1. Summary of Lecture # 3

2. Dental Caries
Definition of tooth cavitation: localized , post-eruptive pathological process involving bacterial acid demineralization of hard tooth tissue resulting in the formation of a cavity.
Types of caries lesions
Stages of dental caries

3. Dental Caries Progression of caries depends on: Ions concentration pH
Salivary flow
Buffering action

4. Dental Caries Ecology of dental caries:
Before teeth eruption the number of MS is very low
The source of infection of infant by MS is from caregiver (usually the mother) by mouth-to-mouth transmission via kissing or sharing spoon during feeding
Jk clarke in england isolated S. mutans from a carious lesion and noted that they are oval and may be mutant of strep

6. Periodontal Disease
Jk clarke in england isolated S. mutans from a carious lesion and noted that they are oval and may be mutant of strep

7. Toothbrushes and Tooth-brushing Methods
October 24, 2007
Abdullah S. Al-Swuailem BDS, MS, MPH, Dr PH

8. Toothbrushes and Tooth-brushing Methods
History:
Arabs used roots of Arak tree (Siwak)
Chinese are credited for inventing the toothbrushes consisting of a handle with bristles ( AD)
Williams Addis (England, 1780) manufactured the first modern toothbrush: handle made of bone with holes for placement of natural hog bristles

9. Toothbrushes and Tooth-brushing Methods
History:
During World War II, nylon bristles replaced natural bristles
There was a variation of handle size, angulation and length of the toothbrush

10. Toothbrushes and Tooth-brushing Methods
Replacement of toothbrushes at 3- to-4 months intervals is provoked by reports of contamination of toothbrushes after oral or medical bacterial /viral infection

11. Toothbrushes and Tooth-brushing Methods
Manual toothbrushes design:
size: large, medium, and small
Texture: hard, medium, soft or extra soft
Bristle design: flat or multi-level bristles (more effective)
Bristles cut bluntly have sharp ends and toothbrushes made with such bristles are more abrasive than end-rounding tips
Handle design:

13. Toothbrushes and Tooth-brushing Methods
Powered toothbrushes
More effective in plaque removal
May result in gingival recession
There is an increase in the use of powered toothbrushes due reduction of prices
Heads are usually smaller than manual toothbrushes

14. Toothbrushes and Tooth-brushing Methods
Patient’s motivation

15. Toothbrushes and Tooth-brushing Methods
Function of a toothbrush and toothbrushing:
Carry dentifrice to tooth surfaces
Remove the dental plaque
Clean teeth of food, debris and stain
Massage the gingival tissues

16. Toothbrushes and Tooth-brushing Methods
Bass, Stillman, Charters
Roll or scrub
Individualized tooth brushing techniques for each patient
Reciprocating horizontal scrub technique
Rotary motion (Fones’s technique)
Simple up- and – down motion (Leonard's technique)

17. Toothbrushes and Tooth-brushing Methods
Stillman technique: Stimulate gingival tissues
Charters technique: toothbrushes placed at 90 degrees to long access of the teeth, so that the bristles are gently forced between teeth
Bass technique: the toothbrush is placed in the gingival sulcus at a 45 degree angle to the long access of teeth. Vibratory movement of toothbrush (back-and-forth strokes)

20. Toothbrushes and Tooth-brushing Methods
Toothbrushing Time and Frequency:
After every meal? Or regularly as advised by American Dental Association (ADA)?
Patients tend always to overestimate their brushing time and frequency
Plaque and caries

21. Toothbrushes and Tooth-brushing Methods
Toothrushing procedures:
Occlusal surface
Anterior lingual areas
Techniques for young children
Methods?
Supervision
Techniques for Adults