PLAQUE CONTROL.

Department ofPublic Health Dentistry

Mridula Bharti 28th Batch

A Brief Description about-

Presented By-

• Dental plaque is a soft sticky and colorless deposit that accumulates on the teeth

• Plaque control is the regular removal of dental plaque and the prevention of its accumulation on the teeth and adjacent gingival surfaces.

INTRODUCTION

• Normally Plaque is invisible to naked eye so a preparation in Liquid, Tablet, or Lozenge form which contains a dye or other coloring agent is used for the identification of bacterial plaque, which is called as Disclosing Agent

Plaque ControlMeasures

Mechanical

Tooth brushing

Dentifrices

Interdental Aids

Tongue Scraper

Toothbrush

These are most widely

used aid for

accomplishing the goal

of plaque control.

These vary in size, design,

length, hardness, and

arrangement of bristles.

Bristles of tooth brushes comes in four varieties-

soft, medium, extra hard. Normally toothbrushes with

soft bristles are recommended for daily use.

Tooth brushes should be replaced every three

months.

ADA Specifications ofa Toothbrush1-1.25 inches in length

5/16 to 3/8 inches in width

2 to 4 rows of bristles

5-12 tufts/row

Bass method technique

Modified bass method

Stillman method

The Charter method

Toothbrushing Methods

It is a most accepted and effective method for removal of dental plaque present adjacent to and underneath the Gingival margin.

Technique- The Bristles are placed at 45 degree angle to the gingiva & moved in

small circular motions. Strokes are repeated around 40 times, 3 teeth at a time. Same method is used to brush the lingual surface Occlusal surface are brushed by pressing the bristles firmly into the pits

& fissures.

Bass Method Technique

• They were introduced in 1939.• Powered toothbrushes are recommended for:

1. Small children or handicapped

2. Hospitalized patients

3. Patients with orthodontic appliances.

4. Patients who prefer them.

Powered Toothbrushes

It is substance used with a toothbrush for the purpose of cleaning the accessible surface of teeth.

They are available in the form of pastes, toothpowder & gels

Dentifrices

Interdental Cleaning Aids1. Dental floss• It is used to remove plaque from interproximal tooth surface• Made from nylon filaments or plastic monofilaments, and can be waxed,

unwaxed, thick, thin, and even flavored.

• 12-18 inches taken• About 4 inches wound around middle finger• Stretched tightly between the thumb & forefinger• Passed gently in interdental areas

Spool method:

These are cone shaped brushes, suitable for cleaning large, irregular or wide interdental spaces.

They are available in various sizes and shapes.

2. Interdental brushes

3. Wooden tips

• Manufactured from orange wood.•Triangular in cross section.• Base of the triangle oriented towards the gingiva• Repeatdely moved in and out of the embrasure.• Restricted to facial aspects of anterior teeth

4. Water Irrigation Devices• Valuable supplement for mechanical plaque control• Removes unattatched plaque and debris.• Built in pump and reservoir•Also used with antimicrobial agents

Tongue Scrapers

These are used to remove

debris from the surface of the

tongue.

Chlorhexidine gluconate is a cationic bisbiguanide which is effective against an array of microorganisms, including gram positive and gram negative organisms, fungi, yeasts and viruses.

It exhibits anti plaque and anti bacterial properties. After a single rinse with chlorhexidine, saliva itself exhibits

antibacterial activity for about 5 hours.

Chlorhexidine

Prevents adsorbtion of bacterial cell wall onto the tooth surface by binding to the bacteria

Chlorhexidine should not be used before/immediately after using a tooth paste as it reduces its effectiveness

Adverse Effects of Chlorhexidine - Brownish staining of teeth on restorations, the staining

however is reversible Loss of taste sensation

Essential oil mouth rinses contains thymol, eucalyptol, and methyl salicylate.

These preparation have been evaluated in three long term clinical studies and demonstrate plaque reductions of 20% to 35% and gingivits reduction of 25% to 35%.

This type oral rinses has long history of daily use and safety.

Non Prescription Essential Oil Rinses

• Phenol derivate which has been recently included in mouth rinses and tooth pastes, to reduce plaque formation.

• Synthetic, non-ionic and used as topical antimicrobial agent• Has broad spectrum of activity against both gram positive and

gram negative bacteria.

Other Agents

Triclosan-

• Morpholino ethanol derivates• Inhibit plaque growth and reduce ginvitis• Causes weak binding of plaque to the tooth surface.• Prebrushing mouth rinse

Delmopinol-

• Used as active agent in antiplaque, due to the basic fact that they would be able to breakdown already formed matrix of plaque and calculus

• Effective when applied rapidly in mouth

Enzymes-

• Antibiotics such as vancomycin, erythromycin, niddamycin and kanamycin have been used as agents for plaque control

Antibiotics-

Periodontal disease- majority of missing teeth Only possible solution to the problem is prevention. Proper oral hygiene practices- controls periodontal disease. Patient education.

Conclusion

o Textbook of Preventive & Community Dentistry : S S Hiremath, 438-443

o Clinical periodontology : Cananya’s 10th Edition, 728-744

o Essentials of PHD : 5th Edition , 302-316

References

Thank You