How long does the resolution of gingivitis take?
up to 10 days
How long does plaque accumulate for before it produces clinically obvious gingivitis?
21 days
When giving OHI what must be done?
diagnose and record in notes
Which toothbrushing method is the most widely accepted and effective technique?
modified bass method - position the brush toward the root at 45 degrees to the teeth
Which type of embrasure space is the following?
- embrasure is filled completely by interdental papilla
- dental floss is effective
type 1
Which type of embrasure space is the following?
- the height of interdental papilla is reduced
- interdental brushes and toothpicks are effective
type 2
Which type of embrasure space is the following?
- the interdental papilla is missing
- interdental brushes and end-tuft brushes are effective
type 3
What are the benefits of using a tongue cleaner?
- removes pathogenic bacteria on the dorsal surface
- reduces bacteria in the saliva
- improves taste
- reduce halitosis
What are 4 indications for a single tufted brush?
- type II embrasures
- fixed dental prosthesis
- for difficult to reach areas
- for persistent pockets
What 4 pieces of advice should be given to denture wearers for denture maintenance?
- daily cleaning with toothbrush and non-abrasive cleaner
- daily soaking in denture cleaning solution
- to be taken out at night: if pt not willing to do this, advise to remove when showering and gently massage soft tissues
- regular recalls for denture maintenance
What advice can be given for a patient with xerostomia? (7)
- establish cause if possible: medical history
- explain increased risk for both caries and perio
- saliva subs
- ice chips/subes
- sugar free chewing gum
- staying hydrated
- avoid alcohol as may exacerbate condition
What advice can be given for a patient with erosion? (6)
- sensitive investigation to establish cause: intrinsic or extrinsic factors
- establish dietary habits either using 24 hour recall or diet diary for a minimum of 3 days
- look at frequency of acid intake – advise to restrict acidic food/drinks to mealtimes
- plain milk/water between meals
- use a straw/avoid swishing when drinking fizzy drinks
- avoid tooth brushing immediately after ingesting acid/vomiting (to avoid further toothwear).
- if evidence of recession/abrasion lesions check tooth brushing technique and advise either electric
toothbrush with pressure sensor or atraumatic technique (fingertips)
What advice can be given for a patient who smokes? (5)
- ask about smoking status, record in notes how many pt smoking and what they are smoking
- ask if they would like to stop smoking
- advise them of the benefits of stopping, making it relevant to them - link to perio and halitosis
- advise they will be more successful at stopping if they recieve support
- act: give information of stop smoking service, praise patient for wanting to stop smoking, advise patient of presence of bleeding gums due to nicotine exiting the system
What is the recommended limits for alcohol consumption?
- 14 units per week max
- 2 alcohol free days per week
What advice can be given for a patient who drinks alcohol? (4)
- establish how much alcohol is consumed per week, advising patient of what a unit is
- ask what their drinking pattern is like - everyday, weekends, binge drinking?
- advise them of the recommended limits
- advise that alcohol is one of the main causes of oral cancer, especially spirits
If dentures are cobalt/chrome (metal based) dentures, what cleaning product should be avoided?
- bleach due to tarnishing and corroding the metal
What 9 pieces of advice would be given to a patient with early caries/caries?
- establish current OH routine
- reinforce importance of night time brushing and decreased saliva flow
- establish what toothpaste is being used
- apply fluoride varnish at least 2x yearly
- establish dietary habits either using 24 hour recall or diet diary for a minimum of 3 days
- look at frequency of sugar intake – advise to restrict sugary food/drinks to mealtimes
- plain milk/water between meals
- explain in simple terms the process of demineralisation and remineralisation
- no eating at least 1 hour before going to bed
- remember to give holistic advice, following guidelines (eatwell guide)
What advice should be given to patients with orthodontic appliances? (4)
- same advice for caries
- avoid chewy/sticky foods as these may damage the appliance
- explain that demineralisation around the appliance can lead to white/brown decalcification marks around the brackets which are permanent
- cleaning around brackets is vital - which ID brushes
