Methods and means of individual oral hygiene. Methods of hygienic care of the oral cavity. Standard method of dental hygiene. Preventive value of oral care. Why does a cold occur

About 300 types of microbes live in the human oral cavity, the activity of which leads to the development of numerous diseases. Proper dental care can reduce the risk of caries by 50%. Cleansing the mouth of food debris after eating, removing tartar prevents loosening of teeth and inflammation of the gums. Following the recommendations of experts and the use of properly selected hygiene products will ensure the health of the oral cavity.

The need for oral hygiene

The importance of hygiene cannot be underestimated - the health of the oral cavity and the body as a whole depends on it. Experts believe that proper dental care is the best way to prevent dental problems and gastrointestinal diseases.

Individual hygiene consists in removing plaque and food particles, cleaning the interdental area and gingival sulcus. The effectiveness of hygiene measures depends on the tools and methods used. The procedure for brushing your teeth should be performed in the same way:

• start from the same place in the dentition;
• get used to a certain sequence;
• withstand the duration of treatment of each part of the oral cavity.

Hygiene practices include several oral cleaning techniques. Most commonly used:

1. Leonardo method. Cleansing with a brush is carried out by movements from the gums up to the crown of the tooth.
2. Phones method. The teeth are compressed, the brush head is at right angles to them. Cleaning the front surface is performed in a circular motion. After opening the mouth, the remaining surfaces are processed in a spiral.

Hygiene procedures should not be limited to home oral care. If soft deposits and thick plaque on the tongue can be removed on their own, then tartar removal is possible only in the dental office.

A hygienist should be visited at least once a year. Tissue health monitoring should be carried out regularly.

Personal hygiene products

Main

To care for the oral cavity, there are a number of tools that every person needs to prevent diseases and maintain tissue health. The main items of oral hygiene include regular or electric toothbrushes and therapeutic toothpastes. The choice of instruments depends on the existing oral problems and the specific tasks they have to perform.

Toothbrush

A toothbrush is the main tool that serves to cleanse the mouth and massage the gums (we recommend reading:). With the help of it, mechanical removal of microparticles of food and plaque is carried out, as well as therapeutic and prophylactic preparations are applied. Toothbrushes are made with small, medium and large heads.

Scientific studies show that it is better to choose a compact oral hygiene product - it is easier to guide, reaching every corner of the dentition. S. B. Ulitovsky highlights toothbrushes for adults, adolescents and children. Adults are recommended brushes with a head length of 2.3–3 cm and a width of up to 1 cm, for children - 1.8–2.5 and 0.8 cm, respectively.

There are several bristle profiles: multilevel, flat, convex, concave. Brushes with different levels of bristles are considered the most effective, as they thoroughly remove accumulated plaque.

Toothbrushes are made using natural and artificial bristles. Natural material is inferior in quality to synthetic, since such instruments are difficult to keep clean, and the presence of a median canal in the hairs leads to the accumulation of microorganisms in them.

Synthetic bristles are made with rounded tips - this avoids injury to the mucosa. The fibers do not have pores, so that pathogenic microorganisms that can cause diseases of the oral cavity do not accumulate in the brush.

Toothbrushes are available with soft, hard bristles and bristles of medium hardness. The latter are considered universal. Hard bristle brushes can be bought by adults with completely healthy gums and teeth. Products with soft fibers are used by patients with mucosal diseases, and are also recommended for children.

Toothpaste (classification according to S. B. Ulitovsky)

S. B. Ulitovsky offers a modern classification of oral hygiene products. Taking into account their action, the doctor of medical sciences identifies 5 generations of toothpastes. The classification was created on the principle of their change over time, since since the invention of pastes, not only the quantity and quality of ingredients have changed, but also their properties and production capabilities. The classification of pastes according to S. B. Ulitovsky is presented in the table.

Additional

Additional care products are not mandatory, their role is to improve the cleaning of teeth and mucous membranes. Some products, such as irrigators or flosses, are required for use by those patients who have implants or dentures. The use of additional oral hygiene products will allow you to maintain tissue health longer.

Toothpick

One of the additional care items is a toothpick - this is the simplest tool for removing food particles from the spaces between the teeth and gum pockets. There are wooden, plastic, rubber toothpicks with a round or pointed end.

Before using the product, the mouth must be rinsed with water, and after cleansing - with a special rinse. Removal of plaque and food debris should be done carefully, since the sharp end of a toothpick can easily injure the delicate mucous membrane.

Floss (dental floss)

Flosses are oral hygiene items that make it possible to remove deposits from the side surface of the teeth. Floss is a thread made of silk or synthetics, packed in a miniature holder box. The floss can consist of one or more fibers, impregnated with fluoride, menthol, etc. This personal hygiene product easily enters the gaps between the teeth where the bristles of the brush do not reach.

Floss is an additional care product that is desirable to use at least twice a day (morning and evening). Having brought the floss between the teeth, you need to press it against the surface of the unit and draw it up and down several times. According to the recommendations for use, it is advisable not to bring the floss to the gums, as it can be cut.

Interdental brush

Interdental brushes are used to remove accumulated plaque from areas that cannot be reached with a thread. For people who do not have any artificial structures in the oral cavity, this type of personal hygiene product is not needed. It is used only by patients who wear crowns, braces to correct the bite and prostheses. It is impossible to clean such products with a regular brush or thread. On sale there are interdental brushes in the form of a cone or cylinder of different lengths and sizes.

Scraper

A scraper is needed to remove plaque from the tongue (we recommend reading:). Microparticles of food get stuck in the papillae, bacteria multiply, which becomes a source of an unpleasant odor. Many toothbrushes have a rubberized ribbed surface on the back of the head that can be used to treat the tongue and cheeks. However, scraper manufacturers claim that their product guarantees better cleaning (due to the tight contact of the tool with the surface of the tongue) (we recommend reading:).

It is desirable to use this personal hygiene product for all people, but there are also special indications for use:

• persistent bad breath;
• systematic smoking;
• diseases of the gastrointestinal tract.

Irrigator

Irrigators are special devices for dental care that supply a jet of water under pressure. The nozzle allows you to direct the flow to a specific area of ​​​​the dentition, removing soft plaque and food particles. When purchasing a tool, you need to pay attention to its characteristics. Today, there are stationary and portable irrigators for individual or family use of mono-jet, pulse type and microbubble technology.

The compact device is of great importance for daily care - it removes plaque more effectively than brushes or flosses. In the device, you can fill not only water, but also a salt solution or a decoction based on raw materials of plant origin.

rinse aid

The importance of rinses cannot be underestimated - they enhance the effect of brushing your teeth using toothpaste, brush and floss. Liquid oral hygiene products are conditionally divided into hygienic and medicinal. The former perform only a deodorizing function, the latter are divided into two types:

• liquids that have an antibacterial effect and reduce the deposition of plaque;
• rinses containing fluorine and other components that mineralize teeth.

Recently, consumers are choosing solutions that are designed to fight certain pathologies or prevent them. Popular liquids:

Rinsing requires 10 ml of solution. Some liquids, according to the manufacturer's recommendations, must be diluted with water. The rinse time is 1 minute.

Denture Care

Dentures allow you to restore the dentition, but have a significant disadvantage - they violate the natural cleansing of the mouth and make it difficult to carry out hygiene procedures. When wearing artificial teeth, the importance of cleaning the oral cavity increases. For quality care:

When wearing prostheses for the prevention of inflammation of the mucous membrane and caries, the use of an irrigator is mandatory. Only a powerful jet of water can remove soft deposits and food that accumulate under removable or non-removable structures. Removable dentures should preferably be lowered into a disinfectant solution once every 2-3 months. Alcohol-free liquid care products should be applied after each meal.

MEANS OF HYGIENE AND PREVENTION OF CARIES

Oral hygiene is one of the important sections of human personal hygiene and the main preventive measure that should be carried out in all people without exception, regardless of the level of dental morbidity and the state of the oral cavity. Oral hygiene is valuable in that it simultaneously contains all the mechanisms of prevention, since the main goal of hygiene is the chemical-mechanical removal of plaque - the main etiological factor in dental caries and periodontal disease.
Oral hygiene products are a kind of multicomponent system, which includes a variety of natural and synthetic substances intended for both preventive and therapeutic effects on the oral cavity as a whole. The use of individual oral hygiene products is necessary both in the morning and in the evening. In our clinic, various hygiene products are presented and available for sale. Our specialists will individually select personal oral hygiene products for you. Let's consider each tool in more detail:
TOOTHBRUSHES
A wide selection of modern hygiene products allows you to choose the best option for each individual case. Even the most elementary hygiene product, like a toothbrush, today is represented by such a huge selection of models that it amazes any imagination and thus makes it difficult to choose.
Toothbrushes are generally divided into major categories based on the softness of the bristles.

Ultra-hard bristles;
Stiff bristles;
Medium bristles;
Soft bristles;
Super soft bristles.

As a rule, toothbrushes with hard and ultra-hard bristles are in demand by individuals whose teeth have large deposits of tartar. These are mainly people with bad habits, such as smoking, abuse of black coffee and strong tea.
Brushes with medium bristles are the most common option, suitable for people with healthy teeth and normal gums.
Brushes with soft and super soft bristles are designed for use by people with bleeding and gum disease, as well as after surgical procedures in the oral cavity.
Among other things, they all differ in the shape of the bristles, the number of rows of bristles, and the purpose.
For example, for wearers of removable dentures, special brushes with hard bristles have been developed. For patients with orthodontic structures, most often their representatives are children wearing a bracket system, there are brushes with mono-beam nozzles that are designed to clean the gaps between the elements of the structure and the surface of the teeth, as well as the spaces between the teeth.
The size of the brushes are also divided for a reason. A toothbrush with a large head is difficult to fit in the mouth, which interferes with optimal and correct brushing movements. The brush with medium and small head easily penetrates hard-to-reach places, for example, behind the buccal surface of wisdom teeth.
Different types and forms of bristle trimming are the development of specialists in order to improve the quality of dental hygiene, by means of power protrusions on the bristles, thanks to which it is easy to clean both the visible and non-visible surfaces of the teeth.
Getting the right toothbrush is half the battle. It is also important to know how to properly brush your teeth and how to store your brush.
Teeth should be brushed twice a day: in the morning after breakfast and in the evening before bed. Our specialists will tell and teach you about the methods of proper brushing your teeth at the reception.
The toothbrush needs to be changed on average every three months, as pathogenic microflora accumulates on its bristles, besides, the brush is erased and does not clean plaque well.
It is advisable to change the brush after suffering a sore throat, flu, stomatitis and other diseases of the oral mucosa and nasopharynx. If this is not possible, then the brush must be washed well and treated with an antiseptic.
There is an opinion that a brush made of natural bristles is more useful. This is not true!!! Natural fibers are significantly porous, thus they accumulate more bacteria on themselves, besides, natural bristles are quite soft and do not provide high-quality cleaning of the teeth.
In addition to conventional (manual) toothbrushes, there are electric and sonic toothbrushes. This is a pretty good choice, especially for people who smoke, but they need to be used in the same way as regular one. Purchasing such brushes does not exempt you from full cleaning according to the same rules as when using conventional (manual) brushes. The main advantage of such toothbrushes is additional vibration for more effective removal of plaque and dental plaque.
A toothbrush is a means of personal hygiene, in no case should you lend your brush to others in order to avoid infection not only with infectious diseases. But also caries, since it has long been proven that the contact route of caries transmission takes place. Store your toothbrush separately. Under the cap, of course, it is convenient, but not hygienic. The bristles must be completely dry, as the extra moisture is the perfect breeding ground for bacteria. After cleaning, the brush must be thoroughly rinsed with water and/or an antiseptic solution.

MOUTH RINSES
Dental elixirs (rinses) are intended for rinsing the oral cavity and are additional means of oral hygiene, they are not substitutes for pastes. They improve the cleaning of the surface of the teeth, prevent the formation of plaque, deodorize the oral cavity. Mouth rinses can be produced as ready-to-use solutions, or as liquid concentrates or dry matter, requiring dilution in certain proportions. They can also be alcoholic or non-alcoholic. Alcohol-free rinses are suitable for children from the age when the child acquires the skills of rinsing the mouth. According to their properties and composition, rinses are divided in the same way as toothpastes. It is necessary to use the rinse twice a day, after brushing your teeth, strictly following the manufacturer's instructions. Evening use of the rinse is very important, as the film of active ingredients created by it remains on the teeth and works all night while you sleep. It has long been known that at night all the recovery processes in the body proceed faster and more actively, therefore, the use of maintenance therapy for teeth is also important at night.
ORAL FOAM
According to most dentists, brushing your teeth in the morning and in the evening is not enough - after each meal, you must definitely clean your mouth, because plaque forms. Every time after eating, pieces of food remain on the teeth. They form the dental plaque. Under the plaque and inside it, like in a sponge, microbes live that destroy teeth. Specialists have introduced a new development - a foam that allows you to constantly maintain the oral cavity in good condition. Foam is an additional means of hygiene. The foam is based on the enzyme papain. It dissolves plaque. The foam should be applied to the teeth, hold in the mouth for 20-30 seconds, and then spit. Foam is intended for people of any age, suitable for people with dentures and orthodontic appliances. Like pasta, foams are divided into adults and children, and differ in their composition. The use of foams is very convenient outside the home, for example, on the road, at work or at school, when after eating there is no way to brush your teeth with a brush and paste. It must be remembered that the foam does not replace the usual morning and evening classic brushing, but the use of foam instead of mouthwash is possible.
DENTAL FLOWS (FLOSSES)
Flosses are designed to thoroughly remove plaque and food debris from hard-to-brush contact surfaces of teeth. Floss is made from a special synthetic fiber. Floss can be waxed or unwaxed, round or flat, with or without impregnation. Unwaxed floss is thinner and easier to move with closely spaced teeth, however, with crowded teeth, a lot of tartar or overhanging edges of fillings, it is better to use waxed floss. Some dental flosses are impregnated with active ingredients that provide anti-inflammatory, anti-carious, etc. Impregnation allows you to further strengthen the tooth enamel and prevent inflammation of the oral mucosa.
Flat flosses penetrate dense interdental spaces more easily, but for failed fillings and orthopedic constructions, flosses of a round weave are better suited.
In addition, there are superflosses - threads with one-sided thickening. This thread has a stiff tip and a combination of unwaxed fragments and a wider nylon fiber. It allows you to clean the contact surfaces of the teeth, and also contributes to a more thorough removal of food debris and plaque from orthopedic and orthodontic structures in the oral cavity.
How to use floss: a thread 35-40 cm long is wound around the first phalanx of the middle fingers of both hands. Then, a tense floss is carefully inserted (using the index fingers on the lower jaw and the thumbs on the upper jaw) along the contact surface of the tooth, being careful not to injure the periodontal papilla. With a few movements of the thread, all soft deposits are removed. Consistently clean the contact surfaces on all sides of each tooth. If used incorrectly, you can injure the gums, so the use of threads is advisable after prior training with the dentist. Children can floss on their own from the age of 10. Before this age, it is recommended for parents to clean the contact surfaces of the teeth in children.
INTERDENTAL FRUSHES
Special interdental brushes are designed for cleaning interdental spaces, cervical areas of teeth, spaces under bridges and fixed orthodontic structures.
Usually they are small in size, the working part may consist of a single bundle of fibers trimmed in the form of a cone, or several bundles placed in one row. The dentist will help you to choose the correct diameter of the brush, since with an incorrectly selected diameter, there is a high risk of damage to the periodontal papilla, or not cleaning the interdental space, which leads to an inflammatory process.
TONGUE BRUSHES
Brushing your teeth should be completed by cleaning the back of the tongue, as the tongue is a kind of reservoir for bacteria. The papillae on the back of the tongue create a large and uneven surface, which contributes to the accumulation of microorganisms and food residues.
The different sizes of these papillae create depressions and elevations, so the tongue is an ideal place for bacteria to grow. The remains of food that accumulate in the recesses between the papillae are used by bacteria for their life activity in other parts of the oral cavity.
Removing bacteria and food debris can slow down the rate at which plaque builds up, which can help reduce tooth decay and bad breath. Tongue brushes are made of metal or plastic. Their action is based on the mechanical removal of food debris and accumulation of bacteria from the back of the tongue. Such a brush is visited on the back of the tongue as close as possible to its root and moved forward, slightly pressing on the tongue. The use of this brush is especially indicated for plaque on the tongue, in the presence of deep "furrows" on the surface of the tongue, for smokers.
TOOTHPICKS
Toothpicks are an additional means of oral hygiene and are designed to remove food debris from the interdental spaces and dental plaque from the side surfaces of the teeth.
Toothpicks are made of wood or plastic, their shape can be triangular, flat and round, sometimes toothpicks are flavored with menthol.
When using a toothpick, it is placed at an angle of 45 ° to the tooth, while its end is in the gingival groove, and the side is pressed against the surface of the tooth. Then the tip of the toothpick is advanced along the tooth, following from the base of the groove to the contact point of the teeth. If the toothpick is used incorrectly, an injury to the interdental papilla and a change in its contour are possible, which, in turn, leads to the formation of a space, a gap between the teeth.
ORAL IRRIGator
The irrigator is an additional means of oral hygiene. There are stationary irrigators - they are connected to a household power supply, as well as portable (road) irrigators - they work from a built-in power source. The irrigator allows you to better carry out the standard procedure for cleaning your teeth and gums. It is a device through the nozzle of which an aimed stream of liquid is supplied, which must first be poured into the tank (except for devices connected to the water supply). In this case, the jet can be sprayed, centered, pulsating or constant. The centered jet washes away food debris, and also partially removes soft plaque from the surface of the teeth, tongue, and gums. The shower mode massages the mucosa, tongue, gums, thereby normalizing blood circulation.
The irrigator can be used both for the treatment and prevention of diseases of the oral cavity. The choice of irrigation fluid depends on your goals. Ordinary water is not suitable, as it does not eliminate the pathogenic microflora of the oral cavity. Therefore, solutions that have a preventive or therapeutic effect are increasingly being used. To find the most suitable one for you, contact your dentist. The use of an irrigator allows you to reduce the number of forced visits to the dentist (you still have to come for preventive examinations), increase the service life of implants, crowns, and fillings. Since a toothbrush is not able to thoroughly clean all the gaps, hard-to-reach places, a directed jet of water or a solution easily copes with this task. There are no absolute contraindications to the use of the device. But, its improper use can lead to unpleasant consequences. Special care is required for people with cardiovascular diseases or with an acute stage of periodontitis. As for the frequency of using the device, as a rule, 2-3 times a week is enough to achieve the optimal result. But when using an irrigator as an additional tool in the treatment of periodontal diseases, the oral irrigator will need to be used more often. But, no matter what problem you are trying to solve with this device, you should definitely consult a dentist. It will help you choose the appropriate treatment mode, as well as the optimal type of solution, water supply mode, jet type, and more.
THERAPEUTIC AND PREVENTIVE SPRAYS
Often people face the problem of bad breath (halitosis). The appearance of which is associated with various factors, the leading of which are the substances (products) of the vital activity of bacteria living in the oral cavity. As long as the number of bacteria is normal, the smell is practically absent, but as soon as the microorganisms begin to multiply uncontrollably, the smell becomes strong and unpleasant. Often bad breath is caused by smoking or poor oral hygiene. Also, bad breath can be the result of a certain diet and type of diet. Bad breath often leads to numerous psychological problems and creates barriers to normal communication between people, so dentists have developed a mouth spray, which should become a mandatory attribute for people suffering from this problem. The main components of the sprays are essential in combination with menthol, which actively eliminate the unpleasant odor after smoking, eating and drinking coffee and the unpleasant odor caused by other causes. The social well-being of people who regularly use oral spray is largely associated with a strong confidence in the cleanliness and freshness of their own breath. An open wide smile allows you to communicate even the most incredulous interlocutor. Conversely, halitosis can be so repulsive that people around them remember only the disgusting smell and forget all the undeniable virtues of their interlocutor. Many manufacturers add additional components to sprays, aimed not only at eliminating odor, but also at preventing and treating diseases of the oral mucosa. Using sprays is easy and simple, but it must be remembered that bad breath, in some cases, can be a sign of diseases of the gastrointestinal tract or a serious disease of the oral mucosa. If the problem of bad breath bothers you, then consult a dentist and gastroenterologist.
ORAL CONCENTRATES
In a diverse range of personal hygiene products, a special place is given to oral concentrates, which are most often in the form of pastes and gels. Concentrates, or as they are also called - Active pastes or gels, should be used only after consultation with the attending dentist, since such agents are mainly used as therapeutic agents. There are Active pastes aimed at the treatment of gum disease. This type of paste can be used as a hygienic toothpaste, as well as a paste for mucosal applications (but only strictly according to indications). There are also concentrated gels for the treatment of increased sensitivity of the teeth. These gels must be used in addition to the usual paste, or instead of it, as well as the application on the teeth to achieve the maximum effect. It must be remembered that more often concentrates are used according to a scheme that includes mandatory breaks for 3-4 weeks after active use for 2-3 weeks. This is due to the body's addiction to the substances included in the composition and, as a result, a decrease in the effectiveness of treatment. Before you start using Active (concentrated) pastes, gels and other products, you must PLEASE READ THE INSTRUCTIONS. Improper use can aggravate the disease of the oral mucosa and lead to irreversible consequences. Do not self-medicate, our specialists will help you understand the variety of products and select an individual product for oral hygiene.
PLAQUE INDICATORS
Plaque forms very quickly - it is enough not to brush your teeth for 12 hours so that it appears in sufficient quantities. Therefore, it is not surprising that a plaque indicator is an important and necessary product among oral hygiene products. It helps to determine where cleaning is needed in the oral cavity and how intensive it should be. If the plaque has been formed for a long time, it can be seen with the naked eye. This is a yellowish or whitish coating on the teeth, which is helped by various pastes, folk remedies, as well as cleaning at the dentist. But first you need to determine if you have plaque, and if so, where it is located. Plaque indicators come in the form of tablets or solutions that color hidden plaque a bright color, helping you locate the plaque. This product is actively used in children to improve oral hygiene, as well as to teach brushing teeth. The plaque indicator is biocompatible and safe to use, ideal for children. It will be a great help in learning how to properly brush your teeth. By cleaning off the coloring matter that has settled on the plaque, children understand the importance of daily thorough brushing.
Individual oral hygiene is the thorough and regular removal of dental deposits from the surface of the teeth, gums and tongue using various means. The health of your teeth is in your hands! Remember to brush your teeth at least in the morning after breakfast and in the evening before bed. The specialists of our clinic will help you choose personal hygiene products for the oral cavity. In the Dental Center "Club 32" a wide range of personal hygiene products is on sale.

As shown by numerous clinical and experimental studies of various authors, the condition of the teeth and periodontium is directly dependent on the hygienic condition of the oral cavity. Among the population, and a number of specialists, there is still an opinion that the issues of oral hygiene are known to everyone and do not need special explanations. However, observations show that it is important not only to explain, but also to instill hygiene habits in patients and monitor their progress. It is necessary to achieve daily absolute removal of any plaque from the teeth. All the efforts of the doctor will be unsuccessful if the patient undergoes regular treatment and does not follow the doctor's advice on oral hygiene at home. The doctor must teach the patient to clean not only easily accessible places, but also all nooks and crannies, the processing of which requires certain skills and training.
Maintaining a good hygienic condition ensures the basic physiological processes in the oral cavity: chewing, digestion, self-cleaning, mineralization. Therefore, educating the public about the rules and methods of oral care is an important task for all healthcare professionals.
Individual oral hygiene
Toothbrushes. The toothbrush is the main tool for removing deposits from the surface of the teeth and gums. There are many types of toothbrushes.
The toothbrush consists of a handle, a neck and a head (working part), on which bundles of bristles are fixed in rows. For many years, natural bristles were used for toothbrushes, but recently artificial bristles have been favored. Artificial fiber toothbrushes have a number of advantages: artificial bristles do not have channels filled with microorganisms; surface of setae smooth, non-porous; the end of the fiber is rounded; hardness adjustment is possible.
For effective brushing of teeth, the size of the working part (head) of the brush is important. For adults, the most acceptable brush head is 22-28 mm long and 8-11 mm wide, for children 20 and 8 mm, respectively.
The brush head should provide optimal access to the molars and be compact, smooth, with rounded corners. The neck should be thin, rounded and at a slight angle to the handle. The handle should be well held and not cause fatigue when moving.
The tips of the bristles should be rounded, as otherwise their sharp, jagged edges can injure the gums. The organization of the bristles also plays an important role in the removal of plaque, the most suitable being a linear organization.
The frequency and shape of the bush planting are also important in the design of the brush. The most convenient is the frequency of planting beams 2.0-2.5 mm apart from each other with their parallel rows (no more than 4 rows) and a flat bristle surface.
Brushes with complex contours of the brush field are commercially available (this is generated by the artistic intentions of the manufacturers). Special clinical observations have shown that such brushes can be traumatic, since during brushing the entire load falls on a small number of bristles protruding from the tuft.
The most effective brushes with soft and medium hardness. The bristles of these brushes are more flexible, clean the gingival sulcus and better penetrate into the interdental spaces, injuring the gums less.
Loss of bristles, their deformation indicate the need to replace the toothbrush, usually after 3-4 months.
The toothbrush gets dirty easily, so it must be kept absolutely clean. After brushing your teeth, the brush should be rinsed under running water and thoroughly cleaned of food debris, toothpaste and plaque. Store it in such a way that it can dry well, for example, in a glass with the head up. This significantly reduces the number of microorganisms in the brush, and the bristles retain their hardness and shape.
However, even careful observance of the rules of oral hygiene using only a toothbrush does not allow to achieve good cleaning of the plaque from the lateral surfaces of the teeth and interdental spaces. As a result, in addition to a toothbrush, it is necessary to use other means: dental floss (floss), toothpicks, special toothbrushes (with one bundle), interdental stimulators, oral irrigators.
Dental floss (floss). The purpose of using dental floss is to remove plaque from hard-to-reach approximal surfaces, as well as food debris that gets stuck between the teeth. Apply waxed and unwaxed threads, round, flat, fluffy. Regardless of the type of thread, when used correctly, the cleaning efficiency is the same. However, the flat and waxed floss passes through the contact points more easily, does not break, and covers a large surface of the tooth. Flossing should be part of your daily oral care routine. It is convenient to do this before brushing your teeth.

The method of using dental floss (Fig. 39):

Flossing should end with a thorough rinsing of the mouth with water. Never make sudden movements between the teeth, as

gum can be damaged. If the floss is difficult to pass between the teeth, then use careful sawing movements. If there is difficulty in moving the floss between the teeth, then it is better to contact a dentist who will find out and eliminate the cause.
When using dental floss, slight soreness and bleeding of the gums are possible at first. But with regular use of the method, these phenomena disappear.
Toothpicks. Another complementary and well-established oral hygiene tool is the toothpick. Like dental floss, toothpicks remove food debris from the interdental spaces and plaque from the sides of the teeth. The use of toothpicks is more effective if there are gaps between the teeth. If the teeth are densely packed and the interdental space is filled with the gingival papilla, then the possibilities of using toothpicks are limited by the gingival sulcus. In these cases, the toothpick is placed at approximately a 45° angle to the tooth, with the tip in the sulcus and the side pressed against the surface of the tooth. Then the tip of the toothpick is moved along the tooth, following from the base of the groove to the contact point of the teeth, trying not to injure the gingival papilla. This procedure is repeated on the lateral surface of the adjacent tooth.
Toothpicks are made of soft wood or plastic and can be triangular, flat or round in shape.
Special toothbrushes. Apply with atypical structure of the dentition, the presence of non-removable bridges, splints. The working part of such brushes consists of one bundle of bristles, usually trimmed in the shape of a cone. In addition, there are brushes that resemble dishwashing brushes. Such brushes are well cleaned wide interdental spaces, as well as spaces under bridges.
Interdental stimulators and oral irrigators. Interdental stimulators are rubber or plastic cones that are found at the ends of the handles of some toothbrushes. Preference should be given to rubber tips. Interdental stimulators serve mainly to massage the gums. With light pressure on the gingival papilla, circular movements are made in the interdental space.
Irrigators are used after brushing your teeth. A pulsating or constant jet of water has an additional cleansing and massaging effect.
Dental floss, toothpicks and other products do not replace a toothbrush, they can be used in addition to brushing your teeth.
Toothpaste. These are currently the most common hygiene products. They must have good cleansing properties, be harmless to the surrounding tissues, have a pleasant taste, low abrasiveness and improved deodorizing properties, and have a therapeutic and prophylactic effect.
Both domestic and foreign industry produces a wide range of toothpastes.
The main components of toothpaste are abrasive, gelling and foaming substances, as well as dyes, fragrances and substances that improve its taste. Abrasives provide the cleaning and polishing effect of the pastes.
The consistency of the pastes is due to the presence of hydrocolloids, most often the sodium salt of alginic acid.
Polyhydric alcohols - glycerin, polyethylene glycol - are introduced into toothpastes to obtain a plastic mass that is easily squeezed out of the tube. These alcohols contribute to the preservation of moisture in the paste during its storage, increase the freezing point, increase the stability of the foam formed during cleaning, and improve the taste of the paste.
Toothpastes also contain foaming agents, in particular surfactants. Depending on their type and quantity, toothpastes can be foaming and non-foaming. Foaming pastes are more effective, as they have an increased cleaning ability, easily wash out food debris, and remove plaque well.
Toothpastes, depending on their composition, can be divided into hygienic and treatment-and-prophylactic. Hygienic pastes have only a cleansing and refreshing effect. Representatives of therapeutic and prophylactic pastes are fluoride-containing toothpastes.
Fluoride toothpastes became widely used in the late 1960s and are recognized in many countries as the most important tool for maintaining dental health. Currently, 95% of toothpastes produced abroad are fluoride-containing. They are considered by many scientists to be the most cost-effective and effective fluoride preparations for personal use, which mainly help to reduce the prevalence of caries in the world. The concentration of fluorine in them is 0.1-0.15%. An indispensable requirement for fluoride-containing toothpastes is a certain content of the active fluoride ion in them. Fluoride, present in the oral cavity, inhibits the metabolism of sugars by bacteria, which leads to a decrease in the formation of acids and the growth of plaque. It has a bactericidal effect on cariogenic bacteria. Being present in enamel, saliva and dental plaque, fluorine contributes to the “recovery” of early carious lesions, accelerating remineralization.
Fluoride toothpastes are recommended for adults and children of all ages. But you don't have to wait for immediate relief from cavities with fluoride toothpastes, you should use them for life.
These pastes do not have any side effects on the human body, and there are no contraindications to their use. Pastes can be used in parallel with the use of fluoridated water or fluoride tablets, and can also be combined with topical use of fluoride compounds. This achieves a total anti-caries effect.
Toothpaste has a certain shelf life - about a year. Then she becomes dangerous in a chemical? com and bacteriological respect.
Before you buy a paste, you should make sure that it is fluorine-containing, hermetically sealed and has not expired. Almost all imported pastes contain fluorine.
Teeth brushing technique. Oral hygiene using a toothbrush and toothpaste is part of general human hygiene. Good oral hygiene can only be maintained by carefully following the rules of brushing your teeth. In doing so, it is necessary to be guided by three main provisions:

1. hygienic care of the oral cavity should be carried out regularly, with the number of brush movements necessary to clean all surfaces and the expenditure of a certain time;
2. without proper teaching of patients to brush their teeth, it is impossible to ensure the necessary level of oral hygiene;
3. the state of oral hygiene and compliance with the rules of brushing teeth should be monitored by medical personnel, which allows you to consolidate hygiene skills and ensure its high level.

acceptable than other methods. The use of this method, along with the correct choice of toothbrushes, allows the most complete removal of plaque.
Cleaning method. Squeeze 0.5 cm of toothpaste onto a wet toothbrush. The bristles of the brush are placed at an angle of 45 ° to the gum (they seem to enter the gingival groove, Fig. 40).

With light scraping movements, move the brush horizontally (back and forth) by half the width of the tooth (short movements). As a result, plaque moves from the area of ​​accumulation at the edge of the gum to the neck of the tooth and into the interdental spaces (buccal and lingual embrasures). Several longer sweeping strokes are then used to remove plaque from the gum line and between the teeth towards the incisal and chewing surfaces. In conclusion, the chewing surfaces are thoroughly cleaned in the longitudinal and transverse directions with short scraping movements, allowing the bristles to enter the recesses of the chewing surface (Fig. 41).
It is necessary to gently, without much pressure, clean the outer, inner and chewing surfaces of each tooth, concentrating on 1 or 2 teeth at a time.

Rice. 42. The sequence of cleaning surfaces, aubav on the upper (a) and lower (b) jaws.

Surface cleaning procedures. Brushing teeth should start from the inner surface of the molars of one side of the upper jaw and, gradually moving forward, brush the inner surface of all teeth. Then they move to the outside (with closed teeth) and clean again to * lars, from where they started processing; they finish the stitch with the processing of chewing surfaces. The same sequence processes the teeth of the jaw (Fig. 42).

7754 0

Individual oral hygiene is the careful and regular removal by the patient of dental deposits from the surfaces of the teeth and gums using various means.

Oral hygiene is a major component in the prevention of dental diseases. Systematic brushing of teeth, removal of soft dental deposits contribute to the physiological process of maturation of tooth enamel.

The biologically active components that make up the hygiene products enrich the tissues of the tooth and periodontium with phosphates, calcium, trace elements, vitamins, increasing their resistance to harmful effects. Regular massage of the gums when brushing your teeth helps to activate metabolic processes, improve blood circulation in periodontal tissues.

Personal oral hygiene products:
■ toothbrushes;
■ toothpastes;
■ dental floss (floss);
■ toothpicks;
■ tongue brushes;
■ chewing gums;
■ chewable tablets;
■ mouth rinses.

Toothbrushes

Since ancient times, the peoples of Asia, Africa, South America chewed the leaves and branches of aromatic plants, and with the split ends of these branches they cleaned the surfaces of their teeth and gums. In India, to this day, some nationalities use branches of the neem tree for this purpose. The first toothbrush resembling modern ones, made of pig bristles, appeared in China in the 14th century. In Russia, during the reign of Ivan the Terrible, after a meal, they used a “pig broom” or a broom-stick with a bundle of bristles.

Currently, there are many models of toothbrushes, the purpose of which is to remove plaque from the smooth, occlusal and proximal surfaces of the teeth.

A modern toothbrush consists of:
■ handles;
■ heads.

In some toothbrushes, for greater mobility of the head, the connection between it and the handle is made flexible. Toothbrushes are:
■ dimensions;
■ fiber properties;
■ the shape of the head and the arrangement of the bundles;
■ rigidity;
■ handle design.

The size

This has more to do with head size. Whereas in the past large head brushes were predominantly used, scientific evidence now favors small head brushes that are easy to manipulate in the mouth and clean hard-to-reach tooth surfaces. To date, such brushes are recommended for use by both adults and children.

The size of the head in a children's brush should be 18-25 mm, in an adult brush - no more than 30 mm.

Fiber properties

At the same time, brushes made from natural bristles are still on sale. This material, of course, is inferior to synthetic fibers in quality.

Its disadvantages are the presence of a median canal filled with microorganisms, the difficulty of keeping the brush clean, the impossibility of perfectly smooth processing of the ends of the bristles, and the difficulty of imparting a certain rigidity to it.

Synthetic fiber bristles were originally made with sharp ends, but later it turned out that they could injure soft tissues. If the bristles have a sharp end section, are filamentous, or are hollow, then bacteria and viruses can multiply on their surface and in depth. For this reason, nowadays the ends of the bristles are made rounded.

Head shape

A brush with a concave shape of the working part of the head is better for cleaning the vestibular surfaces of the teeth, while with a convex one - the lingual ones.

Brushes, where the bristles are located at different levels, are more effective than flat brushes in removing plaque, especially from the proximal surfaces of the teeth.

Arrangement of fiber bundles

As a rule, bundles of setae have different heights: longer (softer) along the periphery, shorter ones in the center.

Each group of beams contributes to a more thorough removal of plaque in a particular area of ​​the dentition. Straight high fibers clean plaque in the interdental spaces; short - in fissures. Fiber bundles located in an oblique direction, penetrating into the periodontal sulcus, remove plaque from the cervical region.

Toothbrushes with a V-shaped fit of the fiber bundles are recommended for cleaning plaque from the contact surfaces of the teeth in individuals with wide interdental spaces.

Some toothbrush models have a power ridge for better cleaning of molars, especially the distal surfaces of the last molars, and deep penetration into the interdental spaces.

Often toothbrushes have an indicator - two rows of fiber bundles dyed with multi-colored food coloring, which discolor with use. The signal to replace the brush is the discoloration of the bristles by half of its height. This usually occurs after 2-3 months with daily brushing twice a day.

Rigidity

There are several degrees of hardness of toothbrushes:
■ very hard;
■ rigid;
■ medium;
■ soft;
■ very soft.

Recommendations to patients on the use of a toothbrush of varying degrees of hardness are purely individual. The most widely used brushes are of medium hardness. Typically, children's toothbrushes are made from very soft or soft fiber. Toothbrushes of the same degree of hardness are recommended for patients with periodontal disease. Rigid and very hard toothbrushes can only be recommended for people with healthy periodontal tissues, however, with the wrong brushing method, they can injure the gums and cause abrasion of hard tooth tissues.

It should be noted that brushes of medium hardness and soft are the most effective, because. their bristles are more flexible and better penetrate the interdental spaces, fissures of the teeth and subgingival areas.

Handle design

There are toothbrushes in which the initial color of the handle changes when brushing the teeth (within 2-3 minutes). It is advisable to recommend this model of a toothbrush to children, which makes it possible to teach a child to brush their teeth properly. The same property is possessed by toothbrushes, in which a rattle is mounted in the handle. With correct (vertical) movements of the brush, a sound is made, and with horizontal (incorrect) movements, the toothbrush is “silent”.

Toothbrushes produced by well-known companies meet modern requirements and take into account the achievements of science and technology. The result is an original design toothbrush.

In 1998, a new model of the toothbrush, Oral-B eXceed, was developed, which uses a microtextured fiber that cleans plaque with the entire surface of the bristle. In the head of this brush, the beams have different heights and are located in two directions, at different angles to the base. The forward-angled tufts penetrate between the teeth and loosen plaque, while the backward-angled tufts remove plaque with a sweeping motion.

Crossed bundles of bristles allow you to remove plaque not only from smooth, but also from the proximal surfaces of the teeth, as well as from the adjacent gums.

The Colgate Total Toothbrush has three groups of bristles: short inner bristles remove plaque from the surface of the teeth, long inner bristles from between the teeth, and long, angled outer bristles remove plaque from the gingival sulcus and massage the gum.

A distinctive feature of Intradent toothbrushes is the bristles impregnated with sodium fluoride.

In Fuchs toothbrushes, the bristles have several microvilli on the sides and are rounded at the ends. In these brushes, the bristles are attached without the use of metal or drilling holes, which avoids gaps where bacteria can accumulate. Thanks to this system of interchangeable heads, the duration of use of the brushes is increased.

In addition to conventional toothbrushes, electric toothbrushes are now becoming more and more popular. Previously, electric toothbrushes were recommended only for people with disabilities or people who had insufficient skills in brushing their teeth. However, studies conducted to date have convincingly proven the benefit of electric toothbrushes in removing plaque.

For children, special children's models have been developed.

G.M. Barer, E.V. Zoryan

Learning elements

Purpose of the lesson: Learn and master oral care techniques.

Basic terms: oral hygiene, methods of brushing teeth, tongue, standard method of brushing teeth.

Test questions:

5) Control of the initial level of knowledge

6) Interview on the topic

a) oral hygiene algorithm.

b) brushing methods

c) use of floss, floss, floss, tape

d) using a toothpick

e) using an irrigator

f) mistakes made in oral care

3) Control of the assimilation of knowledge

Presentation of educational material

Oral hygiene is a set of measures, the most important component of which is brushing your teeth. According to WHO, 92% of the population do not know how to brush their teeth. Oral hygiene in most Russian children is limited to a set of empirical manipulations using a standard toothbrush and paste.

Teeth brushing algorithm

1) Wash your hands with soap.

2) Rinse your mouth with warm water.

3) Rinse your toothbrush thoroughly with water.

4) Clean your teeth with a toothbrush and toothpaste

5) Rinse your mouth.

6) Soap the working part of the toothbrush with soap or treat with a special solution.

7) Put the toothbrush in the box with the head up

There are options depending on the age of the child, the type of toothpaste, the condition of the oral cavity, the preferences of the individual, etc.

Using a toothbrush

Movements of the toothbrush when brushing your teeth:

· Vertical (sweeping) are performed along the axis of the tooth from the gums and are designed to remove plaque from the vestibular and lingual surfaces, partially cervical area and interdental spaces, gums.

· Horizontal (reciprocating) designed to remove plaque from occlusal surfaces.

· Rotational (circular) designed to remove plaque from fissures and pits, the cervical area and massage the gums.

Performing successively the stages of the standard method of brushing teeth, guided by the correct location of the brush in relation to different surfaces of the teeth, the correct choice of the type of movements and the required number of movements on the surfaces of various groups of teeth.

There are many methods of brushing teeth (Leonard, Bass, Fones, Reite, Charter, Smith-Bell, Stillman, Pakhomov, Bokoy).

Standard Teeth Brushing Method (Pakhomov G.N.). The dentition is conditionally divided into 6 segments (molars, premolars, incisors with fangs). Cleaning is carried out with open dentition. The brush is placed at an angle of 45 degrees to the axis of the tooth and with the help of 10 vertical sweeping movements plaque is removed from the vestibular surface of the upper left molars. Alternately, all segments of the upper jaw are cleaned. The palatal surface is cleaned similarly. On the lower jaw, the sequence and types of movements are repeated. The chewing surface of the teeth is cleaned using reciprocating movements.

Leonard Method provides two types of movements: vertical and horizontal. The head is set perpendicular to the axis of the tooth, and with vertical movements from the gums, plaque is removed from the vestibular and oral surfaces. The occlusal surface is cleaned by reciprocating horizontal movements.

Phones method carried out with closed dentition. The toothbrush is placed perpendicular to the axis of the tooth and performed in a circular motion, while simultaneously cleaning the vestibular surfaces of the teeth of the upper and lower jaws. Lingual and chewing surfaces are also cleaned in a circular motion.

Charter Method Designed for both cleaning teeth and gum massage. It is an additional therapeutic measure for inflammatory periodontal diseases. The toothbrush is set at an angle of 45° to the axis of the tooth with bristles towards the cutting edge of the tooth. With gentle circular motions, the bristles penetrate the interdental spaces. After three or four movements, the toothbrush is moved to a new group of teeth and the whole process is repeated. This method is recommended for school-age children with certain manual skills. Cleaning is carried out under the supervision of a dentist.

Self-controlled brushing method (Bokaya V.G.). Before cleaning, stain the tooth years. The vestibular and oral surfaces are cleaned with vertical movements with a maximum grip on the gums. The vestibular surfaces are cleaned with closed jaws in a direct bite with the capture of the gums to the transitional folds. The patient controls the quality of cleaning by the presence of dye every five movements. The maximum capture of the gums provides a thorough removal of plaque and its massage, and the mucosa acts as a dispenser of the force of cleaning movements.

A large number of methods of brushing teeth indicates the urgency of the problem. It is hard to imagine the existence of a simple and effective method of brushing teeth that is universal for everyone. It is impossible to use a single method for adults and children, with a healthy oral cavity and its pathology, in the absence or presence of "orthodontic" problems. However, compliance with certain generally accepted basic principles will optimize the process of removing plaque.

It should be noted that the clinical effectiveness of toothbrushes is to a lesser extent due to their design features. More important factors are thorough oral hygiene instruction and proper brushing technique.

To evaluate the effectiveness of individual oral hygiene and

to motivate the patient to improve the quality of brushing teeth, controlled brushing of teeth (CCH) is carried out by an individual under the control of a hygienic index in the presence of a specialist.

Controlled brushing of teeth is an integral part of a set of measures for hygienic education and upbringing (GO&V) of a child. Dental hygienists are currently engaged in the formation of knowledge and skills in oral hygiene among the population. However, if necessary, a dentist can participate in the process. CCHZ is carried out in several visits.

CCH Methodology

On the first visit a complete dental examination of the patient is carried out, the data are recorded in the medical record. In the presence of an intraoral camera, the patient is shown the identified dental "problems", including the existing microbial plaque. To enhance the effect, plaque can be stained. The video presentation is accompanied by detailed explanations. The hygiene index is determined if no more than 5 hours have passed since the moment of brushing your teeth.

On the second visit the child brings the used items and oral hygiene products. The specialist evaluates the condition of the toothbrush, floss, characteristics of the toothpaste and their compliance with the condition of the patient's oral cavity. The child in the presence of parents (if possible without their participation in the conversation) talks about individual oral hygiene. After that, the teeth are cleaned with the definition of GI before and after the manipulation. The hygienist is located nearby as an observer and fixes all the shortcomings, but does not interfere in the process. The effectiveness of brushing teeth is estimated by the difference in GI scores. When indicated, the selection of adequate items and means of oral hygiene, training in the rules of oral care is carried out.

On the third visit the child comes with a new toothbrush (floss, floss, scraper) and toothpaste (rinse, spray). CRC is being carried out, corrections are being made. In the future, the frequency of visits is determined by the hygienist individually.

Individual cleaning quality control teeth is performed by the patient or parents. For this purpose, special dyes are used: a solution of basic fuchsin, erythrosine, Schiller-Pisarev, Lugol, erythrosine containing tablets. Tablet preparations at home are preferable, as they are more hygienic and stain the entire plaque. CCHZ is best done in the evening if parents have free time.

Using floss

Flossing is a procedure for cleaning interdental spaces and contact surfaces of teeth using floss. The thread is used after each meal, usually 2-3 times a day.

Flossing technique:

Wash the hands;

Cut floss 20–30 cm long;

Fix the ends of the floss on the middle fingers, wrapping it around one much larger fragment;

Using the index and thumb fingers, the floss is gently inserted into the interdental space;

Covering the neck of the tooth in the form of a half-loop, with sawing and vertical movements, carefully advance the thread from the gum;

Update the working part of the thread by moving the loops on the fingers;

At the end of the procedure, dispose of the floss;

Wash the hands.

The use of floss or floss is much more convenient, easier, and contributes to the development of the habit of flossing.

Using a toothpick

Toothpicks are used in the absence of other oral hygiene items. Method of application: place the toothpick at an angle of 45 degrees to the tooth, while the end should be in the periodontal sulcus, and the side should be pressed against the surface of the tooth. Then the tip of the toothpick is advanced along the tooth, following from the base of the groove to the contact point of the tooth.

Using an irrigator

Irrigators are used as an additional hygiene item for cleaning hard-to-reach areas of the oral cavity and gum massage. After traditional toothbrushing with a brush and paste, a powerful jet of water is directed into the interdental spaces, under the fixed elements of orthodontic equipment. The segment clearing sequence is similar to the standard method. The use of IPR in children contributes to the development of oral care habits, as it is an element of the game for them.

tongue cleaning

Hygiene of the tongue involves the removal of plaque, mucus, food debris with a regular toothbrush, a special toothbrush, a nozzle for cleaning the tongue of an electric toothbrush, a scraper. Particular attention should be paid to the hygiene of the tongue in the presence of diseases of the gastrointestinal tract, folded or "geographical" tongue. In these cases, a large amount of mucus and plaque accumulates on the tongue, which creates favorable conditions for the reproduction and vital activity of pathogenic microorganisms.

Hygiene of the tongue is carried out after brushing the teeth. The brush of medium hardness moves with sweeping movements from the root of the tongue to the tip. The number of movements is variable, on average 10–12. After several movements, the brush must be rinsed under running water to remove mucus. The brush is moistened with water or toothpaste. However, the use of foaming paste is not advisable, since a gag reflex may occur.

The use of a scraper is similar to the above method. Use the scraper carefully to avoid injury to the tongue.

To clean your entire mouth, the Colgate 360° Tongue Pads are specially designed to remove up to 36% more bacteria that cause bad breath.