GOOD MORNINGOral Health =Over All Health

MECHANICAL PLAQUE CONTROL

Contents• Introduction• Plaque Control

Mechanical plaque control

(a) Toothbrush

History

Manual tooth brushes

Techniques of tooth brushes

Electric toothbrushes

(b) Dentifrice

(c) Interdental cleaning aids

Dental floss

Interdental brushes

(d) Oral irrigation

Introduction There is a shift in paradigm towards two of the most

prevalent diseases in dentistry

Dental caries Periodontitis

Due to this preventive philosophy , the dentistry for children now focuses to a very large extent on inculcating sound practices In each child patient for ahealthy dentition to last for a life

Preventive dentistry is now the sound foundation for all the dentistry

In order to achieve this goal the home oral hygiene and plaque control Became the most important aspects of patient and parent education

NATURAL PHYSIOLOGICAL FORCES

• All these defenses may best be classified as

SUPERFICIAL ACTION in controlling or mediating plaque

buildup.

• But this is not sufficient for complete removal of plaque

WHY PLAQUE REMOVAL IS ESSENTIAL????

The cause and effect relationship between supragingival plaque and gingivitis

was demonstrated by Loe and his colleagues in 1965.

When plaque was allowed to accumulate, gingivitis developed within 21

days. When plaque control was initiated, the gingivitis was reversed (by

means of efficient plaque control, i.e., brushing and flossing) to clinical

gingival health

The removal of microbial plaque leads to cessation of gingival inflammation, and cessation of plaque control measure leads to recurrence of inflammation

The removal of plaque also decreased the rate of formation of calculus. ( Sanders , 1962)

Thus eliminating the plaque is the key to prevent the occurrence of periodontal disease or halting the progression of the disease.

Masses of plaque first develop( Lang,1973)

MOLAR & PREMOLAR

AREAS

PROXIMAL SURFACES OF

THE ANTERIOR TEETH

FACIAL SURFACES OF

THE MOLARS & PREMOLARS

HOW TO IDENTIFY DENTAL PLAQUE?

Disclosing solutions

It is a preparation either in liquid , lozenges, tablet

that contains a dye or other coloring agent used to identify

bacterial plaque deposits.

Indications

• Patient education

Instruction to patient about plaque control

• Self assessment by patient

• Preparation of plaque indices

• Evaluation of effectiveness of plaque

• control measures

FormulationsSKINNER SOLUTION PREPARATION

Diluted tincture of iodineWater 150ml.

• IODINE PREPARATION Iodine crystalsTincture of iodinePotassium iodideZinc iodidieWaterGlycerin

• Merchurochrome preparation Mercurochrome -1.5gWater -30mlOil of peppermint 3 dropsArtificial non calorigenic sweetner

BISMARCK BROWN Bismarck brownEthyl alcoholGlycerinFlavoring agent

ERYTHROSINE Erythrosine -0.8gWater 100mlAlcohol (95%) 10mlOil of peppermint 3 drops

Plak light system Sodium fluoresceinGlycerin in 75%

• Two Tone Solution

• Block and his coworkers (1975)

Thicker (older)plaque stains BLUE

Thinner (newer)plaque stains RED

Commercially available disclosing agents

Plaque controlDefinition

Plaque control is the removal of plaque and the prevention

of its accumulation on the teeth and adjacent gingival surfaces.

Plaque control also retards formation of calculus that leads to

resolution of gingival inflammation.

OBJECTIVE OF MECHANICAL PLAQUE CONTROL

Complete daily removal of dental plaque with a minimum ofeffort, time, devices, using the simplest methods possible tomaintain

GOOD ORAL HYGIENE.

MODE OF PLAQUE CONTROL

PLAQUE CONTROL

MECHANICAL

TOOTH BRUSHESINTERDENTAL

AIDS

CHEMICAL

MOUTHWASHES

ANTIBIOTICS

ENZYMES

Self performed

1. Tooth brushing

2. Interdental aids

– Dental floss and tape

– Toothpicks

– Interproximal brushes

– Single-tufted brush

3. Adjunctive aids

– Dental irrigation devices

– Tongue scrapers

– Dentifrices

WHAT IS PURPOSE OF A TOOTH BRUSH??

Historically the purpose of brushing was to provide massage to increase the resistance of gingival tissue.

Massage or friction from a hard bristled brush was believed to Increase Keratinization which inturn , resulted in resistance to bacterial invasion

History

• Mechanical cleaning of teeth can be traced back to ancient times.

• Evidence says that oral hygiene was practiced by egyptians 5000 years ago with the help of “ chewstick”

• Excavations in Mesopotamia uncovered elaborate gold tooth picks used by the Sumerians around 3000BC

First bristle tooth brush was found in

China during Tang dynasty.

1498.

One of the earlier tooth brushes made in England was produced by “William Addis” about 1780.

• The first patent for a tooth brush was by HN wadsworth in

1857 in united states.

During 1900s , Celluloid handles gradually replaced bone

handles in tooth brushes.

• Natural animal bristles were also replaced by synthetic fibers,

usually Nylon Bristles in 1938 by Du Pont

• The first electric tooth brush was invened in switzerland by “Dr.Philippe Guy Woog”

The first american electrical tooth brush in US called BROXODENT was released by Squibb in 1960

• General electric introduced a rechargable cordless tooth brush in 1961

1987

Interplak was first rotary action electrical tooth brush

Definition

kaufmann

“artificially hygienic device used in conjunction with dentifrices to brush the

teeth , consisiting usually of a handle and clusters of bristles, so arranged to

exert the most beneficial action possible without causing injury to hard

structurs or adjacent soft tissues”

Parts Of Tooth Brush

• Handle

Manufacturing Specifications

Most often a single type of plastic , or a combination of polymers.

Preferred Characteristics

Easy To Grasp

Does not Rotate Or Slip During Usage

No Sharp Corners Or Projections

Properties

• Exhibit Durability

• Imperviousness To Moisture

• Pleasing Appearance

• Low Cost

• Sufficient Maneuverability

• Variations

A Twist, curve , offset or angle, thickened angles may assist the patient in adaption of brush to difficult to reach areas

• A handle of larger diameter may be useful for patients with limited dexterity,such as children, aging patients, use of patients with certain types of disability