Use of a water flosser for interdental cleaning

Interdental cleaning is an important part of a patient's personal oral care regimen. Water flossers, also known as oral irrigators or dental water jets, can play a vital, effective role in interdental hygiene. Evidence has shown a significant reduction in plaque biofilm from tooth surfaces and the reduction of subgingival pathogenic bacteria from pockets as deep as 6 mm with the use of water flossing. In addition, water flossers have been shown to reduce gingivitis, bleeding, probing pocket depth, host inflammatory mediators, and calculus. Educating patients on the use of a water flosser as part of their oral hygiene routine can be a valuable tool in maintaining oral health.     

Use of a powered toothbrush for hygiene of edentulous implant-supported prostheses

Effective professional maintenance and personal oral hygiene are important for the long-term success and comfortable functioning of implant-assisted dental restorations. Incorporating the most effective oral hygiene devices into each patient's oral hygiene regimen facilitates optimal results. The use of a powered toothbrush with interchangeable brush heads permits effective cleaning of the most access-challenging prosthesis contours. This article presents a useful personal oral hygiene regimen for the long-term maintenance of various implant-supported dental restorations.     

The effect of a microbead dentifrice on microbial load in oral microenvironments

To cite this article:
Int J Dent Hygiene 9 , 2011; 136–142
DOI: 10.1111/j.1601‐5037.2010.00465.x
Sreenivasan PK, Haraszthy VI, Zambon JJ.The effect of a microbead dentifrice on microbial load in oral microenvironments. Abstract: Objectives: The human oral cavity contains several microenvironments or ecologic niches. While mechanical plaque control is well known to reduce the number of supragingival dental plaque bacteria, there is little data on antimicrobial effects in other oral ecologic niches. The present study examined the effects of mechanical plaque control using a microbead dentifrice on bacteria colonizing oral ecologic niches. Methods: Twenty‐two adults (aged 18–70 years) including nine generalized moderate chronic periodontitis subjects and 13 periodontally healthy subjects having average gingival indices ≥1 and plaque indices ≥1.5 completed a 1 week washout phase and refrained from oral hygiene the morning of baseline sample collection. Microbial samples from supragingival dental plaque, buccal mucosa, dorsal surface of the tongue and whole mixed saliva were obtained. Subjects brushed with a microbead dentifrice and, after 10 min, sampling was repeated. The number of anaerobic bacteria was determined by culture on non‐selective media and transformed to log₁₀ for statistical analyses. Results: Mechanical plaque control using the microbead dentifrice resulted in statistically significant reductions in bacterial numbers in each ecologic niche (P < 0.001). The greatest reduction in the number of viable bacteria occurred in samples taken from the buccal mucosa (97.22%) followed by a 95.22% reduction in supragingival plaque bacteria, a 94.51% reduction in the number of bacteria on the dorsal surface of the tongue and a 91.57% reduction in the number of bacteria in whole mixed saliva. Conclusions: Mechanical plaque control using a microbead dentifrice reduces microbial load in microenvironments throughout the human oral cavity.     

Oral hygiene status of dental students as related to their personal and academic profiles

This paper studied the correlation among a number of personal, pre-dental and dental academic variables and sutdent's own personal oral hygiene. Oral hygiene status of 127 second year dental student was meadured accouding to O'Leary, Drake and Naylor (1972). The overall mean plaque score was 46.7% . Only 18.8 % of the students had excellent and good oral hygiene, while 63% of them had poor and very poororal hygiene. There were negative relationships approaching significance between the plaque score of students and their first year dental grade point avderage and second year dental grade point average. A significant negative correlation was observed between plaque score and test scores in Periodontology I. Students who had a better oral hyginene status tended ot obtain higher grades in periodontology I An analysis of the variance for the mean of each of the eleven variables as classified by oral hygiene status was performed. In general, students with better oral hygiene tended to achieve significantly gigher test scores than those students with less favorable oral hygiene in at least seven of the stated academic variables.     

Dental health of children in Australia 1977–1980

A bstract — An extensive programme was begun in 1977 to assess annually the dental health of school children aged four to thirteen years examined by the school dental services in each State and Territory. This report is based on 1,858,439 dental examinations.
In the period 1977 to 1980, the number of DIMF teeth per child was reduced by 26.9 per cent while the oral hygiene index was reduced by 15 per cent. An association was demonstrated between dental caries and oral hygiene. The continuing and substantial reduction in dental caries highlights the need for long-term manpower planning.     

Assessment of oral self-care in patients with periodontitis: a pilot study in a dental school clinic in Japan

Background  

Oral hygiene education is central to every stage of periodontal treatment. Successful management of periodontal disease depends on the patient's capacity for oral self-care. In the present study, the oral self-care and perceptions of patients attending a dental school clinic in Japan were assessed using a short questionnaire referring to existing oral health models.     

Mechanical aids in the prevention of dental diseases in the elderly.

Dental practitioners, who are often unaccustomed to treating geriatric patients, should be taught to accept that old people do not necessarily respond to optimal dental treatment as younger patients do. There is an evident need for continuing education in this respect. The many plaque removing mechanical aids available, such as toothbrushes, toothpicks, and dental flosses, have not been studied in the elderly. Since manual dexterity decreases with increasing age, the use of electric tooth cleaning devices and other aids for improving oral hygiene should be encouraged among the elderly. This is particularly so in patients with physical or mental handicaps. Future studies should investigate the benefits of preventive dental procedures in the elderly and to survey their knowledge, attitudes and behaviour related to oral health. Maintaining proper oral hygiene among the institutionalised elderly has been neglected in many cases. Nurses and other staff in institutions need more information about the role of optimal oral health in the patient's general health and well-being. Staff also need to know more specifically how to help the patients in their daily oral hygiene and how to take care of the patient's dentures. The recently discovered association of poor oral health with life-threatening vascular diseases and other medical catastrophes further emphasizes the importance of maintaining good oral hygiene. Diseases of the mouth and the teeth must be diagnosed and treated in the elderly, who are just as entitled to receive individually designed preventive dental care as are the younger generations.     

The role of dentistry in palliative care of the head and neck cancer patient

Although palliative care for the terminally ill is based on a multidimensional philosophy to provide whole-person comfort care while maintaining optimal function, it does not usually include dentistry in its team approach. Dentists can have a significant role in the care of these patients by providing total, active comfort care of the oral cavity. The function of the oral cavity is essential to the patient's ability to thrive. Therefore, alleviation of pain and prevention of infection in the oral cavity should be a priority in providing total, active comfort for the patient. The oral problems experienced by the hospice head and neck patient clearly affect the quality of his or her remaining life. Through routine assessments and interventions by a dentist on the palliative care team (Figure 4), comfort care for the patient may be improved by the maintenance of oral hygiene and procedures to hydrate the oral mucosa. In addition, routine dental assessments may identify dental disease and facilitate dental interventions for caries, periodontal disease, oral mucosal problems or prosthetic needs. Attention to such detail may reduce not only the microbial load of the mouth but the risk for pain and oral infection as well. This multidisciplinary approach to palliative care, including a dentist, may reduce the oral debilities that influence the patient's ability to speak, eat or swallow. Not only does maintenance of oral health have impact on the quality of life, which is already challenged by the disease, but it also aids in the ability of patients to thrive for whatever precious time is left to them.     

Influence of optimal and excluded oral hygiene on early formation of dental plaque on plastic films

Abstract The influence of oral hygiene on early plaque formation has been studied. The amount and structure of dental deposits formed on plastic films were determined at two occasions with or without a preceding period of effective oral hygiene. Six human subjects developed plaque during 4 hours on plastic films applied to the buccal surfaces of premolars and cuspids. The plastic films with adhering deposits were processed for electron microscopy. In presence of healthy gingiva, the plastic films were covered by a surface coating of acellular material in or on which bacteria, epithelial cells and leukocytes were observed. The microorganisms were almost exclusively Gram-positive cocci. When plaque formation was preceded by a week of excluded oral hygiene, the deposits collected on the same teeth exhibited a threefold increase in the number of bacteria. The relative composition of the flora was altered, as evidenced by a higher number of Gram-negative cells as well as the occurrence of rods and filamentous organisms. The results indicate that neglect of oral hygiene favors an earlier establishment of a complex bacterial flora at the dento-gingival region of the buccal surfaces of premolars and cuspids.     

Acute focal infections of dental origin

This article describes the most important pus‐producing acute oral infections (dental infections) that can spread extra‐orally. Most of these infections are spread by bacteria entering the bloodstream. However, dental infections have a number of other pathways for dissemination. By forming abscesses or phlegmon they can reach facial spaces that communicate with each other and then spread downwards to the mediastinum or upwards to the brain. In such cases dental infections can become, if not properly treated, life‐threatening. It seems that early diagnosis and treatment are imperative, and potentially infectious foci should be traced and eliminated. Dental hygiene and prophylaxis to prevent dental biofilm formation are important measures to reduce the risk of these calamities. The more compromised the host defense is, the more importance should be put on these measures. Although commensal bacteria are often involved in these infections, attention should also be paid to specific periodontal pathogens, and a proper microbial diagnosis, obtained using molecular methods plus bacterial sensitivity testing, can provide the patient with optimal care. Drainage of pus must be established where possible so that the optimal effect of antibiotics can be achieved. Penicillin is still the drug of first choice in settings where suspicion of methicillin‐resistant Staphylococcus aureus is low.     

Improving oral health in Pakistan using dental hygienists

This paper reviews the healthcare system, available dental care, and oral health status of people in Pakistan. Considering the enormous unmet oral health needs, the insufficient supply of dental professionals and the current unstructured dental hygiene curriculum in Pakistan, a mission, vision, and goals for professional dental hygiene in Pakistan is recommended. The authors offer recommendations for competency-based dental hygiene education and practice, professional credentialing, a practice act, and a dental hygiene scope of practice to promote the health, welfare, and quality of life of the Pakistani people. Specifically, the authors recommend increasing the number of quality dental hygiene programs, establishing the dental hygienist as a primary care provider of oral health services, enhancing current dental hygiene curriculum, and establishing a dental hygiene council with responsibility for educational requirements and regulation of dental hygienists in Pakistan.     

The effect of an oral hygiene program on oral levels of volatile sulfur compounds (VSC)

Volatile sulfur compounds (VSCs) produced by bacteria in niches of the oral cavity play a major role in the etiology of bad breath, and can be easily detected by a portable sulfide monitor (Halimeter). To investigate the effect of an oral hygiene program on VSC levels, Halimeter readings were taken from 55 healthy dental students during a course in oral hygiene training, including instruction on brushing, flossing and professional tooth cleaning. Ten students who received no oral hygiene training served as a negative control. The oral hygiene status was measured using the papillary bleeding index (PBI). PBI and VSC values did not show significant changes during the study period of 10 weeks in the control group. In the test group, PBI values significantly decreased compared to baseline and the control, indicating that the oral hygiene program had a benefit on the oral hygiene status. The VSC values also decreased significantly during the study period compared to baseline and the control. It was concluded that in a group of dental students, a thorough oral hygiene training program was capable of reducing the oral level of VSC Halimeter readings.     

Effect of visual impairment upon oral health care: a review

The incidence of visual impairment is increasing globally and in the United Kingdom due to local and systemic disease, medical advances, and the increasing age of population groups. Despite there being a large number of people resident in the UK with a visual impairment, there is little information available regarding the dental health care and needs of such individuals. As reported in other groups of patients with special needs, many individuals with a visual impairment may only seek oral health care when a problem arises, such as pain. Visual impairment may have a negative effect upon oral hygiene with many blind and partially sighted individuals having worse oral hygiene than sighted peers. This review article was undertaken to examine the literature relating to visual impairment, oral health and dental care. This article will discuss the dental aspects of visual impairment, its implications for obtaining dental care, associated oral conditions and medical complications.     

Dental status of patients with mental disorders in a Nigerian teaching hospital: a preliminary survey

Although individuals with mental disorders are reported to experience dental problems similar to the general population, evidence suggests they actually have higher risks of dental disease and increased oral health needs. This study describes the dental status of 105 psychiatric outpatients in a Nigerian hospital. Information was obtained from subject interviews, medical records, and an oral examination to determine their dental caries and periodontal disease status. The oral hygiene status of the study participants was poor; the mean oral hygiene index score was 2.7 ± 1.20. The decayed, missing, and filled teeth ranged from 0 to 9 with a mean of 2.3 ± 2.28. Only five subjects (4.9%) had restorations and the mean number of filled teeth was .14 ± .67. The subjects’ age was significantly related to the mean oral hygiene score (p= .005), the mean gingival score (p= .006), and caries occurrence (p= .047). The oral health status of psychiatric patients in Nigeria is poor, indicating the need to provide oral health education and increase access to dental care for these patients.     

Dental care for children fed by tube: a critical review

No guidelines for the oral care of children fed by tube have been published. Poor oral health (unrestored caries lesions, poor oral hygiene, dependence for oral care) and tube-feeding are associated with the development of aspiration pneumonia. Children fed by tube have abundant calculus, and low caries activity. The potential for dental erosion related to gastroesophageal reflux and oral hypersensitivity is high. To optimize oral health and reduce the risk of aspiration pneumonia, this population should receive dental care at more frequent intervals than children fed orally. Modifications to dental procedures are suggested to minimize the risks associated with dental treatment. Evidence-based treatment guidelines are indicated to optimize dental care for children fed by tube .     

The practical approach to improved oral hygiene

It is possible to preserve or restore oral health and to avoid or treat the two plaque diseases, caries and periodontitis. These two diseases are extremely closely correlated with oral hygiene status. The patient's understanding of oral structures and his or her interest in preserving or restoring healthy teeth and gums depends on instruction and motivation. There is, unfortunately, no scientifically based method of reliably motivating every patient. A person's ability to be motivated is substantially moulded by his social position, intelligence, personality and attitude to his body and health. The techniques and methods illustrated are intended to stimulate and activate appropriate attitudes. A standard of oral hygiene that helps to prevent caries and periodontitis can be achieved only by the dental team in dental practice and not by collective measures.     

Application of the human needs conceptual model of dental hygiene to the role of the clinician : part II.

In summary, the theories of Maslow and of Yura and Walsh have been highlighted as background for understanding the human needs conceptual model of dental hygiene. In addition, 11 human needs have been identified and defined as being especially related to dental hygiene care, and a sample evaluation tool for their clinical assessment and a dental hygiene care plan have been presented. The four concepts of client, environment, health/oral health, and dental hygiene actions explained in terms of human need theory, and the 11 human needs related to dental hygiene care constitute the human needs conceptual model of dental hygiene. Within the framework of the human needs conceptual model of dental hygiene, the dental hygiene process is a systematic approach to dental hygiene care that involves assessment of the 11 human needs related to dental hygiene care; analysis of deficits in these needs; determination of the dental hygiene care plan based on identified deficits; implementation of dental hygiene interventions stated in the care plan; and evaluation of the effectiveness of dental hygiene interventions in achieving specific goals, including subsequent reassessment and revision of the dental hygiene care plan. This human needs conceptual model for dental hygiene provides a guide for comprehensive and humanistic client care. This model allows the dental hygienist to view each client (whether an individual or a group) holistically to prevent oral disease and to promote health and wellness. Dental hygiene theorists are encouraged to expand this model or to develop additional conceptual models based on dental hygiene's paradigm.     

An argument for dental hygiene to develop as a discipline

Abstract:  The practice of dental hygiene was developed to provide oral health education and preventive oral health care, originally for children. It has grown to provide oral health services valued by a broad spectrum of society, but has not attained the desired respect and status accorded to other professional groups. Objective:  Professional disciplines link actions of practitioners with the science that is the foundation of practice. The purpose of this paper is to examine whether dental hygiene practice could benefit from pursuit of development as a discipline. Methods:  Literature on professionalization and disciplines, related to dental hygiene in general and the North American context specifically, was retrieved from databases and grey sources, such as organizational reports. Dental hygiene's current characteristics relative to a discipline were examined. Results:  Dental hygiene has developed some characteristics of a discipline, such as identifying a metaparadigm that includes concepts of the client, the environment, health/oral health and dental hygiene actions, with a perspective that includes a focus on disease prevention and oral health promotion. However, research production by dental hygienists has been limited, and often not situated within theoretical or conceptual frameworks. Conclusion:  Dental hygiene draws its knowledge for practice from a variety of sources. Dental hygiene could strengthen its value to society by prioritizing development of highly skilled researchers to study interventions leading to improved oral outcomes, and transferring that knowledge to practitioners, strengthening links between practice and science. Intentional pursuit of knowledge for practice would lead to dental hygiene's eventual emergence as a professional discipline.     

Congenital neutropenia. Report of a case and a biorationale for dental management.

Congenital neutropenia is characterized by a marked decrease in or lack of circulating PMN's in children with no prior history of drug intake. The neutropenia is persistent and the clinical course is one of early onset of severe, recurrent, and eventually fatal infections. Bone marrow studies show a maturation arrest of neutrophilic precursors. Because of their greatly increased susceptibility to infection, patients with congenital neutropenia present a difficult dental management problem. A case of congenital neutropenia has been presented, as well as a biorationale for dental treatment. On the basis of reports in the literature, the following recommendations for the management of patients with congenital neutropenia are made: 1. The prevention and control of infection and the interception of dental disease before surgical intervention becomes necessary should be the overriding considerations in the management of patients with congenital neutropenia. 2. The carious breakdown of teeth should be prevented by the daily application of a 0.4 per cent stannous fluoride gel in addition to oral hygiene and limitation of sucrose intake. 3. Periodontal therapy should be palliative only, since alveolar bone loss is progressive despite frequent oral hygiene instruction and prophylaxis. The goal of periodontal therapy for patients with congenital neutropenia should therefore be a decrease in gingival inflammation to make the patient's mouth more comfortable and to slow down alveolar bone loss. Periodontal surgery is contraindicated. 4. Bacteremia and subsequent septicemia should be prevented since a minor infection can become life threatening in patients with congenital neutropenia. The patient should rinse for 30 seconds and the gingival sulci should be irrigated with a phenolated antiseptic mouthwash prior to all dental manipulations of the soft tissue. This will significantly reduce the incidence of bacteremia. 5. Surgery should be avoided if at all possible because of the high risk of post-operative infection. All surgery sholld be performed in the hospital, and the patient should be given antibiotics as determined by his physician. Primary closure should be done with fine polyglycolic acid sutures to reduce the chance of infection. If postoperative infection can be prevented, wound healing will progress normally despite the complete absence of PMN's.     

A contribution to the information and instruction of patients in periodontological practice]

Starting from the necessity of expanding the periodontal care of the population, the author points to the special importance of the patient's education, information and instruction in the periodontal practice and to the employment of dental nurses specialized in dental and oral hygiene. The author's approach which is based on an audiovisual method is explained; its advantages and disadvantages are discussed.