Dental plaque removal

Mechanical removal of plaque is the most effective measure against plaque-caused diseases, dental caries, and periodontal diseases. Even before the advent of fluoride treatments, it was assumed that a clean tooth does not decay. A toothbmsh is effective in removing dental plaque and, for those individuals who optimize its use, it usually can adequately control plaque. Despite the proven efficacy of mechanical plaque removal, the amount of patient involvement is such that only about 30% of the population in developed countries and considerably less in undeveloped countries can be expected to adequately remove plaque (1). Hence, supplementary measures such as dentifrices and dental rinses are necessary. 

Abrasive. Dentifrices have the unique ability to remove extrinsic tooth stains, which are caused by agents such as berries, tea, smoking, antibiotics, and certain bacteria as they attach to the dental pellicle. These stains can be removed only by abrasive cleaning a toothbmsh alone is not adequately effective. It has been shown that only 4% of a test population were able to maintain thein teeth in an acceptably stain-free state without an abrasive and that 18% of the population were "heavy" stainers (2). However, colored materials found in dental plaque are removable without abrasives. 

The most common method of eliminating gingivitis is by the mechanical removal of the microorganisms found in dental plaque via toothbrush and floss. However, effective mechanical removal of plaque is a tedious, time-consuming process that is affected by an individual s gingival architecture, tooth position, dexterity, and motivation. Consequently, incomplete removal... 

A 70-year-old man had multiple coin-sized exudative eczematous plaques on his legs and trunk for several months (20). Various kinds of corticosteroid ointments and white petrolatum as an emollient gave him little relief. Patch tests showed that he reacted to 1 % ammoniated mercuric chloride in petrolatum and 0.05% mercuric chloride in water. He had all his dental amalgam removed, and 1 month later his eruption had subsided, leaving pigmentation. 

One of the most important problems of cell adhesion is dental plaque, which is formed when bacteria such as streptococcus mutans and streptococcus sanguis adhere to tooth surfaces, causing decay (caries) and gum disease (gingivitis). Dental plaque can be removed by brushing or prevented by chemical additives, such as chlorhexidine, which kill the bacteria. Study of dental plaque is normally done on hydroxy apatite which is the main component of dental enamel. 

Most tooth problems are directly related to dental plaque. This is a whitish substance that collects on teeth and gums, which is removed by brushing. About 70% of plaque is made up of millions of bacteria, which lodge in a mass of insoluble carbohydrate. Plaque starts with a deposit of salivary mucus on the teeth containing aerobic bacteria that need oxygen to develop. With time, anaerobic bacteria appear they are the principal cause of problems related to plaque. 

To help clean teeth by removing dental plaque... 

More sophisticated dental tools are used by dentists during dental examinations and procedures. A routine dental cleaning removes stains on the teeth, as well as tartar that brushing and flossing cannot remove. Polishing the teeth aids the dentist in visualizing the teeth and makes it more difficult for plaque to accumulate on the surfece of the teeth. Mirrors, scrapers, scalers, and probes are essential in-office dental tools. 

Dynamic interactions between the saliva, diet and oral bacteria lead to the accumulation of material on the tooth surface. This is known as dental plaque which can be defined as the deposit which forms on the tooth in its natural environment and, unlike food debris, cannot be removed by a water spray. It is composed of localized concentrations of bacteria specific to this surface together with some degraded mammalian cells. These are surrounded by a matrix containing both protein and polysaccharide and the whole is bathed in a fluid derived from the saliva. On this basis, plaque can be said to have the characteristics of a simple tissue. 

Calcium ions are fixed into the biofilm by the attraction of carboxy-late functional groups on the polysaccharides. In fact, divalent cations, such as calcium and magnesium, are integral in the formation of gels in some extracellular polysaccharides. A familiar biofilm-induced mineral deposit is the calcium phosphate scale that the dental hygienist removes from teeth. When biofilms grow on tooth surfaces, they are referred to as plaques. If these plaques are not continually removed, they will accumulate calcium salts, mainly calcium phosphate, and form tartar (scale). 

The fact that chlorhexidine, used as a mouthwash, discoloured the teeth, fillings and tongue, and could produce soreness of the mouth, was recorded in SED VIII. The substance has come more to the fore as a result of its promotion in the form of a gel for the removal of dental plaque as a meaits of treating chronic gingivitis. 

The most important form of protection against caries involves avoiding sweet substances (foods containing saccharose, glucose, and fructose). Small children in particular should not have very sweet drinks freely available to them. Regular removal of plaque by cleaning the teeth and hardening of the dental enamel by fluoridization are also important. Fluoride has a protective effect because fluoroapatite (see A) is particularly resistant to acids. 

Disclosing agents are dyes similar to those in food colorings that, when introduced into the oral cavity, color the supragingival plaque and make it easily visible. Various dyes are available in both liquid and tablet form. They are used in the dental office and at home both to increase the patient s awareness of plaque and to demonstrate where self-care has been ineffective in removing plaque. 

Most of the microorganisms are bound and/or mechanically removed via discharge of mucus from the upper respiratory tract, or via the urine, saliva, and tears, or by entrapment and elimination in the intestinal contents before they have the opportunity to multiply. Some adhere to inert bodily structures. For example. Streptococcus mutans attaches to the enamel surface of the teeth (tartar, plaque) in order to elicit dental caries [13],... 

Dental Took. Many common dental tools are available for home use as part of a daily oral care routine. The most basic of dental tools is the toothbrush. Toothbrushes come in a variety of sizes, shapes, and stiffness. Patient age and oral condition determine the best toothbrush for each individual. Toothbrushes usually consist of a plastic handle with nylon brisdes that remove food, bacteria, and plaque that can lead to tartar and dental caries. Toothpaste is usually added to a toothbrush to aid in cleaning the teeth and freshening the mouth. Toothpaste is available in a variety of flavors and compositions and may contain polishing or bleaching agents. Dental floss is another basic tool used to remove food and debris from between the teeth. Floss is available in waxed and unwaxed formulations and in a variety of widths and thicknesses. Mouthwash is a rinse that prevents gum disease. Mouthwash is available in many flavors, but all types reduce the number of germs in the mouth that cause gingivitis. 

A dental rinse containing sodium lauryl sulfate, marketed to be used before tooth-brushing, removes some plaque directly and makes residual plaque easier to remove by brushing. 

So-called sealing of these fissures involves minor clinical procedures. First, the plaque and the pellicle are removed using a dental bur, after which the fissure is widened slightly but only within the enamel. To complete the process, some sort of filling material is placed in the newly opened fissure. 

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