tooth brushing (2)

8/8/2019 Tooth Brushing (2)

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Plaque control measuresin pediatric dentistry


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Definition Dental Plauque

Newman, caranza: The soft deposits that

form the biofilm adhering to the tooth

surface or other hard surfaces in the oralcavity including removable and fixed

restorations.


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Mechanical

Chemical plaque control


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Mechanical plaque control

Tooth brush

Manual 1857

Powered 1939 circular and elliptical and

combination motions.


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Two types of bristles

Naturals bristles from hogs.

Artificial filaments of nylon.

Bristle design

Grouped in tufts 3-4 rows, 5-12 tufts

Rounded preferred than flat cut or coarse cut

Diameter 0.007-0.012 inch for medium

0.005 for kids

Length for adults 0.406 inches for kids 0.344inches


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Size of tooth brush head

Length 1-1.25 inch

Width 5/16- 3/8 inch


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Small children do not yet have the manualdexterity to clean their teeth themselves. Up

to the age of 6, an adult should therefore

always give the teeth a final brush after the

child has finished. However, children shouldbe introduced as early as possible to theMOI

(masticatory , outer surface, inner surface)

brushing technique which uses systematic

movements suited to the abilities of children.


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M =Masticatorysurfaces: brush with

small horizontalmovements. Start atthe back and brushslowly towards the

front

O=Outer surfaces:clean them with

small circularmovements

I = Inner surfaces:use small up and

down movements


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As small children learn a lot through imitationit is a good idea to give your child a children's

toothbrush to play with at an early age and tolet him or her watch you while you brush your

teeth. The child's first attempts to imitate you

will be rather clumsy.


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But two- to three-year-olds can already clean

the masticatory surfaces with simple

horizontal (scrubbing) movements. After thisthey learn the more difficult circular

movements for the outer surfaces and lastly

the small up and down movements for

cleaning the inside surfaces.


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TECHNIQUES FOR CHILDREN:

Normally the Scrubbing technique isadvised for very young children

brush for at least 2 minutes

always use tooth brush with soft bristlesand fluoridated, flavoured toothpaste

A tooth brush with hard bristles can cause

gingival recession (i.e they will recede and movebackward) and if used with an abrasivetoothpaste, can cause tooth abrasion(loss oftooth substance)


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Scrubbing technique


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BassTechnique ( 6-12)

Directly push the filaments toward roots ofteeth at 45 degree angle, press lightly but notenough to bend filaments of brush and gently,brush forward and backward in short vibratorymovement, attempting to press into gums margin

brush for at least 3 minutes

use soft toothbrush with fluoridated

toothpaste


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Modified bass technique: add circularmovement which will cover gum as well as toothsurface. It massages the gums

Roll technique: Position your tooth brushas in bass technique , then roll downwards overtooth surface, away from gum margins. Lift thebrush, position it and repeat. It is the most

commonly used method, it is an easy methodbut it neglects the gum margins.


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Stillman technique: Position your tooth brush

as in bass technique, press the filaments of

your tooth brush till the gum blanches, turn

your wrist through an angle of 45 degree andproceed to vibrate and roll against each tooth.

Wrist movement is required;it is an unpopular

technique because it is difficult. Also the gum

margin is often ignored


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Fones technique (circular method): (3 6 )

Brush is placed perpendicular to teeth. Large

circular motion of brush over clenched teethto simultaneously cover both upper and lower

teeth. A soft tooth brush is used. It was

Previously popular but is not advised

nowadays as it has proven to cause toothabrasion


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Charters method : Brush is angled45downwards, with half the bristles of thebrush over the gum and half over the crown.Vibratory movement along with a circularmotion is done.

ModifiedCharters method (12-19):Modification is to include occlusal surfaces(i.ebittting surfaces). Both these are difficult tolearn, hence unpopular


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How often should a toothbrush be replaced?

A toothbrush should be replaced as soon as thebristles are bent or sticking out since in this state

they are no longer able to clean thoroughly and

can also injure the gums. A toothbrush should

generally be replaced every 810 weeks.However, as small children often chew on

toothbrushes and the bristles start to stick out

much earlier, children's toothbrushes should bereplaced more often.


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Infants 0-1 with gauze

Toddlers (1-3) scrub technique

pre schoolars 3-6- fones or circular

school age 6-12 horizontal scrub or bass technique

adoloscents12-19 modified stillmen or charters method


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