Teeth cleaning

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Teeth cleaning is part of oral hygiene and involves the removal of dental plaque from teeth with the intention of preventing cavities (dental caries), 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.

Contents

Brushing, scrubbing and flossing

Brushing

Careful and frequent brushing with a toothbrush helps to prevent build-up of plaque bacteria on the teeth. [1] Electric toothbrushes were developed, and initially recommended for people with strength or dexterity problems in their hands, but they have come into widespread general use. The effectiveness of electric toothbrushes at reducing plaque formation and gingivitis is superior to conventional manual toothbrushes. [2]

How to Brush [3]

Ensuring effective brushing is important in getting rid of food and bacteria properly.

Step 1) Place a pea sized amount of toothpaste on the brush and hold at a 45 degree angle.

Step 2) In small circular and back and forth motions, move the brush gently along teeth and gums.

Step 3) Brush all surfaces inside the mouth, including the tongue. Ensure that the back sides of the teeth (top and bottom rows) are being cleaned by brushing vertically in up and down motions.

Tip) It is recommended to use a 2/2 strategy which includes brushing two minutes in the morning and two minutes at night as a minimum standard for healthy gums and teeth.

Flossing

In addition to brushing, cleaning between teeth may help to prevent build-up of plaque bacteria on the teeth. This may be done with dental floss or interdental brushes.

80% of cavities occur in the grooves, or pits and fissures, of the chewing surfaces of the teeth, [4] however, there is no evidence currently showing that normal at-home flossing reduces the risk of cavities in these areas. [5]

Special appliances or tools may be used to supplement toothbrushing and interdental cleaning. These include special toothpicks, oral irrigators, and other devices. A 2015 Cochrane review found insufficient evidence to determine whether the interdental brushing decreases the levels of plaque when compared to flossing. [6]

Professional teeth cleaning

Dental hygienist polishing a person's teeth Tooth polishing 9332.JPG
Dental hygienist polishing a person's teeth

Teeth cleaning (also known as prophylaxis , literally a preventive treatment of a disease) is a procedure for the removal of tartar (mineralized plaque) that may develop even with careful brushing and flossing, especially in areas that are difficult to reach in routine toothbrushing. It is often done by a dental hygienist. Professional cleaning includes tooth scaling, tooth polishing, and debridement if too much tartar has accumulated. This involves the use of various instruments or devices to loosen and remove deposits from the teeth. The American Dental Association has designated the code D1110 for adult prophylaxis or dental cleaning and has also designated the code D1120 for the same procedure in children.

As to the frequency of cleaning, research on this matter is inconclusive. That is, it has neither been shown that more frequent cleaning leads to better outcomes nor that it does not. A review of the research literature on the question concluded "[t]he research evidence is not of sufficient quality to reach any conclusions regarding the beneficial and adverse effects of routine scaling and polishing for periodontal health and regarding the effects of providing this intervention at different time intervals". [7] Thus, any general recommendation for a frequency of routine cleaning (e.g. every six months, every year) has no empirical basis. [8] [9]

Complications

Overly vigorous or incorrectly performed brushing or flossing may cause injury to the gingiva (gums). Improper or over-vigorous brushing may cause sore gums, damage to tooth enamel, gingivitis, and bleeding gums. Dentists and dental hygienists can instruct and demonstrate proper brushing or flossing techniques. [10]

Aerosols generated during dental cleaning procedures may spread infection. [11] During the COVID-19 pandemic on 12 August 2020, the World Health Organization recommended that routine dental checkups be delayed in areas of community transmission. [12] Characteristics and detection rate of SARS-CoV-2 in alternative sites and specimens related to dentistry has been extensively reviewed. [13]

Disinfection

Antiseptics help reduce the number of microorganisms present in the oral cavity. [14] Antiseptics are recommended for both daily home care regimens and for use in the dental office setting. These products are used as a preprocedural rinse to reduce bacterial counts prior to routine dental treatments and injections. [15]

A common antiseptic rinsing agent used in the dental office is a 0.2% chlorhexidine product which provides a lowered bacterial count for more than 60 minutes. [16]

Acidity and decay relationship

The regulation of acid production and exposure in the oral cavity is of the utmost importance to maintain healthy enamel. When enamel, cementum, and /or dentin are subjected to an increased number of acidogenic and aciduric bacteria in dental biofilm, the demineralization process begins. When acidogenic and aciduric bacteria predominate the oral flora, there is an increased risk of developing caries. [15]

Reducing acid exposure

Dietary habits:

History

Historically, professional tooth cleaning was sometimes referred to as odontexesis (literally "tooth-scraping") [17] or odontexis ("scraping off"), [17] and the instruments involved odontoglyphs. [18]

Dr. Alfred C. Fones, known as the "father of dental hygiene," was the first to develop the role of a dental hygienist into the current concept of a dental educator and dental professional. The dental hygienist is qualified, same as a dentist, to perform routine dental cleanings. [18]

Related Research Articles

<span class="mw-page-title-main">Mouthwash</span> Liquid rinse for oral hygiene

Mouthwash, mouth rinse, oral rinse, or mouth bath is a liquid which is held in the mouth passively or swirled 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.

<span class="mw-page-title-main">Human tooth</span> Calcified whitish structure in humans mouths used to break down food

Human teeth function to mechanically break down items of food by cutting and crushing them in preparation for swallowing and digesting. As such, they are considered part of the human digestive system. 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.

<span class="mw-page-title-main">Periodontal disease</span> Medical condition

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 and red and may bleed. It is considered the main cause of tooth loss for adults worldwide. 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.

<span class="mw-page-title-main">Toothbrush</span> Oral hygiene tool

A toothbrush is an oral hygiene tool used to clean the teeth, gums, and tongue. It consists of a head of tightly clustered bristles, atop of which toothpaste can be applied, mounted on a handle which facilitates the cleaning of hard-to-reach areas of the mouth. They should be used in conjunction with something to clean between the teeth where the bristles of the toothbrush cannot reach - for example floss, tape or interdental brushes.

<span class="mw-page-title-main">Tooth decay</span> Deformation of teeth due to acids produced by bacteria

Tooth decay, also known as cavities or caries, is the breakdown of teeth due to acids produced 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.

<span class="mw-page-title-main">Dental floss</span> Cord of thin filaments used in interdental cleaning

Dental floss is a cord of thin filaments used in interdental cleaning to remove food and dental plaque from between teeth or places a toothbrush has difficulty reaching or is unable to reach. Its regular use as part of oral cleaning is intended to maintain oral health.

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 periodontist is a dentist that specializes in the prevention, diagnosis and treatment of periodontal disease and in the placement of dental implants.

Dental plaque is a biofilm of microorganisms 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 (supragingival), or below the gumline cervical margins (subgingival). 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.

<span class="mw-page-title-main">Oral irrigator</span> Dental care device

An oral irrigator is a home dental care device which uses a stream of high-pressure pulsating water intended to remove dental 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. However, more research is needed to confirm plaque biofilm removal and effectiveness when used by patients with special oral or systemic health needs.

<span class="mw-page-title-main">Tooth brushing</span> Act of scrubbing teeth with a toothbrush

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. The recommended amount of time for tooth brushing is two minutes.

<span class="mw-page-title-main">Gingival and periodontal pocket</span>

Gingival and periodontal pockets are dental terms indicating the presence of an abnormal depth of the gingival sulcus near the point at which the gingival tissue contacts the tooth.

Bleeding on probing (BoP) 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. BoP is a sign of periodontal 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. BoP seems to be correlated with Periodontal Inflamed Surface Area (PISA).

<span class="mw-page-title-main">Scaling and root planing</span> Dental procedure

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 agents that cause inflammation. It is a part of non-surgical periodontal therapy. This helps to establish a periodontium that is in remission of periodontal disease. Periodontal scalers and periodontal curettes are some of the tools involved.

<span class="mw-page-title-main">Dental public health</span>

Dental Public Health (DPH) is a para-clinical specialty of dentistry that deals with the prevention of oral disease and promotion of oral health. Dental public health is involved in the assessment of key dental health needs and coming up with effective solutions to improve the dental health of populations rather than individuals.

<span class="mw-page-title-main">Oral hygiene</span> Cleaning the mouth by brushing the teeth and cleaning in between the teeth

Oral hygiene is the practice of keeping one's oral cavity clean and free of disease and other problems by regular brushing of the teeth and adopting good hygiene habits. 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 and gum diseases, including gingivitis, and periodontitis.

Dental pertains to the teeth, including dentistry. Topics related to the dentistry, the human mouth and teeth include:

<span class="mw-page-title-main">Gingivitis</span> Inflammation of the gums

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

<span class="mw-page-title-main">Tooth pathology</span> Medical condition

Tooth pathology is any condition of the teeth that can be congenital or acquired. Sometimes a congenital tooth disease is called a tooth abnormality. These are among the most common diseases in humans The prevention, diagnosis, treatment and rehabilitation of these diseases are the base to the dentistry profession, in which are dentists and dental hygienists, and its sub-specialties, such as oral medicine, oral and maxillofacial surgery, and endodontics. Tooth pathology is usually separated from other types of dental issues, including enamel hypoplasia and tooth wear.

Prenatal dental care is the care of the oral cavity during fetal development. The woman’s body is subject to hormonal changes leading to several physical changes in the oral cavity during pregnancy. Some of these changes may cause tooth decay, erosion and periodontal health changes.

Interdental cleaning or interproximal cleaning is part of oral hygiene where the aim is to clean the areas in between the teeth, otherwise known as the proximal surfaces of teeth. This is to remove the dental plaque in areas a toothbrush cannot reach. The ultimate goal of interproximal cleaning is to prevent the development of interproximal caries and periodontal disease. The combined use of tooth brushing, and mechanical and manual interdental cleaning devices has been proven to reduce the prevalence of caries and periodontal diseases.

References

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  12. Nebehay S (2020-08-12). "Delay routine dental checkups in areas of COVID spread: WHO". Reuters. Retrieved 2020-08-12.
  13. Shirazi S, Stanford CM, Cooper LF (March 2021). "Characteristics and Detection Rate of SARS-CoV-2 in Alternative Sites and Specimens Pertaining to Dental Practice: An Evidence Summary". Journal of Clinical Medicine. 10 (6): 1158. doi: 10.3390/jcm10061158 . PMC   8000787 . PMID   33802043.
  14. "Efficacy of preprocedural mouth rinsing in reducing aerosol contamination produced by ultrasonic scaler". J Periodontol (85): 4. 2014.
  15. 1 2 Wilkins' Clinical Practice of the Dental Hygienist (13 ed.). Jones and Bartlett. 2021. p. 422. ISBN   978-1-496-39627-3.
  16. Boyd, Linda D. (2021). Wilkins' clinical practice of the dental hygienist. Lisa F. Mallonee, Charlotte J. Wyche, Esther M. Preceded by: Wilkins (13 ed.). Burlington, MA. ISBN   978-1-4963-9627-3. OCLC   1096288166.{{cite book}}: CS1 maint: location missing publisher (link)
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