Oral hygiene

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Proper oral hygiene requires regular brushing and flossing Toothpasteonbrush.jpg
Proper oral hygiene requires regular brushing and flossing

Oral hygiene is the practice of keeping one's mouth clean and free of disease and other problems (e.g. bad breath) by regular brushing of the teeth (dental hygiene) and cleaning between the teeth. It is important that oral hygiene be carried out on a regular basis to enable prevention of dental disease and bad breath. The most common types of dental disease are tooth decay (cavities, dental caries) and gum diseases, including gingivitis, and periodontitis. [1]

Disease abnormal condition negatively affecting organisms

A disease is a particular abnormal condition that negatively affects the structure or function of part or all of an organism, and that is not due to any external injury. Diseases are often construed as medical conditions that are associated with specific symptoms and signs. A disease may be caused by external factors such as pathogens or by internal dysfunctions. For example, internal dysfunctions of the immune system can produce a variety of different diseases, including various forms of immunodeficiency, hypersensitivity, allergies and autoimmune disorders.

Bad breath, also known as halitosis, is a symptom in which a noticeably unpleasant breath odour is present. It can result in anxiety among those affected. It is also associated with depression and symptoms of obsessive compulsive disorder.

Tooth decay disease involving breakdown of teeth

Tooth decay, also known as dental caries or cavities, is a breakdown of teeth due to acids made by bacteria. The cavities may be a number of different colors from yellow to black. Symptoms may include pain and difficulty with eating. Complications may include inflammation of the tissue around the tooth, tooth loss, and infection or abscess formation.

Contents

General guidelines suggest brushing twice a day: after breakfast and before going to bed, but ideally the mouth would be cleaned after every meal. Cleaning between the teeth is called interdental cleaning and is as important as tooth brushing. [2] This is because a toothbrush cannot reach between the teeth and therefore only removes about 50% of plaque off the surface. [3] There are many tools to clean between the teeth, including floss and interdental brushes; it is up to each individual to choose which tool they prefer to use.

Tooth brushing Manual abrasion of the surfaces of the teeth.

Tooth brushing is the act of scrubbing teeth with a toothbrush equipped with toothpaste. Interdental cleaning can be useful with tooth brushing, and together these two activities are the primary means of cleaning teeth, one of the main aspects of oral hygiene.

Sometimes white or straight teeth are associated with oral hygiene, but a hygienic mouth may have stained teeth and/or crooked teeth. For appearance reasons, people may seek out teeth whitening and orthodontics.

Orthodontics field of dentistry dealing with irregularities in the teeth

Orthodontics is a specialty of dentistry that deals with the diagnosis, prevention and correction of malpositioned teeth and jaws. It can also focus on modifying facial growth, known as dentofacial orthopedics.

A healthy smile 06-10-06smile.jpg
A healthy smile

Tooth cleaning and decay

A 1930s poster from the Work Projects Administration promoting oral hygiene Keep your teeth clean LCCN92517367 (cropped).jpg
A 1930s poster from the Work Projects Administration promoting oral hygiene

Tooth decay is the most common global disease. [4] Over 80% of cavities occur inside fissures in teeth where brushing cannot reach food left trapped after eating and saliva and fluoride have no access to neutralize acid and remineralize demineralized teeth, unlike easy-to-clean parts of the tooth, where fewer cavities occur.

Teeth cleaning is the removal of dental plaque and tartar from teeth to prevent cavities, gingivitis, gum disease, and tooth decay. Severe gum disease causes at least one-third of adult tooth loss.

Teeth cleaning is part of oral hygiene and involves the removal of dental plaque from teeth with the intention of preventing cavities, gingivitis, and periodontal disease. People routinely clean their own teeth by brushing and interdental cleaning, and dental hygienists can remove hardened deposits (tartar) not removed by routine cleaning. Those with dentures and natural teeth may supplement their cleaning with a denture cleaner.

Dental plaque is a biofilm or mass of bacteria that grows on surfaces within the mouth. It is a sticky colorless deposit at first, but when it forms tartar, it is often brown or pale yellow. It is commonly found between the teeth, on the front of teeth, behind teeth, on chewing surfaces, along the gumline, or below the gumline cervical margins. Dental plaque is also known as microbial plaque, oral biofilm, dental biofilm, dental plaque biofilm or bacterial plaque biofilm. Bacterial plaque is one of the major causes for dental decay and gum disease.

Calculus (dental) form of hardened dental plaque

In dentistry, calculus or tartar is a form of hardened dental plaque. It is caused by precipitation of minerals from saliva and gingival crevicular fluid (GCF) in plaque on the teeth. This process of precipitation kills the bacterial cells within dental plaque, but the rough and hardened surface that is formed provides an ideal surface for further plaque formation. This leads to calculus buildup, which compromises the health of the gingiva (gums). Calculus can form both along the gumline, where it is referred to as supragingival, and within the narrow sulcus that exists between the teeth and the gingiva, where it is referred to as subgingival.

Since before recorded history, a variety of oral hygiene measures have been used for teeth cleaning. This has been verified by various excavations done throughout the world, in which chew sticks, tree twigs, bird feathers, animal bones and porcupine quills have been found. In historic times, different forms of tooth cleaning tools have been used. Indian medicine (Ayurveda) has used the neem tree, or daatun, and its products to create teeth cleaning twigs and similar products; a person chews one end of the neem twig until it somewhat resembles the bristles of a toothbrush, and then uses it to brush the teeth. In the Muslim world, the miswak, or siwak, made from a twig or root, has antiseptic properties and has been widely used since the Islamic Golden Age. Rubbing baking soda or chalk against the teeth was also common; however, this can have negative side effects over time. [5]

Twig small thin terminal branch of a woody plant

A twig is a thin branch of a tree or bush.

Feather body-covering structure of birds

Feathers are epidermal growths that form the distinctive outer covering, or plumage, on dinosaurs, birds and possibly other archosauromorphs. They are considered the most complex integumentary structures found in vertebrates and a premier example of a complex evolutionary novelty. They are among the characteristics that distinguish the extant birds from other living groups.

Bone rigid organs that constitute part of the endoskeleton of vertebrates

A bone is a rigid organ that constitutes part of the vertebrate skeleton. Bones protect the various organs of the body, produce red and white blood cells, store minerals, provide structure and support for the body, and enable mobility. Bones come in a variety of shapes and sizes and have a complex internal and external structure. They are lightweight yet strong and hard, and serve multiple functions.

The Australian Healthcare and Hospital Association's (AHHA) most recent evidence brief [6] ) suggests that dental check-ups should be conducted once every 3 years for adults, and 1 every 2 years for children. It has been documented that dental professionals frequently advise for more frequent visits, but this advice is contraindicated by evidence suggesting that check up frequency should be based on individual risk factors, or the AHHA's check-up schedule. Professional cleaning includes tooth scaling, tooth polishing, and, if tartar has accumulated, debridement; this is usually followed by a fluoride treatment. However, the American Dental Hygienists' Association (ADHA) stated in 1998 that there is no evidence that scaling and polishing only above the gums provides therapeutic value, and cleaning should be done under the gums as well. [7] The Cochrane Oral Health Group found only three studies meeting the criteria for inclusion in their study and found little evidence in them to support claims of benefits from supragingival (above the gum) tooth scaling or tooth polishing. [8] [ needs update ]

Dental sealants, which are applied by dentists, cover and protect fissures and grooves in the chewing surfaces of back teeth, preventing food from becoming trapped and thereby halt the decay process. An elastomer strip has been shown to force sealant deeper inside opposing chewing surfaces and can also force fluoride toothpaste inside chewing surfaces to aid in remineralising demineralised teeth. [9]

Between cleanings by a dental hygienist, good oral hygiene is essential for preventing tartar build-up which causes the problems mentioned above. This is done through careful, frequent brushing with a toothbrush, combined with the use of dental floss or interdental brushes to prevent accumulation of plaque on the teeth. [10] Powered toothbrushes reduce dental plaque and gingivitis more than manual toothbrushing in both short and long term. [11] Further evidence is needed to determine the clinical importance of these findings. [11]

Patients need to be aware of the importance of brushing and flossing their teeth daily. New parents need to be educated to promote healthy habits in their children.

Sources of problems

Plaque

Dental plaque, also known as dental biofilm, is a sticky, yellow film consisting of a wide range of bacteria which attaches to the tooth surfaces and can be visible around the gum line. It starts to reappear after the tooth surface has been cleaned, which is why regular brushing is encouraged. [1] A high-sugar diet encourages the formation of plaque. Sugar (fermentable carbohydrates), is converted into acid by the plaque. The acid then causes the breakdown of the adjacent tooth, eventually leading to tooth decay. [12]

If plaque is left on a subgingival (under the gum) surface undisturbed, not only is there an increased risk of tooth decay, but it will also go on to irritate the gums and make them appear red and swollen. [1] Some bleeding may be noticed during tooth brushing or flossing. These are the signs of inflammation which indicate poor gum health (gingivitis). [13] [1]

Calculus

The longer that plaque stays on the tooth surface, the harder and more attached to the tooth it becomes. That is when it is referred to as calculus and needs to be removed by a dental professional. [1] If this is not treated, the inflammation will lead to the bone loss and will eventually lead to the affected teeth becoming loose. [14]

Preventative care

Tooth brushing

Routine tooth brushing is the principal method of preventing many oral diseases, and perhaps the most important activity an individual can practice to reduce plaque buildup. [15] Controlling plaque reduces the risk of the individual suffering from plaque-associated diseases such as gingivitis, periodontitis, and caries – the three most common oral diseases. [16] The average brushing time for individuals is between 30 seconds and just over 60 seconds. [17] [18] [19] [20] [21] [22] Many oral health care professionals agree that tooth brushing should be done for a minimum of two minutes, and be practiced at least twice a day. [23] Brushing for at least two minutes per session is optimal for preventing the most common oral diseases, and removes considerably more plaque than brushing for only 45 seconds [15] [23]

Toothbrushing can only clean to a depth of about 1.5 mm inside the gingival pockets, but a sustained regime of plaque removal above the gum line can affect the ecology of the microbes below the gums and may reduce the number of pathogens in pockets up to 5 mm in depth. [24]

Toothpaste (dentifrice) with fluoride is an important tool to readily use when tooth brushing. The fluoride in the dentifrice is an important protective factor against caries, and an important supplement needed to remineralize already affected enamel. [25] [ needs update ] [26] [ needs update ] However, in terms of preventing gum disease, the use of toothpaste does not increase the effectiveness of the activity with respect to the amount of plaque removed. [15]

Manual tooth brush

The modern manual tooth brush is a dental tool which consists of a head of nylon bristles attached to a long handle to help facilitate the manual action of tooth brushing. Furthermore, the handle aids in reaching as far back as teeth erupt in the oral cavity. The tooth brush is arguably a person's best tool for removing dental plaque from teeth, thus capable of preventing all plaque-related diseases if used routinely, correctly and effectively. Oral health professionals recommend the use of a tooth brush with a small head and soft bristles as they are most effective in removing plaque without damaging the gums. [27]

The technique is crucial to the effectiveness of tooth brushing and disease prevention. [27] Back and forth brushing is not effective in removing plaque at the gum line. Tooth brushing should employ a systematic approach, angle the bristles at a 45-degree angle towards the gums, and make small circular motions at that angle. [27] This action increases the effectiveness of the technique in removing plaque at the gum line.

Electric tooth brush

Electric toothbrushes are toothbrushes with moving or vibrating bristle heads. The two main types of electric toothbrushes are the sonic type which has a vibrating head, and the oscillating-rotating type in which the bristle head makes constant clockwise and anti-clockwise movements.

Sonic or ultrasonic toothbrushes vibrate at a high frequency with a small amplitude, and a fluid turbulent activity that aids in plaque removal. [28] [29] The rotating type might reduce plaque and gingivitis compared to manual brushing, though it is currently uncertain whether this is of clinical significance. [30] The movements of the bristles and their vibrations help break up chains of bacteria up to 5mm below the gum line. [28] The oscillating-rotating electric toothbrush on the other hand uses the same mechanical action as produced by manual tooth brushing – removing plaque via mechanical disturbance of the biofilm – however at a higher frequency.

Using electric tooth brushes is less complex in regards to brushing technique, making it a viable option for children, and adults with limited dexterity. The bristle head should be guided from tooth to tooth slowly, following the contour of the gums and crowns of the tooth. [27] The motion of the toothbrush head removes the need to manually oscillate the brush or make circles.

Flossing

Tooth brushing alone will not remove plaque from all surfaces of the tooth as 40% of the surfaces are interdental. [2] One technique that can be used to access these areas is dental floss. When the proper technique is used, flossing can remove plaque and food particles from between the teeth and below the gums. The American Dental Association (ADA) reports that up to 80% of plaque may be removed by this method. [31] The ADA recommends cleaning between the teeth as part of one's daily oral hygiene regime. [31]

Types of floss include: [1]

A dental hygienist demonstrates dental flossing. Dental flossing 9344.JPG
A dental hygienist demonstrates dental flossing.

The type of floss used is a personal preference; however, without proper technique it may not be effective. [32] The correct technique to ensure maximum plaque removal is as follows: [1]

  1. Floss length: 15–25 cm wrapped around middle fingers.
  2. For upper teeth grasp the floss with thumb and index finger, for lower teeth with both index fingers. Ensure that a length of roughly an inch is left between the fingers.
  3. Ease the floss gently between the teeth using a back and forth motion.
  4. Position the floss in such a way that it becomes securely wrapped around the interdental surface of the tooth in a C shape.
  5. Ensure that the floss is taken below the gum margins using a back and forth up and down motion.

There are a few different options on the market that can make flossing easier if dexterity or coordination is a barrier, or as a preference over normal floss. Floss threaders are ideal for cleaning between orthodontic appliances, and flossettes are ideal for those with poor dexterity. [1]

Interdental brushes

Interdental brushes come in a range of color-coded sizes. They consist of a handle with a piece of wire covered in tapered bristles, designed to be placed into the interdental space for plaque removal. [1] Studies indicate that interdental brushes are equally or more effective then floss when removing plaque and reducing gum inflammation. [1]

The steps in using an interdental brush are as follows: [1]

  1. Identify the size required, the largest size that will fit without force is ideal Often more than one size is required in the mouth.
  2. Insert the bristles into the interdental space at a 90-degree angle.
  3. Move the brush back and forth between the teeth.
  4. Rinse under water to remove debris when necessary.
  5. Rinse with warm soapy water once complete, and store in a clean dry area.
  6. Replace once bristles are worn.

Tongue scrapers

The tongue contains numerous bacteria which causes bad breath. Tongue cleaners are designed to remove the debris built up on the tongue. Using a toothbrush to clean the tongue is another possibility, however it might be hard to reach the back of the tongue and the bristles of the toothbrush may be too soft to remove the debris. Some may find it easier to use a tongue scraper instead because it does not tend to cause a gag reflex as readily as a toothbrush. [1] Steps of using a tongue scraper:

  1. Rinse the tongue scraper in order to clean it and remove any present debris
  2. Start at the back of the tongue and gently scrape forwards
  3. Be sure to clean the sides of the tongue as well, not just the middle portion
  4. After the cleaning is completed, rinse the tongue scraper and any debris that is left behind
  5. Rinse the mouth [33]

Oral irrigation

Some dental professionals recommend subgingival irrigation as a way to clean teeth and gums. [34] [35] [36] [37]

Single-tufted brushes

Single-tufted brushes are a tool in conjunction with tooth brushing. [38] The tooth brush is designed to reach the ‘hard to reach places’ within the mouth. This tool is best used behind the lower front teeth, behind the back molars, crooked teeth and between spaces where teeth have been removed. [3] The single- tufted brush design has an angled handle, a 4mm diameter and rounded bristle tips. [3]

Gum stimulators

Toothbrushes with pointed rubber tips at the ends of the handles have been available for many years, and have more recently been replaced by a standalone tool called a gum stimulator designed to massage the gum line and the bases of the areas between the teeth. Such stimulators help to increase circulation to the gum line and to clear away bacteria which might not be removed by brushing and flossing alone. [39]

Food and drink

Foods that help muscles and bones also help teeth and gums. Vitamin C is necessary, for example, to prevent scurvy which manifests as serious gum disease.

Eating a balanced diet and limiting sugar intake can help prevent tooth decay and periodontal disease.[ citation needed ] The Fédération dentaire internationale (FDI World Dental Federation) has promoted foods such as raw vegetables, plain yogurt, cheese, or fruit as dentally beneficial—this has been echoed by the American Dental Association (ADA). [40]

Beneficial foods

Community water fluoridation is the addition of fluoride to adjust the natural fluoride concentration of a community's water supply to the level recommended for optimal dental health, approximately 1.0 ppm (parts per million). [41] Fluoride is a primary protector against dental cavities. Fluoride makes the surface of teeth more resistant to acids during the process of remineralization. Drinking fluoridated water is recommended by some dental professionals while others say that using toothpaste alone is enough. Milk and cheese are also rich in calcium and phosphate, and may also encourage remineralization. Foods high in fiber may help to increase the flow of saliva and a bolus of fibre like celery string can force saliva into trapped food inside pits and fissures on chewing surfaces where over 80% of cavities occur, to dilute carbohydrates like sugar, neutralize acid and remineralize teeth on easy to reach surfaces.

Harmful foods

Sugars are commonly associated with dental cavities. Other carbohydrates, especially cooked starches, e.g. crisps/potato chips, may also damage teeth, although to a lesser degree (and indirectly) since starch has to be converted to glucose by salivary amylase (an enzyme in the saliva) first. Sugars that are higher in the stickiness index, such as toffee, are likely to cause more damage to teeth than those that are lower in the stickiness index, such as certain forms of chocolate or most fruits.

Sucrose (table sugar) is most commonly associated with cavities. The amount of sugar consumed at any one time is less important than how often food and drinks that contain sugar are consumed. The more frequently sugars are consumed, the greater the time during which the tooth is exposed to low pH levels, at which point demineralisation occurs (below 5.5 for most people). It is important therefore to try to encourage infrequent consumption of food and drinks containing sugar so that teeth have a chance to be repaired by remineralisation and fluoride. Limiting sugar-containing foods and drinks to meal times is one way to reduce the incidence of cavities. Sugars from fruit and fruit juices, e.g., glucose, fructose, and maltose can also cause cavities.

Sucrose is used by Streptococcus mutans bacteria to produce biofilm. The sucrose is split by glucansucrase, which allows the bacteria to use the resulting glucose for building glucan polymer film and the resulting fructose as fuel to be converted to lactic acid.

Acids contained in fruit juice, vinegar and soft drinks lower the pH level of the oral cavity which causes the enamel to demineralize. Drinking drinks such as orange juice or cola throughout the day raises the risk of dental cavities tremendously.

Another factor which affects the risk of developing cavities is the stickiness of foods. Some foods or sweets may stick to the teeth and so reduce the pH in the mouth for an extended time, particularly if they are sugary. It is important that teeth be cleaned at least twice a day, preferably with a toothbrush and fluoride toothpaste, to remove any food sticking to the teeth. Regular brushing and the use of dental floss also removes the dental plaque coating the tooth surface.

Chewing gum

Chewing gum assists oral irrigation between and around the teeth, cleaning and removing particles, but for teeth in poor condition it may damage or remove loose fillings as well. Dental chewing gums claim to improve dental health. Sugar-free chewing gum stimulates saliva production, and helps to clean the surface of the teeth. [42]

Ice

Chewing on solid objects such as ice can chip teeth, leading to further tooth fractures. Chewing on ice has been linked to symptoms of anemia. People with anemia tend to want to eat food with no nutritional value. [43] [44]

Alcohol

Drinking dark-colored beverages such as wine or beer may stain teeth, leading to a discolored smile. Drinking high-concentration alcohol can lead to a dry mouth, with little saliva to protect the teeth from plaque and bacteria. [45]

Other

Smoking is one of the leading risk factors associated with periodontal diseases. [46] [47] It is thought that smoking impairs and alters normal immune responses, eliciting destructive processes while inhibiting reparative responses promoting the incidence and development of periodontal diseases. [48]

Regular vomiting, as seen in bulimia nervosa and morning sickness also causes significant damage, due to acid erosion.

Mouthwash

There are three commonly used kinds of mouthwash: saline (salty water), essential oils (Listerine, etc.), and chlorhexidine gluconate.

Saline

Saline (warm salty water) is usually recommended after procedures like dental extractions. In a study completed in 2014, warm saline mouthrinse was compared to no mouthrinse in preventing alveolar osteitis (dry socket) after extraction. In the group that was instructed to rinse with saline, the prevalence of alveolar osteitis was less than in the group that did not. [49]

Essential oils (EO) or cetyl pyridinium chloride (CPC)

Essential oils, found in Listerine mouthwash, contains eucalyptol, menthol, thymol, and methyl salicylate. CPC containing mouthwash contains cetyl pyridinium chloride, found in brands such as Colgate Plax, Crest Pro Health, Oral B Pro Health Rinse. In a meta-analyses completed in 2016, EO and CPC mouthrinses were compared and it was found that plaque and gingivitis levels were lower with EO mouthrinse when used as an adjunct to mechanical plaque removal (toothbrushing and interdental cleaning). [50]

Chlorhexidine

Chlorhexidine gluconate is an antiseptic mouthrinse that should only be used in two-week time periods due to brown staining on the teeth and tongue. [51] Compared to essential oils, it is more efficacious in controlling plaque levels, but has no better effect on gingivitis and is therefore generally used for post-surgical wound healing or the short-term control of plaque. [52]

Sodium hypochlorite

As mentioned earlier, sodium hypochlorite, a common household bleach, can be used as a 0.2% solution for 30 seconds two or three times a week as a cheap and effective means of combating harmful bacteria. The commercial product is 5% or 6%, so this requires diluting the product by a factor of about 30 (half a tablespoon in a full glass of water). The solution will lose activity with time and may be discarded after one day. [24]

Denture care

Dentures, retainers, and other appliances must be kept extremely clean. It is recommended that dentures be cleaned mechanically twice a day with a soft-bristled brush and denture cleansing paste. It is not recommended to use toothpaste, as it is too abrasive for acrylic, and will leave plaque retentive scratches in the surface. [53]

Dentures should be taken out at night, as leaving them in whilst sleeping has been linked to poor oral health. Leaving a denture in during sleep reduces the protective cleansing and antibacterial properties of saliva against Candida albicans (oral thrush) and denture stomatitis; the inflammation and redness of the oral mucosa underneath the denture. [54] For the elderly, wearing a denture during sleep has been proven to greatly increase the risk of pneumonia. [54]

It is now recommended that dentures should be stored in a dry container overnight, as keeping dentures dry for 8 hours significantly reduces the amount of Candida albicans on an acrylic denture. [55] Approximately once a week it is recommended to soak a denture overnight with an alkaline-peroxide denture cleansing tablet, as this has been proved to reduce bacterial mass and pathogenicity. [56] Duyck J, Vandamme K, Muller P, Teughels W (December 2013). "Overnight storage of removable dentures in alkaline peroxide-based tablets affects biofilm mass and composition". Journal of Dentistry. 41 (12): 1281–9. doi: 10.1016/j.jdent.2013.08.002 . PMID   23948391.</ref>

Education

To become a dental hygienist in the US one must attend a college or university that is approved by the Commission on Dental Accreditation and take the National Board Dental Hygiene Examination. There are several degrees one may receive. An associate degree after attending community college is the most common and only takes two years to obtain. After doing so, one may work in a dental office. There is also the option of receiving a bachelor's degree or master's degree if one plans to work in an educational institute either for teaching or research.

Oral hygiene and systemic diseases

Several recent clinical studies suggest oral disease and inflammation (oral bacteria & oral infections) may be a risk factor for serious systemic diseases, such as: [57] [58]

See also

Related Research Articles

Mouthwash Liquid rinse for oral hygiene

Mouthwash, mouth rinse, oral rinse, or mouth bath is a liquid which is held in the mouth passively or swilled around the mouth by contraction of the perioral muscles and/or movement of the head, and may be gargled, where the head is tilted back and the liquid bubbled at the back of the mouth.

Human tooth calcified whitish structure in humans mouths used to break down food

The human teeth function to mechanically break down items of food by cutting and crushing them in preparation for swallowing and digesting. Humans have four types of teeth: incisors, canines, premolars, and molars, which each have a specific function. The incisors cut the food, the canines tear the food and the molars and premolars crush the food. The roots of teeth are embedded in the maxilla or the mandible and are covered by gums. Teeth are made of multiple tissues of varying density and hardness.

Periodontal disease human disease of the tissues surrounding the teeth

Periodontal disease, also known as gum disease, is a set of inflammatory conditions affecting the tissues surrounding the teeth. In its early stage, called gingivitis, the gums become swollen, red, and may bleed. In its more serious form, called periodontitis, the gums can pull away from the tooth, bone can be lost, and the teeth may loosen or fall out. Bad breath may also occur.

Toothbrush oral hygiene instrument used to clean the teeth, gums, and tongue

The toothbrush is an oral hygiene instrument used to clean the teeth, gums, and tongue. It consists of a head of tightly clustered bristle, atop of which toothpaste can be applied, mounted on a handle which facilitates the cleaning of hard-to-reach areas of the mouth. They are usually used alongside floss.

Toothpaste paste or gel dentifrice used to clean and maintain the health of teeth

Toothpaste is a paste or gel dentifrice used with a toothbrush to clean and maintain the aesthetics and health of teeth. Toothpaste is used to promote oral hygiene: it is an abrasive that aids in removing dental plaque and food from the teeth, assists in suppressing halitosis, and delivers active ingredients to help prevent tooth decay and gum disease (gingivitis). Salt and sodium bicarbonate are among materials that can be substituted for commercial toothpaste. Large amounts of swallowed toothpaste can be toxic.

Dental floss is a cord of thin filaments used to remove food and dental plaque from between teeth in areas a toothbrush is unable to reach. As the build-up of plaque between the teeth is the primary cause of dental disease, such as gingivitis and dental caries, the use of floss is commonly recommended in order to prevent these conditions from developing.

Gums mucosal tissue that lies over the mandible and maxilla inside the mouth

The gums or gingiva, consist of the mucosal tissue that lies over the mandible and maxilla inside the mouth. Gum health and disease can have an effect on general health.

Abrasion (dental) abrasion of teeth

Abrasion is the non carious, mechanical wears of tooth from interaction with objects other than tooth-tooth contact. It most commonly affects the premolars and canines. Based on clinical surveys, studies have shown that abrasion is the commonest aetiological factor for development of non-carious cervical lesions (NCCL) and is most frequently caused by incorrect toothbrushing technique.

Periodontology or periodontics is the specialty of dentistry that studies supporting structures of teeth, as well as diseases and conditions that affect them. The supporting tissues are known as the periodontium, which includes the gingiva (gums), alveolar bone, cementum, and the periodontal ligament. A person who practices this specialty is known as a periodontist.

Oral irrigator Dental care device

An oral irrigator is a home dental care device which uses a stream of high-pressure pulsating water intended to remove plaque and food debris between teeth and below the gum line. Regular use of an oral irrigator is believed to improve gingival health. The devices may also provide easier cleaning for braces and dental implants.

Tooth loss

Tooth loss is a process in which one or more teeth come loose and fall out. Tooth loss is normal for deciduous teeth, when they are replaced by a person's adult teeth. Otherwise, losing teeth is undesirable and is the result of injury or disease, such as dental avulsion, tooth decay, and gum disease. The condition of being toothless or missing one or more teeth is called edentulism.

Bleeding on probing which is also known as bleeding gums or gingival bleeding is a term used by dentists and dental hygienists when referring to bleeding that is induced by gentle manipulation of the tissue at the depth of the gingival sulcus, or interface between the gingiva and a tooth. Bleeding on probing, often abbreviated BOP, is a sign of inflammation and indicates some sort of destruction and erosion to the lining of the sulcus or the ulceration of sulcular epithelium. The blood comes from lamina propria after the ulceration of the lining.

Scaling and root planing removing or eliminating etiologic agents from the teeth

Scaling and root planing, also known as conventional periodontal therapy, non-surgical periodontal therapy, or deep cleaning, is a procedure involving removal of dental plaque and calculus and then smoothing, or planing, of the (exposed) surfaces of the roots, removing cementum or dentine that is impregnated with calculus, toxins, or microorganisms, the etiologic agents that cause inflammation. This helps to establish a periodontium that is in remission of periodontal disease. Periodontal scalers and periodontal curettes are some of the tools involved.

Oral microbiology community of microorganisms in the mouth

Oral microbiology is the study of the microorganisms (microbiota) of the oral cavity and their interactions between oral microorganisms or with the host. The environment present in the human mouth is suited to the growth of characteristic microorganisms found there. It provides a source of water and nutrients, as well as a moderate temperature. Resident microbes of the mouth adhere to the teeth and gums to resist mechanical flushing from the mouth to stomach where acid-sensitive microbes are destroyed by hydrochloric acid.

Tongue cleaner

A tongue cleaner is an oral hygiene device designed to clean the coating on the upper surface of the tongue. While there is tentative benefit from the use of a tongue cleaner it is insufficient to draw clear conclusions regarding bad breath. A 2006 Cochrane review found tentative evidence of decreased levels of odor molecules.

Gingivitis Human disease

Gingivitis is a non-destructive disease that causes inflammation of the gums. The most common form of gingivitis, and the most common form of periodontal disease overall, is in response to bacterial biofilms that is attached to tooth surfaces, termed plaque-induced gingivitis. Most forms of gingivitis are plaque-induced.

References

  1. 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 Darby M, Walsh MM (2010). Procedures Manual to Accompany Dental Hygiene: Theory and Practice. St. Louis, Mo.: Saunders/Elsevier.
  2. 1 2 Claydon NC (2008). "Current concepts in toothbrushing and interdental cleaning". Periodontology 2000. 48: 10–22. doi:10.1111/j.1600-0757.2008.00273.x. PMID   18715352.
  3. 1 2 3 Lee DW, Moon IS (June 2011). "The plaque-removing efficacy of a single-tufted brush on the lingual and buccal surfaces of the molars". Journal of Periodontal & Implant Science. 41 (3): 131–4. doi:10.5051/jpis.2011.41.3.131. PMC   3139046 . PMID   21811688.
  4. "Dental Caries (Tooth Decay)". Centers for Disease Control. 12 December 2018.
  5. "How to Whiten Your Teeth". WebMd.
  6. Gussy MG, Bracksley SA, Boxall A (27 June 2013). "How often should you have dental visits?" (PDF). Deeble Institute.
  7. "American Dental Hygienists' Association Position Paper on the Oral Prophylaxis" (PDF). American Dental Hygienists' Association. 29 April 1998. Retrieved 28 June 2012.
  8. Worthington HV, Clarkson JE, Bryan G, Beirne PV (November 2013). "Routine scale and polish for periodontal health in adults". The Cochrane Database of Systematic Reviews (11): CD004625. doi:10.1002/14651858.CD004625.pub4. PMID   24197669.
  9. "Submission 9(b)—SuperTooth" (PDF). Archived from the original (PDF) on 27 February 2015. Retrieved 22 August 2014.
  10. Curtis J (13 November 2007). "Effective Tooth Brushing and Flossing". WebMD. Retrieved 24 December 2007.Cite journal requires |journal= (help)
  11. 1 2 Yaacob M, Worthington HV, Deacon SA, Deery C, Walmsley AD, Robinson PG, Glenny AM (June 2014). "Powered versus manual toothbrushing for oral health". The Cochrane Database of Systematic Reviews (6): CD002281. doi:10.1002/14651858.CD002281.pub3. PMID   24934383.
  12. Fejerskov O, Kidd E (2015). Dental Caries (2nd ed.). Chichester, West Sussex: Wiley Blackwell. p. 4.
  13. Porth C, Porth C (2011). Essentials of Pathophysiology (1st ed.). Philadelphia: Wolters Kluwer/Lippincott Williams & Wilkins.
  14. Julihn A, Barr Agholme M, Modeer T (June 2008). "Risk factors and risk indicators in relation to incipient alveolar bone loss in Swedish 19-year-olds". Acta Odontologica Scandinavica. 66 (3): 139–47. doi:10.1080/00016350802087024. PMID   18568472.
  15. 1 2 3 Creeth JE, Gallagher A, Sowinski J, Bowman J, Barrett K, Lowe S, Patel K, Bosma ML (2009). "The effect of brushing time and dentifrice on dental plaque removal in vivo". Journal of Dental Hygiene : JDH. 83 (3): 111–6. PMID   19723429.
  16. "Oral health". World Health Organization. 2012. Retrieved 7 May 2017.
  17. Dahl LO, Muhler JC (1955). "Oral Hygiene habits of young adults". J Periodontol. 26: 43–47. doi:10.1902/jop.1955.26.1.43.
  18. Van der Weijden GA, Timmerman MF, Nijboer A, Lie MA, Van der Velden U (August 1993). "A comparative study of electric toothbrushes for the effectiveness of plaque removal in relation to toothbrushing duration. Timerstudy". Journal of Clinical Periodontology. 20 (7): 476–81. doi:10.1111/j.1600-051X.1993.tb00394.x. PMID   8354721.
  19. Van der Weijden FA, Timmerman MF, Snoek IM, Reijerse E, Van der Velden U (July 1996). "Toothbrushing duration and plaque removing efficacy of electric toothbrushes". American Journal of Dentistry. 9 Spec No: S31–6. PMID   9002786.
  20. Saxer UP, Barbakow J, Yankell SL. "New studies on estimated and actual toothbrushing times and dentifrice use." J Clin Dent 1998;9(2):49–51
  21. Robinson HB (September 1946). "Toothbrushing habits of 405 persons". Journal of the American Dental Association. 33 (17): 1112–7. doi:10.14219/jada.archive.1946.0156. PMID   21000167.
  22. Beals D, Ngo T, Feng Y, Cook D, Grau DG, Weber DA. "Development and laboratory evaluation of a new toothbrush with a novel brush head design." Am J Dent. 2000;13:5A–13A
  23. 1 2 McCracken GI, Janssen J, Swan M, Steen N, de Jager M, Heasman PA (May 2003). "Effect of brushing force and time on plaque removal using a powered toothbrush". Journal of Clinical Periodontology. 30 (5): 409–13. doi:10.1034/j.1600-051x.2003.20008.x. PMID   12716332.
  24. 1 2 Slots J (October 2012). "Low-cost periodontal therapy". Periodontology 2000. 60 (1): 110–37. doi:10.1111/j.1600-0757.2011.00429.x. PMID   22909110.
  25. Marinho VC, Higgins JP, Logan S, Sheiham A (2002). "Fluoride varnishes for preventing dental caries in children and adolescents". The Cochrane Database of Systematic Reviews (3): CD002279. doi:10.1002/14651858.CD002279. PMID   12137653.
  26. Bonner BC, Clarkson JE, Dobbyn L, Khanna S (October 2006). "Slow-release fluoride devices for the control of dental decay". The Cochrane Database of Systematic Reviews (4): CD005101. doi:10.1002/14651858.CD005101.pub2. PMID   17054238.
  27. 1 2 3 4 "Brushing – Your Dental Health". Australian Dental Association. Retrieved 16 May 2017.
  28. 1 2 Hashizume LN, Dariva A (December 2015). "Effect of sonic vibration of an ultrasonic toothbrush on the removal of Streptococcus mutans biofilm from enamel surface". American Journal of Dentistry. 28 (6): 347–50. PMID   26846041.
  29. Re D, Augusti G, Battaglia D, Giannì AB, Augusti D (March 2015). "Is a new sonic toothbrush more effective in plaque removal than a manual toothbrush?". European Journal of Paediatric Dentistry. 16 (1): 13–8. PMID   25793947.
  30. Deacon SA, Glenny AM, Deery C, Robinson PG, Heanue M, Walmsley AD, Shaw WC (December 2010). "Different powered toothbrushes for plaque control and gingival health". The Cochrane Database of Systematic Reviews (12): CD004971. doi:10.1002/14651858.CD004971.pub2. PMID   21154357.
  31. 1 2 Accepted Dental Therapeutics. Section III (40th ed.). Council on Dental Therapeutics.
  32. Schmid MO, Balmelli OP, Saxer UP (August 1976). "Plaque-removing effect of a toothbrush, dental floss, and a toothpick". Journal of Clinical Periodontology. 3 (3): 157–65. doi:10.1111/j.1600-051X.1976.tb01863.x. PMID   1067277.
  33. Wiley C (2017). "Using a Tongue Cleaner for a Cleaner Mouth". Colgate. Retrieved 16 April 2017.
  34. Cobb CM, Rodgers RL, Killoy WJ (March 1988). "Ultrastructural examination of human periodontal pockets following the use of an oral irrigation device in vivo". Journal of Periodontology. 59 (3): 155–63. doi:10.1902/jop.1988.59.3.155. PMID   3162980.
  35. Greenstein G (April 1988). "The ability of subgingival irrigation to enhance periodontal health". Compendium. 9 (4): 327–9, 332–4, 336–8. PMID   3073855.
  36. Ciancio S (1988). "Oral Irrigation: A Current Perspective". Biological Therapies in Dentistry. 3: 33.
  37. Flemmig TF, Newman MG, Nachnani S, Rodrigues A, Calsina G, Lee Y, et al. (1989). "Chlorhexidine and irrigation in gingivitis: 6 months correlative clinical and microbiological findings". J Dent Res (68 (spec issue)).
  38. Slot DE, Dörfer CE, Van der Weijden GA (November 2008). "The efficacy of interdental brushes on plaque and parameters of periodontal inflammation: a systematic review". International Journal of Dental Hygiene. 6 (4): 253–64. doi:10.1111/j.1601-5037.2008.00330.x. PMID   19138177.
  39. Prevention Magazine Editors (2 March 2010). The Doctors Book of Home Remedies: Quick Fixes, Clever Techniques, and Uncommon Cures to Get You Feeling Better Fast. Potter/Ten Speed/Harmony/Rodale. p. 442. ISBN   978-1-60529-160-4.CS1 maint: extra text: authors list (link)
  40. Staff (2011). "Prevention". British Dental Centre. British Dental Centre. Retrieved 28 June 2012.
  41. "Fluoride Facts" (PDF). American Dental Hygienists Association.
  42. "Gingivitis". June 2017.
  43. "Symptoms and causes - Mayo Clinic". Mayo Clinic. Retrieved 7 May 2017.
  44. "The cold, hard truth: Chewing ice and teeth". Go Ask Alice!. Retrieved 7 May 2017.
  45. "What Does Alcohol Do to Your Teeth?". Healthline. Retrieved 8 May 2017.
  46. Dietrich T, Maserejian NN, Joshipura KJ, Krall EA, Garcia RI (April 2007). "Tobacco use and incidence of tooth loss among US male health professionals". Journal of Dental Research. 86 (4): 373–7. doi:10.1177/154405910708600414. PMC   2582143 . PMID   17384035.
  47. Palmer RM, Wilson RF, Hasan AS, Scott DA (2005). "Mechanisms of action of environmental factors--tobacco smoking". Journal of Clinical Periodontology. 32 Suppl 6: 180–95. doi:10.1111/j.1600-051X.2005.00786.x. PMID   16128837.
  48. Ryder MI (2007). "The influence of smoking on host responses in periodontal infections". Periodontology 2000. 43: 267–77. doi:10.1111/j.1600-0757.2006.00163.x. PMID   17214844.
  49. Osunde OD, Adebola RA, Adeoye JB, Bassey GO (May 2014). "Comparative study of the effect of warm saline mouth rinse on complications after dental extractions". International Journal of Oral and Maxillofacial Surgery. 43 (5): 649–53. doi:10.1016/j.ijom.2013.09.016. PMID   24314857.
  50. Haas AN, Wagner TP, Muniz FW, Fiorini T, Cavagni J, Celeste RK (December 2016). "Essential oils-containing mouthwashes for gingivitis and plaque: Meta-analyses and meta-regression". Journal of Dentistry. 55: 7–15. doi:10.1016/j.jdent.2016.09.001. PMID   27628316.
  51. Strydonck DA, Slot DE, Velden U, Weijden F. "Effect of a chlorhexidine mouthrinse on plaque, gingival inflammation and staining in gingivitis patients: a systematic review." Journal of Clinical Periodontology. 2012;39(11):1042–1055.
  52. Van Leeuwen MP, Slot DE, Van der Weijden GA (February 2011). "Essential oils compared to chlorhexidine with respect to plaque and parameters of gingival inflammation: a systematic review". Journal of Periodontology. 82 (2): 174–94. doi:10.1902/jop.2010.100266. PMID   21043801.
  53. Harrison Z, Johnson A, Douglas CW (May 2004). "An in vitro study into the effect of a limited range of denture cleaners on surface roughness and removal of Candida albicans from conventional heat-cured acrylic resin denture base material". Journal of Oral Rehabilitation. 31 (5): 460–7. doi:10.1111/j.1365-2842.2004.01250.x. PMID   15140172.
  54. 1 2 Iinuma T, Arai Y, Abe Y, Takayama M, Fukumoto M, Fukui Y, et al. (March 2015). "Denture wearing during sleep doubles the risk of pneumonia in the very elderly". Journal of Dental Research. 94 (3 Suppl): 28S–36S. doi:10.1177/0022034514552493. PMC   4541085 . PMID   25294364.
  55. Stafford GD, Arendorf T, Huggett R (April 1986). "The effect of overnight drying and water immersion on candidal colonization and properties of complete dentures". Journal of Dentistry. 14 (2): 52–6. doi:10.1016/0300-5712(86)90051-5. PMID   3469239.
  56. Duyck J, Vandamme K, Krausch-Hofmann S, Boon L, De Keersmaecker K, Jalon E, Teughels W (2016). "Impact of Denture Cleaning Method and Overnight Storage Condition on Denture Biofilm Mass and Composition: A Cross-Over Randomized Clinical Trial". PLOS ONE. 11 (1): e0145837. doi:10.1371/journal.pone.0145837. PMC   4701668 . PMID   26730967.
  57. Li X, Kolltveit KM, Tronstad L, Olsen I (October 2000). "Systemic diseases caused by oral infection". Clinical Microbiology Reviews. 13 (4): 547–58. doi:10.1128/CMR.13.4.547-558.2000. PMC   88948 . PMID   11023956.
  58. Lai YL (August 2004). "Osteoporosis and periodontal disease". Journal of the Chinese Medical Association. 67 (8): 387–8. PMID   15553796.
  59. Hua F, Xie H, Worthington HV, Furness S, Zhang Q, Li C (October 2016). "Oral hygiene care for critically ill patients to prevent ventilator-associated pneumonia" (PDF). The Cochrane Database of Systematic Reviews. 10: CD008367. doi:10.1002/14651858.CD008367.pub3. PMID   27778318.