closed
- Circular Motion
- Fast wide sweeping from maz to mand finfiva
- Light pressure
- Anterior teeth: edge to edge
- Lingual and palatal
- In and out stroke |
Charters Method Indications | - Orthodontic appliances
- Loosen debris and biofilm
- Abutments
- Post-perio surgery
- Stimulate marginal and interdental gingiva |
Charters Method Technique | - Accomplish rolling stroke method first
- Press lightly
- Vibrate brush
- Use rotary motion of handle
- Bristles toward
- occlusal plane
- Incisal plane
- 45 degree angle |
Horizontal Method Contraindicitons | - Considered detrimental
- with use of abrasive dentifrice, such brushing may produce tooth abrasion
- dental biofilm can remain undisturbed on proximal surfaces |
Horizontal Method Technique | - Unlimited sweep with a horizontal scrubbing motion |
Powered toothbrushes Indications | - More effective than manual
- Many improve compliance
- Useful for patients
- in orthodontic-prosthodontic-restorative treatment
- with dental implants
- who are aggressive brushers
- with disabilities
- Variety of motion, speeds |
Methods for removing plaque from occlusal surfaces | - Handle parallel
- Filaments in pits
- Toe covers most posterior tooth
- Procedure
- vibrate slightly circular
- Maintain tips on surface
OR
- Sharp quick strokes
- lift off, repeat 10x |
Methods for removing plaque from the tongue | -Toothbrush is inferior to tongue cleaners in removing debris and microorganisms
- Start posterior, handle 90 degrees
- Roll filaments towards anterior
- at least 2x daily to control halitosis and anaerobes |
Proximal Cleaning Aid Indications | - Unwaxed vs Waxed Floss
- Waxed: tight proximal contacts
- Unwaxed: normal tooth contacts
- Dental tape
- preferred if surface area is large
- PTFE (polytetrafluoroethylene) ex. Glide
- no fraying
-Braided
- implants
- Tufted |
Spool Method Flossing Technique | - Arm length floss
- wrap around middle fingers
- Use index fingers and thumbs to control movement between teeth
- floss wrapped c-shaped around proximal tooth surface |
Loop Method Flossing Techinque | - Great for children and patients with limited dexterity
- 2 ends tied together in a knot
- same technique as spool method |
Trauma caused by improper flossing | - Too long a piece between fingers when inserting between teeth
- Snapping floss
- no c-shape
- failure to use finger rest for control
- shoeshine motion |
Patient Education
" My gums bleed when I floss" | - Gingival bleeding during flossing
- indicative of inflammation
- Ulcerations in the sulcular lining
- Will subside with daily removal of biofilm
- Flossing shouldn't be avoided
-Active disease needs to be controlled by more frequent flo |
Proximal | Distal or Mesial surfaces |
Occlusal | Chewing surface of posterior teeth |
Facial | Includes labial and buccal surfaces |
Lingual | surfaces towards the tongue |
Buccal | Posterior teeth surface toward the cheek |
Labial | Anterior teeth surface toward the lip |
Embrasure spaces | a space continuous with an interproximal space, produced by curvatures of teeth in contact in the same arch; it provides a passage through which food escapes from the occlusal surfaces during mastication. |
Furcation | The region of a multirooted tooth at which the root divides |
Abrasion (tooth) | The pathological wearing away of tooth substance by mechanical means; grinding |
Abrasion (Gingival) | The wearing down or rubbing away or removal of the superficial layers of skin or mucous membrane in a limited area |
Tuft | part of the toothbrush head, refers to the small, individual clusters of bristles that proceed from a single opening. |