Seminar Test 5
Terms
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- Toothpick in holder
- aka perio-aid; good for perio and ortho patients
- Interdental care is important because
- toothbrushing cannot accomplish biofilm removal for the proximal tooth surfaces and adjacent gingiva
- straight/simple shank
- adapts to tooth surfaces with unrestricted access( anterior teeth)
- stain removal with dental tape
- polishing agent is applied to the tooth and the tape is moved gently back and forth over the area where stain is observed(proximal)
- When using prophylaxis angle what is your finger rest
- tooth structure or an exterior rest; Do NOT use mobile teeth as finger rests
- Amount of brushing- built in timers
- can be effective to help patient increase brushing time
- The Charters Method
- Good for ortho; Direct filaments toward occlusal/incisal plane of teeth
- waxed floss
- helps prevent trauma, slides easily through contact areas, gives it strength and durability
- The Fones Method
- Circular; recommended as an easy-to-learn first technique for young childrenfor young children
- Purpose of hoe scaler
- removes supragingival calculus, particularly large accessible tenacious pieces
- area specific curets are used for
- as a follow for fine scaling and root planing
- Lower/Terminal shank
- section of the shank adjacent to the blade. used to provide slue to appropriate adaption and angulation
- types of strokes by direction
- oblique, vertical, horizontal and circular
- Limitations of Rolling Stroke Method
- can lacerate alveolar mucosa, sweeping strokes may miss cervical third
- The col is inaccessible by
- ordinary toothbrushing
- Frequency of brushing
- Emphasis should be placed on complete biofilm removal daily rather than on the number of brushing; encourage a clean mouth before sleep; biofilm removal should be complete before flouride treatment
- Early brushing methods was believed to
- increase keratinization and resistance to bacterial invasion; also to provide massage to increase resistance of gingival tissue
- Gauze strip
- used on proximal surfaces of widely spaced teeth; surfaces of teeth next to edentulous teeth
- Contraindications for air powder polisher
- sodium restricted diet, respiratory disease, end-state renal disease, communicable infection, root surfaces, spongy gingiva and restorative materials
- No polishing when
- no unsightly stain, patient at risk for caries, respiratory problems, tooth sensitivity, restorations, newly erupted teeth
- The use of polishing is considered what kind of treatment?
- selective cosmetic
- Plan
- plan of care designed to resolve the stated problem(s); procedures performed at the appointment, patient education, and procedures to be performed at subsequent appointment
- Physiologic: Smith's Method
- Toothbrush follows the same physiologic pathway that food follows when moving over the tissue in a natural masticating act.
- cleaning agents
- are round,flat, nonabrasive particles, can be used on any tooth surface unlike polishing agents
- Natural bristles are
- considered unsanitary
- when polishing use
- wet agents, low speed with rubber polishing cup with a light intermittent touch
- Brush storage
- Store open air with head in upright position avoiding contact with other brushes; or container with sufficient holes
- stainless steel working end
- maintains finish without corrosion
- Type III embrasure
- Extensive recession or complete loss of the interdental papilla
- cutting edge
- fine line where two surfaces meet
- air powder polishing
- effective method for mechanical removal of stain and biofilm; uses air, water and sodium bicarbonate/aluminum trihydroxide that delivers a controlled spray
- unwaxed floss
- pressure against tooth spreads fibers, giving wider surface for biofilm removal, frays more easily, may feel uncomfortable around fingers
- Main areas for oral microorganisms are
- dorsum of the tongue, gingival sulci and pockets and the dental biofilm on all teeth
- Less rigid, more flexible shank
- provides more tactile sensitivity and is used for removal of fine deposits and mantence of root debridement
- Purpose for curets
- sub gingival scaling
- Diameter of handles
- wider and hollow to provide comfort
- Interdental area of anterior
- single papillae that may form a col
- Handle
- part of the instrument that is help during activation of working end
- surface papillae: filiform
- minute projections
- Soap method
- subjective,objective,assessment and plan
- Instrumentation balance
- the working end of a balanced instrument is centered in line with the long axis of the handle
- lateral surfaces
- meet or are continuos to form the back of the instrument
- Diameter of filaments
- thinner are softer and more resilient
- Cleaning toothbrushes
- clean thoroughly after each use
- Prophylaxis angle attachments
- rubber polishing cups and bristle brushes
- Occlusal Brushing
- loosen biofilm packed in pits and fissures and margins and restorations; press moderately with the filaments so they do not bend
- Instrument design number
- Traditional number used to identify the specific instrument
- What layer of the tooth contains the greatest amount of fluoride
- the outer layer of the tooth
- Methods considered detrimental
- horizontal and scrub-brush
- The first choice for an intraoral finger rest is
- the tooth or teeth adjacent to the tooth being treated
- Finishing strips
- used for proximal surfaces; with one smooth side and the other side that serves as a carrier for abrasive agents bonded to that side; used only when all other techniques fail
- carbon steel working end
- known for its hardness, strength, and ability to hold an edge longer
- Amount of brushing- Combination
- Use of count system in combination with clock system may produce the most complete removal of biofilm
- The Stillman Method
- Designed for massage and stimulation as well as cleaning cervial areas; brush ends placed partly on gingiva and partly on cervical areas
- Interdental Brushes
- good for open embrasures, exposed furacations, dental implants, ortho appliances and other hard to reach areas
- The Rolling Stroke Method
- Cleaning gingival and removing biofilm from teeth without emphasis on gingival sulcus
- handle weight
- lighter weight enhances tactile sensitivity and lessens fatigue
- Root planing stroke
- applying a varying mount pressure, depending upon surface texture of root surface
- Power toothbrush motion: Translating
- Up-and-down movements parallel to long axis of brush handle
- Hoe scaler
- single straight cutting edge; blade turned at a 99 degree angle to the shank
- Type II embrasure
- Slight to moderate recession of interdental papilla
- Dental floss is
- the most effective when interdental papillae are present and there has not been loss of attachment
- Purpose of scalers
- removal of supragingival claculus or calculus removal of gross calculus that is slightly below the gingival margin when the calculus is continuos with the supragingival calc.
- Root debridement stroke
- a lighter pressure is applied as a curet disrupts and removes dental biofilm from the root surface of a previously root planed tooth
- Assessment
- interpretation of subjective and objective data; dental hygiene diagnosis recorded in this section (i.e. perio class, caries classification, PI score, etc)
- When should you floss your teeth?
- For best results, before toothbrushing; allowing fluoride to reach interproximal areas for prevention of caries
- Power toothbrush motion: side-to-side
- Side-to-side, perpendicular to long axis of brush handle
- surface papillae: fungiform
- not as high as filiform and create elevations and depressions that trap debris and microorganisms
- File scaler
- multiple cutting edges lined up as a series of mini hoes on a round, oval or rectangular base
- Porte Polisher
- wood point at a contra-angle; designed especially for extrinsic stain removal or application of treatment agents such as for hypersensitive area
- working end
- part used to carry out purpose and function of instrument
- shank
- connects the working end with the handle
- Acute alterations
- scuffed epithelial surface with denuded underlying connective tissue
- Power toothbrushes weren't actively promoted until
- the 1960's
- trauma to gingiva occurs most frequently
- on facial surfaces over teeth prominent in the dental arch
- Area specific curet
- each curet is designed for adaptation to specific surfaces; face is offset at 70 degrees; only one cutting edge is used
- Vertical: Leonard Method
- A vigorous sweeping motion
- types of stroke by function
- working and assessment
- Power toothbrush motion: Oscillating
- Rotates from center to the left, then to right. Degree of rotation varies from 25 - 55 degrees
- Limitations of the Charters Method
- Brush does not reach gingival sulcus to remove subgingival ; requires high dexteritybiofilm
- Two suggestions for toothbrushing
- begin in problem areas first or have a sequence varied at least once a day to ensure complete biofilm removal
- Bristle brush
- use selectively; limited to occlusal surface
- Early toothbrushes were made of
- Hog's bristles, horse's hair, sponges and herb roots
- Length of filaments
- shorter are stiffer and less flexible
- Power toothbrush motion: Pulsating
- Pulsations are in the direction toward interproximal
- Angled/complex shank
- adapts to the tooth surface with restricted access(proximal surfaces of posterior teeth)
- size of abrasive particles
- the larger the more abrasive
- Wooden interdental cleaner
- used for cleaning proximal tooth surfaces where the tooth surfaces are exposed and interdental gingiva are missing. Space must be adequate otherwise gingival tissue may be traumatized
- Straight scaler/jacquette
- two cutting edges on a straight blade; triangular in cross section with a pointed tip. Internal angles of 70 to 80 degrees are formed where the lateral surfaces meet the face at the cutting edges
- working stroke
- a definite, well controlled firm stroke of moderate to heavy pressure used for calculus removal
- universal curets are used for
- subgingival scaling for removal of as much of the calculus as possible
- rigid thick shank
- stronger and able to withstand pressure without flexing. Needed for removal of heavy deposits
- The Modified Stillman method
- Incorporates a rolling stroke after the vibratory phase
- Limitations of Bass Method
- requires dexterity; rolling stroke may need to precede sulcular brushing. The two should be performed seperately
- Elongated terminal shank
- designed to give better access to deep pockets
- Diamond working end
- work by means of abrasion; highly technique sensitive: must be used with little or no pressure
- Advantages of soft end-rounded brush
- more effective cleaning cervical areas, less traumatic to tissue, can be directed into sulcus and interproximal, applicabable around ortho.
- hardness of abrasive particles
- harder particles abrade faster
- Power toothbrush motion: Cradle or twist
- side to side with an arc
- Interdental area of posterior
- two papillae that are connected by a col
- Purpose of a file scaler
- crushes and fractures calculus into fragments prior to use of curets; burnished calculus that is impervious to removal can be removed by this
- Power toothbrush motion: Rotational
- moves in a 360 degree circular motion
- Brush replacement
- at least every 2 to 3 months; before filaments become frayed or splayed, contamination, or are immunosuppressed
- Universal curet
- can be adapted for instrumentation on any tooth surface; face is usually perpindicular; cutting edge used on both sides with a toe and semi-circular in cross section
- Amount of brushing- count system
- count 6 strokes in each area for methods with stroke or count slowly to 10 for each brushing vibration
- Dental Abrasions
- The wearing away of tooth structure that results from a repetitive mechanical habit; Incorrect brushing especially with an abrasive dentifrice is the most common cause
- objective data
- measured/observed data by use of senses(i.e. dental charting, EO IO, radiographic findings, etc)
- Chronic alterations
- changes in gingival contour, gingival recessions
- Interdental Tip
- used for cleaning debris from interdental area and removal of biofilm by rubbing exposed tooth surfaces; for biofilm removal at or just below gingival margin
- Type I embrasure
- Interdental papilla fills the gingival embrasure (In health)
- polishing for 30 seconds with pumice paste may remove as much as
- 4 um of outer enamel
- Prophylaxis angle stroke used
- for each tooth, work from the gingival third toward the incisal third of the tooth
- Angle of filaments
- angled are more flexible and less stiff that straight filaments
- Angulation
- refers to the angle formed at the cutting edge of an instrument between the tooth surface and the face of the instrument
- Three basic handpiece designs
- straight, contra-angle and right angle
- Prophylaxis angle
- contra-angle or right angle attachment for handpiece to which polishing devises are attached
- Amount of brushing- Clock system
- Patient brushes thoroughly while watching clock for 3-4 minutes; Does not ensure thorough coverage because more accessible areas may get more brushing time
- Number of Filaments
- Increased density gives added support/stiffness
- Limitations of Modified Stillman Method
- Tissue laceration can result without careful placement; vibratory aspect may be ineffective for biofilm removal if done too quickly
- Effects of cleaning tongue
- slows biofilm formation, reduces number of microorganisms, reduces potential halitosis and contributes overall cleanliness
- When cleaning the tongue what should you not do
- Do not scrub the papillae
- Power toothbrush vs. Manual
- Power brushes are more effective than manual
- Waxed vs. Unwaxed
- research has shown no difference in effectiveness; biofilm removal depends on how floss is applied
- Which abrasive polish do you use first
- least coarse to coarse
- Sickle scaler
- two cutting edges on a curved blade; triangular in cross section, has a tip; internal angles of 70 to 80 degrees are formed where the lateral surfaces meet the face at the cutting edges
- application of hoe scaler
- two point contact is maintained with the tooth to stabilize the instrument during the positioning and activation
- Single-tuft Brush
- good for open inter proximal areas, fixed dental prostheses, difficult to reach areas
- Instrument design name
- school or individual originally responsible for the design or development
- The Bass method: Sulcular Brushing
- filaments are directed toward gingival margin at 45 degree angle. Direct tips into sulcus and vibrate
- Effect of shank length
- too short a distance limits action; too long a distance may result in an unbalance instrument
- Power toothbrush motion: Counter-rotational
- Each tuft of filaments moves in a rotational motion; each tuft moves counter-directional to adjacent tuft
- Influencing factors for toothbrush selection
- Patient, gingiva,position of the teeth, shape of teeth and exposed root, compliance and the brushing method selected
- Microorganisms in saliva are principally from
- the tongue
- shape of abrasive particles
- irregular shaped with sharp edges
- Power toothbrush motion: Combination
- Combination of simultaneous yet different types of movements
- subjective data
- obtained from what the patient expresses; have their chief complaint in quotes
- Purpose for power toothbrush
- Patients physically able and patients with disabilities or limited dexterity
- curet adaptation
- the toe third or lower third of the cutting edge is maintained on the tooth surface at all times
- assessment stroke
- a light pressure equal to the use of an explorer is applied as the curet blade is moved across the tooth surface