1. Prevention of periodontal diseases

2. Prevention is better than cure. Prevention is cheaper than cure. Prevention of a disease is greater good in life than its cure.

3. Periodontal disease can be Gingivitis, Periodontitis. Symptoms: bleeding gum. Swollen red gum. Receding gum. Gums pulling away from teeth. black/ yellow deposits on teeth. Loose or sensitive teeth. Bad breath ( halitosis).

4. Causes: 1. Poor oral hygiene. 2. Hormonal changes. 3. Certain medications. 4. Poor nutrition. 5. ILL fitting dentures and braces. 6. Smoking. 7. Diabetes. 8. HIV infections.

5. Prevention and treatments of gum diseases: 1. Good oral hygiene practices. 2. Scaling and root planning. 3. Periodontal surgery. It has been shown that removing plaque once every 48 hours is sufficient to reduce microbial plaque accumulations

6. PLAQUE CONTROL

7. Remember…..!!! Plaque is soft deposit that form the biofilm adhering to the tooth surface. What do we mean by plaque control? Plaque control is the removal of dental/microbial plaque and the prevention of its accumulation on the teeth and adjacent gingival tissues. It also deals with the prevention of calculus formation.

8. Plaque is the major etiology of periodontal disease, therefore, daily plaque removal is success of ALL PERIODONTAL disease and dental treatment. Position: supra and subgingival plaque control.

9. Methods of plaque control 1- Mechanical plaque control methods: I. Individuals. II. Professional. 2- chemical plaque control methods: I. Individuals. II. Professional.

10. Mechanical plaque control methods Objective: is to complete daily removal of dental plaque with a minimum of effort time devices using the simplest methods possible. These methods include: 1. Tooth brush. 2. Dentifrice. 3. Interdental cleaning aids. 4. Oral irrigation.

11. Tooth brush It can be manual or power device. 1728 toothbrush made from Horse Hair. 1857 toothbrush painted in America.

12. ADA specification of toothbrush Length : 1 to 1.25 inches. Surface area : 2.54 to 3.2 cm. No. of tufts : 5 to 12 per row. Width : 5/16 to 3/8 inches. No. of rows : 2 to 4 rows of brushes. No. of bristles : 80 to 85 per tufts.

13. Ideal properties or tooth brush selection 1. Tooth brush should be able to reach and efficiency clean most area of tooth surface. 2. No signal toothbrush is adequate for all patient. 3. Proper brush provide easy accessibility to all are of the of the mouth. 4. Small handed brushes are often helpful. 5. Easy for patient to manipulated. 6. Brushes should be compatible with recommended brushing technique. 7. Both natural and nylon bristles are satisfactory. 8. Soft brush is recommended. 9. Should be replaced every 3 months.

14. Materials used in tooth brush 1. Natural bristles : Hog. 2. Artificial filament nylon. Nylon filament is superior : 1. Due to its homogeneity of material. 2. Bristles size are resistance to fracture. 3. Repulsion of water and debris.

15. Powered toothbrush Appears in 1939. to make plaque control easier. Its mainly recommended: 1. Individual lacking motor skills. 2. Handicapped patient. 3. Patient with orthodontic appliance. 4. Hospitalization patient. 5. Whoever wants to use.

16. Motion: reciprocal of back motions and some with combination of booth circular and elliptical motion. Powered tooth brush cleaner resembles a dental prophylaxis and hand piece with rotary rubber up.

17. Patient should be lustrated for proper use. For children: come in different shapes and colors it has soft round head to avoid soft tissue damage. It also play music at 1 min interval for monitoring brushing.

20. EFFECTS & SEQUELAE OF THE INCORRECT USE OF MECHANICAL 1. Gingival erosion. 2. Gingival recession. 3. Cervical abrasion.

21. Brushing technique 1. Horizontal method (scrub). 2. Leonard method ( vertical). 3. Bass method. 4. Stillman’s method. 5. Modified stillman’s method ( roll). 6. Charters method. 7. Methods of cleaning with powered toothbrush.

22. Selection of method depends on the individual Certain criteria should be assessed when selecting a toothbrush and tooth brush technique for the individual patient: 1- patient clinical situation: I. State of gingival and periodontal tissue in regard to health. II. Anatomic limitations. 2-patient personal situation: I. Patient level of dexterity. II. Motivation level, ability of patient to act on recommended procedure.

23. Brushing sequence and timing 1. Patient is instructed to start with molar region of one arch around the opposite side than continue back around the lingual or facial surfaces of the same arch. 2. Last surface to be brush are occlusal. 3. patient instructed to strock each area 10 time of spend 10 seconds per area then move on to next area. 4. Time: 2 minutes ( 30 sec per quardnent)

25. Care of the toothbrush  The toothbrush may be a vector for pathogens.  The idea of bristles from different brushes touching one another and passing the bacteria back and forth is not unheard of. It is also interesting to note that a toothbrush near a flushing toilet has potential to be contaminated with fecal matter.

26.  Bacterium including Staphylococci, streptococci, Candida, Haemophilus, fungi, molds, Corynebacterium, pseudomonads, and coliforms are present on toothbrushes used for a few weeks.  The contaminated toothbrush is most harmful to people with compromised immune systems.

27.  Using a clean toothbrush frequently helps reduce bacteria in the mouth.  An immunocompromised person should ideally use a new brush every day, or at least one that has been disinfected between use.  A pre-rinse with an acceptable mouthwash before brushing would be a good investment as well.

28.  Using toothpaste can reduce the bacterial load in the brush.  For most people the traditional use of a toothbrush with toothpaste applied then rinsed off when finished will keep the brush free of pathogens, or at least most of the pathogens.

29. Thank you