Summary of Lecture # 3

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

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

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

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

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

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 (618-907 AD) Williams Addis (England, 1780) manufactured the first modern toothbrush: handle made of bone with holes for placement of natural hog bristles

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

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

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:

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

Toothbrushes and Tooth-brushing Methods Patient’s motivation

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

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)

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)

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

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