OH aids crowns, bridges, implants and prosthesis

• Why use interdental cleaning aids?

  Tooth brushing alone will not remove dental plaque thoroughly, because many areas are inaccessible to the toothbrush filaments, particularly crowns and bridges.
• Interdental areas with mature plaque create.......

  ....anaerobic conditions for periodontal bacteria
• What is biofilm?

  collection of microbes living on a surface in a complex community

  
• When considering ID cleaning aids, what factors must be considered?

  • Individual approach
  • Dentition and existing restorations
  • Level of disease
  • Patients dexterity
  • Patient commitment/motivation
  • Socio-economic circumstances
• What are ideal properties of an ID cleaning aid?

  • readily available
  • effective
  • good value for money
  • easy to use
• What is the clinicians role in maintaining crowns/bridges/implants etc?

  Reinforcement, encouragement and adaptation of oral hygiene aids One to one advice Given by an intra oral clinician Understanding of the patients oral disease status, medical status and plaque retention factors
• What is the ladder of competence?

  • Unconsciously incompetent - can't do; no opportunity to learn↓
  • Consciously incompetent can do; needs support & supervision↓
  • Consciously competent -can do; sometime needs advice↓
  • Unconsciously competent - can do; can teach others
• What are benefits of interdental brushes?

  • root surfaces are concave
  • teeth that have root recession
  • furcation tunnels
  • around crowns, bridges, over-dentures, implants and natural teeth
• What 4 things should we consider to select the correct interdental brush?

  1) size

  2) design

  3) area

  4) competence
• What did Karoussi et al (2004) find in relation to peri - implantitis?

  Karoussi et al (2004) found that bacteria found in advanced periodontal disease are also implicated in peri-implantitis

  
• What is the disadvantage of interdental brushes?

  Patient may damage gingiva by incorrect technique and brush size Not ideal for tight interdental areas Wire filament within the core of the brush may bend Expense
• What is dental floss useful for?

  •In narrow spaces between natural teeth•In cases where single implant shave been placed•Pontics of bridgework

  
• What can be used for cleaning under pontics of bridges?

  Superfloss A floss threader

  
• What are some disadvantages of floss?

  Not effective near concave root surfaces. Not effective in large interdental areas. Certain dexterity needed. Possible trauma to gingiva.
• What are advantages and disadvantages of flossettes?

  Allows interdental cleaning for patients with less dextrous ability Disadvantages - limited use and less effective than interdental brushes
• What is the single tufted brush useful for?

  • distal surfaces of last molars
  • Lingual surfaces
  • Gingival recession
  • Fixed orthodontic appliances
  • Implants - especially the cover screws