SECTION 2

ORAL HYGIENE INSTRUCTION

REASON FOR PROCEDURE

Oral hygiene instruction is given to patients to ensure that they are maximising their efforts to remove plaque from their teeth in order to minimise the damage caused by periodontal disease and caries.

Dietary advice is also given to help patients to avoid foods and drinks that are particularly damaging to their teeth – those high in refined sugars and those that are acidic.

When the advice is correctly followed on a regular basis, patients can enjoy a well cared for and pain-free mouth, as well as avoiding the expense of reparative dental treatment.

The procedures to be discussed are:

• Use of disclosing agents
• Toothbrushing
• Interdental cleaning

USE OF DISCLOSING AGENTS

Background information of procedure

Disclosing agents are vegetable dyes supplied in liquid or tablet form and in various colours, usually red or blue.

They act by staining any plaque on the tooth surface to their own colour, thus making it far easier to show the presence and location of the plaque to the patient, as plaque is normally a creamy white colour and may be difficult to see otherwise (see Figure 2.1a, b).

Once stained, suitable oral hygiene instruction can be given to remove the plaque effectively. The dyes do not stain the teeth themselves, or any restorations.

Details of procedure

The agents can initially be used at the practice by the oral health team, so that the correct problem areas can be identified and suitable cleaning advice given. The patient can then use the agents at home to check his or her progress on a regular basis. The most common agents are disclosing tablets.

Technique

• A protective bib is placed over the patient so that his or her clothing is not inadvertently marked
• The patient is given one disclosing tablet and asked to chew it for about 1 min
• The patient spits out the chewed tablet and saliva, but does not rinse out
• Using a patient mirror, any stained plaque is pointed out by the oral health team and the worst areas are noted (very often the gingival margins)
• Detailed advice is then given on improved brushing techniques to eliminate the plaque from these areas
• The patient can follow these instructions immediately, so that all the stained plaque is removed, under the supervision of the oral health team
• With the plaque easily visible as a result of the disclosing agent, the patient is able to see his or her own pr/>
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