To understand the main trends that must be observed during hygienic measures in the oral cavity, consider the following situations: the presence of single crowns (metallic, plastic, metal-ceramic); bridge prostheses; partial and complete removable prostheses.
When it comes to a single, separately standing crown, then practically no difference in carrying out hygienic procedures, in the oral cavity with healthy teeth and gums, there is no single crown, with the exception of some nuances. First, if it is a metal crown, steel or gold, then it should go to the seashest groove by 1 mm. This is the theory.
In practice, we often see quite often, especially in the distal sites, that the contact surfaces of the indigenous teeth are processed not to the end and as a result, the contact side of the crowns hang over the gum or cut into the remaining ledge of the root, which leads to the fact that the crown hangs over the gums. Ideally, such work should be remade, as it is a frank marriage, but it often happens. The fact is that there are such situations, they are also echoing with situations arising against the background of periodontal diseases, when, due to pathological resorption of the alveolar process, the gums and the crown hangs over it from all sides.
In these cases, food, liquids are especially intensively accumulated under an artificial crown, which contributes to a faster destruction of the tooth under it, especially since its solid fabrics are already removed. In these cases, it should be resorted to a particularly intensive purification of intersubolic gaps and spaces under the scoring edges of the crown. If we consider that we use the flosses constantly, then you need to add a superfloss, ultrafposs, satin phosse and enshik.
When using a dental thread introduced by the hanging edge of the crown, it is necessary to make circular movements thread, which contributes to the best elimination of food residues. Just need to be careful not to cut a thread. Much more efficient to use superflos and rams.
In mandatory, after that, you should make a bath with a rinse. Well contribute to the cleansing of unscrewing spaces irrigators in jet mode.
When metal-ceramic crowns, when the bog of the crowns with the tooth droplets goes at the expense of a specially formed step, the transition from an artificial crown to a natural root becomes more smooth, but this does not mean that you can ignore this fact.
On the contrary, any accumulation of plaque on the border of media leads to a more rapid destruction of the fixing material, against the background of a more intensive formation of the dental. Therefore, it is necessary to especially carefully use superfloses, giving it around the root with an artificial crown and do stretching-return movements. Then, at the expense of the loosen part of the thread, all the first-purpose surfaces of both the tooth and the artificial crown are better cleaned.
The following option is the presence of intermediate defects, when a defect with missing teeth is limited to healthy natural teeth at both ends. In these cases, bridges use bridges of non-removable dentures.
The essential difference in conducting IPRs by persons with bridges, non-removable dentures (MNZP), metal, combined, metal-ceramic, having any features in the form of the design of the prosthesis, will not.
In any case, it will consist of the following steps:
Purification of the outer part of the MNZP
- cleansing actual CNR crowns;
- Cleaning the body of a bridge.
Cleansing the inside of the MNZP
- Cleansing internal (hidden) spaces around MNZP crowns and closed with soft tissues of hidden parts of the actual artificial crowns MNZP;
- cleansing the inner surface of the body of a bridge of a bridge, washing space, in order to avoid formation.
Table 1. The main individual means of oral hygiene used in the power of the mouth of bridges of bridges of non-removable dentures and their features of their use (with.B. Ulitsksky)
|Individual means of oral hygiene||Indications and features of application|
|Preventive manual toothbrush||Most effective and advocated in its use, a brush with a multi-level brush field, a power protrusion, a bristle medium stiffness and a degree of wear|
|Medical and prophylactic toothpastes||The most acceptable paste is the paste of the average degree of abrasiveness, which has soft anti-permanent and astringent properties (due to extracts and / or oils and / or plants) and moderate antimicrobial properties (due to fluoride compounds, the action of which is directed exclusively to the pathogenic microflora, but not saprophistic ).|
|Hygienic dental elixirs||You can use, but they are ineffective|
|Medical and prophylactic dental elixirs||You can use their effectiveness somewhat higher than the previous position|
|Hygienic rinsers for mouth||You can use much different from elixirs|
|Medical and prophylactic rinsing||The most optimal option, especially non-alcoholic, containing extracts and / or oils of herbs and / or plants and possessing anticipaths, anti-permercial, antimicrobial, binders, deodorizing effects. Use at the end of the hygienic procedure.|
|They purify intersubolic gaps of teeth without MNZP, as well as interdental intervals or any spaces in teeth covered with artificial crowns, as well as mesial surfaces in front of standing support crowns and distal surfaces behind standing reference crowns.|
|Non-membered hygienic set for individuals with MNZP. Due to the rigid guide, the superfloss is introduced into the washing space, and the loose part is most effectively assembled, and then removed from the inner surface of the MNZP body.|
|Brush-enshik||If the interdental gaps allow, then with its help they are well cleaned, but it is even better to use it to purify the flushing gap.|
|Monopropic, low-tech toothbrushes special purpose||It is used to purify the seed areas.|
|Electric toothbrushes||Provide excellent quality of oral hygiene.|
|Irrigators||Very effective for leaching food residues in Reghem «jet» and the gum massage in mode «soul». Stove - before the start of hygienic procedures; shower - at the end.|
table 2. The main individual means of oral hygiene used in the presence of partial and complete removable dentures in the oral cavity, and the features of their use (with.B. Ulitsksky)
|Individual means of oral hygiene||Indications and features of application|
|Preventive manual toothbrush||In the presence of an incomplete set of teeth in the oral cavity, the number of teeth, requiring individual hygienic care. However, this does not mean that it is possible, as before Ignoring the conduct of individual hygienic events in the oral cavity. The brush must be selected according to the size of the oral cavity and the size of the teeth. Preference is given to the bristle of the average degree of rigidity. In any case, it should have a rounding and polished bristle tips, a multi-level brush field consisting of power protrifications and active recesses, microtectic bristles and the degree of its wear. These are the main parameters to significantly increase the cleansing efficiency of the toothbrush and translating it from the hygienic in the rank of prophylactic.|
|Medical and prophylactic toothpastes||First of all, preference is given «Herbian» Pastas. Fluoride components play the role of antimicrobial substances, and their presence in paste for persons belonging to this contingent does not play a significant value.|
|Medical and prophylactic rinses for mouth||If before a person was not able to properly care for his own oral cavity, at least lose their most of them, it is necessary to make a maximum effort to preserve the remaining teeth. It must be understood that no, even the best dentures, are not able to completely compensate and perform the functions of natural teeth. Therefore, it is necessary to use rinsers with soft anti-permanent, astringent and pronounced deodorizing and moderate antimicrobial properties.|
|Any of them should be used to purify the gaps between the remaining teeth. Their choice is determined by the size of the gap. Satin phossea is much stronger on the gap and so do not get fucked like other dental threads.|
|If the interdental intervals allow, then it is necessary to clean them one of the specified species of the interdental agents.|
|Preventive Electric Toothbrushes with Round Head||You can use them as successfully as manual prophylactic, it is preferable that they have a two-level bristle, display of bristle wear, two types of stiffness of bristles, rounded and polished bristle tips.|
|Monopropic, low-tech toothbrushes special purpose||One of the types of these brushes must be used, since only with their help you can remove the dental flare from the brisk region, especially with the pagan and pagan surfaces of the teeth.|
|Irrigators||When there are not so many natural teeth left, after all, it is necessary to fight for them, and irrigators can be used unlimited number once a day. If after each meal of food to remove the residues of food and make a light massage of the adjacent gum, then the oral cavity will acquire former youth and freshness.|
Recently, there has been a mass of products for partial and complete removable prostheses with antiseptic, deodorizing properties and intended not only for processing prostheses, but also for storage.
Therefore, the oral hygiene of persons with partial removable dentures (CSPP) and complete removable dentures (PSLP) should be considered two: for individuals with the CSPP - this is an individual hygienic care for the remaining teeth and gums, language and mucous membrane of the oral cavity, and Individual hygienic care for the CSPP; For persons with PSLP - this is an individual hygienic care for the mucous membrane of the oral cavity and language, and individual hygienic care for the PSLP.
We disassemble the main trends that exist in the individual oral hygiene. In each case, the dentist-prosthetist, together with a dentist-hygienicist or, in its absence, with a periodontalist, constitutes an individual hygienic program for the care of PR and prostheses and periodically monitors its implementation. Therefore, it is so important to know which of the existing means of individual oral hygiene can be used and should be used.