OTHER ORAL HYGIENE AIDS

Other Oral Hygiene Aids■ Dental Floss/Tape ■ Dentifrice■ End Tuft Brush ■ Floss Threaders ■ Superfloss■ Denture brush■ Irrigation devices■ Proxabrush■ Gingival stimulators ■ Mouth rinses ■ Disclosing agents

Dental Floss/Tape

■ used interproximally to remove plaque (floss is circular in shape and tape is flat). Flossing should be completed before brushing at least once per day. Floss comes in many varieties (flavored, fluoridated, stretchy, waxed, unwaxed and fabric) there is no difference in the effectiveness of the different varieties, as long as the patient is comfortable with it.

■ https://www.youtube.com/watch?v=mW_IlfQGeKA&index=5&list=PLTgwgFPCr09NGXiAfPpQ_7XAYVVfOx7Ns – Click the link to use use

Dentifrice■ another term for toothpaste. There are dozens of brands and types.

Can come in the form of gels, pastes, powders and liquids. You should recommend patients choose one that carries the ADA Seal of Acceptance and that contains fluoride (unless it is for a child less than 2 years). Be cautious about highly abrasive toothpastes which may cause sensitivity and damage to teeth. All other factors are up to the patient (whitening, sensitivity, organic etc.).

End Tuft Brush

■ small brush in a narrow cone shape. Used for hard to reach areas, ortho appliances, fixed bridges, space maintainers and teeth with exposed proximal surfaces (solo teeth).

■ https://www.youtube.com/watch?v=xe3rYPG4I_A

Floss Threaders

■ used to floss under the pontic of a fixed bridge, looks like a large, flexible sewing needle. Used with regular floss, very helpful for patients with limited dexterity or large hands.

Superfloss

■ has three parts in one piece; stiff end for threading, thick, rounded, furry middle and regular floss. Great for braces and fixed appliances. Easy to thread under appliances and clean with the thick, plush area.

■ https://www.youtube.com/watch?v=di2qXuxZwHI

Denture brush

■ very rigid brush with hard bristles. Used to clean the acrylic and metal surfaces of dentures…NOT for teeth. Should be used with denture cleanser, mild soap, non-abrasive toothpaste or dishwashing detergent to keep the denture clean. Always clean dentures over a sink full of water to avoid dropping and breaking the acrylic.

■ https://www.youtube.com/watch?v=NRMqNV-lRBw

Irrigation devices

■ “Waterpik” delivers a stream of water through a nozzle to forcefully expel particles and massage the gingiva with pulsing water. Very useful in interproximal and subgingival cleaning and for cleaning around implants, braces or other appliances. Can be useful for those who can’t physically use floss or brush appropriately but should not replace them all together.

■ https://www.youtube.com/watch?v=_VThotpGq7g

Proxabrush

■ plastic handle used with a variety of disposable, small, nylon bristle brush attachments that come in several shapes (round, cone, tapered, small and large). Made for use in the embrasure area and are very useful for perio patients. Tips can be used 3-4 times before throwing them away.

■ https://www.youtube.com/watch?v=1c7MmGpC0BA

Gingival stimulators

■ usually a rubber tip or a wooden pick used in between teeth to stimulate blood flow and condition the tissue. Used in a gentle, rotating motion.

■ https://www.youtube.com/watch?v=wlDYnktlddg

Mouth rinses

■ used to flush debris from the mouth, freshen the breath and some types provide fluoride, kill bacteria and whiten teeth. Not a substitution for brushing and flossing.

Disclosing Agents

■ Coloring agent that makes plaque visible when applied to teeth. Comes in liquid form and a chewable table. When using the liquid form the patient rinses their mouth with it for 30 seconds. With the table the patient will chew the tablet and use their tongue to spread the agent on the teeth. With both the patient should not swallow.

■ https://www.youtube.com/watch?v=5mcFvMWGB6A

Prescription Mouthwash

■ Prescription mouthwash most often prescribed is Chlorhexidine (PerioGuard or Peridex). ■ Prescription plaque control rinse that is effective for the control of gingivitis.

Chlorhexidine inhibits bacterial growth by attaching to plaque and is active for 12-24 hours.

■ Cannot solely treat periodontitis but is very helpful in controlling inflammation and subgingival plaque after SRP, prophy or perio surgery.

■ The active ingredient is inactivated by most toothpaste so it should not be used immediately before or after brushing.

■ Side effects include staining with prolonged use, altered taste sensation, hypersensitivity and increased calculus formation because dead bacteria calcifies quicker.

■ Most effective against gram positive (Streptococcus mutans is more sensitive to it than lactobacillus).

■ Standard prescription before and after implant placement and tissue regeneration procedures and sometimes after full mouth or impacted 3rd molar extractions.

Special Dental Conditions:

■ *Acute Inflammation or traumatic lesions – can make brushing painful, patients should be instructed to brush all non-affected areas and resume regular oral hygiene as soon as possible. Rinsing with warm salt water can encourage healing and remove debris.

■ *After perio surgery – patients should be given instructions regarding areas with sutures or dressings. Vigorous brushing could dislodge dressings, unaffected areas can be brushed as normal.

■ *After extractions – patients are often reluctant to brush but adjacent teeth need to be cleaned to reduce bacteria and promote healing. Surgical site should be avoided for 2-3 days.

■ *Temporary crowns – floss should be used in a sliding motion instead of popping it through the contact which may dislodge the crown, brushing can be completed as usual.