Concept and practice of plaque-control

نویسنده

  • Per Axelsson
چکیده

The effect of plaque control on gingivitis and periodontitis is well-documented. In short-term investigations, chemical plaque control (oral rinsing twice a day with 0.2% chlorhexidine-gluconate solution) has been effective in the prevention of human gingivitis. Experimentally produced human gingivitis heals completely within one week when the same method is employed. Tooth cleaning with oral hygiene aids every other day prevents the initiation of gingivitis. Cleaning every third or fourth day, on the other hand, prevents neither the development nor the persistence of gingivitis. A combination of oral hygiene instructions and mechanical professional tooth cleaning at proper intervals can almost completely prevent the development of both gingivitis and periodontitis. In crossover studies and studies based on the "split-mouth " technique, frequent mechanical, professional tooth cleaning is superior to oral hygiene instructions assuming the same frequency. Finally, it must be stressed that the effect of home care and professional tooth cleaning on gingivitis and periodontitis differs radically when ordinary tooth cleaning is concentrated on the "key-risk" as opposed to the "nonrisk " surfaces. Definition of Dental Plaque Dawes et al. 1963 described plaque as the soft, tenacious material found on tooth surfaces which is not readily removed by rinsing with water. The most clinically observable plaque on the smooth surfaces of the teeth along the gingival margin may be termed dentogingival plaque. Dentogingival plaque which occurs on the approximal surfaces, apical to the contact points, is termed approximal dental plaque. Plaque may be found below the gingival margin in the gingival sulcus or in the periodontal pocket and is termed subgingival plaque. We normally will find non-attaching bacteria in the most apical position of the periodontal pocket. In children and adults up to 40 years of age, interproximal dental plaque is mainly subgingival because the gingival papilla normally fills up the interproximal space. In spite of some loss of periodontal attachment, the papilla will fill up the interproximal space due to edema. After tooth cleaning, the supragingival plaque along the gingival border of the teeth reaccumulates slowly during the following two days. The thickness of the plaque increases dramatically after the third day, to a maximum after seven days. Etiology of Periodontal Disease In 1965, Lbe and associates demonstrated that clinical symptoms of gingivitis developed in students with clinically healthy gingiva within two to three weeks if dental plaque was allowed to freely accumulate. If adequate tooth cleaning was resumed, the gingival inflammation cleared up within a week. Subclinical symptoms of gingival inflammation in the form of a discharge of exudate from the gingival sulcus appear within four days if plaque is allowed to accumulate freely in the dentogingival region. Page & Schrbder have demonstrated that an initial gingival lesion develops within approximately four days from a condition of healthy gingiva if plaque is allowed to accumulate freely. Lang and associates demonstrated in 1973 that students who completely freed their teeth of plaque at least every other day, did not develop clinical symptoms of gingival inflammation over a six-week period. On the other hand, those students who cleaned their teeth only every third or fourth day all displayed signs of gingivitis. If gingivitis remains untreated, there is a gradual increase in the edema in the gingiva. The subgingival microflora undergoes a gradual transformation into a preponderance of gram-negative anaerobic rods — straight, curved and mobile. Saxe et al., Lindhe and associates have demonstrated that gingivitis induced by bacteria, if left untreated, gradually results in periodontitis. Today the interest in certain bacteria in the subgingival microflora associated with etiology of periodontitis is concentrated on: Bacteroides asaccharolyticus, Fusobacterium nudeatum, Actinomyces israelii, Eike-

برای دانلود متن کامل این مقاله و بیش از 32 میلیون مقاله دیگر ابتدا ثبت نام کنید

ثبت نام

اگر عضو سایت هستید لطفا وارد حساب کاربری خود شوید

منابع مشابه

Evaluation of zinc as an adjunct in chlorhexidine containing toothpaste on gingival and plaque index

BACKGROUND AND AIM: Bacterial plaque is the uppermost element in periodontal diseases. Chlorhexidine (CHX) is one of the utmost influential materials in chemical plaque control and ORTHOKIN is a toothpaste claimed to encompass CHX. Although there are various studies on efficacy of different types of CHX formulation in toothpaste, no literature has focused on the anti-plaque effects of toothpast...

متن کامل

The Effect of Clinical Concept Mapping on Discipline Based Critical Thinking of Nursing Students

Introduction: Enhancing nursing students' critical thinking is a challenge faced by nursing educators. This study is aimed at determining the effect of clinical concept mapping using nursing process on discipline based critical thinking of 4th year nursing students. Methods: In this quasi-experimental study, a convenient sample of 32 nursing students participated. They were randomly assigned t...

متن کامل

Comparison of the Effect of Natural Turpentine and Synthetic Sugar Free Gums on Dental Plaque pH Recovery

Introduction:Many different kinds of chewing gum can increase the flow of saliva, and they have been proven to have anti-bacterial effects as well. The aim of this study was to compare the effect of natural turpentine and synthetic sugar-free gums on dental plaque pH after a sucrose challenge. Methods: This randomized clinical trial was conducted on 15 subjects, who refrained from oral hygiene ...

متن کامل

Comparing the Effect of Multimedia and Practical Education on the Oral Hygiene of Orthodontic Patients

Introduction: Brackets and other fixed orthodontic appliances not only make tooth brushing more difficult, but also provide a suitable environment for the accumulation of plaque. To prevent this situation, dentists usually educate their patients to control the plaque formation and maintain good oral hygiene. This study aims to compare the effect of multimedia and practical education on the know...

متن کامل

Effect of an Iranian Toothpaste Compared with a Commonly Used Foreign-Made Toothpasteon Plaque Index of 9- to 12-Year-Old children: a clinical trial

  Abstract Introduction: Mechanical plaque removal is the most reliable method of oral hygiene practice. However, to maximize its effect, it should be accompanied by the use of chemical agents such as toothpastes, mouth washes and fluoride gels. This study aimed to compare the effect of tooth brushing with an Iranian toothpaste compared to a commonly used foreign-made toothpaste on plaque in...

متن کامل

Efficacy of Plaque Control by Tooth Brushing with and without Different Dentifrices: A Clinical Trial

  Objective: Microbial plaque is among the main etiologies of periodontal disease, and tooth brushing with toothpaste is the most commonly used method of plaque control. This study aimed to compare the efficacy of tooth brushing with and without three different dentifrices.   Methods: Thirty dental students were randomly selected to participate in this clinical trial and were asked to refrain f...

متن کامل

ذخیره در منابع من


  با ذخیره ی این منبع در منابع من، دسترسی به آن را برای استفاده های بعدی آسان تر کنید

برای دانلود متن کامل این مقاله و بیش از 32 میلیون مقاله دیگر ابتدا ثبت نام کنید

ثبت نام

اگر عضو سایت هستید لطفا وارد حساب کاربری خود شوید

عنوان ژورنال:

دوره   شماره 

صفحات  -

تاریخ انتشار 2003