Methods of individual oral hygiene. Means used in professional oral hygiene

Learning elements

Purpose of the lesson: Learn and master oral care techniques.

Basic terms: oral hygiene, methods of brushing teeth, tongue, standard method of brushing teeth.

Test questions:

5) Control of the initial level of knowledge

6) Interview on the topic

a) oral hygiene algorithm.

b) brushing methods

c) use of floss, floss, floss, tape

d) using a toothpick

e) using an irrigator

f) mistakes made in oral care

3) Control of the assimilation of knowledge

Presentation of educational material

Oral hygiene is a set of measures, the most important component of which is brushing your teeth. According to WHO, 92% of the population do not know how to brush their teeth. Oral hygiene in most Russian children is limited to a set of empirical manipulations using a standard toothbrush and paste.

Teeth brushing algorithm

1) Wash your hands with soap.

2) Rinse your mouth with warm water.

3) Rinse your toothbrush thoroughly with water.

4) Clean your teeth with a toothbrush and toothpaste

5) Rinse your mouth.

6) Soap the working part of the toothbrush with soap or treat with a special solution.

7) Put the toothbrush in the box with the head up

There are options depending on the age of the child, the type of toothpaste, the condition of the oral cavity, the preferences of the individual, etc.

Using a toothbrush

Movements of the toothbrush when brushing your teeth:

· Vertical (sweeping) are performed along the axis of the tooth from the gums and are designed to remove plaque from the vestibular and lingual surfaces, partially cervical area and interdental spaces, gums.

· Horizontal (reciprocating) designed to remove plaque from occlusal surfaces.

· Rotational (circular) designed to remove plaque from fissures and pits, the cervical area and massage the gums.

Performing sequentially the steps of the standard method of brushing teeth, guided correct location brushes in relation to different surfaces of the teeth, the correct choice of the type of movements and the required number of movements on the surfaces of various groups of teeth.

There are many methods of brushing teeth (Leonard, Bass, Fones, Reite, Charter, Smith-Bell, Stillman, Pakhomov, Bokoy).

Standard Teeth Brushing Method (Pakhomov G.N.). The dentition is conditionally divided into 6 segments (molars, premolars, incisors with fangs). Cleaning is carried out with open dentition. The brush is placed at an angle of 45 degrees to the axis of the tooth and with the help of 10 vertical sweeping movements plaque is removed from the vestibular surface of the upper left molars. Alternately, all segments of the upper jaw are cleaned. The palatal surface is cleaned similarly. On the lower jaw, the sequence and types of movements are repeated. The chewing surface of the teeth is cleaned using reciprocating movements.

Leonard Method provides two types of movements: vertical and horizontal. The head is set perpendicular to the axis of the tooth, and with vertical movements from the gums, plaque is removed from the vestibular and oral surfaces. The occlusal surface is cleaned by reciprocating horizontal movements.

Phones Method carried out with closed dentition. The toothbrush is placed perpendicular to the axis of the tooth and performed in a circular motion, while simultaneously cleaning the vestibular surfaces of the teeth of the upper and lower jaws. Lingual and chewing surfaces are also cleaned in a circular motion.

Charter method Designed for both cleaning teeth and gum massage. It is an additional therapeutic measure for inflammatory diseases periodontal. The toothbrush is set at an angle of 45° to the axis of the tooth with bristles towards the cutting edge of the tooth. With gentle circular motions, the bristles penetrate the interdental spaces. After three or four movements, the toothbrush is moved to a new group of teeth and the whole process is repeated. This method is recommended for school-age children with certain manual skills. Cleaning is carried out under the supervision of a dentist.

Self-controlled brushing method (Bokaya V.G.). Before cleaning, stain the tooth years. The vestibular and oral surfaces are cleaned with vertical movements with a maximum grip on the gums. The vestibular surfaces are cleaned with closed jaws in a direct bite with the capture of the gums to the transitional folds. The patient controls the quality of cleaning by the presence of dye every five movements. The maximum capture of the gums provides a thorough removal of plaque and its massage, and the mucosa acts as a dispenser of the force of cleaning movements.

A large number of methods of brushing teeth indicates the urgency of the problem. It is difficult to imagine the existence of a simple and effective method brushing teeth, universal for everyone. It is impossible to use a single method for adults and children, with a healthy oral cavity and its pathology, in the absence or presence of "orthodontic" problems. However, compliance with certain generally accepted basic principles will optimize the process of removing plaque.

It should be noted that the clinical effectiveness of toothbrushes is to a lesser extent due to their design features. More important factors are thorough instruction in oral hygiene and correct technique brushing your teeth.

To evaluate the effectiveness of individual oral hygiene and

to motivate the patient to improve the quality of brushing teeth, controlled brushing of teeth (CCH) is carried out by an individual under the control of a hygienic index in the presence of a specialist.

Controlled brushing teeth is an integral part of the complex of measures for hygienic education and upbringing (GOiV) of the child. Dental hygienists are currently engaged in the formation of knowledge and skills in oral hygiene among the population. However, if necessary, a dentist can participate in the process. CCHZ is carried out in several visits.

CCH Methodology

On the first visit a complete dental examination of the patient is carried out, the data are recorded in medical card. In the presence of an intraoral camera, the patient is shown the identified dental "problems", including the existing microbial plaque. To enhance the effect, plaque can be stained. The video presentation is accompanied by detailed explanations. The hygiene index is determined if no more than 5 hours have passed since the moment of brushing your teeth.

On the second visit the child brings the used items and oral hygiene products. The specialist evaluates the condition of the toothbrush, floss, characteristics of the toothpaste and their compliance with the condition of the patient's oral cavity. The child in the presence of parents (if possible without their participation in the conversation) talks about individual oral hygiene. After that, the teeth are cleaned with the definition of GI before and after the manipulation. The hygienist is located nearby as an observer and fixes all the shortcomings, but does not interfere in the process. The effectiveness of brushing teeth is estimated by the difference in GI scores. When indicated, the selection of adequate items and means of oral hygiene, training in the rules of oral care is carried out.

On the third visit the child comes with a new toothbrush (floss, floss, scraper) and toothpaste (rinse, spray). CRC is being carried out, corrections are being made. In the future, the frequency of visits is determined by the hygienist individually.

Individual cleaning quality control teeth is performed by the patient or parents. For this purpose, special dyes are used: a solution of basic fuchsin, erythrosine, Schiller-Pisarev, Lugol, erythrosine containing tablets. Tablet preparations at home are preferable, as they are more hygienic and stain the entire plaque. CCHZ is best done in the evening if parents have free time.

Using floss

Flossing is a procedure for cleaning interdental spaces and contact surfaces of teeth using floss. The thread is used after each meal, usually 2-3 times a day.

Flossing technique:

Wash the hands;

Cut floss 20–30 cm long;

Fix the ends of the floss on the middle fingers, wrapping it around one much larger fragment;

Using the index and thumb fingers, the floss is gently inserted into the interdental space;

Covering the neck of the tooth in the form of a half-loop, with sawing and vertical movements, carefully advance the thread from the gum;

Update the working part of the thread by moving the loops on the fingers;

At the end of the procedure, dispose of the floss;

Wash the hands.

The use of floss or floss is much more convenient, easier, and contributes to the development of the habit of flossing.

Using a toothpick

Toothpicks are used in the absence of other oral hygiene items. Method of application: place the toothpick at an angle of 45 degrees to the tooth, while the end should be in the periodontal sulcus, and the side should be pressed against the surface of the tooth. Then the tip of the toothpick is advanced along the tooth, following from the base of the groove to the contact point of the tooth.

Using an irrigator

Irrigators are used as additional subject hygiene for cleaning hard-to-reach areas of the oral cavity and gum massage. After traditional toothbrushing with a brush and paste, a powerful jet of water is directed into the interdental spaces, under the fixed elements of orthodontic equipment. The segment clearing sequence is similar to the standard method. The use of IPR in children contributes to the development of oral care habits, as it is an element of the game for them.

tongue cleaning

Hygiene of the tongue involves the removal of plaque, mucus, food debris with a regular toothbrush, a special toothbrush, a nozzle for cleaning the tongue of an electric toothbrush, a scraper. Particular attention should be paid to the hygiene of the tongue in the presence of diseases of the gastrointestinal tract, folded or "geographical" tongue. In these cases, the language accumulates a large number of mucus and plaque that creates favorable conditions for the reproduction and vital activity of pathogenic microorganisms.

Hygiene of the tongue is carried out after brushing the teeth. Brush medium degree stiffness is moved by sweeping movements from the root of the tongue to the tip. The number of movements is variable, on average 10–12. After several movements, the brush must be rinsed under running water to remove mucus. The brush is moistened with water or toothpaste. However, the use of foaming paste is not advisable, since a gag reflex may occur.

The use of a scraper is similar to the above method. Use the scraper carefully to avoid injury to the tongue.

To clean your entire mouth, Colgate 360° mouthguards with tongue cleaning pad are specially designed to remove up to 36% more bacteria, causing the appearance bad breath.

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Oral hygiene strategy. - Self cleaning. - Rubbing. - Rinse and means for it. – Brushing teeth with a toothbrush (device of manual and motor brushes, basic and auxiliary methods of brushing teeth, powders, gels and pastes for brushing teeth). - Cleaning the proximal surfaces of the teeth. - Age features of hygienic care for the oral cavity. Teaching children and adults individual teeth cleaning.

Oral hygiene strategy

The anatomical shape of the crowns of the teeth and their relative position in the dental arch are best suited to the tasks of mechanical food processing. However, dietary fibers (vegetable and meat) can get stuck between the teeth, and crushed food can form soft dental deposits, which creates discomfort and causes disease.

Animals take some measures to extract food particles: cleaner fish feed in the mouth of large fish, crocodile teeth are food stores for tari birds - this is how natural symbiotic relationships are formed that help clean teeth. great apes help themselves, wielding toothpicks. They believe that ancient man also managed with toothpicks, but as civilization developed, tough fibrous food was replaced by crushed, softened chemical and thermal culinary technologies, which changed the hygienic status of the oral cavity and required more significant efforts to care for the teeth.

An oral hygiene strategy consists of physical and/or chemical attack on dental plaque in order to:
a) destroy their internal structure;
b) destroy their bonds with the substrate (enamel, cement or dentin of the exposed root, prostheses, soft tissues oral cavity);
c) remove fragmented dental deposits from the oral cavity.

The choice of the type of exposure and its intensity should be such that a compromise between efficiency and safety is observed. So, if a large force is applied when brushing the teeth, then the teeth are well cleaned, but enamel, cement, periodontium, etc. can be damaged, and if the applied friction force is sparingly small, it will not rid the teeth of deposits.

Hygienic care of teeth is a technically difficult task: dental deposits are not very accessible to direct exposure because:
. lie on curvilinear, concave and convex surfaces of teeth with different radii of curvature (dental arch, each tooth surface);
. are located in narrow retention points (in the recesses on the enamel, interproximal spaces);
. cover areas of teeth that are closely adjacent to other organs and tissues (tongue, branches of the lower jaw, etc.);
. tooth surfaces occupy a large total area.

Therefore, to ensure good level oral hygiene needs a whole arsenal various methods using various items and hygiene products.

The subject of hygiene is called simple and complex (manual, mechanical, electrical, etc.) devices that have a mechanical effect on dental deposits - brushes, threads, toothpicks, irrigators, etc.

Hygiene means are usually paste-like (pastes, gels) or liquid (elixirs, rinses) preparations that act mechanically on dental plaque and often have preventive additives of a chemical nature.

Depending on the degree of complexity, hygiene procedures can be performed by the patient independently at home (home, individual oral hygiene) or only in a dental office by a hygienist, assistant, dentist (professional oral hygiene).

Self cleaning

To some extent, this process can be interfered with by such natural cleansing forces as the flow of oral fluid, the movements of the muscles of the tongue, cheeks and lips. However, the self-cleaning effect of retention points is very small and depends on the rate of salivation and the viscosity of the oral fluid, and it is the smaller, the lower the rate of salivation and the higher the viscosity of the oral fluid. Therefore, no matter how useful eating fresh vegetables and fruits, salivary products (crackers, sour foods), no matter how attractive chewing gum - all this cannot solve the problem of mechanical cleaning of the retention points of the teeth from dental plaque.

Rubbing

Wiping the teeth is a relatively safe manipulation, so it is the first oral hygiene procedure in a child's life. Rubbing allows more or less successful cleaning of the incisor surfaces, helps to adapt the six-month-old child to manipulations in his oral cavity and facilitates the transition to using a toothbrush.

It should be remembered that with manual (finger) wiping, not all, but only the convex surfaces of the teeth can be cleaned: the vestibular surfaces of the incisors and canines, tubercles, gingival zones of temporary molars, equatorial zones of permanent molars and premolars. The quality of cleaning these surfaces depends on the strength of hand movements and on the quality of gauze (hardness, density, relief). Rubbing a child's teeth should be carried out under constant visual control in order to avoid injury to the gum tissue.

Rinsing and means for it

During rinsing, the liquid is moved by the efforts of the muscles of the cheeks and tongue along the oral cavity, the liquid is filtered between the teeth and thus loosely lying food residues and the outer layers of plaque are displaced. The low cleansing mechanical effect of rinsing is complemented by the chemical activity of liquid oral preparations used both for hygienic (rinses, deodorants) and special (balms, tonics, decoctions and herbal infusions) purposes.

The components of official liquid products are water, flavors, flavors, dyes, alcohol, detergents and therapeutic and prophylactic additives.

Flavorings (oils of mint, anise, cinnamon, myrrh, lavender, sage, nutmeg, eucalyptus, citrus, thymol, cloves, cumin, coniferous extracts, etc.), sweeteners (cyclomate, saccharin) and dyes (yellow C 1.19140; blue C 1.42051, C 1.69800; green C 1.74260) make up a bouquet, which is the main selection criterion softener by the consumer.

Ethyl alcohol makes up 6-21% of rinse aids and more than 30% of elixirs. Alcohol stabilizes the “formula” of the drug, reveals its taste and aroma, and provides a long “aftertaste”. The fact that the preparations contain alcohol limits their use for oral hygiene of children, drivers, etc. Recently, in connection with negative action alcohol on the oral mucosa (burning, discomfort, degenerative changes, plasmorrhoea) recommend the production and consumption of products with a minimum (up to 8%) alcohol content or without it at all.

Detergents (surfactants, surfactants, surfactants) - a special class chemical substances with surface active properties. They reduce the tension of the oral fluid and the hygiene product, which helps to evenly distribute the product in the oral cavity, on the surface of the tooth. Surfactants create foam, loosen the structure of soft dental deposits, emulsify them, which helps further mechanical cleaning of the tooth with a brush. In addition, surfactants exhibit antimicrobial properties, block a number of plaque enzymes and thereby reduce its growth.

Soaps were the first detergents in hygiene products, but their inherent alkaline reaction and harsh, poorly masked taste gradually replaced soaps from oral hygiene. A natural detergent is sodium lauryl sulfate, derived from coconut oil: a substance with an easily masked taste that works at neutral pH values. Synthetic surfactants that are part of oral hygiene products are sodium dioctyl sulfosuccinate, sodium lauryl sulfoacetate, sodium sarcosinate-laurol, artificially created sodium lauryl sulfate, betaine, sodium salt fatty acid tauride.

They are tolerant of changes in pH (work in both alkaline and neutral, and even acidic environments), do not form sediment in hard water and saliva. Less commonly used are sodium dodecyl sulfate, cetavlon, sodium oleate, cetylpyridine. The concentration of surfactants in oral hygiene products is strictly controlled, as they are highly toxic (they must not be swallowed!), They can increase vascular permeability and provoke degenerative changes in the oral mucosa.

To stabilize liquid hygiene products, buffer components (phosphates), antiseptic preservatives (methylparaben, propylparaben, benzoates), viscous substances (glycerin) are added to them.

Many liquid hygiene products have a preventive effect; among the preventive anticaries additives to liquid hygiene products, antiseptics (triclosan, chlorhexidine, phenol) and fluorides are the most popular.

Established hygienic requirements for mouthwashes:
. the absence in the prescription of carbohydrates fermented by microbial plaque;
. acidity within pH=3.0-9.0;
. biological safety proven in experiments on living organisms;
. the content of fluoride in one package is not more than 300 mg.

Due to the presence of components that are not intended to be swallowed, liquid hygiene products may be recommended for rinsing the mouth in patients who can control swallowing - adults and children over 6 years of age. Rinsing the mouth with the use of certain liquid hygiene products is recommended:
. as the only method of hygienic oral care in situations where more effective measures are dangerous for periodontal tissues (postoperative gum conditions, thrombocytopenia, etc.) or technically impossible (field conditions);
. for preliminary hygienic treatment of the oral cavity in order to loosen dental deposits;
. at the end of the toilet of the oral cavity - for a chemical effect on the tissues of the oral cavity (to modify the adhesive properties of the enamel surface, increase mineralization, to prevent periodontal tissue diseases, etc.).

T.V. Popruzhenko, T.N. Terekhova

The leading component of the prevention of dental diseases is oral hygiene. Systematic cleaning of teeth, removal of still soft dental deposits contribute to the physiological process of still maturation of the enamel of teeth. Biologically active components of hygiene products (dental pastes, elixirs), it enriches the tissues of the tooth and periodontium with phosphate salts, calcium, microelements, and vitamins, increasing their resistance to harmful effects. Regular massage of the gums while still brushing the teeth still contributes to the activation of metabolic processes, and to the improvement of blood circulation in the periodontal tissues.

Oral hygiene plays an important role in the prevention of the oral cavity. According to the literature, regular controlled two-time daily brushing for two years reduces the incidence of caries by 2 times.

Exactly at childhood the probability of occurrence of caries is close to 100%. This is due to the inability of the child's body to resist bacteria, the structure and vulnerable structure of the tooth itself, and other factors.

Most best option for parents, consult a dental hygienist who will show your child how to properly brush their teeth and how often to brush their teeth.

Preventive hygiene of the oral cavity is also a complex event, which includes daily brushing of the teeth, and also a visit to the dental hygienist once every six months. Oral hygiene products are still a kind of multi-component system, which also includes a variety of natural and synthetic substances, which are also intended for both prophylactic and therapeutic effects on the oral cavity as a whole. In order to have a healthy and beautiful smile, it is important to choose the right products for oral hygiene. Quality care is the key to strong teeth and gums. Oral hygiene items are also divided into basic and auxiliary ones:

Basic: toothbrushes, dental floss (floss).

Auxiliary: toothpicks, brushes, irrigators, tongue scraper.

Consider the basic subject of oral care. Classification of toothbrushes

1. By type, toothbrushes are: children's, teenage, adults.

2. According to the toothbrush group: hygienic, prophylactic (periodontal), additional (special purpose). Special purpose brushes can equally be used by both adult patients and children and adolescents.

3. According to the class of the toothbrush: manual (manual), mechanical (manual), electric.

4. By subclass: straight, angular (angular).

5. By sub-subclass: without indication and indicator.

6. By type of bristle: natural, artificial.

7. By bristle class (by bristle material): nylon, setron, perlon, derolon, mixed, combined, microtextured.

8. According to the subclass of bristles (according to the degree of rigidity): artificial bristles - very soft type"Sensitive", soft type "Soft", medium degree of hardness type "Medium", hard type "Hard", very hard type "Extra Hard", "HN"; mixed (a combination of bristles of different degrees of stiffness), combined (a combination of several types of materials that change the stiffness of the bristles).

9. According to the group of bristles (according to the nature of the placement of the bundles and the degree of processing of the bristles):

a) artificial bristles of a toothbrush: single-level, two-level, three-level, multi-level;

b) artificial bristles: cut, polished, rounded, ground, combined.

All over the world, most adults brush their teeth incorrectly, and accordingly they teach their children to brush their teeth incorrectly.

Experience shows that required level hygiene skills and systematic oral care in children can only be provided with the collaboration of dentists, nursery and kindergarten teachers, teachers and parents. special attention require children with dentoalveolar anomalies, since the incorrect position of the teeth and their crowding predispose to the occurrence of dental caries and periodontal disease.

Oral hygiene consists of training, performing hygiene measures, monitoring the correctness of their implementation and includes brushing your teeth and rinsing your mouth. To do this, use special tools and hygiene items that allow you to effectively clean the oral cavity from dental deposits and food debris.

There are certain requirements for oral hygiene products and items:

Absolute harmlessness to dental tissues and oral mucosa;

Good cleansing properties;

Anti-inflammatory effect on the gums and oral mucosa;

Anticarious action;

Do not disturb the physiological balance of the microflora of the oral cavity;

Do not affect the activity of salivary enzymes;

Do not change the acid-base balance in the mouth, etc.

Let's consider the standard method of cleaning Pakhomov G.N.'s teeth. The dentition is conditionally divided into several segments. Brushing the teeth still begins with a site in the area of ​​​​the upper right chewing teeth, still sequentially moving from segment to segment. In the same order, he still brushes his teeth, he is still on the lower jaw. When cleaning the vestibular and oral surfaces of the molars and even premolars, the working part of the toothbrush is placed at an angle of 45 ° to another tooth and it cleans from the gums to the tooth, while still removing plaque from more teeth and gums. The chewing surfaces of the teeth are cleaned with horizontal (reciprocating - translational) movements, so that even the fibers of the brush still penetrate deep into the fissures and the interdental spaces.

The vestibular surface of the frontal group of teeth is the upper and mandible he is cleaned with the same movements, he is like molars and he is premolars. When cleaning the oral surface, the brush handle is still perpendicular to the still occlusal plane of the teeth, while the fibers are still at an acute angle to them and capture not only the teeth, but also the gums. Finish cleaning all the segments in a circular motion. It is still most widely used in individuals without periodontal pathology.

Technical equipment: slide projector "Peleng", dental unit, chair, sets of instruments for examination of the oral cavity, plaque indicators, toothbrushes, pastes, gels, elixirs, toothpicks, flosses.

Tutorials: slides, tables, stands, phantoms.

Controls: control questions, tasks, situational tasks, questions for test control of knowledge, homework.
Questions learned earlier and relevant to this lesson. Composition, properties of saliva and oral fluid (department of biochemistry).
Lesson plan

1. Checking homework.

2. Theoretical part. Means and methods of individual oral hygiene. Teeth brushing methods. Means and methods of professional oral hygiene. Interview on control questions and control tasks. Solution of educational situational problems.

3. Clinical part. Demonstration by the teacher of methods of brushing teeth on a phantom: standard, for periodontal diseases, combined and others. Demonstration of the technique of using interdental flosses (flosses). Demonstration of individual oral hygiene products at the booth.

4. Independent work of students. Teaching students the rules of brushing their teeth, holding conversations on the selection of brushes and toothpastes.

5. Analysis of the results of independent work of students.

6. Solution of control situational problems.

7. Test control of knowledge.

8. Assignment for the next lesson.
annotation

Primary prevention of dental diseases includes a set of measures. The leading event in this complex is oral hygiene. It is customary to distinguish between personal and professional hygiene.

Individual hygiene is understood as the careful and regular removal of deposits from the surface of the teeth and gums by each person. Professional oral hygiene is carried out by a specialist (dentist or hygienist) and ensures the removal of soft and mineralized dental deposits, quality control of individual hygiene, diagnostics early stages dental caries and periodontal disease.

Personal oral hygiene products- these are toothbrushes, oral irrigators, dental floss, tooth powders and pastes, gels, tooth elixirs, chewing gum.

Methods of individual oral hygiene are brushing your teeth and rinsing your mouth.

Mechanical removal of dental plaque is carried out using dental brushes. The toothbrush consists of a handle and a working part, represented by rows of bristle tufts. Artificial fibers are mainly used as bristles. By stiffness, there are three types of bristles: hard, medium, soft; according to the length of the working part and the size of the handle - adults and children. There are also electric toothbrushes.

The toothbrush should be individual for each person. The service life is on average from one to three months, until the deformation of the bristle bundles occurs.

However, even careful observance of the rules of oral hygiene with the use of toothbrushes alone does not allow to achieve cleansing of the interdental spaces. For this use dental floss (floss). They are made from man-made fibres. A thread 30-40 cm long is inserted into the interdental spaces, pressed against the surface of the tooth and held up and down, making 6-7 movements. Also for this purpose, toothpicks are used - wooden and plastic; irrigators - a jet of water under pressure of 2-10 atm is used. through the tip. Pressure is created by compressors, medicinal substances are added to the water.

Chemical cleaning of teeth from plaque is carried out using toothpaste. Currently, the world's leading manufacturers of toothpastes involve not only technologists, designers, engineers, but also dentists in the creation of new types, so that the pastes meet the needs of the population as much as possible, depending on specific dental situations. Toothpaste is a complex system, in the formation of which many components are involved:

a) abrasives (chalk, sodium bicarbonate, dicalcium phosphate, polymeric compounds of methyl methacrylate, etc.);

b) wetting agents (glycerol and sorbitol) that prevent the evaporation of water and help maintain the homogeneity of the paste;

c) binder (natural resins);

d) foaming substances, or detergents (lauryl sulfate), which promote the formation of foam and facilitate the process of brushing teeth;

e) antimicrobials or preservatives (alcohols, benzoates, formaldehydes);

f) water 20-30%;

g) therapeutic and prophylactic additives that determine the purpose of the paste;

h) gelling agents.

Toothpastes can be distributed according to affiliation (children's, teenage, adult), according to consistency, according to purpose, according to the degree of foaminess, according to the content of elements, etc.

The most significant gradation of toothpastes by purpose (Table 1), in accordance with it, all toothpastes are divided into two main groups: hygienic and therapeutic and prophylactic.

Table 1

Classification of practical gradation of toothpastes

Hygienic toothpastes are designed to clean teeth from plaque and deodorize the oral cavity (“Orange”, “Family”, “Mint”, “Moscow”, “Good morning”, “Phosphorin”, “Ovenal”, “Red-White”) .

Therapeutic and prophylactic toothpastes are divided into two subgroups: simple and complex. Simple therapeutic and prophylactic toothpastes have any one effect: anti-caries or anti-inflammatory, or abrasive. Compound therapeutic and prophylactic pastes are divided into combined and complex. Combined pastes include pastes, which include two or three therapeutic and prophylactic components aimed at the therapy and prevention of one type of pathology. Complex toothpastes include several therapeutic and prophylactic components that act on different kinds pathology.

In the context of the emergence of more and more complex toothpastes with a targeted effect, the dentist should be engaged in the selection of toothpaste and recommend it in accordance with the specific dental and hygienic status of the patient. To do this, you need to know the main focus of toothpastes:

a) for the prevention of caries - contain fluorine and phosphorus-calcium compounds;

b) for the prevention of gum disease - include herbal and anti-inflammatory components (extracts of chamomile, sage, eucalyptus, etc., chlorhexidine, triclosan, etc.);

c) for sensitive teeth to external irritants, containing hydroxyapatite or tricalcium phosphate and contributing to the obturation of dentinal tubules, or fluorine-containing with potassium nitrate, providing isolation of nerve fibers.
Basic rules for brushing your teeth

Sweeping, scraping, circular and reciprocating movements are used for brushing teeth.

Sweeping movements are carried out from the gums to the edge of the crown, they are necessary for cleaning the buccal, palatine, lingual and vestibular surfaces of the teeth. Scraping and reciprocating movements are used to clean the chewing surfaces of the teeth. Circular movements are carried out on all surfaces after scraping movements. The toothbrush is placed perpendicular to the surface to be cleaned. To create stereotypy, first, the dentogingival zone of the molars is cleaned from any side, moving along the vestibular surface to the chewing, and then to the palatal surface. Then they move on to premolars and anterior teeth. First, brush the teeth of the upper jaw, then the lower. Each segment surface needs to be cleaned with 8-10 brush strokes, and 300-400 brush strokes are required to clean all teeth. The most optimal scheme for brushing your teeth is brushing twice a day: in the morning and in the evening after meals.
Professional oral hygiene

The term "professional oral hygiene" refers to the thorough removal of soft and hard dental deposits from all surfaces of the teeth and gums. prophylactic under the control of plaque indicators. Professional oral hygiene is carried out by a dentist or hygienist and includes: training, accounting, monitoring the hygienic condition of the oral cavity, correction, registration of the state of teeth and oral tissues, systematic removal of dental deposits from inaccessible surfaces.

4. Toothbrushes, requirements for them, differences, selection, service life.

5. Interdental cleaners.

6. Toothpastes, composition.

7. Toothpastes, practical gradation.

8. Basic rules for brushing your teeth.

9. The concept of "professional oral hygiene".

10. Stages of professional oral hygiene.
Control tasks

Task 1. Match the hygiene products:

Task 2. What means provide mechanical removal of plaque?

10. On the second visit for professional oral hygiene, the patient independently cleaned the surfaces of the teeth with a toothbrush and paste in front of a mirror. The doctor gave advice on correct use interdental cleaners.

Have all the measures provided for at this stage of professional hygiene been carried out by the doctor?

1. When examining the oral cavity in the cervical region of the teeth of the upper and lower jaws, a significant accumulation of soft plaque. On closer examination, it turned out that the patient long time uses a soft toothbrush.

What are the reasons for this hygienic status in the oral cavity? Give recommendations on the care, storage and life of the toothbrush.

2. The patient finds it difficult to choose a toothbrush and interdental cleaners. Conduct a consultation on the selection of these personal oral hygiene products for the patient, indicate what needs to be emphasized.

3. A patient came to the dentist with complaints of bleeding and soreness of the gums in the area of ​​35, 34 and 33 teeth.

Objectively: interdental papillae and marginal gingiva in the area of ​​these teeth are edematous, hyperemic, with a wound surface. From the anamnesis it was found out that the patient used a new toothbrush.

Explain and list possible reasons acute inflammation gums.

4. Patient K., aged 30, complained of pain when eating, brushing teeth, spontaneous bleeding of the gums.

On objective examination, the marginal gingiva and periodontal papillae are edematous, hyperemic, the papillae are enlarged, and bleed when touched. False gingival pockets were found without violation of the periodontal attachment.

Diagnosis: exacerbation of chronic catarrhal gingivitis medium severity.

What toothbrush and toothpaste should be recommended to the patient for the period of treatment? Give a rationale.

5. In the course of professional oral hygiene during the interview, it turned out that during brushing the teeth, the patient uses scraping and reciprocating movements on all surfaces of the teeth, starting from the front teeth and ending with the molars.

Is there a violation in the method of brushing teeth? If so, describe the basic rules for cleaning the surface of the teeth.

6. In the process of professional oral hygiene, the doctor examined the oral cavity, stained plaque with subsequent demonstration to the patient, removed dental plaque, gave recommendations on right choice means of personal hygiene of the oral cavity.

List the steps involved in professional oral hygiene.

7. A patient consulted a dentist complaining of bleeding gums while brushing his teeth.

Objectively: interdental papillae and marginal gingiva are edematous, hyperemic, papillae bleed when touched. The hygiene index is 1.6 points. A diagnosis of acute serous gingivitis was made.

8. During professional oral hygiene on the third visit, the patient cleaned the surface of the teeth with a toothbrush and toothpaste on his own. The doctor checked the quality of teeth cleaning.

Have all manipulations been performed at this stage? List the terms of repeated monitoring of the patient's compliance with oral hygiene.

9. The patient complains of increased tooth sensitivity from external stimuli.

As part of complex treatment the patient was recommended toothpaste containing hydroxyapatite or tricalcium phosphate, as well as fluoride toothpaste with potassium nitrate.

10. A patient came to the dentist with complaints of bleeding gums when eating hard food and brushing his teeth.

Objectively: interdental papillae are swollen, hyperemic, cyanotic, bleed when touched. Abundant soft plaque. Hygiene index 4 points.

What methods and means of individual and professional oral hygiene can be recommended to the patient? Give a rationale.

1. What oral hygiene products are considered individual?

a) toothbrushes

b) flosses;

c) toothpastes;

d) irrigators;

e) rubber cups.

2. What components are included in the composition of hygienic toothpastes?

a) abrasives;

b) moisturizers;

c) natural resins;

d) foaming agents;

e) anesthetics;

f) therapeutic and prophylactic supplements.

3. How are therapeutic and prophylactic toothpastes divided?

a) combined;

b) combined;

c) complex;

d) simple;

c) complex.

4. What are interdental cleaners?

a) toothpicks

b) flosses;

c) irrigators;

d) strips.

5. Which of the following substances are classified as components of therapeutic and prophylactic toothpastes?

a) abrasives;

b) humidifiers;

c) preservatives;

d) detergents;

e) therapeutic and prophylactic additives;

f) antibiotics;

g) cauterizing substances.

6. Specify the methods of individual prevention of the oral cavity:

a) brushing your teeth

b) removal of tartar;

c) irrigation of the oral cavity;

d) removal of dental deposits from inaccessible surfaces.

7. List the main movements used when brushing your teeth:

a) sweepers;

b) rubbing;

c) circular;

d) reciprocating.

8. What substances are included in the composition of anti-caries toothpastes?

a) sodium fluoride;

b) anti-inflammatory components;

c) antimicrobials.

9. What substances are included in the composition of toothpastes used for the prevention of periodontal diseases?

a) fluorine compounds;

b) plant extracts;

c) phosphorus-calcium compounds.

10. What are hygienic toothpastes for?

a) cleaning from plaque;

b) deodorization of the oral cavity;

c) prevention of gum disease;

d) prevention hypersensitivity teeth.

a) define personal and professional hygiene;

b) list personal oral hygiene products;

c) list hygienic pastes;

d) composition of toothpastes;

e) classification of therapeutic and prophylactic toothpastes;

f) stages of professional oral hygiene.
Literature

Main

1. Borovsky E.V., Therapeutic dentistry / E.V. Borovsky, V.S. Ivanov, Yu.M. Maksimovsky, L.N. Maksimovskaya. - M.: Medicine, 2001. - S. 212-219, 266-269, 718-727.

2. Dental diseases: a practical guide / ed. prof. N.N. Garages. - Stavropol: Publishing House of StGMA, 1998. - S. 338-342.

3. Maksimovsky Yu.M. Therapeutic dentistry / Yu.M. Maksimovsky, L.N. Maksimovskaya, L.Yu. Orekhov. - M.: Medicine, 2002. - S. 225-231.

Additional

1. Therapeutic dentistry: tutorial/ ed. prof. L.A. Dmitrieva. - M., 2003. - S. 580-585.

2. Test tasks for monitoring the level of knowledge in the propaedeutics of dental diseases / ed. prof. MM. Pozharitskaya. - M., 2000. - S. 48

3. Test tasks on the propaedeutics of dental diseases. Part I. Therapeutic dentistry / ed. prof. N.N. Garages. - Stavropol, 2003. - 40 p.

4. Ulitovsky S.B. Toothpaste / S. B. Ulitovsky. - St. Petersburg, 2000. - 272 p.

60-90% of school-age children and almost 100% of adults have dental caries. In 15-20% of middle-aged people (35-44 years), severe periodontitis (gum disease) is found, which can lead to tooth loss. The issue of prevention of oral diseases is crucial.

The most common and massively encountered risk factors for the development of oral diseases are the presence of plaque, tartar, poor oral hygiene.

plaque or dental plaque - These are organized colonies of bacteria, some of which cause the development of gum disease, the other part - the development of caries.

Tartar is hardened plaque that forms on the surface of the teeth.

| Poor oral hygiene often associated with improperly used brushing technique.

Professional oral hygiene in our clinic is a set of measures aimed at preventing and eliminating risk factors for the development of oral diseases. This procedure is carried out individually for each patient, taking into account his characteristics and consists of the following steps:

• | Removal of tartar without damage to tooth enamel with ultrasound

• | Removal of plaque without trauma to the soft and hard tissues of the oral cavity by treating the tooth surface with a soda-containing solution under pressure (Air-Flow)

• | Polishing treated surface

• | Deep fluoridation- treatment of the surface of the teeth with fluorine-containing preparations (for professional use in dentistry). In the human body, fluoride is mainly found in tooth enamel. With insufficient content of it, the destruction of tooth enamel and, as a result, the development of caries occurs.

• | Teaching and monitoring oral hygiene. A disposable toothbrush is issued, with which you brush your teeth according to your usual method under the supervision of a doctor. Further, the control of the plaque remaining after brushing the teeth is carried out with the help of plaque-coloring tablets. After that, the doctor conducts training in an individual method of brushing your teeth that is relevant to you, taking into account your characteristics, as well as the selection of individual oral hygiene products.

As a rule, plaque and tartar that cover the surface of the teeth are dark in color, due to which the teeth as a whole darken. Therefore, when removing plaque and stone, many patients mistakenly believe that they have undergone a whitening procedure, although the true color has only returned to the teeth. As a rule, the formation of tartar and plaque lasts from 4 to 6 months. Therefore, it is important to visit the dentist at least once every six months.

| It's important to know, if these modern devices are used incorrectly, unprofessionally, a procedure aimed at removing dental deposits can cause microtrauma of the gums and destruction of tooth enamel. And then regular professional teeth cleaning ceases to be a preventive measure, moving into the category of violators of the integrity of the oral organs.