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- 1. Interdental Aids Seminar-2 Dr.Leena Parmar MDS 1st yr Department of Periodontics
- 2. INDEX Interdental Area Planning of Interdental Care Various Interdental Aids Dental floss and tape Knitting Yarn Gauze strip Interdental tips Toothpick in Holder Wooden interdental cleaner
- 3. Interdental Area In health interdental gingiva fills the interproximal area Three types of gingival embrasure I. Type I II. Type II III. Type III
- 4. Classificaton of Gingival Embrassures TYPES OF EMBRASSURES CONDITION OF GINGIVA IN EMBRASSURE RECOMMENDED CLEANING AIDS I II III IV V Embrassures are completely occupied by healthy interdental papilla About 75% of embrassure is occupied by the gingiva About 50% of the embrassure is occupied by gingiva About 25% of the embrassure is occupied by gingiva Complete los of Superfine and thin dental floss, used only for cleaning Sulcus Medium or coarse and thick dental Floss Thin fine pointed small spiral interdental Brushes Thick spiral interdental Brushes and fine bristle ended unitufted b Brush Bristle ended unitufted
- 5. Anatomy of Interdental Area Posterior teeth- -two papilla(one facial and one palatal) -connected by col anterior teeth- -single pyramidal papilla Epithelium of col is thin and non keratinized
- 6. Inflammation, edema, Deepening of col Biofilm formation in interdental area and inaccessibility for tooth brush Initiation of gingival diseases
- 7. Planning of Interdental Care History of personal oral care Dental and gingival anatomy assessment-teeth position, embrassure, probing depth Extent and Location of Dental Biofilm Personal Factors- handicap or disability,knowledge of interdental oral care
- 8. Various Interdental Aids Dental floss and tape Knitting Yarn Gauze strip Interdental tips Toothpick in Holder Wooden interdental cleaner
- 9. Image
- 10. Dental Floss Most widely recommended interdental aid Material- silk, nylon, expanded PTFE(plastic Monofilament polytetrafluoroethylene) Types a) twisted/nontwisted b) Bonded/nonbonded c) Waxed/nonwaxed d) Thick/thin
- 11. Features of waxed or Expanded PTFE Smooth floss surface which prevents trauma to soft tissue Slides through contact area easily Monofilament resist breakage or shredding Wax gives strength and durability
- 12. Features of unwaxed floss Thinner floss-used in tight contacts Pressure against tooth surface spreads nylon on wider surface for biofilm removal Sharper edges require special attention
- 13. Enhancements Color and flavors have been added Therapeutic agents like fluoride and whitening agents have also been added Power flossing devices are available-moves in short circular motion when device is switched on
- 14. Method
- 15. Video
- 16. Tufted dental floss Regular dental floss alternated with thickened tufted portion Two variables Single,precut lengths Superfloss 2 foot length ,5 inch tufted portion adjacent to 3 inch stiffened end. Roll or NuFloss- Tufted portion (1 inch long ) alternated with plain floss about one and a half inch long.
- 17. Indications adjacent to wider embrassures with loss of interdental papilla. Mesial & distal abutments and under pontics of FPD or orthodontic appliances.
- 18. Knitting Yarn Indications 1. Tooth surface adjacent to wide proximal spaces 2. For mesial & distal abutment of FDP and under pontics
- 19. Gauze Strip Indications 1. Proximal surface of widely spaced teeth 2. Surfaces of teeth next to edentulous area 3. Distal & mesial surface of abutment teeth. 4. Under posterior cantileverd section of fixed appliance
- 20. Interdental Brushes Types : 1. Small Insert brushes with reusable handle 2. Brushes with wire handles
- 21. Indications Proximal tooth surfaces adjacent to open embrassures , orthodontic appliances , Fixed Prosthesis, Periodontal splints Concave proximal surfaces Exposed class IV furcation For application of chemotherapeutic agents Fluroide dentifrices, antibacterial agents, desensitizing agents.
- 22. Single-Tuft brush (End-Tuft , Unituft) Single tuft or group of small tufts , 3- mm in diameter, flat or tapered with staright or contra-angled handle.
- 23. Indication for use 1. For open interproximal areas 2. For dental prosthesis 3. Difficult to reach area Lingual surface of mandibular molars.,Abutment teeth , distal surface of posterior most teeth Procedure 1. Direct the end of tuft into the interproximal area along the gingival margin. 2. Combine a rotating motion with intermittent pressure
- 24. Interdental tip Conical or pyramidal flexible rubber tip attached to handle.
- 25. Indications 1. For cleaning debries from interdental areas 2. Biofilm removal at and just below gingival margin. Procedure 1. Trace along the gingival margin with the tip position just beneath the margin (1-2 mm ) 2. Rub the tip against the teeth as it is moved in & out of an embrassure and under a contact area. Position with gingival form.
- 26. Tooth pick in holder Round tooth pick inserted into a plastic handle with contr-angled ends. Also known as Perio-Aids
- 27. Indications Patients with periodontitis Orthodontic patients.
- 28. Procedure Insert the round tapered tooth pick into the end of the holder, twist the tooth pick firmly into place and break off the long & cleanly to prevent sharp edges. Apply tooth pick at the gingival margin at right angle application with moderate pressure, trace the gingival margin. To remove biofilm just below the gingival margin apply the end at less than 45 degrees. Maintain the tip on the tooth surface following the sulcus.
- 29. Wooden Interdental cleaner 2 inch long device made of Bass wood or Birch wood. Used for wider gingival embrassures.
- 30. Procedure First teach the patient to use a rest by placing the hand on cheek/chin/ or by placing a finger on the gingiva , convenient to the place where tip will be applied. Soften the pointed end of wood in mouth & moistening with saliva. Hold the base of the triangle towards the gingival border of interdental area & insert horizontally. Clean the tooth surface by moving the wedge in & out while applying the burnishing stroke with moderate pressure , 1st on one side of the embrassure & then on other. Four strokes each
- 31. Dental water flosser
- 32. Irrigation-Irrigation helps to reduce the levels of biofilm and debris from around crowns, bridges, orthodontic appliances and implants, and in interdental areas. There are a variety of devices on the market. Usually power driven and handheld, these deliver a pulsating jet of water (or prescribed solution) from a reservoir to the required area . The pressure at which the solution is delivered can be altered by the patient. A selection of tips are often available,depending on manufacturer,for targeted delivery of the solution.
- 33. Method of use-The manufacturers instructions should be followed, The tip should be directed towards the interdental area and held at 90 to the long axis of the tooth. Patients should start with a low pressure setting until they are used to the device. The temperature of the liquid should be comfortable to them A sink or basin should be nearby, so water or solution can be drained away Tissues/towels should be nearby
- 34. conclusion only tooth brushing does not remove the interdental biofilm Patient should be educated and motivated about the interdental cleaning Interdental aids should be selected as per the anatomy of gingival embrassures.
- 35. References Clinical periodontology-Carranza,9th edition Essentials Of Community Dentistry-Soben Peter,3rd edition Clinical practice of the dental hygienist-Esther M Wilkins,3rd &10th edition Interdental oral hygiene aids and their application-Leanna Wynne, Dental Nursing March 2012 Vol 8 No 3
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