Sensitive things require Extra Care

Dr. Misri Khan

BDS, MCPS

Department of Operative Dentistry

Khyber College of Dentistry, Peshawar

ORAL HYGIENE

Its importance and its implications on General Body Health.

KNOWLEDGE

Must Know

KNOWLEDGE

WISE TO KNOW

KNOWLEDGE

NICE TO KNOW

ORAL HYGIENE

Its importance and its implications on General Body Health.

HYGIENE

Principles & Practice of General & Personal Cleanliness for the promotion of health and prevention of diseases.

ORAL HYGIENE
(Dental Hygiene)
Principles and Practice of Hygiene as applied to mouth i.e.
.Teeth .Gums .Oral Mucosa It includes all the steps and measures that the patients and the doctor carry out for the prevention of diseases of the oral tissues and maintenance of the optimal oral and dental health.

BAD ORAL HYGIENE

A Danger to your Health
SIGNIFICANCE
1. 2. 3. 4. 5. 6.

Diseases in the Oral Cavity. Affect the Chewing process. Affect the Phonation. Halitosis Bad smell from the mouth. Incidence of Mouth Cancer. Affect the General Body Health.

BASIC KNOWLEDGE

Oro-Dental Tissues
Tooth & Periodontium (Gum). .1 Nerve supply of the Oral Cavity. .2 Blood Vessels associated with the Oral Cavity. .3 Pathway of blood from heart to tooth and back to heart. Venous & Lymphatic drainage of the face. .5 Relationship of the tooth with maxillary sinuses. .6 The spaces distribution around the Oral Cavity. .7 Oral Flora. .8

.4

Tooth Decay Or Caries

DEFINITION
Tooth caries is a breakdown / softening of the tooth tissue-hence form a cavity in the tooth.

AETIOLOGY
It is a bacterial diseasedepends on establishment of caries triad: Host (tooth & surrounding structures). Agent (parasitesPlaque microorganisms) Environment or Medium (Carbohydrate in diet).

CARIES TRIAD
HOST:
Tooth Salivary Factors Muscular Activity Habits Group Susceptibility Age Environment

CARIES TRIAD
Host Tooth:
a. c. Fluorine

Composition-b.

carries Tin

Calcium

1.

3.

Morphology a. Self Cleansable areas. b. Non-Self Cleansable areas. Location and Alignment of Teeth.

CARIES TRIAD
Host
SALIVARY FACTORS:
1.Composition: a. Phosphate 1 carries carries

b. Organic Substance c. pHAlkalinity d. Viscosity e. Flow f. Antibacterial elements g. Antibody elements.

CARIES TRIAD
Host
MUSCULAR ACTIVITY
a. b. c. d.

Tongue Cheek. Lips Muscles of face

HOST HABITS
Poor eating habits desertssnackssweets. Disciplined Oral hygiene. Good eating habitsno snacks between meals.

CARIES TRIAD
Host
GROUP SUSCEPTIBILITY
Male & Female Civilized and primitive, Societies

AGE GROUP
Before age of 20 years. After age of 20 years.

HOST ENVIRONMENT
Phosphate, Content of food and water. Fluoride in water

CARIES TRIAD
AGENTS (PARASITES)
Microorganisms in the plaque---streptococcus mutants. Salivary glycoprotein. Sticky polysaccharide (Dextran).

ENVIRONMENT (MEDIUM)
Modern diet a. Deleted protective factors e.g. Phytates. b. Added Cariogenic factors e.g. Refined Carbohydrates. c. Frequency of meals. Characteristics of Food a. Hard & Fibrous Food. b. Carbohydrates in Food. c. Fluoride, Phosphate and Vitamins in Food. d. Soft and Sticky Food.

Diseases in the Oral Cavity

Tooth decay or caries. Hypersensitivity. Infection in the pulp. Pulpitis. Necrosis of the pulp. Periapical Abscess. Alveolar Abscess. Periapical Granuloma. Periapical Cyst. Osteomylitis. Osteonecrosis. Cellulitis. Maxillary Sinusitis. Ludwigs Angina. Spread of infection into Lateral & Posterior pharyngeal spaces. Spread of infection into Retropharyngeal & Mediastinum spaces

Diseases in the Oral Cavity

2.Gums Diseases.
(Bleeding Gums). Periodontitis (Pocket formation in gums). Loss of tooth supporting tissue (Tooth become shaky). Ultimate loss of tooth. Periodontal abscess Periapical abscess Alveolar abscess Osteomylitis Cellulitis Ludwigs angina spread of infection in the surrounding spaces. Acute Ulcerative Necrotising Gingivitis.
Bleeding

Gingivitis

Gum Bad Smell Severe Pain High fever

Circumcoronitis

(Gum infection around Erupting

Tooth) Pregnancy Epulis

Diseases in the Oral Cavity

3. Salivary Gland Disease. Bacterial infection occur due to retrograde passage of oral bacteria into the gland substance via the Duct. 4. Temporo Mandibular Joint Diseases  TMJ dysfunction Syndrome.  Due to loss of teeth  Malocclusion  TMJ infection from the Teeth & Gum.

BAD ORAL HYGIENE

A Danger to your Health
SIGNIFICANCE 1. 2. 3. 4. 5. 6. Diseases in the Oral Cavity. Affect the Chewing process. Affect the Phonation. Halitosis Bad smell from the mouth. Incidence of Mouth Cancer. Affect the General Body Health.

AFFECT THE CHEWING PROCESS Painful Teeth Painful Gums Shaky Teeth Loss of Teeth Malocclusion TMJ Pain Circumcoronitis Restricted Mouth opening

AFFECT THE PHONATION

Missing Teeth Painful Teeth Shaky Teeth Painful Gums TMJ Pain

HALITOSIS

Tooth Decay or Cavity Gum infection Food lodgment in mouth

Incidence of the Mouth Cancer

Relationship between Bad Oral Habits & Bad Oral Hygiene.

Smoking Tobacco Chewing Pan Chewing Niswar

AFFECT GENERAL BODY HEALTH

Some serious diseases are caused or aggravated:
1. 2. 3. 4. 5. 6. 7. 8. 9. 10. Stomach ulcer & Malignancy Cardiovascular (Heart) ailments:
a. b. Infective Endocarditis Septicemia/Bacteremia

Brain Disorders Lungs Infection Ear & Eye infection Tonsils Infection Allergic Asthma Joint Pains Liver & Gallbladder Infection Kidney Infection

STOMACH
1. Stomach Ulcer (Bad oral hygiene). 2. Stomach Malignancy (continuous irritation from Bad oral hygiene).

BRAIN DISORDERS
1. Through Nervous 2. Through Facial Vein
a. Cerebral Abscess b. Subdural Empyema c. Septic Thrombus Phlebitis of cortical vein and venous Sinuses.

LUNGS ABSCESS

Pleuro Pulmonary infection by Anaerobes

CARDIO VASCULAR AILMENTS

Bacteremia / Septicemia Infective Endocarditis Odonto-Cardiac Pain

Prevention of Oral & Dental Diseases

Dental

Care Program Principles of Prevention

ORAL HYGIENE
Principles and Practice of Hygiene as applied to mouth i.e.
. . . Teeth Gums Oral Mucosa

It includes all the steps and measures that the patients and the doctor carry out for the prevention of diseases of the oral tissues and maintenance of the optimal oral and dental health.

DENTAL CARE PROGRAM

1. Early infancy
a. b. c. d. e.

Care of toothless gums. Care of even single tooth (when appears) Care of milk teeth Bottle feeding. Care of permanent teeth

A young child of 23 years (involve parents) 2. School going children & adults (follow principles of prevention)
1.

PRINCIPLES OF PREVENTION

Prevention of disease. Control of disease. Patient awareness, education & motivation. Development of host resistance. Restoration of the function & rehabilitation. Maintenance of Oral Health.

Different Stages of Prevention

Primary prevention. Secondary prevention. Tertiary prevention. Prevention involve: a. Individuals b. Professionals (Doctors & auxiliaries) c. Community

PRIMARY PREVENTION
Primary preventive services by the Dental professions Plaque control (scaling & polishing). Dental caries activity tests. Simple remedies.
a.professional topical fluoride application. b.Pits & fissures sealants etc.

Diet counseling 2. Training & Demonstrations to patients

1.

PRIMARY PREVENTION
Primary preventive services by the community 1. Community water fluoridation. 2. School water fluoridation. 3. Fluoride supplements programmes.
(Tablets, Losenges, Oral drink, Drops, Salts etc)

1. Fluoride Mouth rinse programmes. 2. School sealants programmes.

PRIMARY PREVENTION

Primary preventive services by the individuals Self examination. Diet planning & control. Oral hygiene practice (home care).

PRIMARY PREVENTION
Home Care Instructions
Plaque disclosing agents (Tincture Iodine, coloring agents). Tooth brushes. Dentifrices (powder, paste, liquid, gel). Tooth brush techniques. Inter-dental hygiene. Special cleaning aids. Electric tooth brushes. Irrigation devices (water, fluoride, saline, M/W). Chemically plaque control (chlorhexidine). Fluoride supplement programme (Tablets, Losenges, Oral Drink, Drops)

PRIMARY PREVENTION
Home Care Instructions
Tooth brushing techniques
a. b. c. d.

Horizontal Reciprocating Vertical sweeping Rotating Vibrating

Inter-dental Hygiene (Tooth pick, inter-dental brushes, Dental floss, Gauze strips, Polishing cloth, Rinsing etc)

PRIMARY PREVENTION
Development of Host Resistance Nutrition and Host resistance.
a. b.

Child Geriatric Local application Systemic use Amount of sweet taking. Frequency of sweet taking Sticky food

1.

Fluoride
a. b.

2.

Sweets & Host resistance

a. b. c.

PRINCIPLES OF PREVENTION
1. 2. 3. 4. 5. 6. Prevention of disease. Control of disease. Patient awareness, education & motivation. Development of host resistance. Restoration of the function & rehabilitation. Maintenance of Oral Health.

SECONDARY PREVENTION
Control of disease
Arrest & treat the disease. b. Control the infection causing factors. c. Prevent the recurrence.
a.

SECONDARY PREVENTION
Patient awareness and communication
Aware the patient about present disease/dangers of bad oral hygiene. b. Aware the patient about causative factors. c. Simple clinical procedures (e.g. simple filling, scaling etc). d. Past history of repeated/progressive diseases.
a.

SECONDARY PREVENTION
Educate & motivate the patient
Change the attitude from repair to prevention. b. Outline steps & measures to prevent oral diseases. c. Give home care instructions
a.

SECONDARY PREVENTION
Demonstration, Assessment & Retraining
Training & Demonstration to patient in clinic. b. Periodic reinforcement to patient.
a.

PRINCIPLES OF PREVENTION
1. 2. 3. 4. 5. 6. Prevention of disease. Control of disease. Patient awareness, education & motivation. Development of host resistance. Restoration of the function & rehabilitation. Maintenance of Oral Health.

TERTIARY PREVENTION
Restoration of Function
1. 2. 3.

Treat the established disease Prevent loss of function Rehabilitation

TERTIARY PREVENTION
Maintenance of Oral Health Goals of maintenance therapy
1. 2. 3. 4. 5. 6. Re-examination & Re-evaluation. Re-motivation & New information to patient. Re-instructions in home care procedures. Plaque removal in clinic. Topical fluoride application in clinic. Simple fillings etc.

It is the END of Presentation

THANKS TO:
Associate Prof. Dr. Qiam Ud Din Assistant Prof. Dr. Shaheed Iabal Mr. Fazal Ullah (Library Assistant) Mr. Syed Hameed Ali Shah (Computer Engineer)