Oral hygiene - rules of care, periodontal diseases

Diseases of the oral mucosa include not only those familiar to every dentist, but also diseases such as candidiasis, cheilitis, and stomatitis. The oral mucosa is also important for assessing the general condition of the patient and his immunity. Indeed, often the oral mucosa is almost the first place of manifestation of infectious diseases, such as syphilis, tuberculosis, scarlet fever, diphtheria, and gonorrhea. And here the dentist should not only accurately diagnose the infectious disease in order to help the person, but also warn himself so that cross-infection does not occur.

ICD - deposits (growths) on teeth:

K03.6 - deposits (growths) on teeth
K03.60 - pigmented coating (black, green, orange)
K03.61 - due to the habit of using tobacco
K03.62 - due to the habit of chewing betel nut
K03.63 - other extensive soft deposits (white deposits)
K03.64 - supragingival calculus
K03.65 - subgingival calculus
K03.66 - dental plaque
K03.68 - other specified deposits on teeth
K03.69 - deposits on teeth, unspecified

Mechanism of plaque formation

Plaque formation on teeth begins 2 hours after brushing.

Dental plaque has the following formation mechanisms:7

The surface of the tooth is coated with saliva; it contains proteins to which microorganisms attach more easily.

2. The number of microorganisms gradually increases, they produce acids and polysaccharides - high molecular weight carbohydrates that serve as food for acid-producing bacteria.

3. Subsequently, the number of bacteria increases, and the plaque structure becomes stronger. And acids destroy tooth and gum tissue.

Methods for detecting plaque

To determine the quality of home hygiene, you can use solutions of dyes: erythrosine, basic fuchsin, bismarck brown fluorescent sodium. These dyes do not have a pathological effect on the enamel or the oral mucosa. Special tablets are widely used.6

Directions for use: Chew 1 tablet thoroughly and then rinse your mouth with water. What is colored is plaque on the teeth.

It is recommended to use the tablets for children over 6 years of age.5

Contraindication for use is individual intolerance to the constituent components of tablets or solutions.

List of neurotic dental diseases

Stressful periods have a particularly detrimental effect on the state of the body. In addition, as practice shows, the quality of oral hygiene deteriorates sharply. A person simply forgets about cleaning or does not do it thoroughly enough, which increases the risk of developing caries. The parallel use of sedative medications disrupts the production of saliva and causes a feeling of dryness.

Gradually, all this is reflected in psychosomatics - muscle spasms and pain are detected. The most common occurrence is excessive clenching of the jaw.

Bruxism

A disorder characterized by uncontrollable grinding of teeth caused by emotional stress. As a rule, it makes itself felt during sleep. The causes of its appearance include stress, prolonged depression, and malfunctions of the masticatory apparatus.

Grinding

This is not so much a full-fledged disorder as a symptom. Occurs when muscle spasms occur when the patient clenches his jaw tightly. In the vast majority of cases, the person does not even know there is a problem. It is detected during routine dental examinations.

The influence of dental plaque on the development of periodontal diseases

Periodontal tissue is the tissue that holds the tooth in the jaw. If you remove at least one of them, the mobility of the tooth increases, which ultimately leads to its loss.

In 80% of cases, the leading role in the occurrence of periodontal pathology belongs to dental plaque. Of course, there are a number of factors (iatrogenic effects on the periodontium, for example, braces; occlusal trauma, malocclusion; malnutrition; stress; chronic diseases of organs and systems) that contribute to the occurrence of periodontal diseases.2

Plaque microorganisms and their toxins damage the epithelium and cause irritation, which leads to connective epithelial damage and inflammation.

Endotoxins (waste products of gram-negative bacteria) are aggressive; they increase capillary permeability, disrupt cell metabolism, which leads to necrosis. In response to this, the body produces many antibodies (proteins to destroy dangerous cells and viruses) and enzymes that destroy periodontal tissue. And due to the high amount of antibodies, periodontal tissue weakens its protective functions, which allows bacteria to easily destroy them.

The most common microorganisms found in dental plaque are Actinomyces, Actinobacillus, Bacteroides, Eikinella corrodens, Fusobacterium, Vielonella recta, Treponema denticola, Capnocytophaga.8

Diseases associated with enamel

What are the possible dental problems due to enamel damage? In the vast majority of cases, they are associated with violations of the structure and integrity of the rows. Usually they are a consequence of internal failures in the body. They are eliminated only at the moment when the factor that provoked their exacerbation disappears.

Fluorosis

A chronic disease that develops during eruption. Accompanied by structural damage, darkening, and loss of dentin. The reason is excess fluoride, which is explained by long-term use of fluoridated water, medications, etc.

Cracks

Deviation, usually localized on the anterior chewing row. It looks like vertically or horizontally located defects of a non-carious nature. Appears due to sudden temperature changes, aggressive chemical exposure, or due to injury.

Turner teeth

An advanced form of local manifestations of hypoplasia. It is fixed long before the first eruptions and has nothing to do with carious lesions. Externally it looks like an enamel layer. Sometimes accompanied by excessive sensitivity.

Hypoplasia

Pathological phenomena of a congenital nature, which is characterized by a complete or partial absence of enamel. If we talk about the external picture, then it is worth noting depigmented or white spots, rather large grooves based on the surface, as well as small depressions. Caused by incorrect structure of hard dental tissues. If left untreated, it is complemented by acute forms of caries.

Wedge-shaped defect

Disadvantages expressed in wedge-shaped cavities in the cervical region of the units. This occurs due to the fact that certain areas of the enamel disappear, resulting in wedge holes. The problem can be registered on any element, but more often on fours and fives.

Tartar

Tartar is mineralized plaque on teeth.

More often it is located on the crown of the tooth, i.e. above the gum. But if the periodontal tissue is destroyed and the gum moves away from the tooth, the root is exposed and the tartar is already below the gum.

It is assumed that subgingival calculus is formed from components of blood serum, since it does not have contact with saliva.2

The different topography of these types of tartar suggests a different mechanism for their removal.

Supragingival calculus is removed using hand instruments and scalers
Subgingival calculus is often removed surgically to allow better visualization of the approach.

Classification: types of main dental diseases of the teeth

Conventionally, all violations can be divided into two broad categories - those associated with damage to the enamel, and those caused by processes occurring in periodontal tissues. There is another classification principle - based on “carious” affiliation:

with existing caries lesions;
non-carious deviations.

The second option is considered the simplest and most convenient to treat if the problem is detected at an early stage. In addition, it is easier for patients to comply with prescriptions, which simplifies the process of rehabilitation measures.

Note that congenital and hereditary pathologies stand apart. They are formed in the womb and are very difficult to correct.

Individual oral hygiene

Individual oral hygiene is the removal of plaque by the patient himself at home using various hygiene products; in other words, it is home brushing of teeth. Home hygiene does not always remove all dental deposits, but proper hygiene will reduce the amount of plaque and bacteria.

Toothbrush

The toothbrush should be soft.
For many, this is surprising, because most are accustomed to using a brush of high and medium hardness - but this is wrong. Using a soft brush will initially seem like poor hygiene, but there are benefits to it as more time will be spent brushing and hygiene will be done properly.

Thanks to a soft toothbrush, the risk of injury to enamel and gums is reduced. The toothbrush should have smooth, thick bristles.3,13

Mono-tuft toothbrush

Allows you to thoroughly clean the gingival sulcus area.
The mono-beam cleans areas that are inaccessible to a regular brush. A mono-beam brush is convenient to use when the gag reflex is pronounced. This brush is a must-have hygiene product; you can use it to clean your teeth without using toothpaste.3,14

Rules for using a mono-beam brush:

Hold the monotuft brush vertically
Place the brush so that the bristles are around the gum line
We move the beam from one tooth to another along the gum line with soft stroking movements.
We don't put pressure
We repeat the same steps on the inner surface of the teeth.

Dental floss

Dental floss should be safe and not injure the gums when used correctly.
Dental floss can be classified by color, thickness and fiber structure. Classification of dental floss:

CLASSIFICATION	A COMMENT
classification:	Shape:3	a comment:	flat – for tightly set teeth round – for wide interdental spaces tape – in the presence of diastemas and three-spaces between teeth Superfloss - threads with different thicknesses (used in children with braces, and in adults with implants).
classification:	By processing:	a comment:	waxed (with a wax coating). After waxing, the material easily penetrates between the most crowded teeth unwaxed (no wax coating). Unwaxed thread cleans better. Its difference is close contact and a large coverage area. The downside is that this thread is more traumatic.
classification:	According to the presence of impregnations:	a comment:	with flavorings (fruit, menthol) with medicinal impregnations (with fluorine, without fluorine, with and without antiseptics)
classification:	Based on holder availability:	a comment:	Flosssticks are dental floss with holders. Disadvantages of floss sticks: uncontrollable tension force the need to rinse the thread after each interval greater risk of gum injury Dental floss should be used after every meal to prevent food from getting stuck in the teeth.10

Rules for using dental floss:

1. It is necessary to unwind about 40 cm of thread from the roll and cut it using the built-in cutter.

2. The ends of the thread are wound around the middle fingers.

3. The middle part of the thread is clamped with the index finger and thumb so that 5 cm remains

4. The thread is threaded between the teeth and moved with sawing movements without strong pressure.

5. The tooth is grasped from all sides and gently brushed from top to bottom.

6. The used piece of thread is wound around the middle finger (can be washed with water), the next gap is cleaned with a clean piece

7. The floss is threaded through the same gap to clean the adjacent tooth.

When should you start flossing?

Up to 2 years of age, floss is not used - until baby teeth completely erupt. The exception is when the child has tight contacts between the front incisors.
2.5-6 years – the period of “contact caries”. Its occurrence is associated with densification of the dentition. A toothbrush cannot fully clean the interdental spaces. It is necessary to use dental floss. Closer to 6 years, you can use a ribbon thread or an irrigator.
From the age of 6 – brushing teeth with floss becomes an obligatory ritual; the child can be taught to practice independent hygiene

Dental brushes

It is advisable to use a brush every time after eating.
One procedure is enough; too sudden and repeated movements can injure the gums. Terms of use:

1. It is necessary to insert a brush between the teeth closer to the gum

2. The brush should lie at a slight angle relative to the gum

3. It is necessary to carefully move the brush so that it goes right through between the teeth.

4. Strong pressure and pressure should be avoided, the brush should pass easily

5. At the end, you can carefully remove the brush and repeat the procedure with all teeth

Dental floss removes food debris between the teeth, and dental brushes clean them of plaque. At first, it will be difficult to use dental brushes, so it is recommended to start with the smallest sizes and gradually increase them. When you first start using brushes, your gums may bleed.4

Tongue scraper

Plaque on the tongue may indicate the accumulation of pathogenic bacteria that are located in the papillae of the tongue.
These bacteria, in turn, can:

migrate to teeth and cause caries
cause bad breath
accumulate on the gums, causing inflammation
negatively affect overall oral health
yellow coating on the tongue does not look aesthetically pleasing

We must not forget about tongue hygiene, since pathogenic microorganisms can get on the teeth and nullify the effect of brushing.

It is not recommended to brush your tongue with a toothbrush or the back of it. The best cleansing effect can be achieved using a tongue scraper. Scrapers come in metal and plastic. It is recommended to use plastic ones, as they do not injure the tongue.3

Irrigator

A device for cleaning plaque and food particles between teeth. Hygiene is carried out under the pressure of a water jet. An irrigator cannot replace dental floss. Thanks to the irrigator, hydromassage of the gums occurs and blood circulation improves.

Normal appearance, structure and functions of the palate

The palate is the top of the oral cavity in the form of a dome or vault, separating it from the nasal passages. The sky is divided into two parts:

hard - at the base there is a bone plate covered with a mucous membrane;
soft - these are muscles covered with a mucous membrane that raise the palatine during swallowing and lower during breathing.

Sky functions:

respiratory protection;
participation in the chewing process;
assistance in the formation of speech sounds.

Normally, both parts of the palate are a soft pink hue. In diseases of the nasopharynx, redness of the mucous membrane occurs. A purple or bluish tint may appear. The acquisition of a yellow color by the palate in a child or adult indicates the presence of pathology.

Teeth brushing methods

Pakhomov method G.N.12

All teeth are conventionally divided into several sections (chewing left and right, and front)
They start brushing their teeth with the chewing right teeth, then move on to the front teeth and end with the chewing teeth on the left.
The anterior (labial) and posterior (lingual) surfaces are cleaned with sweeping movements from the gums to the edge of the tooth, the brush is held at an angle of 45°
The chewing surface is cleaned with back and forth movements.

Fones method12

When brushing your teeth using this method, you need to close your teeth together and smile broadly, the front surface of all teeth is brushed in a circular motion.
Next, with the mouth slightly open, the inner (lingual and palatal) surface of the teeth is cleaned in a circular motion.
The chewing surface is brushed in a circular motion

Baas method12

The toothbrush is held like a pen
Use circular movements to clean each tooth one at a time, without applying too much pressure. This cleanses the outer and inner surfaces of all teeth.
When cleaning chewing teeth and the inner surface of all teeth, some of the bristles must be placed on the gum, and some on the enamel.
The chewing surface must be cleaned in a circular motion, the bristles should fit snugly against the tooth, but not bend.

Treatment of teeth and gums in Moscow dentistry

During the pandemic, many people refuse to visit the dentist, believing that solving dental problems can be left “for later.” This opinion is erroneous, since the health of the entire body depends on the health of the teeth.

We offer the right solution to the existing problem with the health of teeth and gums - immediate treatment of dental diseases in a specialized center for family dentistry in Moscow - “Aesthetics”. To make your visit to the doctor as safe as possible for you, be sure to follow all preventive measures recommended by WHO.

In turn, specialists will do everything possible to protect their patients from any risks of contracting the coronavirus. Disinfection of work rooms, equipment and instruments used in treatment and diagnosis is carried out regularly. To minimize contact with strangers, we recommend making an appointment with a doctor by calling +7 (495) 66-574-55 for a specific day and time.

In our center you can receive professional dental care provided by qualified doctors. We have set affordable prices for all treatment and diagnostic procedures, and provide discounts on prosthetics and dental implantation to citizens of preferential categories.

All patients who leave their reviews on the site also receive a guaranteed 3% additional discount (in addition to the main one) on all dental services. Share your opinion, leave your reviews and don’t miss the opportunity to save your personal budget on dental treatment and prosthetics at the Aesthetics family dentistry center.

Professional hygiene

Professional oral hygiene should be carried out every 6 months. For brace wearers, hygiene is mandatory every quarter.

Stages of professional hygiene: 11

ultrasonic treatment (scaling) - removal of hard dental plaque
Air Flow cleaning – removing soft plaque
polishing with a brush and abrasive paste
fluoridation, calcination – if necessary

The Skyler is used for ultrasonic cleaning of plaque and tartar from the surface of the tooth and under the gum. Scaling can be performed under local anesthesia.

The second stage is Air Flow - teeth cleaning with a special device using fine powder, air and water supplied under high pressure.

Benefits of Air Flow:7

cleaning hard-to-reach areas from plaque
polishing the enamel surface
decreased adhesion (sticking) of bacteria
whitening effect

After cleaning, polishing is carried out using a rotating brush and a special paste. It is very important. By making the surface of the teeth smooth, the doctor prevents bacteria from attaching to the enamel.

At the end of the procedure, a mineralizing gel containing fluoride and calcium salts, necessary for the prevention of caries and increased sensitivity of the gums, is applied to the teeth. The gel is applied only when necessary.

Prevention

Above, we examined in detail what dental diseases are called and what are the main reasons for their occurrence. Now let's talk about preventive measures to avoid serious problems and pathologies.

If you experience any strange sensations in your mouth, it is recommended that you make an appointment with your dentist immediately. He will conduct an initial examination and draw up an individual treatment program. However, in some cases it is possible not to resort to aggressive measures of influence and limit oneself to supportive manipulations.

So, what needs to be done to prevent the development of diseases?

Do not ignore the symptoms that appear - go to the doctor immediately.
Do not let the disease worsen, follow all dental recommendations and prescriptions.
Get professional examinations every six months.
Maintain hygiene at home, use only high-quality products.
Don’t forget about professional hygiene - ultrasonic cleaning should be done once every six months to a year.

In addition, it is important to adhere to the principles of proper nutrition and give up bad habits.

Other dental diseases: list of dental diseases with photos

Next, we propose to analyze ailments that may appear as a result of teething or age-related changes.

Grinding

A pathology in which there is a rapid decrease in hard tissue. Provokes thinning of enamel and damage to dentin. It can affect both individual units and full-fledged rows.

Erosion

A process in which a violation of enamel integrity is recorded. Some areas are damaged symmetrically. Main signs: changes in pigment, various cosmetic defects, painful reaction to cold or spicy food.

Pathological resorption

Loss of root tissue caused by chronic diseases, advanced periodontal disease or progressive pulp disease. It can be one-sided or combined. In the absence of rehabilitation and therapeutic therapy, tooth loss occurs.

Deposits and build-ups

They are mineralized residues that form above or below the gums. The main material for formation is food particles, the results of the activity of pathogenic microorganisms, as well as components of saliva. They trigger processes that provoke periodontitis.