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Summary of LectureSummary of Lecture ## 33

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Dental CariesDental Caries

Definition of tooth cavitation: localized , postDefinition of tooth cavitation: localized , post--

eruptive pathological process involving bacterialeruptive pathological process involving bacterial

acid demineralization of hard tooth tissue resultingacid demineralization of hard tooth tissue resultingin the formation of a cavity.in the formation of a cavity.

Types of caries lesionsTypes of caries lesions

Stages of dental cariesStages of dental caries

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Progression of caries depends on:Progression of caries depends on:

1.1. Ions concentrationIons concentration

2.2. pHpH

3.3. Salivary flowSalivary flow

4.4. Buffering actionBuffering action

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Ecology of dental caries:Ecology of dental caries:

-- Before teeth eruption the number of MS is veryBefore teeth eruption the number of MS is very

lowlow-- The source of infection of infant by MS is fromThe source of infection of infant by MS is from

caregiver (usually the mother) by mouthcaregiver (usually the mother) by mouth--toto--

mouth transmission via kissing or sharing spoonmouth transmission via kissing or sharing spoon

during feedingduring feeding

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Periodontal DiseasePeriodontal Disease

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Toothbrushes andToothbrushes and

ToothTooth--brushing Methodsbrushing MethodsOctoberOctober 2424,, 20072007

Abdullah S. AlAbdullah S. Al--Swuailem BDS, MS, MPH, Dr PHSwuailem BDS, MS, MPH, Dr PH

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ToothTooth--brushing Methodsbrushing Methods History:History:

-- Arabs used roots of Arak tree (Siwak)Arabs used roots of Arak tree (Siwak)

-- Chinese are credited for inventing theChinese are credited for inventing thetoothbrushes consisting of a handle withtoothbrushes consisting of a handle withbristles (bristles (618618--907907 AD)AD)

-- Williams Addis (England,Williams Addis (England, 17801780))

manufactured the first modern toothbrush:manufactured the first modern toothbrush:handle made of bone with holes for placementhandle made of bone with holes for placementof natural hog bristlesof natural hog bristles

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ToothTooth--brushing Methodsbrushing Methods History:History:

-- During World War II, nylon bristlesDuring World War II, nylon bristles

replaced natural bristlesreplaced natural bristles

-- There was a variation of handle size,There was a variation of handle size,

angulation and length of the toothbrushangulation and length of the toothbrush

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ToothTooth--brushing Methodsbrushing Methods

Replacement of toothbrushes atReplacement of toothbrushes at 33-- toto--44

months intervals is provoked by reportsmonths intervals is provoked by reports

of contamination of toothbrushes afterof contamination of toothbrushes after

oral or medical bacterial /viral infectionoral or medical bacterial /viral infection

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Powered toothbrushesPowered toothbrushes

-- More effective in plaque removalMore effective in plaque removal

-- May result in gingival recessionMay result in gingival recession

-- There is an increase in the use ofThere is an increase in the use ofpowered toothbrushes due reduction ofpowered toothbrushes due reduction of

pricesprices-- Heads are usually smaller than manualHeads are usually smaller than manual

toothbrushestoothbrushes



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Patients motivationPatients motivation



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ToothTooth--brushing Methodsbrushing Methods Function of a toothbrush andFunction of a toothbrush and

toothbrushing:toothbrushing:

1.1. Carry dentifrice to tooth surfacesCarry dentifrice to tooth surfaces

2.2. Remove the dental plaqueRemove the dental plaque

3.3. Clean teeth of food, debris and stainClean teeth of food, debris and stain

4.4. Massage the gingival tissuesMassage the gingival tissues

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ToothTooth--brushing Methodsbrushing Methods ToothTooth--brushing Methodsbrushing Methods

-- Bass, Stillman, ChartersBass, Stillman, Charters

-- Roll or scrubRoll or scrub-- Individualized tooth brushing techniques forIndividualized tooth brushing techniques for

each patienteach patient

-- Reciprocating horizontal scrub techniqueReciprocating horizontal scrub technique

-- Rotary motion (Foness technique)Rotary motion (Foness technique)

-- Simple upSimple up-- andand down motion (Leonard'sdown motion (Leonard'stechnique)technique)

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ToothTooth--brushing Methodsbrushing Methods ToothTooth--brushing methods:brushing methods:

-- Stillman technique: Stimulate gingival tissuesStillman technique: Stimulate gingival tissues

-- Charters technique: toothbrushes placed atCharters technique: toothbrushes placed at9090 degrees to long access of the teeth, so thatdegrees to long access of the teeth, so thatthe bristles are gently forced between teeththe bristles are gently forced between teeth

-- Bass technique: the toothbrush is placed inBass technique: the toothbrush is placed in

the gingival sulcus at athe gingival sulcus at a 4545 degree angle to thedegree angle to thelong access of teeth. Vibratory movement oflong access of teeth. Vibratory movement oftoothbrush (backtoothbrush (back--andand--forth strokes)forth strokes)

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ToothTooth--brushing Methodsbrushing Methods Toothbrushing Time and Frequency:Toothbrushing Time and Frequency:

-- After every meal? Or regularly asAfter every meal? Or regularly as

advised by American Dental Associationadvised by American Dental Association

(ADA)?(ADA)?

-- Patients tend always to overestimatePatients tend always to overestimate

their brushing time and frequencytheir brushing time and frequency

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ToothTooth--brushing Methodsbrushing Methods Toothrushing procedures:Toothrushing procedures:

-- Occlusal surfaceOcclusal surface

-- Anterior lingual areasAnterior lingual areas

Techniques for young childrenTechniques for young children

--

Methods?Methods?-- SupervisionSupervision

Techniques for AdultsTechniques for Adults

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Documents

221PDS Lecure-4-Oct-24-07