Daily Oral Hygiene Research Articles

The effects of sucralfate suspension and diphenhydramine syrup plus kaolin-pectin on radiotherapy-induced mucositis

A prospective, double-blind study compared the effectiveness of sucralfate suspension with diphenhydramine syrup plus kaolin-pectin in reducing severity and pain of radiation-induced oropharyngeal mucositis. Fourteen patients who received at least 4600 cGy to the oral cavity used one of the mouth rinses four times a day, beginning at 1600 cGy. Data were collected on daily perceived pain and helpfulness of mouth rinse, weekly mucositis grade, weight change, and interruption of therapy. Analysis of data revealed no statistically significant differences between the two groups in any parameter. A retrospective review of 15 patients who had received at least 4600 cGy radiation to the oropharynx but had not used a daily mouth-coating rinse, was compared with the study group. Comparison of the two groups suggested that consistent daily oral hygiene and use of a mouth-coating agent will result in less pain and may reduce weight loss and interruption of radiation because of severe mucositis.

Geriatric dentistry. A textbook of oral gerontology

Good oral health in old age is particularly important for maintaining adequate oral function, preventing pain and discomfort, controlling localized or systemic inflammation, sustaining social interaction, and preserving quality of life. Given that oral health is an integral part of general health and well-being, and that major chronic systemic and oral diseases share common risk factors, oral health prevention and promotion should be embedded within routine medical assessment and care provision. The role of medical physicians, particularly primary care physicians, geriatricians, and elderly care physicians, in community and long-term care facilities in assessing and promoting oral health in frail older adults is critical and has been emphasized in recent European recommendations. All physicians should appreciate the importance of oral health and incorporate an initial oral health screening into routine medical assessment and care. A short interview with patients and carers on current oral health practices may help to assess the risk for rapid oral health deterioration. The interview should be followed by an oral health assessment, using validated tools, for nondental health care providers. Based on these findings, the physician should decide on necessary follow-up procedures, which may include oral health counseling and/or dental referral. Oral health counseling should include advice on daily oral, mucosal, and denture hygiene; denture maintenance; dietary advice; smoking cessation; limitation of harmful alcohol consumption; management of xerostomia; and frequent dental review. To enable physicians to perform the tasks recommended in this publication, appropriate teaching at both undergraduate and postgraduate levels must be delivered in addition to provision of appropriate continuing education courses.

Rationale for the Lingual Approach to Mandibular Osseous Surgery

The definitive treatment of periodontitis for pocket elimination and the establishment of periodontal architecture that can be effectively maintained with daily personal oral hygiene techniques is sometimes an elusive goal. Performing osseous reduction, primarily from the lingual aspect of the posterior mandible, definitely helps in accomplishing such a goal. This paper should not be interpreted to mean that osseous correction of bony defects should be approached strictly from the lingual, since almost all cases require some buccal recontouring if a satisfactory soft and hard tissue architectural form is to be achieved. Clinical observation and experience have shown that the anatomical patterns, seen in relation to the mandible, have a powerful effect on normal periodontal architecture as well as the types and locations of bony defects encountered. Tooth to bone relationships deserve attention. The buccal housing of the alveolar bone is frequently thin in the premolar region and occasionally on the first molar, while the external oblique ridge causes thicknened bone over the second molar. The vestibular depth on the buccal of the molars is often quite shallow, meaning that only a very limited amount of osteoplasty-osteoectomy can be performed from the buccal. The lingual housing of the alveolar bone is normally thickened and shelf-like from the distal of the third molars to the mesial aspect of the premolar region. Because the posterior teeth are inclined lingually from the second premolar distally, the buccal marginal bone height is higher occlusally than the lingual bone margins, with the interproximal bone therefore sloping somewhat apically and lingually. Interdental craters are the most common defect seen with the onset of periodontitis. Such defects in the lower arch tend to occur beneath the contact areas of the teeth, which are much further to the lingual than in the maxilla. The highest percentage of interproximal craters are shallow and not amenable to grafting techniques in the hands of most clinicians. These shallow craters are prime candidates for osseous reduction techniques. With the progression of periodontitis, the interproximal defects frequently extend to include infrabony lingual defects. Although obtaining lingual access for osseous reduction techniques is often difficult, osteoectomy-osteoplasty techniques performed primarily from the buccal of the posterior mandible frequently result in compromise of the lingual and over treating the buccal in terms of osteoectomy procedures. The lingual embrasure spaces are usually wider than on the buccal, and with adequate reduction of the mylohyoid ridge, greater access for oral hygiene procedures is provided.

Toothbrushing force study.

Although the toothbrush has been in use for about 200 years, interest in the fundamentals of toothbrush design has been limited.1'2 During the past 30 years, a number of studies on toothbrush design have been published, but many gaps in our practical knowledge of the fundamentals of toothbrushing still remain to be filled.2A Ability to maintain adequate oral hygiene depends, in part, on the acceptability of such a program to the individual. It has been postulated that the individual is more likely to carry out an effective oral hygiene program if the time required to accomplish such a program is within limits acceptable to him.2 The less time required for the daily oral hygiene routine, the more likely the patient will adhere to the program. To this end, the vertical oscillating, electrically powered toothbrush makes an acceptable oral hygiene program more feasible, because it provides the same end results in far less time than the conventional manual toothbrush.2 Interest has recently been directed to the abrasive effects of various toothbrushes but, before meaningful dentifrice abrasive studies can be undertaken, a series of toothbrushing force studies must be conducted to answer the following questions: How does an individual use a toothbrush, either automatic or conventional? What force is applied through the brush to the tooth surface? How do these forces vary during brushing procedures in the various age groups? What are the means and extremes of brushing forces; and how does the motion of the brush or the character of the bristles influence such forces? Although a number of published reports have included estimates of the brushing forces of various types of toothbrushes,13,5 these estimates do not agree. For example, Phaneuf, Harrington,

Prevention of Dental Disease

Dental caries and periodontal diseases are among the most common bacterial diseases affecting humans. Even though substantial reductions in the levels and severity of these diseases and their sequelae have been documented in most Western nations, millions of children worldwide continue to experience caries, periodontal disease, tooth loss, and malocclusions. Much of dental disease can be prevented if patients or those responsible for providing oral health care to patients engaged in daily oral hygiene practices, had access to optimal systemic and topical fluorides, maintained sound dietary practices, and sought professional dental care on a regular basis. Dental diseases and their sequelae are largely preventable.The goal of this chapter is to provide clinicians with guidelines that can help oral health care providers keep infants and toddlers free from preventable oral disease. The stakeholders involved in infant oral health extend beyond just dental personnel. They include patients, their parents, pediatricians, and medical specialists, as well as anyone else interested in or responsible for a child's health and well-being. Planning for a lifetime of oral health should begin shortly after conception and should continue regularly to ensure that risk factors for oral disease are recognized early and dealt with effectively throughout pregnancy, infancy, childhood, and adolescence.

How we can improve our operative dentistry

In summary may I re-emphasize that if we wish to improve our operative dentistry and become better balanced dentists, we must observe the following cardinal principles: 1. Thorough diagnosis, including full-mouth apical and interproximal x-rays, properly mounted accurate study casts, and clinical examination correlating all diagnostic findings. 2. Responsibility for the restoration of the health of the investing tissues of the mouth. 3. Proper treatment planning, including a visualization of each operation before its execution. 4. Instruction in daily oral hygiene and periodic patient recall in order to insure the maintenance of oral health. Improvement in our operative dentistry will be insured, if we as operators study our results with the critical eye of self-analysis.