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PERDIODONTICS - Non Surgical

Oral hygiene

Oral hygiene is the practice of keeping the mouth clean in order to prevent cavities (dental caries), gingivitis, periodontitis, bad breath (halitosis), and other dental disorders.

Oral hygiene consists of both personal and professional care. Dental X-rays (radiographs) may be performed as part of routine professional examinations.

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Personal care

Brushing and flossing

Careful and frequent brushing with a toothbrush and the use of dental floss help to prevent build-up of plaque bacteria on the teeth. These bacteria metabolize carbohydrates in our meals or snacks and excrete acid which demineralizes tooth enamel, eventually leading to tooth decay and toothache if acid episodes are frequent or are not prevented. Calculus (dental) or tartar buildup on teeth usually opposite salivary ducts is because of calcium deposits in resident plaque. Frequent brushing and swishing saliva around helps prevent these deposits. Cavities can be costly, in terms of the monetary cost to drill out the cavities and insert dental fillings, and in terms of the tissue already damaged.

Almost all cavities occur where food is trapped between teeth and inside deep pits and fissures in grooves on chewing surfaces where the brush, toothpaste, mouthwash, saliva and chewing gum, cannot reach.

Special appliances or tools may be recommended to supplement (but not to replace) toothbrushing and flossing. These include special toothpicks, oral irrigators, or other devices. Initially electric toothbrushes were only recommended for persons who have problems with strength or dexterity of their hands, but many dentists are now recommending them to many other patients in order to improve their home dental care. In many parts of the world natural toothbrushes are used. In the Muslim world the miswak or siwak is made from twigs or roots that are alleged to have an antiseptic effect when applied as a toothbrush.

Food and drink in relation to oral hygiene

Foods that help muscles and bones also help teeth and gums. Dairy contributes vitamin D, strengthening teeth. Breads and cereals are rich in vitamin B while fruits and vegetables contain vitamin C, both of which contribute to healthy gum tissue. Lean meat, fish, and poultry provide magnesium and zinc for teeth. Some people recommend that teeth be brushed after every meal and at bedtime, and flossed at least once per day, preferably at night before sleep. For some people, flossing might be recommended after every meal.

Better

Some foods may protect against cavities. Milk and cheese appear to be able to raise pH values in the mouth, and so reduce tooth exposure to acid. They are also rich in calcium and phosphate, and may also encourage remineralisation. All foods increase saliva production, and since saliva contains buffer chemicals this helps to stabilise the pH at just above 7 in the mouth. Foods high in fiber may also help to increase the flow of saliva. Unsweetened (basically sugar free) chewing gum stimulates saliva production, and helps to clean the surface of the tooth.

Worse

Sugars are commonly associated with dental cavities. Other carbohydrates, especially cooked starches, e.g. crisps/potato chips, may also damage teeth, although to a much lesser degree. This is because starch is not an ideal food for the bacteria. It has to be converted by enzymes in saliva first.

Sucrose (table sugar) is most commonly associated with cavities, although glucose and maltose seem equally as likely to cause cavities. The amount of sugar consumed at any one time is less important than how often food and drinks that contain sugar are consumed.[citation needed] 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. It is important therefore to try to encourage infrequent consumption of food and drinks containing sugar so that teeth have a chance to repair themselves. Obviously, limiting sugar-containing foods and drinks to meal times is one way to reduce the incidence of cavities.

Artificially refined sugar is not the only type that can promote dental cavities. There are also sugars found in fresh fruit and fruit juices. These foods (oranges, lemons, limes, apples, etc.) also contain acids which lower the pH level. On the other hand, carbonic acid found in soda water is very weakly acidic (pH 6.1), and not associated with dental cavities(provided the soft drink is sugar free, of course). That said, soft drinks are not as healthy for the teeth as milk, because of their lower pH and lack of calcium. Drinking sugared soft drinks 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 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.
Smoking and chewing tobacco are both linked with multiple dental hazards. Regular vomiting, as seen in those who practice bulimia, also causes significant damage.

Other

Retainers- can be cleaned in mouthwash or denture cleaning fluid. Fluoride-containing, or anti-plaque (tartar control) toothpastes or mouthwashes may be recommended by the dentist or dental hygienist. Dental braces may be recommended by a dentist for best oral hygiene and health. Dentures, retainers, and other appliances must be kept extremely clean. This includes regular brushing and may include soaking them in a cleansing solution.

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Professional care

Dental hygienist polishing a patient's teeth

Regular tooth cleaning by the dental hygienist is recommended to remove tartar (mineralized plaque) that may develop even with careful brushing and flossing, especially in areas that are difficult for a patient to reach on his own at home. Professional cleaning includes tooth scaling and 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.
Most dental hygienists recommend having the teeth professionally cleaned at least every six months.

More frequent cleaning and examination may be necessary during the treatment of many of the dental/oral disorders. Routine examination of the teeth is recommended at least every year. This may include yearly, select dental X-rays. See also dental plaque identification procedure and removal.
However, in between cleanings by a dental hygienist, everyone must have good oral hygiene to support the professional care.

Complications


Usually there are no complications to the upkeep of oral hygiene; however, overly vigorous or incorrectly performed brushing or flossing may result in injury to the gingiva (gums). Some results of improper or over vigorous brushing may include: worn-out bristles, unusually sore gums, damage to enamel of teeth, gingivitis and bleeding gums.
One should always call the dentist or dental hygienist if instructions or demonstration of proper care.

 

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