Lisa Mayo, RDH, BSDH Staci Janous, RDH, BS POLISHING, FLOSS, FLUORIDE, INSTRUMENT SHARPENING DH101:...

Lisa Mayo, RDH, BSDH

Staci Janous, RDH, BS

POLISHING, FLOSS, FLUORIDE,

INSTRUMENT SHARPENING

DH101: PRECLINICAL SCIENCES

CONCORDE CAREER COLLEGE

Wilkins CH 27: ToothbrushingWilkins CH 28: Interdental Care and IrrigationWilkins CH 29: Dentifrice & mouthrinsesWilkins CH 35: FluoridesWilkins CH 38: Instruments and principles for

instrumentation

Nield CH 22: Concepts for instrument sharpeningNield CH 23: Instrument sharpening techniquesNield CH 28: Cosmetic polishing procedures

REFERENCES

1. Polishing2. Floss3. Toothbrushing4. Toothpaste5. Fluoride6. Adjunct Aids7. Oral Hygiene Instruction

OUTLINE

OBJECTIVE #1: POLISHINGNIELD CH28

Cosmetic procedure to help remove extrinsic stains from teeth

Thorough brushing/flossing can produce the same eff ects as polishing

Can scratch tooth surfaces: esp cementum/dentinDoes NOT improve the uptake of fluorideSome patients like and others do not

POLISHING

Aerosol production and splatter Do not use on patients with known communicable

conditions (TB) Do not use on patients with respiratory conditions or

immunocompromisedCreation of bacteremia (bacteria in the bloodstream)

Need to make sure premed was taken prior to polishing

Iatrogenic damage to tooth surface CEJ is thin and can be abraded by polishing agents Polishing creates heat is not done properly (primary

teeth w/large pulp chamber) Could injure gingiva

POLISHINGADVERSE EFFECTS

1. Lack of stain2. Sensitive teeth (can use sensitive polish paste)3. Do not polish exposed cementum or dentin

(recession)4. Restored tooth surfaces (scratching, eroding, pitting

can occur)5. Newly erupted teeth (mineralization is occurring)6. Implant abutments7. Areas of demineralization (soft tooth structure)8. Gingiva

POLISHINGCONTRAINDICATIONS

Selective polishing: polishing only those areas with an objectionable appearance

Current theories: remove as much stain as possible with hand or power driven devises fi rst before polishing

The most common technique for stain removal is with RUBBER CUP POLISHING/POWER DRIVEN POLISHING

POLISHING

Components1. Handpiece (handle)

Slow speed handpiece Attaches to dental unit

2. Prophy angles (shank) Can be right-angled (straight shank) or contra-

angled (bent shank) Many companies manufacture Can be reusable or disposable (our clinic uses,

most common)3. Prophy cup attachments (more on another slide)

POLISHING

POLISHING

POLISHINGCORDS AND HANDPIECE

Poor Ergonomics

POLISHING

POLISHING

Latch Design Threaded Head Button-Ended Head

3. Prophy Cup AttachmentsNatural or synthetic rubbers: non-latex which are very soft and flexible

Internal cup design: wide range, effect cleaning ability and amt prophy paste delivered to the tooth

Length and diameter: vary (short or standard)Flexibility: soft and firmBristle brush attachments

Ortho appliancesPits and grooves of teethCareful not to injure gingiva

POLISHING

POLISHING

Abrasive AgentSubstances that remove extrinsic stains by scratching and abrading the tooth surface

Differing particle sizes/grit: larger the size = deeper scratches

Manufacturers label as extra fine, fine, medium, coarse, extra coarse

Use the smallest grit particle size to achieve your goals

POLISHINGMINIMIZING TOOTH LOSS

Rubber Cup AdaptationParallel to tooth surface being polishedWhen angle = ↑ scratching

Pressure: use just enough pressure to make the cup flare slightly

Speed of Application: SLOWEST speed as possible so as NOT to overheat tooth

Application Time: 1-2sec per tooth

POLISHINGMINIMIZING TOOTH LOSS

POLISHING

POLISHING

TOO MUCH PXPASTE!!

POLISHING

1. Before Polishing Discuss importance daily plaque control/removal Remove as much stain as possible with

instruments2. Patient Preparation

Review patient medical history for contraindications

Explain the rationale for selective polishing Obtain informed consent Make sure eyewear is in place

3. Clinician Preparation PPE Low or High Speed Suction

POLISHING PROCEDURE

4. Supine patient position5. Latex-free cup with correct grit paste6. Establish correct fulcrum7. Rest handpiece in V-Shape area of your hand

between index finger and thumb8. Hold cord between 4 th & 5 th finger9. Hold cup away from tooth & activate foot pedal so

speed is slow and steady10. Start UR Facial most posterior tooth and polish each

tooth until end at the UL Facial most posterior tooth11. Apply just enough pressure to make rim of cup flare

slightly12. Use a wiping-motion on the crowns of the teeth

covering the entire facial surface and flaring the cup into the interproximal

POLISHING PROCEDURES

13. Refi ll prophy cup with paste every 3-4 teeth. An empty cup will not polish the teeth and only create excessive heat. Be sure to remove saliva from the cup on a dry gauze before placing cup back into the mouth.

14. Once upper facials are completed, the clinician will polish upper linguals #16-1

15. Rinse the upper arch thoroughly16. Drop down to mandibular arch and polish in the

same sequence (#32-17F then #17-32L)17. Rinse after mandibular arch completed

POLISHING PROCEDURE

Hard for patient if you do NOT rinse until completed both arches of polishing (a lot of prophy paste in their mouths they may swallow)

Many prophy pastes DO contain fluoride (read labels carefully)

Many ingredients in prophy paste: some patients may have allergies to them (ex: Yellow dye #5)

Some patient do NOT like px paste: off er alternatives (no polishing, let them brush their own teeth, air polishing)

Use any sequence you like as long as it is the same for every patient so you do NOT miss areas (for now while you are learning, use the sequence presented today)

POLISHINGKEY POINTS

Point Value: 1 0

1. Uses sufficient paste    

2. Applies paste to 2 - 3 teeth at a time    

3. Uses a secure fulcrum and fulcrum finger as pivot    

4. Uses the proper speed (as slow as possible)    

5. Uses the proper grasp on the handpiece    

6. Cover all surfaces    

7. Rinses or suctions paste as needed by patient    

8. Operator position is correct    

9. Adjusts light as necessary    

10. Operator uses mirror correctly    

*11. Utilizes proper infection control protocol    

TOTAL POINTS: 

POLISHING COMPETENCY

OBJECTIVE #2: FLOSS

Recommended prior to brushing: fluoride from toothpaste can reach interproximally

12-15in length of flossWrap floss around middle fingerUse thumb and index finger of each hand for guidingGrasp fi rmly with only ½in of loss between fingertips

FLOSSWILKINS P.412

Rotate floss to use a new section often Use a GENTLE, slow, sawing motion to guide floss

past each contact areaControl floss to avoid floss-cuts in gingival tissuesCurve the floss around each tooth and slide up-

and-down with firm pressure making a “C-shape” with the floss Floss should be inserted under the gingival

tissues until reaching a “stopping point” (about 1-2mm deep)

FLOSSWILKINS P.412-413

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Indicated for use proximal surfacesAids in minimizing decay interproximallyMaterials

1. Silk: Not used anymore, 1st developed 2. Nylon. Nylon multifilaments

Waxed or Unwaxed Circular (floss) or flat (tape)

3. Expanded PFTE: Plastic monofilament polytetrafluoroethylene with wax

Types of floss Research has shown no difference in the

effectiveness of waxed or unwaxed floss for biofilm removal

Biofilm removal depends on how floss is applied

DENTAL FLOSSWILKINS P.411

Waxed / PFTE Helps prevent trauma to tissues Slides through contact area with ease Resists breakage or shredding when passed over

irregular tooth or root surface (overhang fillings, calculus, etc…)

Unwaxed Thinner Pressure against a tooth surface spreads the

nylon fibers and gives a wider surface for biofilm removal

Be careful not to floss cut oneself!! Can fray when rubbed over an irregular tooth/root

surface

DENTAL FLOSSWILKINS P.411

Enhancements1. Color 2. Flavors (mint, cinnamon most common)3. Therapeutic agents: fluoride, whitening

Limited research as to their effectiveness

DENTAL FLOSS

REVIEW

Floss is made of the following materials except:

A) silkB) waxed nylonC) unwaxed nylonD) expanded PTFEE) wood filaments

ANSWER

E) Wood filaments is the correct answer.Floss is made from silk, waxed and

unwaxed nylon, and expanded PTFE.

FLOSSING COMPETENCY

Point Value: 1 0 1. Uses approximately 12 - 15 inches of floss     2. Wraps floss around middle fingers     3. Establishes and maintains a fulcrum (one in the anterior, two in the posterior)

4. Uses index finger as a guide     5. Inserts floss at an angle to the tooth     6. Passes floss through the contact area with “see-saw” motion

7. Controls floss to prevent “snapping”     8. Maintains short length ¾ “ to 1” between index fingers     9. Presses floss against teeth    10. Creates and maintains a “C” formation    11. Slides under the gums with an “up-and-down” motion    12. Avoids injury to the interdental papillae    13. Continually wraps / unwraps to use the clean portion of the floss

14. Utilizes correct dental lighting positioning    *15. Utilizes proper infection control protocol    Total Points:

OBJECTIVE #3: TOOTHBRUSHINGWILKINS CH27

The most commonly used device for removing oral biofilm

Well designed to remove oral biofilm from the facial, lingual, and occlusal tooth surfaces

Patients NEED toothbrushing instructionsToothbrush Filament Design

Filaments: # & arrangement varyMost filaments are 10 -12 mm long

TOOTHBRUSHING

CHARACTERISTICS OF AN EFFECTIVE MANUAL BRUSH

Conforms to patient requirementsEasily manipulatedReadily cleanedEnd-rounded filamentsProperties

Flexibility, softness, strength, lightness of handle

REVIEW

Which one of the following characteristics would be least desirable in a toothbrush?

a. Conforms to individual patient in size, shape, and texture

b. Readily cleaned and aerated, impervious to moisture

c. Bristle or filament height 21 mmd. End-rounded filamentse. Durable and inexpensive

ANSWER

C) Bristle or filament height 21 mm is the correct answer.

The filament height is usually 11 mm, not 21 mm. Filament height is not one of the characteristics of an effective toothbrush, either.

Copyright © 2010 by Saunders, an imprint of Elsevier Inc.

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43Copyright © 2010 by Saunders, an imprint of Elsevier Inc.

Typically activated by electricity or batterySuitable for almost any clientEffective in controlling stainPatients need power toothbrushing

instructions

POWER TOOTHBRUSH

2 minutes is often the recommended amount of time

Average brushing time is <30seconds

Patients usually think their brushing time is more than double the actual time

Recession & AbfractionAbrasive / Too Hard Brushing Incorrect technique (scrubbing back-and-forth)

TOOTHBRUSH POINTS

Copyright © 2010 by Saunders, an imprint of Elsevier Inc.

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SEE HANDOUT FOR DIFFERENT METHODS & WILKINS P.393

RollBass SulcularModified BassStillmanModified StillmanFones(circular)Horizontal (scrub)Leonard (Vertical)Occlusal

TOOTHBRUSH TECHNIQUE

Copyright © 2010 by Saunders, an imprint of Elsevier Inc.

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BASS OR

STILLMAN

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CHARTERS

50

ROLL

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FONES

HORIZONTAL/SCRUB

OCCLUSAL BRUSHING

QUESTION

If your patient was a child with limited dexterity what method of brushing would you recommend?

ANSWER

Roll or FonesFones 1st technique for kids prior to dexterity development

Roll: good as a technique prior to being able to use sulcular

QUESTION

What method of brushing is recommended for a 12 year old patient in full orthodontics?

ANSWER

ChartersFilaments 45 degree angle toward occlusal

Enough pressure to force filaments between teeth

Vibrate back and for 10sec 2-3x/teethHeel/toe for anterior lingual’s

BRUSHING TECHNIQUE

Light, comfortable grasp Control brush at all times Grasp handle in the palm of the hand with thumb

against the shank, near the head of the brush so that it can be controlled effectively

Position filaments in the proper direction for placement on the teeth (depends on the brushing method using)

Apply appropriate pressure: Too much pressure bends the filaments and curves them away from the area where brushing is needed

WHICH ONE DOES YOUR TOOTHBRUSH LOOK LIKE?

CARE OF TOOTHBRUSHES

Brush replacement: 2-3 monthsMore often for immunosuppressed personsDispose anytime after an illness or infection or surgery

Rinse thoroughly after each useBrush storage

Open air with head in upright positionClose container encourage bacterial growth

OBJECTIVE #4: TOOTHPASTEWILKINS CH29

↓ Caries ↓ Biofilm formation ↓ Gingivitis↓ Supragingivial calculus↓ Tooth sensitivityRemove stains

DENTIFRICES

1. Abrasives 20-40%2. Humectants 20-40%3. Water 20-40%4. Detergents 1-2%5. Binders 1-2%6. Sweeteners 1-2%7. Coloring Agents as needed8. Flavoring as needed9. Preservatives 2-3%

TOOTHPASTE COMPONENTSWILKINS P.425

TOOTHPASTE COMPONENTS

Abrasives (20-40%)Clean and polishPhysically remove biofilm and stainCalcium carbonate, phosphate salts, hydrated aluminum oxide, silica’s

TOOTHPASTE COMPONENTS

Humectants (20-40%)Retain moisturePrevent hardening when exposed to airStabilize preparationXylitol, glycerol, sorbitol

Detergents (1-2%)Loosen debrisSurfactant (↓ surface tension)Foaming and emulsify debrisSodium lauryl sulfate

TOOTHPASTE COMPONENTS

Binders (1-2%) Stabilize Mineral colloids, natural gums, seaweed,

celluloseColoring agents

Attractiveness but may cause mucosal rxns Vegetable dyes, tartrazine

TOOTHPASTE COMPONENTS

Sweeteners/Flavoring Agents Create a favorable taste Xylitol, glycerine, manitol, sorbitol, saccharine,

essential oilsPreservatives (2-3%)

Prevent bacteria growth Prolong shelf lifeAlcohol, benzoates, phenols

SPECIALTY TOOTHPASTE

WhiteningHydrogen peroxide Carbamide peroxide

Tooth sensitivity: occlude dentinal tubulesPotassium nitrate/citrate/chloride

Gingivitis reductionStannous FluorideTriclosanZinc citrate Sodium Monofluorophosphate

SPECIALTY TOOTHPASTE

Calculus reductionTetrapotassium pyrophosphateTetrasodium hexametaphosphate (ex: Crest Pro Health)

Zinc chlorideZinc citrateTriclosan (ex: Colgate)

In a dentifrice, what is the function of the humectant?

A) Prevents separation of ingredientsB) Prolongs a product’s shelf lifeC) Maintains the consistency of the product

D) Retains moisture

REVIEW

D) Retains moisture is the correct answer.

The purpose of the humectant is to retain moisture. The binder prevents separation and maintains consistency and the preservative prolongs shelf life.

ANSWER

Fluoride

OBJECTIVE #5

Fluoride & Tooth DevelopmentFluoride & The BodyFluoride Toxicity & Lethal DosesFluoride Delivery

1.Community Water2.In-Office3.At-Home OTC and Rx

FLUORIDE OUTLINE

FLUORIDE & TOOTH DEVELOPMENT

WILKINS P.428 & CH35MOSBY’S DENTAL HYGIENE BOARD

REVIEW

Fluoride is a nutrient essential to the formation of sound teeth and bones

Pre-Eruptive: Mineralization stageFluoride is deposited during the formation of the enamel

Fluoride is incorporated directly into the structure during mineralization

Results in the development of shallower occlusal grooves and fissures

FLUORIDE & TOOTH DEVELOPMENT

Post-EruptiveUptake is most rapid on the enamel surface during the first years after tooth eruption

Continuing intake of drinking water with fluoride provides a topical source as it washes over the teeth

Fluoride in enamelUptake: depends on amt fluoride in oral environment and length of time of exposure to fluoride

Natural constituent of enamelOuter surface has highest concentrations

FLUORIDE & TOOTH DEVELOPMENTWILKINS P.518-520

FLUORIDE ABSORPTION IN BODYWILKINS P.518

Begins in stomach as hydrogen fluoride (HF)Rate depends on solubility of F compound & gastric activity

↓ when taken with milk/foodWhatever not absorbed by

stomach goes to small intestineMax blood levels reached in

30min after intake

FLUORIDE DISTRIBUTION IN BODYWILKINS P.518

Strong affi nity for calcified tissues – 99% located in mineralized tissues

Highest concentration in surfaces closest to the source supplying F (ie: tooth surface)

Stored in crystal lattice of teeth and bonesAmount stored varies w/intake amt, exposure

time, age/stage of developmentDentin fluoride concentrations < enamel

FLUORIDE EXCRETION IN BODYWILKINS P.518

Kidneys by urineSmall amts in sweat and fecesLimited transfer via breast milk

FLUORIDE TOXICITY & LETHAL DOSEWILKINS P.536

Toxic Dose Induce emesis F ion will bind to MILK or LIME JUICE Call 911

Safe Dose Adult: 1.25-2.5G Child: 0.5G

Lethal Dose F 32-64mg of PURE fluoride per Kg body weight Adult: 5-10G Child: 0.5-1.0G

Amt F Ingested

Emergency Tx

≤5mg/kg 1. Admin fluoride-binding agent

≥5mg/kg 1. Induce vomiting (emesis)2. Admin fluoride-binding agent3. Seek medical tx

≥15mg/kg 1. Seek medical tx2. Induce vomiting3. Cardiac monitoring

FLUORIDE: TOXICITYWILKINS P.536

Symptoms being within 30min – 24hrsGI: hydrochloric acid acts on F ion to form

hydrofluoric acid – irritates stomach lining Nausea, vomit, diarrhea, abdominal pain,

increase salivation, thirstSystemic Involvement

Symptoms of hypocalcaemia (low calcium levels in blood)

Convulsions, paresthesia Cardiac failure, respiratory paralysis, death

Treatment Induce vomiting (emesis) Administer F-binding agents

FLUORIDE: TOXICITYWILKINS P.536

Skeletal fluorosisResults after long-term use of water with 10-25ppm for industrial exposure

Dental fluorosisWhen excess F is in drinking water during the years of tooth developmentBirth until 12-16yrs

FLUORIDE THERAPYCOMMUNITY WATERWILKINS P.522-523

SystemicFluoridation: adjustment of F ion content in water supply to the optimum physiologic concentration that will provide:

1965: 1st communities fluoridatedAvg cost: $0.13 - $5.48 per person/yearMost cost effective way to bring F to a community!!

FLUORIDE THERAPYCOMMUNITY WATERWILKINS P.522-523

Community FluoridationLevels range 0.7-1.2ppm mg/LEPA monitorsCompounds used:

1. Sodium fluoride2. Sodium silicofluoride3. Hydrofluosilic acid

FLUORIDE THERAPYCOMMUNITY WATERWILKINS P.522-523

Community Fluoridation Most effective in reducing caries smooth surface Least effective in reducing caries pit and fissures Anterior teeth have better protection then

posterior due to above reason

FLUORIDE THERAPYCOMMUNITY WATERWILKINS P.522-523

Community Fluoridation Disadv.

1. Have to drink community water Reasons why not universal

1. Controversial effects of systemic F2. Public not informed of benefits of F3. Powerful Lobbyist's

Prevention of dental caries Id special problems: areas adjacent to

restorations, orthodontic appliances, xerostomiaDesensitization of recession

Fluoride aids in blocking dentinal tubulesPatient and/or parent education

Help patients understand the benefits & limitations of topical fluoride

FLUORIDE DELIVERYIN-OFFICE

WILKINS P.527

IN-OFFICE FLUORIDEWILKINS P.528

Fluoride Percent Notations

NaF (neutral sodium fluoride) 2% Gel or foam

NaF (neutral sodium fluoride) 5% Varnish

APF (acidulated phosphate fluoride)

1.23% Gel or foamNot for colored restorations

SnF (Stannous fluoride) 0.8% Unpleasant tasteStains teethGingival sloughingDiscolor restorations

IN-OFFICE FLUORIDETECHNIQUE

WILKINS P.529-530Tray technique: Gel or foam

Covers all exposed root surfacesFollow manufacturer recommendations for length of time (ADA ONLY supports 4min)

Post-Op: No rinse, eat, drink, brush, or floss 30 min after tray

Varnish technique (5% NaF)Premeasured wells w/ applicator brush Post-Op

Avoid hot drinks, alcoholic beveragesNo brushing or flossing teeth 4 -6 hours

Point Value: 1 0

1. Selects proper tray size    

2. Use proper amount of fluoride foam    

3. Patient in upright position    

4. Dries teeth    

5. Inserts trays properly    

6. Inserts saliva ejector in between trays and positions for patient comfort. Has patient hold suction.

7. Instructs patient to tilt head forward slightly    

8. Stays with patient throughout procedure    

9. Times procedure for 1min    

10. Removes trays and saliva ejector correctly    

11. Has patient inset saliva ejector for final suction    

12. Gives proper post-op instructions    

*13. Utilizes proper infection control protocol    

TOTAL POINTS: 

FLUORIDE COMPETENCYTRAY ONLY, NOT VARNISH THIS

TERM

Who? Xerostomia, Root surface hypersensitivity, Rampant caries

Dentifrices that are brushed on 2-3x/day OTC or Rx Stannous fluoride Neutral Sodium Sodium Monofluorophosphate

FLUORIDE FOR HOME USEWILKINS P.523

At-Home Rx Fl in Trays

1.1%NaF (5,000ppm) Safe for restorations

1.1%APF (5,000ppm) Not safe for restorations

0.4%SnF (1,000ppm) Can stain teeth

Low potency/high frequency (OTC)High potency/low frequency (Rx)Not for use <6yrs

FLUORIDE MOUTHRINSEWILKINS P.533

Mouthrinse Rx Frequency

Rx or OTC

0.2% NaF (905ppm) 1x/week Rx

0.044% NaF/APF (200ppm) 1x/day OTC

0.05% NaF (230ppm) 1x/day OTC

0.0221%NaF (100ppm) 2x/day OTC

REVIEW

Which of the following systemic fluoride delivery methods would be considered most economical?

A) Dietary fluoride supplementsB) Naturally occurring in foodsC) Community water fluoridationD) Professional fluoride treatment

ANSWER

C) Community water fluoridation is the correct answer.

Community fluoridation is the most economical systemic method for caries prevention available. Dietary supplements and foods that contain fluoride are sources of systemic fluoride, but are not as economical. Professional applications are not considered systemic.

OBJECTIVE #6: ADJUNCT AIDSWILKINS CH28

WILL COVER IN MORE DEPTH IN CLINIC II

Toothbrushing does not reach the interproximal surfaces

Who may need:1. Increased risk for or who have periodontal

disease 2. Orthodontics3. Large embrasure spaces4. Arthritis (inability to floss correctly)

ADJUNCT AIDS

ADJUNCT AIDS

Disclosing agentsFloss (braided, unbraided, waxed, unwaxed, or tape)Floss holderFloss threaderTufted floss, yarn, gauzeEnd Tuft Interdental proxy brush/aidsWooden/plastic/triangular wedges/sticksToothpicks, perio aid, rubber tipTongue cleanersPower brushOral Irrigation/Water JetDenture brush

ADJUNCT AIDSCOMPETENCY

Point Value: 1 0

1. Disclosing agent    

2. Fones method of brushing    

3. Leonard method of brushing    

4. Stillman method of brushing    

5. Modified Stillman method of brushing    

6. Charters method of brushing    

7. Bass method of brushing    

8. Modified Bass method of brushing    

9. Roll method of brushing    

10. Interdental brush    

11. End tuft brush    

12. Toothpick holder    

13. Wedge stimulators    

14. Rubber tip stimulator    

15. Floss holder    

16. Floss threader    

17. Tongue cleaners    

TOTAL POINTS: 

ORAL IRRIGATION

Effective method of delivery for Chemotherapeutic agents

Disrupts loosely adherent microbial colonization

Point tip perpendicular to long axis of tooth

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DENTURE BRUSH

END-TUFT BRUSH

INTERDENTAL/PROXY BRUSH

WOODEN/PLASTIC PICKS

FLOSS HOLDER/PICKERS

RUBBER TIP STIMULATORS

TONGUE CLEANERS

POWER BRUSH

OBJECTIVE #7: OHIWILL COVER IN MORE DEPTH CLINIC

II

Explain what you will be discussing with patientHave patient demonstrate how they brush/floss

fi rstMake suggestions and teach correct way to

brush/flossThen you demonstrate how to brush/floss

correctlyAllow patient time to practice and demoSuggest adjunctive aids as indicatedEncouraging and motivationalSpeaks at patient’s levelGives instructions written down if needed

ORAL HYGIENE INSTRUCTIONS

Disclosing solution to help identify areas of plaque & calculus supragingivally!

Good to do prior to OHIWe use in clinic and record on Plaque-Index O’Leary’s

FormSelective dye in solution that stains materia alba,

plaque, soft debris, pellicle (will learn next week)

OHI

OHI: PLAQUE INDEX

CLINICAL ASSESSMENT OF ORAL BIOFILM

The presence of oral biofi lm is most commonly assessed by passing a dental explorer over the tooth surface

Disclosing agents are used to make oral biofi lm clinically visible1. FLUORESCEIN DYE (FD&C Yellow No.8)

Visible under UV light More expensive but will leave no visible stain behind

2. Two-tone dyes (FD&C Red No.3 & Green No.3) Combo solution Can differentiate old rom new biofilm Discloses plaque but not gingival tissues

DISCLOSING SOLUTION

Will stain decalcified and pitted tooth surfaces

Use Vaseline on lips and restorationsAvoid using prior to sealant application

THE END