Tips for the oral hygiene: instructions for teeth care, the right choice of funds. The value of the hygiene of the oral cavity in the prevention of diseases of the teeth Theoretical rationale for the oral hygiene, as a method for the prevention method of a number of diseases
At all times, the health of the teeth and the gums indisputably communicated with the oral hygiene, the ancient healers argued that the man is healthy while his teeth are healthy. Considering the high prevalence of caries of teeth, periodontal diseases, it is quite clear to the desire of modern dentists to use all existing methods of prevention to prevent dental diseases and reduce the intensity of their flow. One of the most efficient and at the same time the most simple and accessible prevention measures of these diseases is the right and effective care of the teeth, the oral cavity as a whole using the entire arsenal of modern properties of oral hygiene.
The preventive value of the care of the oral cavity does not cause any doubt, this is convincingly evidenced by the data of a special study of dental status depending on the level of hygiene of the oral cavity. Research on volunteers, clearly demonstrate that people with the exclusion of active hygienic measures in the presence of carbohydrates in a short time arise multiple foci of enamel demineralization completely disappearing with subsequent regular and thorough care of teeth.
The rational care for the oral cavity is the basic method of prophylaxis and may be the character of the etiological, i.e. aimed at eliminating the causes of diseases of the oral cavity (dental depth microorganisms). The presence of fundamental knowledge about the causes and development of diseases is a necessary prerequisite for the development of their primary prevention. The most effective are methods of prevention affecting the cause of diseases.
In this abstract, if possible, data on the theoretical rationale for the hygiene of the oral cavity as a basic method for the prevention of the main dental diseases is presented, modern methods and the hygiene facilities of the oral cavity, recommendations for their use, depending on the dental status and the age of a child, a teenager, an adult.
1. Theoretical rationale for oral hygiene, as a method for preventing a number of diseases
The targeted prevention of caries of teeth and periodontal diseases requires a distinct idea of \u200b\u200bthe reasons that cause these diseases, factors that contribute to their development and mechanisms of their interaction.
Numerous literature data indicate that the dental flare is one of the important etiological and pathogenetic links in the development of caries of teeth. The initial damage to the caries occurs in places where favorable conditions are created for the accumulation of plaque (pits and fissuras, on the approximal surfaces and the pearfishes). For the occurrence of caries of the teeth, a etiological factor is necessary - the cariesogenic microflora of the oral cavity. Without it, under what conditions the caries of the teeth can not arise. In the presence of carieseogenic microflora, the development of caries can occur only if there are certain conditions and factors (pathogenesis links). To do this, the reception of high-fucked carbohydrates should be provided and a dental plaque should be formed. But at the same time, the condition of caries is not necessarily formed. As a result of a constant acid production, the predominance of demineralization processes over remineralization should occur. In this case, the caries can develop with a low level resistance to the enamel of teeth.
According to WHO (1996), more than 80% of the world's population is subject to periodontal diseases leading to the loss of teeth, the appearance of chronic infection in the oral cavity, a decrease in the reactivity of the body, microbial sensitization and other disorders. What are the causes of perodontal diseases? An important role in the emergence of inflammatory diseases of periodontal (gingivitis, periodontitis) also plays a dental flare. Normally in the oral cavity contains many microorganisms, and they do not have a pathogenic action. In addition, there are a number of mechanisms for protection against the possible pathogenic effect of a dental plaque. In which cases, the normal microflora is able to cause pathological changes in periodontal? Obviously, this happens when microorganisms accumulate in very large quantities and ordinary local protective mechanisms are not able to neutralize their toxic and enzymatic effect, or when the activity of local protective forces is insufficient.
It should be remembered that the availability of fundamental knowledge about the causes and development of diseases is a necessary prerequisite for the development of effective methods of their prevention. The main pathogenic factors for organs and oral tissues are:
microflora (neither caries nor periodontal disease arises without it)
soft dental flare with microflora life products, saliva precipitates with complex metabolic processes and dental stone - that is, surface formations on the teeth;
food remnants and, first of all, carbohydrate food in the oral cavity.
In the emergence and especially the development of caries of teeth and periodontal diseases, a significant role is also given to superficial formations on the teeth. In the development of etiopathogenetic prevention of dental diseases, it is necessary to take into account the peculiarities of these formations, their physiological and pathogenetic effects on the oral bodies. On the surface of the tooth there are cuticle, pellicula, as well as a dental plaque, dental flare and tooth stone. All surface formations on teeth, with the exception of cuticle and pellicula, are infected and play a negative role in the development of dental diseases.
In order for the oral cavity to maintain in a healthy state, it is necessary to remove dental deposits in a timely manner and efficiently. Food residues and a soft dental flare can be removed when the patient is observed by the patient's personal hygiene of the oral cavity using a toothbrush, toothpaste, the intentional means of oral hygiene. Removing mineralized dental sediments (dental) and dental plates are made by a dentist with special tools.
Good teeth hygiene helps prevent the diseases of the oral cavity, mainly, it is raised and stones that are the main causes of Dysen and Caries diseases. Good oral hygiene can also help prevent or delay dental diseases. Often it is possible to hear the expression: "My grandmother never cleaned his teeth, and hurts it in 89 years old; Or: "Why clean them, get sick - urvil and put bridges." Of course, every person has the right to decide how to dispose of his health. But only it is worth it in mind that the carious cavity threatens not only the injured tooth. Caries teeth can provoke diseases internal organs, cause a decrease in the body's protective abilities. It should also be noted that the treatment of caries and its complications will require much more time than daily cleaning of teeth. Back in ancient times, people paid attention to the hygienic state of their teeth. So, for example, more than 1.8 million years ago, primitive people were used as a tooth brushed herbs and trees branches. People of early cultures as hygienic items used wooden, bronze and even golden toothpicks. The ancient Egyptians used to clean the teeth with wooden chopsticks, risen from one end.
(Salvador's root)
Here are our ancestors of oral hygiene use. So why do you need cleaning teeth? From the residues of food remaining on the teeth after meals, a dental flare is formed. Each dental gram contains millions of microbes. Microbes use dental carbohydrates for their lively. One of the products of carbohydrate processing is acid, which destroys the tooth tissue, causing the occurrence of caries. It follows that, removing the dental tax during the cleaning of the teeth, the risk of caries is reduced.
Bacterial plaque molecules.
Dental flare (dental plaque).
Types of dental raid, as a result of which it appears?
White raid.
According to its consistency, these are soft and sticky deposits, they are colonies of bacteria, and accumulate on teeth, fillings, crowns, prostheses, and even on the gums and language. Such a hoist is every person. It is formed as a result of not high quality or not regular cleaning of teeth. The tax may hide the caries under it and causes inflammation of the gums. It may be causal smell of mouth, unpleasant taste sensations, as well as serve as a mineralization center in the formation of a toothache.
Solid dental raids (stones).
The deposition of the stone is happening both in the patent and in the competent area. In the formation of an independent tartar, minerals coming from saliva are involved; Under the gingny - from the gum liquid. Toothstone and plaque have a negative impact on the gums and teeth of a person. They contribute to the reproduction harmful microorganisms. This can lead to inflammation of the deceine of various intensity.
Brown dental tax.
More often occurs in smokers, and its color depends on the nicotine and the intensity of smoking. It is difficult to purify with a toothbrush and pastes. Brown dental tax can occur in non-smoking. To paint teeth can coffee, firmly brewed tea. Children can also meet dark raids. The problem lies at all in the disease of the dairy teeth, but in dysbacteriosis. The fact is that up to three years of the intestinal microflora is not fully formed this and causes the appearance of fungal plaque.
Green bloom.
The appearance of a green flush is provoked by a special type of fungi, which are called chromogenic. The green color of the plaque is explained by chlorophyll, which is the product of the vital activity of these microorganisms. Quite often, such a flare is found on the milk teeth in children, less often in adults. Green raid on the teeth in children is removed only in the chair at the dentist.
These questions are also asked: I clean my teeth, and the fence accumulates, why?
Many patients assure that they brush their teeth high quality and regularly, and the fence continues to accumulate. The reason can be the features of a person: manual skills, a state of toothbrush, the health status of the body, reception of drugs
The value of the oral hygiene in the prevention of diseases of the teeth
Human health is inextricably linked with the conditions of life, labor and recreation. Consequently, the regime of personal life, the implementation of hygienic requirements, compliance with certain useful Soviets Warned from diseases. Along with other general general measures, one of the most important links of prevention and treatment of a number of human diseases is the oral hygiene. Healthy teeth And the gums are a similar condition of normal digestion.
The oral hygiene has a big story. More Ancient Greeks were honored by hygiene under the name of Gigii - the goddess of the health, the daughter of the ancient Greek god of the healing of the Eskulap. Most peoples consider dazzling white teeth with a better decoration.
Indeed, the oral hygiene is a huge aesthetic factor and an indicator of a common culture. The smell of exhaled air determines the state of the oral cavity. In case of insufficient care, the oral cavity is noted nasty smell From mouth due to rotation of food and their decomposition. In addition, the microbes of the oral cavity, acquiring special virulence, when talking, cough, sneezing, or when using a common toothbrush can be transmitted to another person. The source of bacteria and the cause of many diseases are also sick, destroyed teeth, which are also a cosmetic defect if it is anterior teeth.
What happens with insufficient mouth care? It turns out that the teeth are formed and accumulates the raid, which, which is the source of microorganisms and is a complex of various microbes. The more significant raid on the teeth, the more microorganisms and more diverse their types.
It would seem that it is easier to understand the teeth. But if you want to have healthy and strong teeth, it needs to be done correctly.
And so - care for the oral cavity:
Yes, strictly (and boring!) Speaking, this is a whole range of daily hygienic events, the main purpose of which, avoid caries and gum inflammation. But my dear, it is also important, if not more than well-kept skin, excellent haircut and french manicure! After all, the permanently magnificent smile, which is achieved only due to the careful care of the oral cavity, is able to block all the other of your advantages and achieve one of its novel charm! The rest of the advantages are also obvious. So nice with the next visit to the dentist, to avoid unpleasant communication with Bormashina and hear the cherished words: "With your teeth, everything is in order." And all thanks to the right cavity care.
And, if seriously, the right cavity care retains the teeth of the intention, safety and the necessary quantity, due to the prevention of the plaque. And the bacterial bloom is the first cause of inflammation of the gums and the occurrence of carious cavities.
Since it has already been mentioned that the care of the oral cavity is the complex, then the entire treatment of the oral cavity goes in several stages:
The first stage is cleaning the teeth with a toothbrush and paste. It is carried out twice in the morning after breakfast and in the evening before bedtime. If the gum disease is already concerned, the amount of teeth cleaning increases to 3-5 times a day. It is very important, but few know about it, the toothbrushes must dry out dry between use. Therefore, if the teeth are cleaned often, it is recommended to have a couple of brushes and alternate them.
Toothbrush must be soft, with a rounded bristly end, and the brush head is small to achieve all hard-to-reach places. It is necessary to change it every 2-3 months. There are special brushes for interdentary spaces - small and especially good to remove plaque and food from a wide space between the teeth. Advanced brushes with rubber tips are designed for careful gum mass.
Tooth paste you can choose to your taste, or, with certain problems, on the recommendation of the dentist. Of course, the toothpaste for the care of the oral cavity should contain fluorides, strengthening enamel, calcium carbonate and sodium bicarbonate to remove the plaque. More modern ingredients - compounds of silicon with elevated cleansing properties. For many suffering from increased enamel sensitivity, there are toothpastes with reduced abrasive and chemically inert cleansing compounds. There are toothpastes for those who, despite the regular care for the oral cavity, there is an accelerated formation of a dental stone. Their soluble pyrophosphates do not allow the mineral substances on the surface of the teeth and suppress the growth of the tartar.
Optimal time to clean the teeth: two or three minutes. Usually everyone is stacked at 30-40 seconds, therefore it makes sense to clean my teeth several times, focusing on the clock. But it is not necessary to overdo it. Also simply with an excessive intense and long-term care of the oral cavity, it is possible to damage enamel and gums.
The main thing in the care of the oral cavity is a professional technique. First, the brush is installed on the gum line, at an angle of 45 degrees to the teeth from the outside. Make circular movements with a brush, cleaning 2-3 tooth at the same time. In order to clean the inner side of the front teeth, they have a brush vertically, and make careful movements up-down. The same movements are processed chewable and internal surfaces of other teeth.
Since the flare is formed not only on the teeth, but in the language, causing an unpleasant smell, then the care of the oral cavity necessarily includes its cleaning. Begin to clean the tongue from the tip, then move to the middle and sides.
Additional application to the brush and paste of rinsers and dental threads when careing for the oral cavity, reduces the destruction of the teeth (imagine!) By 40%.
Tooth thread (floss), and only it can clean the side surface of the teeth and a particularly pocket area of \u200b\u200bthe gum, where the larger accumulates the most accumulating, the gums inflammation begins faster. Since the choice of dental yields to care for the oral cavity is very large, the easiest way to ask the pharmacy flat, lubricated floss, because they are less likely to damage the gum fabric. Ideal time to clean the floss-stayed bed.
Rinsers cope with those bacteria that remain in the mouth after cleaning the teeth, and it is better to use the rinse after cleaning a toothbrush and dental thread. The rinsers, depending on the composition, have an anticipatic, deodorizing, anti-inflammatory and astringent action, and can also reduce the bleeding of the gums and contribute to the restoration of the mucous membrane of the oral sheath.
Despite the daily efforts to care for the oral cavity, in some particularly hard-to-reach places, the flare still remains and gradually hardens in the dent stone. It is possible to remove it only at the dentist during the next visit, one or twice a year. It is very important for preventing gum diseases and untimely loss of teeth.
Everything is simple enough, right? And in fact, takes no more than ten minutes a day. The main thing is not to forget about all the rules of the oral cavity and not to be lazy.
And a few more rules you need to know and remember:
- Avoid drinking too hot or too cold food and drinks. This leads to the occurrence of enamel microcracks, reduces its strength and predisposes to the development of caries.
- Remember that toothpastes can provide teeth with calcium and fluorine no more than 30%. The rest you should receive from food (dairy products, green tea, legumes, greens).
- Do not use teeth to split nuts, opening bottles, snocking the threads, etc. In this case, the formation of cracks of the enamel, irregularities and cavities in the teeth occurs, which increases the risk of caries.
Be healthy and do not forget to regularly visit your dentist!
Doctor dentist GBUZ "Bichur CRH" Metropolskaya N.G.
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The formation of a soft dental plaque and the retention of food residues on the teeth are the so-called local cariesogenic factors creating conditions for prolonged enzymatic activity of microorganism, the formation of acid and demineralization of the tooth (CRABB, 1976). Positive correlation of caries intensity with high index Oral hygiene is proved in numerous epidemiological and clinical studies. In this regard, the task is primarily in the wide propaganda of the feasibility of hygienic care and the oral cavity. Unfortunately, despite the fact that the entire population is covered by medical care, some of the children and even adults do not clean their teeth or clean it irregularly. G. I. Kadnikova (1975) established unsatisfactory oral hygiene in more than 80% of schoolchildren of the cities of Latvia.
Taking into account the works that show the connection between the oral hygiene and the intensity of the caries, it is recommended to clean the teeth from the plaque. However, as you know, a certain amount of dental plaque is updated during the time expired until the next cleansing, and also remains in difficult places.
There are also searching effective toolsCountering the depositing of the dental target. Clark (1975) and Krischke (1969), summing up studies in this direction, report on attempts to apply antibiotics, bactericidal substances, urea, drugs. Reduced surface tension, enzymes (especially proteolytic), exchange resins. Rosen et al. (1956), McClure and Hewitt (1946) observed a decrease in the number of cases of caries, if the flora of the plaque was damaged by chemicals or antibiotics.
Variable success use chewing gums without medicinal impurities or with content drugs. Chewing gums that are injected with vitamin K, nitrofuran, chloroorl, fluoride components, can slow down the accumulation of dental plates, teeth and pigmentation stone. However, without further, broader studies, dentists. Currently, cannot yet recommend or reject chewing gumSo there are disgraced opinions about its effectiveness in the improvement of the oral cavity.
The use of antibiotics, which can limit the accumulation of microbes in the dental (Bowen, 1969), can hardly be justified if the previous situation is restored after canceling the drug.
Black (1915) recommended properly use a toothbrush with toothpaste after meals. At the same time, the clean surface of the teeth is ensured within 12 hours after meals, but after that microorganisms again "stick" to the surface of the tooth. In addition, the microbes are "getting used to" to antiseptic means and antibiotics, producing strains-resistant strains.
In the works of MiClos et al. (1968) The decrease in dental deposits by 50% was observed when using sulfhydryl inhibitors (like iodacetamide) precipitation of mineral components in dental. Perspectively the use of dextranase type enzymes, an extremely low concentration of which is capable of inhibiting the formation of dextrins, lyse the dental flare and prevent its deposit with simultaneous decrease in the damage to the caries of teeth in animals.
FOSDICK et al. (1955) indicated that in order to ensure the greatest efficiency of the prevention of caries, the enzyme inhibitors should have affinity for the material of the dental plaque so that it is not quickly removed by saliva. When analyzing a large number of components in the laboratory, the authors concluded that N-Lauril sodium sarzinate and sodium dehydroacetate corresponds to theoretical requirements.
Hayden and Glass (1959) For 2 years, a 2% solution of N-lauree sodium sarcosinate was used as part of a toothpaste and noted a significant decrease in the prevalence of caries of teeth from schoolchildren.
There is experience in cleaning teeth with pasta, which was introduced by ammonium and urea. Kerr and Kesel (1951) reported that the toothpaste containing these substances (5% ammonium phosphate and 3% of urea) reduces the caries intensity by 10% more than control toothpastes. The Kircheimer and Douglas (1950) and Jenkins and Wright (1951) and Jenkins and Wright (1951) are consistent with this, who believed that ammonium ions themselves do not play a specific role in reducing dental plates and prevention of caries.
In experiments on animals to clean the teeth of rats and hamsters, a step containing ammonium ions and urea was used, but it turned out to be no more efficient than the control toothpaste. The same thing was observed in the beave of late studies.
For neutralization of acids formed in dental, calcium gliderophosphate at a concentration of 0.25-1-2.5% (Bowen, 1969) is used, restriction of childbirth in food (HOUTE, 1964), hygienic cleaning of teeth (Jenkins, Dawes, 1964) and other means.
The most efficient and affordable dental removal means is cleaning the teeth with a toothbrush. Regardless of the type of cleansing agent, the best effect is obtained by using a toothbrush from natural bristles.
Fones (1927) announced a decrease of more than 50% of the prevalence of caries of permanent teeth of schoolchildren after 10 years of proper cleaning of teeth. FosDick (1960) examined a group of students 2 years after the purpose of cleaning the teeth and rinsing the mouth after meals and noted the decrease in the number of carious cavities by 41% compared with the student control group.
When cleaning the teeth with the simultaneous use of fluorine, in order to prevent caries, attention should be paid to the following: the anticipatic effect of the fluorine is reduced by half, if the timing is not removed before processing the teeth (BIBBY, 1942; Knitson, Feldman, 1947). The best prohibition of fluorine is manifested if it is included in the enamel, so after applying fluorine it is desirable to refrain from cleaning the teeth to ensure longer penetration into enamel. Fluorine concentrates in dental at large quantities: according to Hardwick (1961), up to 60: 1,000000. Finally, with intensive cleaning of teeth, from 50 to 100% of the fluorine enabled in enamel is removed.
The perfect dental powder (paste) should clean and polish the surface of the tooth with minimal erasing and scratching. Merciless actions, the purpose of which is to remove the dental plaque, should not at the same time lead to damage to the tooth pellicula and the underlying enamel structures.
Currently, for mechanical cleaning, teeth most often use toothbrushes, toothpicks, powders and toothpastes. The latter can also have a targeted pharmacological (medical and prophylactic) effect. Named yields of oral hygiene are applied individually at home.
A. I. Rybakov and A. V. Granin (1970) recommend a toothbrush with a small working part of natural bristles. Bush bugs should not be thick (to enter interdental intervals), elastic, but not excessively rigid. Brushes with rigid bristles, as well as brushes from synthetic material have elevated abrasive properties. In therapeutic institutions, special brushes referred to in the action of bormer, fixture for irrigation of the oral cavity, toolkit for removing a dental plaque and a dental stone.
In the oral cavity there are exceptionally favorable conditions for reproduction of microbes. The largest amounts of them are formed in the interdental intervals, sedental pockets, sediments on the teeth, the folds of the mucous membrane. Flora oral cavity It depends on the nature of the food, the frequency of its admission, washing the action of saliva and, undoubtedly, from the care of the oral cavity. Excess carbohydrates in food contributes to the reproduction of the acid-forming flora, excess protein gives the opposite effect. The presence of anaerobic microorganisms is an indicator of insufficient hygienic care for the oral cavity. It has been established that the cleaning of the teeth significantly reduces the number of bacteria in the oral cavity and the damage to the caries. The rational hygiene of the oral cavity also leads to the normalization of microflora in quantitative terms.
Although thorough cleaning of teeth, carried out with direct medical control, leads to significant qualitative and quantitative changesThrough different times (from several hours to 1-2 months) in different people, the composition and the number of microflora return to the initial level. Only the doctor can individually determine the optimal tooth cleaning mode and assign the most rational means of hygiene.
With the help of a toothbrush, removes of food and soft dental deposits (raid) from all surfaces of the teeth and from the interdental gaps are removed, so it is important to choose to choose a toothbrush. It is often noted that, despite the constant cleaning of the teeth, the state of the oral cavity is not improved. Medical examination in such cases indicates that the cleaning of the teeth is not effective enough. This largely can depend on the irrational, size or quality of the toothbrush.
When choosing a toothbrush, pay attention to its FD "RMU, which should be adapted to the shaped of the dentition, on the quality of the material from which the burst beams are made on their length and location. From the caliber and the length of the bristles of the toothbrush, the elasticity, strength and duration of its operation are dependent. Toothbrush must be such a design so that it can be free to clean each tooth; For this, the working part (head) and the handle must have a definite curvature and be convenient. The brush should not be great, otherwise it will not clean the side and rear surfaces of the rear teeth due to the impossibility of promoting it into the rear section of the mouth with closed jaws. Depending on the degree of rigidity, the toothbrushes are used for milk, replaceable and permanent bite, as well as with cosmetic, medical and preventive purposes. Adults can enjoy tough, children - soft brushes.
The shelf life of the toothbrushes with two-time cleaning of the teeth per day should be no more than 4 months, brushes made of artificial fiber - not more than 6-8 months. Store brushes in the family must be separate, better in individual glasses, working part of the brush up.
Definition of index hygiene. Before appointing teeth cleaning, first of all, it is necessary to establish the quality of the cavity of the oral cavity. This is carried out using a hygienic index on Fedorov-Volodkina. To do this, use the color of the six lower front-old teeth with a solution of potassium iodide solution (Kalii Jodati 2.0, Iodi Puri 1,0, AQ. DESTILL. 40.0). Quantitative estimate is made on a five-point system: staining the entire surface of the tooth crown - 5 points, 3/4 surfaces - 4 points, 1/2 surface - 3 points; 1/4 surfaces - 2 points, no staining - 1 point. The calculation is carried out by the formula:
where: DSR is a general indicator of dental cleaning; Ki is an indicator of the degree of color of one tooth: n is the number of teeth studied (usually 6). Normally, this indicator (hygiene index) should not exceed 1.1-1.3 points.
G. N. Pakhomov modified the index of hygiene Fedorov-Volodkina, proposing to evaluate the amount and quality of the dental plaque on 12 teeth of the upper and lower jaws:
This allows you to more accurately determine the hygienic state of the mouth, as it takes into account the dental flare not only on the slope of the lower jaw, but also on the chewing teeth.
A qualitative assessment is carried out on a three-point system: intensive staining of the surface of the tooth - 3 points, weak staining - 2 points, no staining - 1 point. Calculation lead by the formula:
where: SCP is the average degree color degree; SN is an indicator of the degree of color of one tooth; n - the number of teeth studied.
Fedorov-Volodkina's hygiene index in itself and especially in the modification of G. I. Pakhomov is an objective criterion, on the basis of which one can judge the degree and nature of the hygienic care of the teeth of an individual or group of people. The definition of the index is simply and accessible, the calculation takes a little time. This method can also serve as an illustration of the quality of teeth cleaning when teaching hygienic skills.
Hygienic cleaning of teeth. Patients, especially children, it is necessary to train the right cavity care and teeth.
Cleaning teeth with a brush and paste should be made twice a day - in the morning and in the evening. In the morning it is advisable to do it after breakfast to remove the residues of food from the oral cavity. An empty stomach is vigorously rinse the mouth.
Cleaning teeth with a brush is made in front along the axis of the tooth, on the chewing surfaces - in front of the back, and with. Sky and paternal sides are also along the tooth's axis. The movements of the brush can be "scuba" or "sweeping". The cleaning of the teeth should be given at least 2-3 minutes, which corresponds to 300-400 pair movements of the brush and makes it possible to remove soft dental sediment as possible. Hygienic toothpastes that do not contain therapeutic additives ("Mint", "Children's" and others) are used to clean the teeth. The results of teaching children to care for the oral cavity should be monitored using a hygienic index.
Anticious toothpastes . Taking into account that one of the essential factors in the pathogenesis of caries are a mild dental flare and residues of food carbohydrates in the oral cavity, their elimination should be considered an important preventive event. In addition, the effective measures of prevention of caries are those that are aimed at strengthening the tooth resistance to the pathological process. Such a goal can be achieved by local exposure to the tissue of teeth or on the metabolic processes in the body, which are directly related to the mineralization of solid tooth tissues.
As a basis for experimental and theoretical prerequisites on this issue, ideas that the teeth tissues after the rubberization are becoming permeable for soluble organic and inorganic oral fluid compounds, as well as data on age-related changes in the cavity of the crystal structure of the tooth and the anticariosogenic effect of phosphorus preparations, calcium and fluorine. In experiments, the possibility of penetrating therapeutic substances in tooth tissue from toothpaste is proved. The influence of fluorine that is part of the toothpaste, on the permeability of the in-clock tissues of the teeth.
In the mechanism of influence of fluorine toothpaste on solid tissue of teeth leading is a modification of the level of permeability and ionic exchange processeswhich for different substances can be different. At the same time, the main tendency is planned - the sealing of the enamel structure. Thus, fluoride pastes under certain conditions of use can be a powerful means of preventing caries of human teeth. Clinical evidence of the anti-diagnosis efficiency of a row of toothpaste, which contains ions of mineral elements and fluorine.
Currently available for use with the impression of the prevention of caries are toothpastes "Pearls" and "Cheburashka" proposed by Yu. A. Fedorov. In their composition there are calcium and phosphorus ions (calcium hider phosphate), which, when contacting the tooth, has a mineralizing effect. The Riga Cosmetic Factory produces a fluorine-containing toothpaste. The Moscow Medical Dental Institute and Score-Eale-Dovatel Institute of Natural I.Sintytic fragrant substances are developing calcium glucu-nat and fluorine pastes that will be released in the current five-year plan. From imported tooth pastes, the "signal-2", "lobalut" and other, containing sodium fluoride possess.
Appointment of anticipatic toothpastes and control over their application. Anticipatic toothpastes are better to prescribe to children when there have not yet been complete ripening of the cutting teeth. In case of inspection of the oral cavity, the KPU, the PPC and the hygiene index are registered. Assign one of the anticiparantic toothpastes. The duration of the use of prophylactic toothpaste is determined individually. Children, predisposed to fast development Caries should be prescribed anticiparantic toothpastes for 10-15 years after the rubberization of constant teeth. You can cancel such a paste only if it is replaced by another, more efficient. For example, instead of the paste "Pearls" you can use fluorine-containing paste ("Lock" and other).
Children with relatively greater resistance, to caries (low source KPU, slow, minor increase in the incidence of caries), recommend anticiparantic tooth paste for 1-3 years, after which it is replaced by its usual hygienic. If necessary, again by 6 months - 1 year prescribe an anticiparantic toothpaste.
In the fields of the country with low fluorine in drinking water, anti-diagnosis toothpastes, including fluorine-containing, are prescribed for a longer period (3-5 years or more). In areas of S. increased amount Fluorine in drinking water use calcium-containing toothpastes or ordinary hygienic. It is impossible to use fluorine-containing toothpastes, as this can contribute to the development of fluorosis.
Anticious toothpastes are prescribed for children to use at home. An important role belongs to parents who are obliged to follow the right and regular use of dental pastes.
A promising method for the prevention of caries with the help of hygiene products is the cleaning of teeth by children under observation. The procedure for cleaning the teeth is carried out at school, children's nursery and other organized teams pediatrician, medical sister or hygienist. For all possible methods of organizing the cleaning of teeth (at home or at school), an objective criterion for evaluating its effectiveness should not be a statement of the cleaner procedure itself, but the determination of the index of hygiene and caries indexes in the nearest and long-term deadlines.
Anticious toothpastes are shown to people whose organism is weakened by various common diseases irradiated, as well as pregnant women. At the same time, the care of the oral cavity is also assigned strictly by a physician. You should give preference to a soft brush from elastic natural bristles. Dental powders with elevated abrasive properties, pregnant women and irradiated patients are contraindicated. To activate the processes of self-cleaning of the mouth, it is recommended to use fresh vegetables and fruits (carrots, cabbage, radishes, apples, pears, etc.). The chewing of solid food contributes to the strengthening of salivation and, consequently, the self-cleaning of teeth from adhesive residues. Cleaning the teeth is recommended twice a day - in the morning and before bedtime. After each meal, the mouth must be ringed with warm water.
Dental diseases...........................265
Individual cavity care ............................... 265
From the history of the occurrence of hygiene of the oral cavity .................. 265
Means and methods for the care of the oral cavity ........................... 266
Toothpaste ........................................... 267
Biology active components toothpaste .................... 268
Combination of drugs of fluoride .............................. 270
Antimicrobial components of toothpaste ....................... 271
Security control of toothpaste ............................. 272
Solutions for rinsing the oral cavity ............................... 275
Toothbrushes .............................................. 277
Methods for cleaning teeth ......................................... 282
Electric brushes .......................................... 283
Dental filaments - floss ........................................ 284
Toothpicks ............................................... 284.
Irrigation devices .................................. 285
Professional hygiene ...................................... 285
Technique of holding ...................................... 287
Air-drivey scales ................................. 288
Hand tools ...................................... 288
Polishing the surface of the teeth .............................. 288
Professional hygiene for patients with implanted teeth
and at HIV patients ..................................... 290
Preventive treatment ..................................... 290
Identification of patients for preventive treatment .............. 291
Treatment of active caries of teeth and selection of material ................... 292
Silafts (sealants) for Fissur enamel ............................. 294
Antimicrobial agents and their use for oppression of infection ......... 296
Chlorhexidine ........................................... 296.
Fluorides for local applications .............................. 297
Fluoride varnish ......................................... 298
Sodium fluoride gels with phosphate ...................... 300
The market of preventive services in dentistry ......................... 301
System of diagnostics and prophylactic treatment ................... 302
Approximate text of letters to patients .............................. 303
Chapter 14. PR Cancer PreventionAnd ..................... 309.
The prevalence of cavity cavity .............................. 309
The main reasons for the occurrence of cavity cavity ..................... 310
Smoking tobacco ......................................... 310
Smokeless tobacco ......................................... 311
Other causes of cancer ...................................... 313
The role of a dentist's doctor in diagnosis and prevention .................... 314
Screening surveys of the mucous membrane ....................... 314
Diagnostics of the cavity cancer using toluidine blue .......... 316
Factors preventing the development of cavity cancer .................... 316
Chapter 15. Prevention in the elderly ................... 319
Level and significance of the problem .................................. 319
Prevention - the main way to achieve health .................... 324
Pricky caries .......................................... 325
Periodontal diseases ......................................... 327
Abrasion of solid teeth tissues .................................. 328
Chapter 16. Sanitary and hygienic education of the population -
The most important component of preventive programs ......... 330
Definition and principles ...................................... 330
Positive communication ........................................ 333
Motivation to the formation of health care ...................... 333
Getting medical knowledge - the process of knowledge ..................... 334
Hygienic education of young preschool children .............. 336
Hygienic education of schoolchildren ............................... 341
The main results of the study ............................. 343
Methods of sanitary education of parents ................. 348
Features medical Education adult population ................ 350
Chapter 17. The main directions and methods of prevention
Dental abnormalities and deformities ................... 352
Bite and anomalies of development .................................... 352
The main reasons for the development of dental anomalies and deformities ........... 355
Artificial feeding .................................... 357
Pathology of the upper respiratory tract ............................... 357
Harmful habits ........................................... 357
Diseases of teeth and jaws ................................... 358
Violation of physiological equilibrium muscles ........................ 358
Prevention of dental anomalies and deformities depending on the causes
their development ............................................ 358
Prevention of dental anomalies in the period of intrauterine development ..... 362
Prevention of dental anomalies associated with artificial
feeding .......................................... 364.
Prevention of dental anomalies and deformations associated with harmful
habits ............................................. 366.
Violation of the function of nasal breathing .............................. 366
Prevention of dental anomalies and deformities associated with destruction
and lack of teeth ....................................... 369
Hygienic education in the process of orthodontic treatment .............. 371
Chapter 18. Organization of Implementation and Evaluation of Efficiency
Preventive programs .............................. 377
Historical experience and prospects ................................. 377
Situation analysis ........................................ 380
Determination of the measurable goals of the prevention program ................... 385
Planning preventive events ........................ 389
Prevention of dental diseases among the population of Belarus ..... 389
The results of the implementation of the program .............................. 393
The introduction of a project at an affordable cost of fluoride-containing tooth pastes ...... 394
Justification of the project ..................................... 394
The efficiency of using a new pasta ........................ 395
Use of toothpaste in a communal project ................. 396
Conclusion ................................................ 398.
Dental health of the future ............................... 398
Appendix ............................................. 402.
Map to evaluate dental status (WHO. 1997) .................. 402
Introduction
Numerous reports, including the World Health Organization, suggest that the end of the 20th century was marked by a decrease in the prevalence of dental diseases in a number of Western countries.
In recent decades, in world practice, prevention as an independent discipline was exclusively rapid development. This was promoted by the active position of WHO and the successful implementation of a number of disease prevention programs, on the basis of which practical approaches were formed and the methods of preventive work were developed. This can be attributed to the doctrine of a healthy lifestyle, about the transitional state between health and illness (presessal), about the risk factors, adaptation and deadaption. These areas of research, a significant part of which were carried out in the USSR and in Russia, became the basis of the subject of prevention as a scientific discipline. They arose due to the real need of the population, determining the level of its health, the frequency of identifying the initial forms of diseases associated with the increased risk of their occurrence.
Not so long ago, the objects of study in dentistry were caries of teeth and gum disease. As science develops, the list of problems and items of study related to dentistry has been expanded. This is due to the unique characteristic of the oral cavity, including in addition to the teeth and the gums, holding their connective tissue and bone structures, solid and soft panel, mucous membrane, tongue, lips, salivary glands, chewing muscles, top and low jaw, chewing muscles and temporomandibular joint. At the same time, an important component of the oral cavity is also an extensive network of blood and lymphatic vessels, nerve endings that feed and protect the tissue, provide them with a bond with a brain, and with the whole body of a person. In this regard, the authors showed that dental health means much more than the preservation of the teeth in good condition. It indicates the absence of any pain in maxillofacial region, symptoms of manifestation of common diseases and neoplasms, congenital neba defects or lips. Healthy state The organs and tissues of the maxillofacial complex ensures a comfortable implementation of vital functions, including speech, breathing, chewing and swallowing food, as well as the expression of the psycho-emotional state of a person.
Introduction
The textbook emphasizes that by carefully studying the state of the maxillofacial complex, the symptoms of nutritional disorders, various systemic diseases, including infectious and immune, and some malignant tumors. Therefore, an ancient expression "Mouth is a mirror of the body", it is impossible to more accurately reflect the importance of health status information that can be obtained with a complex dental examination.
A significant role in ensuring dental health belongs to medical professionals, including dental staff. However, it is important that recommendations and information on their part of them are not only heard, but also implemented in practice every person. Such recommendations include regular visitors of the dentist, everyday cavity care, cessation of tobacco consumption and other tips on reducing the risk of dental diseases by maintaining healthy image Life. These issues are devoted to a significant part of the present textbook.
There is no doubt that the concept of general and dental health in the 21st century will undoubtedly be the promotion of human health and prevention of diseases, since the main dental diseases can be eliminated by implementing adequate social policies. One of the tasks of dental personnel is the belief of political and public figures of various levels to take the necessary social measures aimed at solving the problems of strengthening general and dental health, and to participate in their implementation. A number of domestic researchers marked stabilization and even reducing the level of dental diseases in some regions of the country.
The authors of this publication considered their main goal to emphasize the attention of students and dental doctors on the possibility of a significant improvement in the dental health of the population through the introduction of utility and individual methods of prophylaxis. It has become real at present due to the accumulated international experience in studying data on the prevalence of dental diseases and a clear clinical understanding of the mechanism of their development.
Uponcing chapter 17, "The main directions and methods of preventing dental anomalies and deformations" are used by the works of V. G. Sunzova, and in a number of chapters of the preventive profile - the works of A. G. Kolesnik and P. A. Leus. The authors express them sincere thanks.
Academician RAMS, Professor V.K. Leontiev, Professor G. N. Pakhomov
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