Healthy gums appear light and are sharply defined. Bone completely surrounds the roots of the teeth. Teeth are firmly anchored into the bone.
Gingivitis is an infection of the gum tissue and is the initial stage of the disease process. Gums become red, swollen and may bleed easily. Underlying bone levels are unaffected.
Periodontitist is classified as mild, moderate and severe depending upon the amount of destruction to the gums, ligaments and bone that surround teeth. As the disease progresses, gum separate from the teeth and form gum pockets. These pockets get deeper as more underlying bone is destroyed. Gum pockets will collect increasing amounts of bacterial plaque and tartar as the disease process worsens. Teeth will loosen as more bone is lost.
Healthy V/S Periodontal Disease
Bass Method of Brushing
Bass Tooth Brushing Technique
I. Purposes and Indications
For all patients for bacterial plaque removal
adjacent to and directly beneath the gum line
A. Grasp Brush Handle Direct the filaments apically (up for maxillary,
down for mandibular teeth).
B. Angle the Filaments Place the brush with the filament tips directed
straight into the gingiva . The filaments will be
directed at approximately 45 degrees to the long
axis of the tooth.
C. Press Lightly Without Flexing Press lightly so the filament tips enter the gingiva
and cover the gingival margin. Do not bend the filaments.
D. Vibrate the Brush Vibrate the brush back and forth with very short strokes
without disengaging the tips of the filaments from the
sulci. Count at least 10 vibrations.
Modified Bass Method
Modified Bass Method ( only currently recommended technique )
This is widely excepted as the most effective measure for the removal of plaque around the gumline, this area being the most significant in the control of early and advanced gum disease.
Direct the brush towards the roots of the teeth at a 45º angle. Press lightly but not enough to bend the bristles and then gently, with short movements, brush back and forth in a vibratory type action.
This may seem a little more difficult behind (tongue/palate) the front teeth. If you use a pencil grip, it is easy to brush side-to-side in these areas.
Stillman Toothbrushing Method
For use of massage and stimulation of the gums, and cleaning directly above the gums
Place the toothbrush bristles
partly on the gums and partly
above the gums
Press side of brush lightly
flexing the toothbrush bristles;
gums should slightly blanch -
Angle toothbrush at 45-degree angle
Use a back and forth rotary motion with light pressure
Modified Stillman method
This was designed for massage and stimulation (a very outdated notion) as well as cleaning, but is equally ineffective and more difficult to master than the Roll method as it employs both a rolling and a vibratory type action.
The brush is placed with the bristles angled towards the tip of the roots and in contact with the gum tissue. It is then pressed until the gum blanches. The brush is simultaneously rolled away from the gums and vibrated, then repeated for each tooth.
Roll Stroke Method
Many of people were taught, and still use, the roll technique - this method does not clean the teeth well and pays little attention to the gum line, and therefore is ineffective. It is an awkward technique to master.
The brush is placed against the gums and rolled away from the gums towards the biting or chewing surface.
Fones Brushing Method
This was probably one the first methods taught by the dental profession, especially in the US. Dr. Fones founded the first Dental Hygienists course in the US, and his technique was the standard method used for many years, it is often called the
Circular method .
With the teeth closed, place the tip of the bristles gently against the side of the back teeth. Sweep the brush vigorously over the tooth surface in a circular motion covering both upper and lower teeth working your way forward. When cleaning the front teeth, bring them edge to edge and continue brushing.
Charter’s Tooth brushing Method
Good cleaning between teeth
Limited sulcular cleaning
Useful around orthodontics, bands, fixed prostheses
Place the toothbrush away from the gums
Vibrate the brush gently
Count 10 strokes
Reposition the brush and repeat
Spool Method of Flossing There are two types of floss from which to choose: Nylon floss PTFE (monofilament) floss USED IN TYPE I EMBRASURES
Great for dislodging particles between teeth
Easy flossing with one hand
Tightly string floss on holder
Select an area to begin flossing and floss throughout the mouth
Set a fulcrum on the cheek or in the mouth
Use a gentle seesaw motion to pass between the teeth
Guide the floss to the gum line
Curve the floss into a C shape against the tooth
Slide it gently into the space between the gingiva and the tooth
Use both hands to move the floss up and down on one side of the tooth
Use a push and pull motion with floss holder
Continue until all teeth are completed
Dispose of floss
Wash off floss holder with warm water and soap, dry, and store in clean, dry area until next use
Floss Threader Used for flossing under bridges, orthodontic appliances, implants, and between connected crowns Type I embrasure v Break off a piece of floss from the spool 4 to 6 inches long v Thread the floss through eye of floss threader, overlapping floss 1 to 2 inches v Grasp threader with thumb and index finger of one hand v Insert tip of threader from the front surface through an opening between the teeth v Pull floss threader towards the inner end of teeth until threader has passed completely through between the teeth v Slide the floss threader off the floss and remove from mouth
Works well in wide embrasures: Type II and III for reducing gingival inflammation and exposed root areas
Moisten the bristles of the brush with saliva
v Insert bristles into embrasure at a 90-degree angle to tooth surface (long axis of the tooth)
v Move brush using in-and-out motion from outside and/or inside surfaces of appropriate areas
v Rinse bristles under running water as necessary to remove debris
v Upon completion of use, rinse entire handle and bristles with soap and warm water
v Store in clean, dry place
v Replace bristles as they become worn or splayed, after an illness, or every 3 months .
Rubber or plastic tips are recommended for gingival massage, for plaque removal in open embrasure, type II and III embrasures, margins tissue following periodontal surgery and exposed roots.
Place side of the rubber tip interdentally and
slight pointing upwards at 45 degrees angle.
Move in and out with slow stroke, rubbing the
tip against the teeth under the contact area.
Remove from the space between teeth and trace
the gum line with the tip position just below the
margin following the contour of the gum.
Once all appropriate areas are completed, rinse
stimulator with soap and warm water, then store
in a clean, dry place.
o Replace rubber tip as it becomes worn, cracked or splayed .
Denture Care Dentures can break, so always fill the sink with water, then clean your dentures over the sink, just in case they slip out of your hands by accident. Rinse your dentures thoroughly to remove loose food particles. Use cool or warm water. But never use hot water – it can warp your dentures. Apply a denture cleaning paste to a moistened denture brush or a soft-bristled toothbrush. Do not use ordinary toothpaste, bleach, vinegar or soap unless directed to do so by your dental professional. Brush all surfaces thoroughly. Avoid using brushes with stiff bristles, as they can damage the denture material. Rinse dentures well under the faucet to remove all traces of cleaning paste. While you sleep at night, soak your dentures in a cleanser (such as Fixodent®) or one recommended by your dental professional. Brush your gums, tongue and palate with a soft-bristled regular toothbrush to remove plaque and stimulate circulation. Then reinsert your dentures.
DENTAL IMPLANT CARE
CARING FOR YOUR IMPLANTS
YOUR IMPLANTS CAN SERVE YOU FOR YEARS IF YOU KEEP YOUR MOUTH HEALTHY AND TAKE CARE OF YOUR IMPLANTS. JUST LIKE YOUR NATURAL TEETH, YOU SHOULD BRUSH AFTER EVERY MEAL.
SPECIAL CLEANING AIDS
A SMALL TOOTH BRUSH OR SPECIAL INTERDENTAL BRUSH CAN BE USED TO CLEAN THE ABUTMENTS. USE A BRUSH WITH A BENT HANDLE TO REACH BEHIND YOUR TEETH TO CLEAN THE ABUTMENTS.
USE GAUZE OR SPECIAL FLOSS WITH A FOAM COATING TO CLEAN AROUND YOUR GUMS, ABUTMENTS AND PROSTHETIC TEETH.