THE effective control of plaque (bacteria and food particles sticking to the surface of unclean teeth) represents the basis of oral health. It is not of primary importance the method used to remove plaque, provided that the required objective is achieved. So even if your toothbrush was lost, you could still take good care of your mouth. However, try to get a toothbrush, as it’s the ideal tool for oral care.
There are defined specifications for toothbrush design and brushing methods to standardised professional recommendations.The toothbrush should be a small one that is about six inches in length, with soft bristles, handle aligned on the same plane as the head, and the brushing profile should be flat with the bristles all of equal length.
Two important factors must be considered when brushing the teeth. First, you must strictly follow a specific sequence. For example, begin with the last left molar of the upper jaw moving to the last upper right molar, then down to the last right lower molar, finally moving across to the left last lowest molar.
The other important factor is thoroughness. The entire surface of each tooth should be sanitised as well as the interdental area, for one minute each day. If, therefore, you have all your permanent teeth, you should spend a total of 32 minutes every day in practising oral care. Remember you do not need toothpaste, plain water will do.
There are eight scientific methods of tooth brushing, the most widely accepted being the modified stillman. This method is designed for massage and stimulation as well as for cleaning the neck area of the tooth. The brush ends are placed partly on the gum and partly on the neck area of the tooth and are directed to the root of the tooth. Moderate pressure is applied and the handle is given a slight rotary motion while the brush ends are
maintained in position on the tooth surface, always in the direction in which the tooth grows.
Repeat many times before moving to the adjacent tooth and not forgetting to include the palatal (inner) faces. The biting surfaces are cleaned by vibrating brush with light pressure, while maintaining the bristle tips on the occlusal surface, permitting the tips to work their way into the pits and fissures.
Excessive pressure curves the bristles, so that the tips cannot get into the pits and fissures. The most effective time to brush is just before retiring to bed at night. The use of toothpaste or dentifrice is not essential, although the regular brands which contain nine ingredients, including abrasives, detergents, fluoride, binders and humectants, serve to facilitate our objective.
Because plaque located on the surfaces between two teeth is inaccessible to usual brushing, a means for proximal plaque removal is necessary for complete preventative care. The use of dental floss or tape should always precede brushing. (Three strands of thread together will suffice in this crisis.) Hold a 12-inch length of floss with thumb and index finger of each hand. Grasp firmly with half-inch of floss between the fingertips. The ends of the floss may be tucked into the palm and held by the ring and little finger, or the floss may be wrapped around the middle finger.
For the upper teeth, the floss should be directed up by holding it over two thumbs or a thumb and an index finger. Rest a side of a finger on teeth of the opposite side of the upper arch to provide a balance and a fulcrum. When flossing the lower or mandibular teeth, direct the floss down by holding the index fingers on the top of the strand. One index finger holds the floss on the lingual and on the outer (facial). Hold the floss in a diagonal or oblique position and ease it past each contact area with a gentle sawing motion, curving the floss around each tooth, working from below the gum line, making up and down motions and shoe shine strokes.
The diet plays an integral part in oral care. In this regard, food is classified into two categories, protective and cariogenic. Cariogenic food contributes significantly to the formation of caries and especially includes those which are sugary and sticky. Sugar is converted to acid faster than starch, while the sticky property facilitates longer contact with the enamel.
Protective food is generally fibrous and contains vitamins, minerals and fluoride. Greens, vegetables, ground provisions, corn etc. are examples of protective foods. Although avoiding cariogenic foods is ideal, extra oral care is required after use. Vigorous mouth rinse with water when tooth brushing should be practised.
Dental plaque sometimes becomes mineralised (hardened), forming calculus or tartar. These appear as brown or greenish crusts on the enamel around the neck areas or on the inside (lingual) surface of the lower incisors (front teeth). As the calculus develops, it penetrates below the gum line infecting the gum, connecting fibres and bone.
This condition is called periodontitis and is just as common as caries. When periodontitis becomes chronic, the signs include easy haemorrhage (patient spits blood when brushing), receding gums (tooth appears to be growing longer), and absorption of the alveolar bone with deep pockets between the gum and tooth (tooth becomes loose or shaking).
Scaling, root planning and polishing constitute the treatment for periodontitis since by removing the irritation caused by the subgingival calculus, the destructive process would be interrupted and reversed to a certain degree. Because periodontal disease is usually painless, the onset is insidious and the debilitating effects are generally not recognised until it is too late.
