1. Interdental Care Dentalelle Tutoring
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2. Types of Gingival Embrasures
This is the most important!
Depending on the size of that ‘space’ will depend on what interdental aids you will recommend
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3. What is the col?
Under the contact area between the lingual papilla and facial papilla
DIFFERENT from the embrasure
The epithelium covering the col is thin and non keratinized
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4. Gingivitis
STARTS in the interdental area (or at least has a greater chance of happening) because the col isn’t protected very well
If bacteria from the plaque is left to sit there, it causes inflammation which is gingivitis
Concavities and grooves allow that plaque to hide in those areas a lot easier
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6. Assessment
What type of anatomy does the patient have? What do the teeth look like and what does the gingiva look like?
Does the patient have any crowns? Bridges? Implants?
Do some plaque assessments – plaque free score for example, or using disclosing tabs
Is the patient handicapped? A child? Do they need additional brushing instruction?
**Keep it simple – suggest aids that are easy to use, help them increase their oral hygiene steps but don’t go overboard, etc
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7. Review of Toothbrushing
Charters
Fones
Stillmans
Bass
Let’s talk , which is which?
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8. Floss Waxed – stronger, easier to get through contacts
Thinner floss – helpful in very tight contacts. Special attention must be given to avoid trauma to tissue due to the thin nature
Unwaxed – can be hard for the patient to use and can fray
BEST TO USE FLOSS BEFORE BRUSHING
GINGIVITIS AND PERIO BEGINS IN THE COL AREA WHICH IS WHY FLOSSING IS SO IMPORTANT!
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9. When would a floss holder be used?
For someone who cant lift their arms
Someone in a wheelchair
Someone who has difficulty wrapping the floss around their fingers
A teenager with braces
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10. When would a floss holder be used?
For someone who cant lift their arms
Someone in a wheelchair
Someone who has difficulty wrapping the floss around their fingers
A teenager with braces
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11. What is Superfloss used for?
To aid in flossing
For those who don’t like the string floss
For elderly patients, it’s a thicker floss
Under appliances
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12. What is Superfloss used for?
To aid in flossing
For those who don’t like the string floss
For elderly patients, it’s a thicker floss
Under appliances
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13. What can knitting yarn be used for?
Small spaces
Class I embrasures
Larger spaces
For implants only
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14. What can knitting yarn be used for?
Small spaces
Class I embrasures
Larger spaces – often used with a floss threader to get under bridges and appliances
For implants only
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15. What is a gauze strip used for?
For wide spaces
Teeth next to edentulous areas
Next to abutment teeth
All of the above
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16. What is a gauze strip used for?
For wide spaces
Teeth next to edentulous areas
Next to abutment teeth
All of the above
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17. What are interdental brushes used for?
When spaces are in between the teeth
When the teeth have no spaces
When papilla is missing
For cleaning dentures
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18. What are interdental brushes used for?
When spaces are in between the teeth *can also be used to apply agents to the area (fluorides, desensitizing, antibacterial, etc)
When the teeth have no spaces
When papilla is missing
For cleaning dentures
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19. What is an end-tufted brush used for?
Any hard to reach area, space, and orthodontics
Implants only
Children’s teeth with the charters method
In conjunction with an electric toothbrush
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20. What is an end-tufted brush used for?
Any hard to reach area, space, and orthodontics = also bridges, partial dentures, implant abutments, etc.
Implants only
Children’s teeth with the charters method
In conjunction with an electric toothbrush
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21. Interdental tip, what is this?
Smaller bristles attached to the end of a handle
Attachment on an electric toothbrush
A flexible rubber tip attached to a handle
None of the above
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22. Interdental tip, what is this?
Smaller bristles attached to the end of a handle
Attachment on an electric toothbrush
A flexible rubber tip attached to a handle
None of the above
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23. What can a toothpick in a holder be used for?
Furcation areas
Recessions
Denture cleaning
Tight spaces
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24. What can a toothpick in a holder be used for?
Furcation areas
Recessions
Denture cleaning
Tight spaces
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25. What can be used if the interdental papilla is missing?
Floss
Small interproximal brush
Rubber tip brush
Wooden interdental cleaner
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26. What can be used if the interdental papilla is missing?
Floss
Small interproximal brush
Rubber tip brush
Wooden interdental cleaner
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27. Saliva + Dentifrices
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28. Toothpastes Reduce biofilm formation Reduce gingivitis
Prevention of caries
Remineralization of early caries
Reduction of dentin hypersensitivity
Reduction of supragingival calculus
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29. Toothpastes cannot: Reduce subgingival calculus
Promote remineralization
Prevent caries
Reduce gingivitis
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30. Toothpastes cannot: Reduce subgingival calculus
Promote remineralization
Prevent caries
Reduce gingivitis
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31. What are the two agents that reduce biofilm formation?
Triclosan and zinc citrate
Irrigation and triclosan
Humectant and astringent
Zinc citrate and humectant
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32. What are the two agents that reduce biofilm formation?
Triclosan and zinc citrate (triclosan is the primary agent shown to reduce gingivitis)
Irrigation and triclosan
Humectant and astringent
Zinc citrate and humectant
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33. What is the most common agent used to reduce dentin hypersensitivity?
Zinc citrate
Triclosan
Sodium hexametaphosphate
Potassium nitrate
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34. What is the most common agent used to reduce dentin hypersensitivity?
Zinc citrate
Triclosan
Sodium hexametaphosphate
Potassium nitrate
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35. What is NOT an agent found in toothpaste to reduce supracalculus formation?
Pyrophosphate salts
Zinc salts
Hydroxide
Triclosan
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36. What is NOT an agent found in toothpaste to reduce supracalculus formation?
Pyrophosphate salts
Zinc salts
Hydroxide
Triclosan
..and sodium hexametaphosphate is also shown to reduce supracalculus formation
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37. In toothpastes: Detergent (foaming agent) – 1-2%
Binder (thickener) 102%
Cleaning and polishing agent (abrasive) – 20-40%
Humectant – 20-40%
Preservative – 2-3%
Flavouring (sweetener) – 1-1.5%
Water – 20-40%
Therapeutic agent – 1-2%
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38. Joe has come to you for his regular 6 month cleaning and he wants to try a new toothpaste. Which one do you recommend?
Selection depends on what the client needs
Anything approved by the dental association
Anything with fluoride
Anything that inhibits inflammation
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39. Joe has come to you for his regular 6 month cleaning and he wants to try a new toothpaste. Which one do you recommend?
Selection depends on what the client needs – is caries a concern (fluoride), dentin hypersensitivity, inflammation, calculus, etc.
Anything approved by the dental association
Anything with fluoride
Anything that inhibits inflammation
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40. Mouth rinses are used to:
Inhibit intraoral microorganisms
Reduce intraoral microorganisms
To increase aerosol production of the ultrasonic scaler
To increase aerosol production of the high speed handpiece
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41. Mouth rinses are used to:
Inhibit intraoral microorganisms
Reduce intraoral microorganisms
To increase aerosol production of the ultrasonic scaler
To increase aerosol production of the high speed handpiece
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42. What does an astringent do in chemotherapeutic agents?
Neutralizes odor
Alleviates pain
Shrinks tissues
Reduction of gingivitis
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43. What does an astringent do in chemotherapeutic agents?
Neutralizes odor - deodorizing
Alleviates pain - anodyne
Shrinks tissues - astringent
Reduction of gingivitis – gingival health
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44. What is cariostatic? Inhibits demineralization
Deposits fluoride ions on enamel
Deposits fluoride ions in carious lesions
Interferes with cell metabolism
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45. What is cariostatic?
Inhibits demineralization AND enhances remineralization
Deposits fluoride ions on enamel
Deposits fluoride ions in carious lesions
Interferes with cell metabolism
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46. Chlorhexidine Broad antibacterial activity
Binds to oral and soft tissues
Attaches to the bacterial cell membrane, thereby damaging the cytoplasm causing lysis
Binds to pellicle preventing biofilm accumulation
Bactericidal (kills) AND bacteriostatic (interferes)
Lasts 8-12 hours!!
Antimicrobial and anti gingivitis agent
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