Preventitive Procedures: Selective Polishing, Tooth Brushing and Flossing Techniques

Rubber Cup Polishing

The first thing that everyone should know is, polishing is a selective procedure. Not every patient needs to have their teeth polished or every single tooth in the mouth only the teeth with a stain.

The purpose of polishing are too remove extrinsic (stains on the outside of the tooth) stains that cannot be removed but brushing or scaling.

RCP is also used for polishing amalgam (form of filling), which makes the filling more resistant to tarnishing and corrosion. It prepares the teeth for cavity preventing agents like sealants. Also used before cementation of orthodontic bands, crowns, and bridges. Lastly, for polishing of the root surfaces that have been exposed during periodontal surgery to reduce endotoxins and bacteria on the cementum.

The Effects of Rubber Cup Polishing

A RCP and cause a person to have a bacteremia which means there is an introduction of bacteria that is localized in the mouth, and then goes into your blood stream. This happens when plaque is not under control and then the RCP brush irritates the gum tissue causing it to bleed and then the plaque gets into the blood stream. This can also clog your arteries so floss and brush your teeth daily!!!

Another effect RCP has is that it produces aerosols. The biological contaminant of aerosols stay suspended for long periods, increasing disease transmission to the dental team and patients.

Another very important effect of RCP is that it removes 2mm of your tooth enamel. Which is why dental assistants want to selectively polish the teeth. It is also important to have the fluoride treatment after the polish because it puts that enamel back(we'll talk about this later)! Newly erupted teeth should not be polished because the tooth enamel isn't fully mineralized.

It can also cause teeth to have a rougher surface if a very abrasive polishing paste was used to get off a tough stain. A rougher surface is a perfect place for bacteria to colonize and ferment the carbohydrates to make the acid that gives you a cavity.

Note: Stains and deposits removed by polishing will return promptly if plaque control is not carried out faithfully (brushing and flossing).

Self Care With Tooth Brushing and Flossing

Have you ever wondered if a product your using REALLY works? Well if it has the Canadian Dental Association (CDA) seal of recognition, then it has been tested and proven to work. I'm not saying that products that do not have this seal don't work, but if you want to be 100% sure, look for this seal.

Purposes of Dental Flossing

With the effective use of dental floss it accomplishes the removal of dental plaque and debris that adhere to the teeth, restorations, orthodontic appliances, fixed prostheses, pontics and around implants from the gingiva (gums) in the interproximal (contacts areas in between the teeth) area and the sulcus (the area when the gums attach to the tooth. Also the place were plaque and food debris are harboured. Very important to clean) space. Flossing also aids in identifying the presence of subgingival (below the gum line) calculus (plaque turned into a hard deposit). It also reduces gingival bleeding. A lot of people might be surprised by this, but the reason your gums bleed when you floss is because your not flossing enough! The bleeding means that your gums are irritated by the plaque and food build up.



Types of Dental Floss

Note: Clinical studies have shown no difference in the effectiveness of unwaxed or waxed floss.

-unwaxed: thinnest floss available, awesome for tight contact teeth, easier removal of plaque, frays very easily.
-waxed: slides threw contact areas without fraying easily, better for people with moderate to heavy calculus.
-expanded plastic monofilament fluorothylene (OMG!) a.k.a PTFE:
-variable diameter (super floss): equally effective as waxed or unwaxed, has 3 segments of floss 1) a length of waxed or unwaxed floss, 2) a shorter segment of nylon mesh work, 3) a nylon needle portion.
- braided: intended for cleaning dental implant posts,can be washed after use and is reused after drying.

Methods of Flossing

There are two main methods of flossing: the spool method, and the loop method.

Spool Method:
Step 1: Get a piece of floss that is as long as your forearm
Step 2: The bulk of the floss is lightly wound around one of your middle fingers
Step 3: The rest of the floss is similarly wound around the middle finger of your opposite hand.This finger can wind or take up the floss as it becomes soiled or frayed to permit access to the unused portion
Step 4: The last three fingers are clenched pulling the floss tightly and leaving the index finger and thumb of each hand grasping a length of one inch between the hands
Step 5: The floss is then guided through the contact area with two index fingers and thumbs depending on the ares being treated.
Step 6: Make sure you are making a "C" shape with the floss and moving up and down 5-6 times to completely clean the tooth

Loop Method:
Step 1: Get a piece of floss as long as your forearm
Step 2: The ends of the floss are tied together securely to form a loop
Step 3: All fingers except the thumbs are placed within the loop so that the finger or thumb tips are used to place floss between the teeth will be 1 inch apart
Step 4: Make sure you are making a "C" shape with the floss and moving up and down 5-6 times to completely clean the tooth

 This is the "C" shape you want to make



Interdental Aids

If you have recession flossing becomes less effective, so you may need to use some interdental aids to clean in between your teeth and hopefully restore your gums to their healthy state.

Types of interdental aids:
Sulca brushes, end-tuff brush: when using this brush place it right where the gum in connected tot he tooth and gently move in small circles

Rubber Tip Stimulator (awesome name I know): trace along the gingival margin with the tip positioned just below the margin

Tongue cleaner: Sweep the brush foreword and repeat 6-8 times in each area. But be gentle and do not vigorously scrape the tongue.

Quality's to Look For in a Acceptable Tooth Brush

Handle is easy to grip, and does not slip. No sharp corners or projections, and light weight

You want the size of the bristle head to fit the size of your mouth.

The bristle length should be half an inch average

Only soft or extra soft bristle should be used, anything harder then that can damage the ginigva

Bristle should be rounded and polished

So basically get a soft, nylon, multi-tufted toothbrush with rounded bristles.

Note: The average life span for a tooth brush is 3 months

The easiest and quickest brushing technique is the Fones method.

Step 1: With the teeth closed, place the brush inside the cheek with he brush tips lightly contacting the gingiva over your last tooth's gum surface with very little pressure

Step 2: Use a fast and wide circular motion which sweeps from your upper teeth to the lower teeth (including your gums) with a very light pressure.

Step 3: Bring your front teeth end to end contact and make those same light pressure strokes

Step 4: On the tongue side of your teeth use a side to side method, and same with the bite surfaces of your teeth.

Well that's it for my first blog!! I know it was incredibly long, hopefully not boring, but that's everything that my test on Thursday consists of haha so why not. I hope it really helped everyone to have a better understanding of brushing properly.