Motivation and oral hygiene instructions

1. MOTIVATION AND ORAL HYGIENE
INSTRUCTIONS
By:- nuha fadhil
University of baghdad

2. INTRODUCTION
 The by-product of bacterial plaque
contribute to development of both dental
caries and periodontal diseases .
 At home the mechanical removal of plaque
is a necessary part of preventing these
diseases

3. WHAT IS THE BACTERIAL PLAQUE ?
It is thin film that sticks to teeth containing
saliva and microbes and other substances
.

4. MOTIVATION
 The term "motivation" means conveying to the patient,
through a series of words, and examples, the
importance that self-performed oral hygiene has in the
health of the oral cavity.
 In order to achieve this goal, dentists must possess:
A. - Technical skill
B. - Communication skill
 Dentist may have great technical skill, but will not
succeed in their profession if they are unable to
communicate with their patients in order to motivate
them

5. HOW WE CAN MOTIVATE THE PATIENT ??
1- information :- Aims at increase the compliance of
the patient so the patient will recognizes oral health
as a valuable goal of therapy.
**this can be achieved by following step by step
motivation system which include simple
demonstration :-
A) Symptoms of diseases VS. the healthy site ,
bleeding ,pocket depth ,recession etc…

7. More picture to be shown to he patient ,,explain to
the patient what would happen if the periodontal
diseases left untreated (transition from health to
disease)

8. B) Radiographic bone height,, normal or loss
C) Explain reasons of disease ,, bacterial plaque

9. D) Demonstrate the plaque accumulation by using
disclosing agent .
Ex) erythrocin tablet which converts the color of the
dental plaque into red . And disclosing solution

10. 2- testing the acquirement of knowledge :- by simply
asking the patient to repeat what you already
demonstrate in information step ,, if the patient
seems not understand what you explain then repeat
the information step in simple language.
3- acquiring knowledge will lead to change in
patient’s attitude
4- change in patient behavior is the logical result
which is expected from motivation

11. SUGGESTIONS FOR MOTIVATING PATIENTS
• Extramural
• or
• intramural
Actions that
dentists and
the dental
profession may
take to improve
the milieu in
which the
patient will
motivate
himself can be
considered as
either

12. Extramural procedures
 Because most periodontal patients are adults, and
adults have beliefs that are often difficult to change,
the profession should concentrate on informing patients
when they are childreen.
 Extramurally this could be done by the dental profession
through a more active participation in the health
program at the elementary school level.
 It could be accomplished by supplying attractive
audiovisual materials to the school, by participating in
school functions, and by cultivating and educating the
teachers, who are very powerful opinion makers in the
child's life.

13. Intramural procedures
 Once the patient makes an appointment with the dentist, he
has evidenced a certain amount of need, or the
appointment would never have been made.
 After he arrives, stronger motivation is evidenced.
 Even though the patient has not come to the office for
relief of pain, you may assume that he has come for the
relief of some other anxiety (disquiet of mind).

14.  For a patient to make a dental visit and to undergo
treatment that is oriented toward prevention he must
believe the following:
1. That he is susceptible to periodontal disease
2. That periodontal disease is personally serious
3. That there is something he can do to treat or correct
the condition
4. To a lesser degree that the condition occurred due to
natural causes

15. ORAL HYGIENE INSTRUCTIONS

16.  Oral hygiene includes all the processes for keeping mouth
clean and healthy. Good oral hygiene is necessary for
prevention of dental caries, periodontal diseases, bad breath
and other dental problems.
Importance of good oral hygiene:-
Prevention is always better than cure. Good
oral hygiene habits will keep away most of
the dental problems saving you from
toothaches and costly dental treatments.

17. BY MAINTAINING GOOD ORAL HYGIENE WE
CAN PREVENT :-
Dental caries
gingivitis
periodontitis
halitosis

18. PLAQUE CONTROL
 Plaque control is a regular removal of microbial plaque and
prevention of accommodation on the teeth and adjacent
gingival surfaces microbial plaque is the major etiological
factor of periodontal diseases and is related to the dental
caries gaining patient cooperative in the plaque removal is
critical to long-term success of all periodontal and dental
treatment .
Mechanical plaque control
• Most common use
• Brushing and interdental aids
Chemical plaque control
• It is adjunctive to mechanical means
• Mouth wash , dentifrices and gel
Professional plaque control

19. BASIC STEPS FOR MAINTAINING ORAL
HYGIENE:
Brushing teeth (al least twice
a day or after every meal)
Flossing regularly
Proper diet

20. Other interdental
cleaning
Rinsing
regular dental
check-up

21. 1.BRUSHING:
1-Always use a soft bristled toothbrush
2-Use Fluorided toothpaste
3. Don’t brush too hard because this can cause gingival
(gum) recession.
4. Brush teeth for a minimum of two minutes at least twice a
day.
5.Brush gums and tongue along with your teeth.
6. -Hold toothbrush at a 45-degree angle at the gum line,
brushing in a circular motion. This sweeps plaque out of the
gingival pocket

22. BRUSHING METHODS
 A) sulcular (bass) method :-
 The bristles pointed at a 45 degree angle into the
gingival sulcus , vibrate the brush gently forth and
back about 20 times .this method is useful for
patient with periodontal problems .
 * 45 degree angle to
gingival margin .
 * vibrate .

23. B) rolling method :-
This method useful for stimulation of gingiva .
Place the brush above the free gingiva exerting
slight pressure ,, draw the brush toward the
occlusal surface .

24. C) charter’s method :-
This method is useful for the patient with
severe loss of interdental papilla height , fixed
prosthesis , previous gingival surgery ,subside
ulcerative gingivitis .
*restricted vibration
with the bristles incline
coronary at 45 degree

25. D)modified stillman’s method :-
The brushing technique is similar to the bass
method except you do shorter horizontal
strokes.
*press and vibrate
*roll

26. E) fone’s method:-
Rotary brushing technique
This brushing technique is pretty self-explanatory.
You need to brush your teeth using a rotational
method. But the problem is that it can be very tricky
for your teeth, since you will end up brushing some of
them too much and others none at all.

27. POWERED TOOTH BRUSH
 Powered tooth brush have been shown to improve oral
health of :-
1- children and adolescents .
2- children with physical and mental disabilities .
3- hospitalized patient ,including the older adults who need
to have their teeth to cleaned by caregivers .
4- patient with fixed orthodontic appliance .
The vibration have also been shown to interfere with
bacterial adherence to oral surface

28. 2. PROPER DIET
1. Avoid foods that are high in sugar content.
2.Carbonated drinks are more acidic than non carbonated
drinks; hence more dangerous.
3.Foods like potato crisps tend to stick in the grooves; stay for
an extended period and cause decay.
4.Avoid excessive intake of fruit juices (can be very acidic).
They can be diluted with water.

29. 3.REGULAR FLOSSING
 The dental floss is the most widely recommended tool for
removing the plaque from the proximal tooth surface .floss
is made from nylon filament or plastic mono-filament and
can be waxed or un-waxed ,thin ,even flavored.

30.  METHOD:
 1. Use an arms length (18 inches) of floss. Wrap around
fingers mostly to one side.
 2. Floss each tooth forming a “C” shape with the floss
each time.
 3. A new area of floss should be introduced into each
gingival pocket.
 4.Don’t forget to floss behind your last molar.

31. Dental tape :- similar to the dental
floss but wider
Super floss:- it is used in patient with
crown ,orthodontic appliance and
bridge work ,,it has a stiffed end to
thread between teeth a spongy
portion to brush the teeth and floss
section for conventional flossing

32. 4.OTHER INTERDENTAL AIDS :
1.Single tufted brushes
one large bristle for cleaning spaces
between teeth , to carry medicated gel
into pockets . and work well on lingual
surface of lower molars and premolars
which missed during use toothbrush
2.Interdental brushes: for cleaning
spaces between teeth .for cleaning
pontics ,concave root surface in
periodontal patient who has severe
recession

33. 3.Interdental wood-sticks: soft ,triangular
shaped ‘tooth picks’ made from either wood
or plastic used for interdental cleaning. The
base rest on gingiva and apex in contact
with proximal surface of tooth it’s move in
and out the embrasure to remove plaque ,,
the dis-advantagte it’s not reached to
posterior area and lingual surface.
Water pik: a home dental care device. It
uses a stream of pulsating water to remove
plaque and food debris between teeth as
well as below the gum line. The oral irrigator
improves gingival health.

34. 5.RINSING:
Adjunctive to mechanical methods ,, ex. Chlorhexidine 0.2%
mouth wash .
What we should instruct our patients to use it ???
 Volume used is 10ml
 brush your teeth and then use the mouth-wash after 30
min.
 Rinse your mouth with chlorhexidine for 60 sec.

35.  after you spite it do not eat or drink at least 30 min. to let it
take it action
 Use it twice daily at morning and evening
 It is important to follow manufacturer’s instructions.
 Do not rinse the mouth with water after
 Flouride rinses helps to boost the strength of newly erupted
teeth.
 Daily rinses must be alcohol free (they cause dryness of
oral mucosa)

36. 6.REGULAR DENTAL CHECK-UP:
 Good oral hygiene should be a joined effort
between you and your dentist.
 Your dentist, if visited regularly, will detect and
prevent any problem before it becomes hazardous
for you.
 Regular dental checkups are an essential part of
dental hygiene routine for young and old alike.

37. SIGNS OF GOOD ORAL HYGIENE:
Good oral hygiene results in a mouth that
looks and smells healthy. This
means: Your teeth are clean and free of
debris
 Gums are pink and do not hurt or bleed
when you brush or floss
 Bad breath is not a constant problem.

38. REFERENCES
 1. Carranza’s clinical periodontology - 10th edition
 2. Clinical practice of the dental hygienist - Esther M
Wilkins