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Plaque control measuresin pediatric dentistry
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Definition Dental Plauque
Newman, caranza: The soft deposits that
form the biofilm adhering to the tooth
surface or other hard surfaces in the oralcavity including removable and fixed
restorations.
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Mechanical
Chemical plaque control
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Mechanical plaque control
Tooth brush
Manual 1857
Powered 1939 circular and elliptical and
combination motions.
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Two types of bristles
Naturals bristles from hogs.
Artificial filaments of nylon.
Bristle design
Grouped in tufts 3-4 rows, 5-12 tufts
Rounded preferred than flat cut or coarse cut
Diameter 0.007-0.012 inch for medium
0.005 for kids
Length for adults 0.406 inches for kids 0.344inches
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Size of tooth brush head
Length 1-1.25 inch
Width 5/16- 3/8 inch
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Small children do not yet have the manualdexterity to clean their teeth themselves. Up
to the age of 6, an adult should therefore
always give the teeth a final brush after the
child has finished. However, children shouldbe introduced as early as possible to theMOI
(masticatory , outer surface, inner surface)
brushing technique which uses systematic
movements suited to the abilities of children.
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M =Masticatorysurfaces: brush with
small horizontalmovements. Start atthe back and brushslowly towards the
front
O=Outer surfaces:clean them with
small circularmovements
I = Inner surfaces:use small up and
down movements
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As small children learn a lot through imitationit is a good idea to give your child a children's
toothbrush to play with at an early age and tolet him or her watch you while you brush your
teeth. The child's first attempts to imitate you
will be rather clumsy.
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But two- to three-year-olds can already clean
the masticatory surfaces with simple
horizontal (scrubbing) movements. After thisthey learn the more difficult circular
movements for the outer surfaces and lastly
the small up and down movements for
cleaning the inside surfaces.
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TECHNIQUES FOR CHILDREN:
Normally the Scrubbing technique isadvised for very young children
brush for at least 2 minutes
always use tooth brush with soft bristlesand fluoridated, flavoured toothpaste
A tooth brush with hard bristles can cause
gingival recession (i.e they will recede and movebackward) and if used with an abrasivetoothpaste, can cause tooth abrasion(loss oftooth substance)
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Scrubbing technique
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BassTechnique ( 6-12)
Directly push the filaments toward roots ofteeth at 45 degree angle, press lightly but notenough to bend filaments of brush and gently,brush forward and backward in short vibratorymovement, attempting to press into gums margin
brush for at least 3 minutes
use soft toothbrush with fluoridated
toothpaste
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Modified bass technique: add circularmovement which will cover gum as well as toothsurface. It massages the gums
Roll technique: Position your tooth brushas in bass technique , then roll downwards overtooth surface, away from gum margins. Lift thebrush, position it and repeat. It is the most
commonly used method, it is an easy methodbut it neglects the gum margins.
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Stillman technique: Position your tooth brush
as in bass technique, press the filaments of
your tooth brush till the gum blanches, turn
your wrist through an angle of 45 degree andproceed to vibrate and roll against each tooth.
Wrist movement is required;it is an unpopular
technique because it is difficult. Also the gum
margin is often ignored
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Fones technique (circular method): (3 6 )
Brush is placed perpendicular to teeth. Large
circular motion of brush over clenched teethto simultaneously cover both upper and lower
teeth. A soft tooth brush is used. It was
Previously popular but is not advised
nowadays as it has proven to cause toothabrasion
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Charters method : Brush is angled45downwards, with half the bristles of thebrush over the gum and half over the crown.Vibratory movement along with a circularmotion is done.
ModifiedCharters method (12-19):Modification is to include occlusal surfaces(i.ebittting surfaces). Both these are difficult tolearn, hence unpopular
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How often should a toothbrush be replaced?
A toothbrush should be replaced as soon as thebristles are bent or sticking out since in this state
they are no longer able to clean thoroughly and
can also injure the gums. A toothbrush should
generally be replaced every 810 weeks.However, as small children often chew on
toothbrushes and the bristles start to stick out
much earlier, children's toothbrushes should bereplaced more often.
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Infants 0-1 with gauze
Toddlers (1-3) scrub technique
pre schoolars 3-6- fones or circular
school age 6-12 horizontal scrub or bass technique
adoloscents12-19 modified stillmen or charters method
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