19,prevention of PD.ppt

7/27/2019 19,prevention of PD.ppt

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PREVENTION

OFPERIODONTAL

DISEASE


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1.Primary: which is either healthpromotion or specific protection aimedto prevent a certain disease.

2.Secondary: attempt to prevent furtherprogression or reverse a reversible

disease or condition.

3.Tertiary: to treat or rehabilitation of apermanent damages.


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Prevention inperiodontology

mean:

Plaque control


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Plaque control can be classified

as:

1Professional

2Mechanical

3Chemical


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MECHANICAL

METHODS OFPLAQUE REMOVAL


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Toothbrushing

techniques:


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Requirements of a

satisfactory methodof toothbrushing:


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1. The technique should cleanall tooth surfaces, in particular

the area of the gingival crevice

and the interdental region.


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2. The movement of the brush

should not injure the soft or

hard tissues. Vertical and

horizontal scrubbing methods

can produce gingival recession

and tooth abrasion.


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3. The technique should be

simple and easy to learn. A

technique which one person

finds easy to use may be

difficult for someone else.


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4. The method must be well

organized so that each part

of the dentition is brushed in

turn and no area overlooked.


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The most important two tooth

brushing techniques are:

1. The roll technique.

2. The Bass technique.


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Requirements of a

satisfactory

toothbrush


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1. The brush head should be small

enough to be manipulatedeffectively everywhere in the

mouth, A length of about 2.5cm is satisfactory for an adult;

about 1.5 cm is suitable for achild.


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2. The bristles should be of evenlength so that they function

simultaneously. A convex or

concave brush with bristles of

different lengths will not clean a

flat surface withoutundue

pressure.


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3. The texture should allow

effective use without causingdamage to either soft or hard

tissues. Stiffness depends onthe diameter and length of the

filament and its elasticity.


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4. The brush should be easyto keep clean. Densely

packed tufts tend to retaindebris and toothpaste at the

base of the bristle.


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5. The toothbrush handle

must rest comfortably and

securely in the hand. Itshould be broad and thick

enough to allow a firm gripand good control.


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Electric toothbrushes

The electric toothbrush is now awell-accepted part of the home-

careprocedure.


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There have been many studiescomparing the effectiveness of

the hand and automatic brushand the results indicate that

the subjects control is more

important than the appliance.


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For the uninstructed patientthe automatic brush is as

effective if not more effective

as the manual brush. The

automatic brush is especially

useful to the handicapped

person.


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Frequency of

brushing


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Theoretically one could

clean the teeth once everyother day and prevent

plaque from accumulatingto the point where it would

provoke some gingival

inflammation.


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Toothpastes


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Typical

constituents

Are as follows:


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Abrasives: e.g. calcium carbonate, calcium

pyrophosphate, aluminum silicate, etc.

Antibacterial agents: e.g. sodium lauryl

sulphate, zinc citrate trihydrate, triclosan, etc.

Anticaries agents: e.g. sodium

monofluorophosphate, sodium fluoride, etc.

Desensitizing agents: e.g. strontium salts,

sodium fluoride, formalin, etc.


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Fillers and thickeners: e.g. sodium

carboxymethyl cellulose, etc.

Humectants to keep the paste moist: e.g.

glycerin, etc.

Detergents: e.g. sodium-lauryl sulphate.

Flavoring agents, often mint.

Coloring agents. synthetic dyes.

Sweeteners: e.g. sodium saccharin.


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Interdentalcleaning


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CHEMICAL PLAQUE

CONTROLL


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1. Suppression of the oral flora.

2. Inhibition of bacterial colonization ofthe tooth surface.

3. Inhibition of plaque-forming factors,e.g. dextran.

4. Dissolution of established plaque.

5. Prevention of mineralization ofplaque.


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Mouthwashes


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Mouthwashes are commonly mixtures of:

An antibacterial agent; 0.2% chlorhexidine

gluconate appears to be the most effective,quaternary ammonium salts are frequently used.

Alcohol to enhance antibacterial activity and taste,

and to help keep flavoring agents in solution.A humectants, e.g. sorbitol, to prevent drying-out.

A surfactant to help keep ingredients in solution.

Flavorings, coloring agents, preservatives, and

water as vehicle.


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PROBLEMS

TO BE

OVERCOME


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1- Manual dexterity:It is necessary to

find out whichtechnique the

patient can best

perform.


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2- Oral perception:

Visual, oral andolfactory faculties

vary from oneperson to another.


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3-Tooth position:Mal alignment isone of the most

common causes ofdifficulty.


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4- The form of tooth contact:

The smaller the area of

contact the easier it is to clean.


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5- Faulty restorative andprosthetic dentistry:

create problems of plaque

control which can be

extremely difficult to becorrected.


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6- Diet:

Both the chemicalcomposition and the

physical character offood are important.


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Rules of patient

motivation


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1-Do not take any prior knowledge for

granted.2. Give information in simple everyday

language and avoid jargon.

3. Do not give too much information at

one time, and repeat everything that

you have said.


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Change in attitude

to dental health


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Several arguments may be

employed:

1.Impaired function.

2. Personal hygiene.

3. Social handicap.

4. General health.


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19,prevention of PD.ppt