toothbrushing and dental floss
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| Explain the rationale for daily plaque removal by the patient. | -Applying dentifrice (toothpaste)
-Removal of plaque/biofilm
-Removal of food/stain
-Stimulate the gingiva
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| Bass Method Indications | - Biofilm removal adjacent and directly beneath the gingival margin
- Open interproximal areas
- Exposed root surfaces
- Abutments
- Periodontal surgical patients
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| Bass Method Contraindictions | - Difficult for children
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| 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
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| Modified Bass Technique | same as Bass method plus a sweeping motion following the vibratory strokes in each section
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| Stillman's Method Indications | Message and stimulation as well as cleaning the cervical areas of the teeth
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| Stillman's Method Contraindictions | Excessive pressure can lead to tissue blanching
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| 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
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| Modified Stillman Method Indications | - Minimize gingival trauma
- Massage gingival tissue
- Increase biofilm removal effects
- Cervical areas and exposed proximal surfaces
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| Modified Stillman Method Technique | - Combination of the Rolling Stroke and Bass Methods
- Great for someone with a lot of inflammation
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| Rolling Stroke Method Indications | - Emphasis not on gingival sulcus
- children with healthy gingiva
- Sulcular technique too difficult
- General cleaning
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| Rolling Stroke Method Contraindicitons | - brushing too high during initial placement can lacerate the alveolar mucosa
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| Rolling Stroke Method Technique | - Brush is rolled from cervical third to incisal third
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| Circular (Fones) Method Indications | - Easy to learn for young children
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| Circular (Fones) Method contraindicitons | - Can be detrimental if paired with vigorous brushing
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| 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
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| Charters Method Indications | - Orthodontic appliances
- Loosen debris and biofilm
- Abutments
- Post-perio surgery
- Stimulate marginal and interdental gingiva
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| 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
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| Horizontal Method Contraindicitons | - Considered detrimental
- with use of abrasive dentifrice, such brushing may produce tooth abrasion
- dental biofilm can remain undisturbed on proximal surfaces
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| Horizontal Method Technique | - Unlimited sweep with a horizontal scrubbing motion
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| 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
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| 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
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| 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
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| 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
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| 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
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| Loop Method Flossing Techinque | - Great for children and patients with limited dexterity
- 2 ends tied together in a knot
- same technique as spool method
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| 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
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| 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
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| Proximal | Distal or Mesial surfaces
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| Occlusal | Chewing surface of posterior teeth
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| Facial | Includes labial and buccal surfaces
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| Lingual | surfaces towards the tongue
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| Buccal | Posterior teeth surface toward the cheek
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| Labial | Anterior teeth surface toward the lip
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| 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.
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| Furcation | The region of a multirooted tooth at which the root divides
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| Abrasion (tooth) | The pathological wearing away of tooth substance by mechanical means; grinding
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| Abrasion (Gingival) | The wearing down or rubbing away or removal of the superficial layers of skin or mucous membrane in a limited area
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| Tuft | part of the toothbrush head, refers to the small, individual clusters of bristles that proceed from a single opening.
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