Toothpaste app? / Middle East’s Dentist Meet Recommends Power Brushes for Improved Oral Hygiene / Classic versus modern: Comparison of new method of professional dental cleaning / Oral health and diabetes discussed at premier event in Singapore
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Untitled
Dental tribune Middle East & Africa Edition | January-February 2016
hygiene tribune 1D
Classic versus modern: Comparison of new method
of professional dental cleaning
by adina Maurer, germany
T
he early work of prophylaxis pioneers Axelsson
and Lindhe in the late
70s already described the content and procedure of a dental prophylaxis session. Due
to scientiic and technological progress, new possibilities
are available today that enable
professional dental cleaning in
a more eficient, effective and
gentle way (minimally abrasive
and atraumatic) with increased
> Page 4D
Fig. 1: Conventional preparation of tray.
Fig. 2: Modern preparation of tray.
Middle East’s Dentist Meet Recommends
Power Brushes for Improved Oral Hygiene
First dental consensus agrees that electric power brushing is best for oral health; 80 per cent
of children between 12-15 years have unhealthy gums, according to research
by the Dubai Healthcare Authority
by Oral-b
D
ubai, uae: A group
of the Middle East’s
leading dentists have
come together to agree on how
best to promote good oral hygiene through brushing. Held
in Dubai at the end of August
and supported by Procter &
Gamble, the irst dental consensus has issued a series of
recommendations to help improve oral hygiene in the region. These proposals, which
focused on tooth brushing
habits across the Middle East,
include an agreement that
electric power brushes are
more effective at maintaining
oral health, and that Bluetooth
enabled power brushes have
the potential to encourage better oral care among children.
Co-chaired by Hamdan Bin
Mohammad’s College of Dental Medicine’s Professor Crawford Bain and Dr Arwa AlSayed, Director for the Saudi
Board of Periodontics, the
meeting of ten dentists from
Lebanon, Oman, Saudi Arabia
and the United Arab Emirates
met for two days to discuss how
best to promote better brushing habits among the region’s
consumers. Research undertaken by the Dubai Healthcare
Authority in February of this
year found that 80 percent of
children in Dubai between
the ages of 12 and 15 have unhealthy gums.
The group agreed on the following recommendations:
1. Evidence suggests that power brushes are more effective
in the short & long term compared to manual brushes. According to present data, over
the short & long term, power
brushes are better at maintaining oral health.
2. Evidence suggests that oscillating-rotating power brushes
are superior to all others in the
short & long term.
3. Bluetooth enabled power
brushes with interactive apps
and smart guides have the potential to aid in better compliance from children. This consensus suggested that power
brushing can be started at
any age if parent and child are
comfortable with it.
4. Power brushes with an oscillating-rotating mode of action
are more effective than others at reducing and preventing
gingivitis in the short & long
term.
5. Power brushes with an integrated pressure feedback
mechanism could have the potential of reducing soft & hard
tissue abrasion.
“This was the irst time that
we’ve brought together such a
group of experts to talk about
the pressing need to improve
the region’s oral hygiene. The
Middle East in general suffers
from poor oral hygiene when
compared to regions such
as Western Europe, and as a
profession we felt that it was
important to come together to
agree on how to change the
status quo. Regular brushing
is an essential part of good oral
health, and by using power
brushes we can better maintain our oral health both in the
short term and the long term,”
> Page 3D
Toothpaste app?
by Kimberly bray, rDh, MS
W
hat determines your
level of conidence
in
recommending
a product to your patients?
My conidence level depends
on doing some of my own research and coming to my own
conclusions.
When I irst heard about Crest
Pro-Health toothpaste and the
wide range of cosmetic and
therapeutic beneits it provides, I have to admit I was curious. The only product I own
that can do just about anything
is my smartphone! It’s a phone,
camera, iPod, and so much
more! Then I started wondering, what if toothpaste could
work that way, providing all of
the key oral health beneits in
a single tube? What would be
the advantages? As it turns out,
I could think of quite a few:
•Convenience. Many patients
just don’t have time to use
more than one oral care product to get a wide range of beneits. They would prefer to simply use one product.
•No trade-offs. Patients could
select the app I want,
a multi-beneit dentifrice would provide
all of the beneits with
each use.
•Widely applicable. It
would be a product that
Figure 1. Crest Pro-Health is compared to
would offer beneits for
an app-like “smart toothpaste.”
both teens and adults
alike.
get therapeutic beneits with- •Provide therapeutic protecout trading off cosmetic ben- tion. It would provide proteceits of extrinsic whitening, tion against caries, plaque,
tartar control, and breath pro- gingivitis, and sensitivity.
tection.
•No selection required. Un- My list of potential beneits
like my smartphone, where I turned out to be pretty im-
pressive. So I decided to do
some research on Crest ProHealth toothpaste. Here are
the questions I asked and what
I learned.
What is the basis for Crest
Pro-health formulations?
Crest Pro-Health (CPH) dentifrice is based on a unique,
patented system of stabilized
stannous luoride (SnF2) and
a cosmetic ingredient, sodium
hexametaphosphate (NaHMP).
> Page 2D
[2] =>
Untitled
2D hygiene tribune
Dental tribune Middle East & Africa Edition | January-February 2016
< Page 1D “Toothpaste app?”
Stannous luoride has a long
history of use in oral products
for protection against caries,
sensitivity, plaque, gingivitis, and oral malodor.1 Crest
with Fluoristan, introduced
by Procter & Gamble (P&G) in
1955, contained SnF2 and was
the irst dentifrice to receive
the American Dental Association (ADA) Seal of Acceptance
for the therapeutic prevention
of caries. Stannous luoride
is the only luoride source to
provide beneits against caries, sensitivity, and plaque/gingivitis. It was the potential of
this multi-beneit therapeutic
agent that motivated P&G scientists to work for more than
three decades to overcome
the early limitations of SnF2based dentifrices. These limitations included formula stability, an astringent taste, and
mild extrinsic staining of teeth
in some patients.
One breakthrough along the
way was the discovery of polyphosphates, such as NaHMP,
as cosmetic agents. Pyrophosphates were used in Crest
Tartar Control dentifrices to
provide tartar control beneits.
Compared to pyrophosphate,
NaHMP is a larger polymer
with more potential attach-
ity; and whitening. In fact, CPH
dentifrice is the only toothpaste on the market to earn acceptance in all ive categories.
Eficacy demonstrated in
technical studies, clinical trials
Over 80 publications and research presentations support
the eficacy of CPH dentifrice.
The results show CPH dentifrice is:
1. Effective in preventing and
reducing the incidence of caries. Use of a luoride-containing dentifrice is known to be
effective in reducing caries
and reversing early carious lesions by promoting remineralization and preventing demineralization.2
In addition, luoride may also
limit the production of acid associated with cariogenic bacteria.3 Stookey et al. conducted
a two-year clinical trial with
955 subjects. A dual-phase prototype of CPH provided 17% to
25% fewer caries relative to
a standard sodium luoride
(NaF) dentifrice.4 Anticaries
beneits were also demonstrated by Wefel et al. in an in situ
study.5
Figure 4. Stain reductions after 2 weeks of use of
CPH dentifrice. Example subject images above:
Baseline (row A) and two-week images (Row B).
(Courtesy of American Journal of Dentistry24)
ment sites to the tooth surface. This larger size improves
adsorption to tooth enamel,
which provides surface stain
removal and interferes with
calciication of plaque to provide tartar control beneits.
NaHMP was successfully used
in Crest toothpastes to improve
whitening beneits. The successful formulation of NaHMP
and stabilized SnF2 in a single
dentifrice formulation is the
key breakthrough leading to
the introduction of CPH dentifrice in 2005.
how does CPh dentifrice
perform?
CPH dentifrices containing a
system of stabilized SnF2 and
NaHMP have been shown to
provide a full range of therapeutic and cosmetic beneits
(see Figure 1). The eficacy
of CPH dentifrice has been
demonstrated in randomized,
blinded, controlled, and independent clinical studies.
Based on these clinical studies, CPH dentifrice has been
awarded the Seal of Acceptance from the ADA in ive categories: cavities; gingivitis and
plaque; oral malodor; sensitiv-
2. Effective in
building
protection
against
dentinal hypersensitivity. Laboratory
studies
show SnF2 reacts
to form precipitates, which occlude dentinal tubules and provide
sensitivity relief.
Figure 2 shows
high magniication
scanning
electron micrographs (SEM) of
dentinal tubules
before and after
the use of CPH
dentifrice.1
Independent clinical studies
showed signiicant fast6,7,8
and long-term sensitivity relief as measured by tactile and
thermal methods compared
to standard luoride negative
controls. Results from one
clinical study showed a 44%
decrease in thermal sensitivity
and up to a two times greater
tolerance to tactile sensitivity
after eight weeks of use.6
3. Effective in reducing plaque
and gingivitis. These beneits
are due to the broad spectrum
antibacterial action of SnF2. By
killing and inhibiting bacteria
associated with plaque, CPH
dentifrice reduces the development of gingivitis. Gingivitis, if
left untreated, can lead to periodontitis, which can eventually lead to tooth loss. Emerging
research suggests that poor
gingival health may be linked
to systemic conditions.9 Figure
3 demonstrates that the antibacterial activity of CPH dentifrice remains strong for 16
hours compared to a control in
a live/dead assay.10
Numerous clinical studies,
ranging from short-term studies to six-month clinical tri-
Figure 2. Left: SEM shows open tubules after treatment with a nonsensitivity luoride toothpaste. Right:
SEM shows closed tubules after treatment with CPH
dentifrice. (Courtesy of Compend. Cont. Educ Dent1)
als, have shown signiicant
reductions in plaque, gingival
inlammation, and bleeding
after use of CPH dentifrice relative to positive and negative
controls.11-17
4. Effective in reducing breath
malodor. The antibacterial action of SnF2 inhibits the breakdown of residual proteins in
the mouth to form volatile sulfur compounds responsible for
oral malodor.18 Two independent clinical studies involving
a total of 75 subjects showed
signiicant reductions in halitosis overnight after using CPH
dentifrice compared to a standard NaF control.19
A longer-term study20 of 71
subjects showed signiicant reductions in halitosis after one
week and three weeks of CPH
use compared to a standard
NaF control.
5. Effective in reducing formation of calculus. Laboratory studies have shown that
NaHMP signiicantly reduces
the crystal growth and mineralization of plaque either in
aqueous solution or in a dentifrice compared to a conventional anti-tartar dentifrice
containing pyrophosphate.21
These indings were supported by results of two independent six-month clinical trials
in which CPH dentifrice and a
CPH prototype showed a 56%
and 55% reduction in calculus
formation, respectively, compared to marketed controls at
six months.22,23
6. Effective in whitening teeth
by removal and prevention of
stains. The combined action of
NaHMP and an advanced, high
cleaning silica system results
in stain removal and whitening beneits. The surface activity of NaHMP competes with
stains for surface sites, effectively preventing the buildup
of new stains. Figure 4 shows
the removal of surface stains
after only two weeks of CPH
use.
Four separate clinical trials,
summarized in two publications, compared the stain
removal eficacy of CPH dentifrice with that of a positive
control whitening dentifrice at
two different time points: baseline and two weeks;24 and baseline, three, and six weeks.25 In
all cases, a highly signiicant
improvement in stain removal
was measured from baseline
for both the CPH and positive
control whitening dentifrice.
In addition, the whitening beneits of the CPH dentifrice were
not signiicantly different from
the positive control.
Figure 3. Bacterial activity of CPH dentifrice remains
strong after 16 hours in a live/dead assay. The CPH
dentifrice (right) killed 90 to 99% of the salivary bacteria 16 hours after a single 60-second exposure to the
product compared to a water control (left), which still
shows virtually all live cells. Green-stained cells represent live microbial cells; red-stained cells represent
dead cells. (Courtesy of Compend. Cont. Educ Dent1)
“It helped with my sensitivity and has a nice,
refreshing taste. It’s also good for the gums.”
What do patients and professionals think about CPh?
The eficacy of CPH dentifrice
is supported by an extensive
body of clinical evidence.
However, its success ultimately depends upon its effectiveness and acceptability to users in the home environment.
The question is do the beneits
measured or observed in a controlled clinical environment
by clinical specialists translate
into product acceptability? In
other words, are dental beneits observed by patients and
dental professionals in clinical
studies evident when used in
the home environment? These
questions have been addressed
in two recent home-use studies. These studies showed that
CPH dentifrice is effective for
and acceptable to both patients
and dental professionals who
used it at home as part of their
normal oral hygiene routine.
Practice-based assessment. A
practice-based assessment of
CPH dentifrice was conducted among patients across the
USA.26 In this study, both patients and their dental professionals answered a questionnaire at the beginning and at
the end of the three- to fourmonth use period (up to six
months in 25% of cases).
Of the 1,078 patients who responded:
•88% rated the product “excellent/very good” or “good”
•77% of those who noticed improvements in their oral health
planned to continue using the
product
•83% rated CPH positively for
reducing surface stains
•9 out of 10 patients rated the
product positively in the areas
of “keeping mouth healthy,”
“cleaning teeth thoroughly,”
“making gums healthier,” and
“freshening breath” (see Figure 5)
Of the 1,267 responses from
dental hygienists and dentists:
•68% noted improvement in
their patients’ gingival bleeding/inlammation and a reduction in the formation of
calculus
•61% noted reduced sensitivity
•57% noticed reduced staining
Eighty percent of the dental
professionals indicated they
would recommend CPH dentifrice to their other patients.
That jumped to 91% of dental
professionals who noted improvements in their patients’
oral health or staining.
Usage study among dental
professionals. Recently, a CPH
usage experience study was
conducted among dental professionals.27 After receiving a
tube of Crest Pro-Health (Clinical Gum Protection variant)
for their personal use, approximately 2,100 dental professionals completed an optional
online survey about their experience using the product:
•99% of dental professionals
rated their experience with
the product as “excellent/very
good/good”
•96% indicated they would
continue to use the product
•92% agreed that dentifrices
containing SnF2 can beneit
their patients more than other
toothpastes
•81% said they had recommended CPH dentifrice to patients in the past and 96% said
they would recommend CPH
to more patients now that they
had experienced the product
themselves (see Figure 6).
When asked why they would
recommend CPH to more of
their patients, some responses
given were:
•”I believe patients can beneit
from this product.”
•”I can only vouch for a product I have personally used and
liked.”
•”I believe this is the best product on the market right now.”
•”Ortho patients need that extra level of protection.”
•”It feels clean, and there was
noticeable plaque reduction in
my mouth.”
•”It helped with my sensitivity and has a nice, refreshing taste. It’s also good for the
gums.”
•”I have seen a clinical improvement with Crest ProHealth.”
Clinical studies demonstrate
that CPH dentifrice puts the
power and convenience of
an eficacious, multi-beneit
toothpaste in the palm of your
hand, providing seven therapeutic and cosmetic beneits
with each use. Real-world, inhome studies show the eficacy
of CPH dentifrice established
> Page 3D
[3] =>
Untitled
hygiene tribune 3D
Dental tribune Middle East & Africa Edition | January-February 2016
< Page 2D “Toothpaste app?”
in controlled clinical trials
translates into effectiveness
and acceptability among both
patients and dental professionals.
Recent studies have shown
that dental care routines that
include CPH, an Oral-B oscillating-rotating power toothbrush, and regular use of dental loss can further enhance
oral care beneits to patients.
These indings show that you
can be conident in recommending CPH dentifrice to
your patients, knowing that
the vast majority are likely to
notice and appreciate beneits
of a clean, healthy mouth and
gums.
Author’s acknowledgment: To
Ms. Anita Guy for assistance
with manuscript preparation.
About the Author
Kimberly Bray is professor and
director for the Division of Dental Hygiene at the University of
Missouri-Kansas City School of
Dentistry. She currently teaches in three degree programs
including two degrees with distance learning options.
Prof. Bray has 24 years of clinical experience in both general
and periodontal practice with
research interests in patient
adherence, alternative learning strategies, and product eficacy.
Figure 5. Summary of patient survey results from
practice-based evaluation of CPH dentifrice. The percentage of patients rating the CPH dentifrice as “excellent/very good/good” in each category shows the high
effectiveness and acceptability among patients who
used the product at least three months and completed
the survey. (Courtesy of Journal of Dental Hygiene26)
references
1. Baig AA , He T. A novel dentifrice technology for advanced
oral health protection: a review of technical and clinical
data. Compend Cont Educ
Dent 2005;26 (supp 1):4-11.
2. Marinho VC, Higgins JP,
Sheiham A, et al. Fluoride
toothpastes for preventing
dental caries in children and
adolescents. Cochrane Database of Systematic Reviews
2003;1 CD00278.
Editorial note:
The full list of references is
available from the publisher.
PRINT
L
DIGITA N
IO
T
A
C
U
ED
EVENTS
< Page 1D “Middle East’s
Dentist Meet Recommends
Power Brushes for
Improved Oral Hygiene”
said Professor Crawford Bain,
Program Director Periodontology, at Hamdan Bin Mohammad College of Dental Medicine.
The two-day meeting was attended by Professor Khaled
Balto, Chairman Department
of Endodontics at King Abdulaziz University, and King Saud
University’s Dr. Montasser AlQutub, Associate Professor in
Periodontology & Implantology, both from Saudi Arabia,
and Dr. Nabeel Al-Sabeeha,
Consultant Prosthodontist at
the Ministry of Health in Ras Al
Khaimah, Dr. Elias Berdouses,
Assistant Professor Department of Paediatric Dentistry at
Dubai’s European University
College, Dubai-based Dr. Ajay
Juneja, Specialist Prosthodontist and Esthetic Dentist, Dr.
Eftherios Kaklamanos, Assistant Professor of Orthodontics,
at the Hamdan Bin Mohammed College of Dental Medicine, all of whom are based in
the UAE, as well as Dr. Badar
Monir Zaki, Senior Consultant
Orthodontics & Dentofacial
Orthopedics, Al Nahdha Hospital from Oman and Dr. Nabih
Nader, Clinical Chief Oral &
Maxillofacial Surgery Department, from the Beirut-based
Lebanese University.
.
The DTI publishing group is composed of the world’s leading
dental trade publishers that reach more than 650,000 dentists
in more than 90 countries.
Figure 6. Summary of in-home usage study of CPH
dentifrice among dental professionals. Results showed
the product is highly effective and widely accepted
among dental professionals participating in the study.
More study participants indicated they would recommend CPH dentifrice to their patients after using the
product at home.
[4] =>
Untitled
4D hygiene tribune
Dental tribune Middle East & Africa Edition | January-February 2016
< Page 1D
comfort for patients and dental staff. Hand instruments
that have only limited tissuepreserving properties can be
replaced in preservation therapy by ultrasonic instruments
(Piezon, EMS Electro Medical Systems, Munich) and air
polishing (Air-Flow with low
abrasive erythritol-based Plus
powder, EMS) for the beneit of
dental staff and patients. In the
following article, the classical
method (Axelsson / Lindhe) is
compared to the modern method (guided bioilm therapy)
based on a patient case.
Using the example of a 20-yearold patient with braces, increased plaque deposits and a
hyperplastic gingiva, the author describes the procedure,
the implementation and time
management of a structured,
professional prophylaxis session. The upper jaw was treated
with the modern method using piezo technology (EMS No
Pain) and air-low technology
(EMS, Air-Flow with Plus powder). The lower jaw was treated
according to the classic, conventional method (hand instruments, ultrasonic technology,
polishing cup, brush, polishing
paste CCS red and Proxyt ine,
Ivoclar Vivadent, Ellwangen).
Procedure (work phases)
1. Workplace preparation
It is advisable to speciically
set up basic tools and products
for the respective treatment
measures of the patient and to
prepare them accordingly (Fig.
1-3). In that way you can save a
lot of time during the prophylaxis treatment and simplify
compliance with the hygiene
chain.
2. Patient pick-up and repeat
anamnesis (2 minutes)
A short introductory talk, in
which speciic needs and questions can be addressed, gives
the patient a sense of having arrived, creates trust and conveys
interest and professionalism.
This is followed by the control
and questions on the case history. This vital step has the objective of ascertaining changes
in health, new risks, prevention
of infection and medicines, and
integrating them into the treatment process. The information
helps to clarify and ensure that
the right technical and material resources are used for the
prophylaxis session without
exposing the patient or dental
staff to any health risk. Only after clariication can the professional cleaning session begin.
3. Disinfection of oral cavity
(1-2 minutes)
In order to reduce the number of bacteria prior to further treatment, rinsing with
0.2% chlorhexidine is recommended. Another modern way
is to clean the entire oral cavity (full-mouth treatment according to Flemmig) including tongue, cheek, palate and
mucolabial fold using air-low
technology and Plus powder
in a gentle and simple manner
(Fig. 4). This seemingly simple
step already serves to carry out
successful bioilm management (guided bioilm therapy).
4. Diagnostics (7 minutes)
After the visual inspection of
the teeth, follows the inspection of the mucous membranes
in the oral cavity. This is where
tongue surface/underside, the
palate, base of the mouth, the
mucolabial
fold
as well as lips and
inner surfaces of
the cheeks are accurately inspected.
After that, a reevaluation of caries,
periodontitis
and erosion diagnostics is carried
out (PSI, measurement of probing
depths, oral hygiene indices, etc.).
This is where electronic systems that
enable a follow-up
have proven their
worth. In order
to ascertain the
plaque index, it is
helpful to stain the
teeth using Mira
Fig. 3: Air-Flow Master Piezon device.
2 Ton (miradent,
Hager & Werken
GmbH & Co. KG,
Duisburg).
The
patient
situation
can be represented
neutrally and made
visible (Fig. 5). In
order to ensure an
Fig. 4: Cleaning the oral cavity with erythritol.
accurate reproducibility of the indices, it is advisable
for the entire team
involved in prophylaxis to agree on
the documentation
and evaluation of
a particular index
and system.
5. Oral hygiene
reinstruction and
Fig. 5: Staining with Mira 2 Ton color before
remotivation
(5
cleaning the upper and lower jaw.
minutes)
The diagnostic indings should
be discussed in detail with the
patient. They are the basis for
successful reinstruction and remotivation of oral hygiene measures at home. Only if patients
understand their situation, can
better compliance be expected.
Visual aids such as a magnifying mirror and an intraoral
camera are very useful for instruction purposes. Based on
the obtained indings, patients
should then be individually instructed on the use of some of
the many available tools (manual toothbrush, rotating or sonic toothbrush, toothpastes, interdental brushes, dental loss,
tongue cleaners, etc.) but not be
overwhelmed with too many
options and techniques. In
summary, it must be stressed
that in order to achieve effective oral hygiene, the instruction and motivation of patients
is a central and challenging
component of professional
prophylaxis sessions. The selection of the appropriate tools
and instruction depends on the
individual needs and abilities
of the patient.
6. treatment preparation (2
minutes)
This includes the use of safety
goggles as protection against
infections for both the dental
staff and the patient. Furthermore, lips should be protected
by putting crème on them. Patient comfort can likewise be
increased by using an OptraGate rubber appliance (Ivoclar
Vivadent), which allows a clearer view of the oral cavity. The
use of parotis rolls can also be
very helpful.
7. Professional tooth cleaning
(30 minutes)
7.1. Modern preservation
therapy (general)
Modern professional dental
cleaning involves the removal
of hard and soft deposits in a
particularly gentle way. Bioilm
management today plays an increasingly important role. With
the air-polishing technology
with low abrasive powders, the
surfaces are not only cleaned
and subjected to bioilm management in supragingival and
sulcular regions, but also in
subgingival regions even into
deep pockets. A classic polishing with conventional polishing pastes, cups and brushes,
which is only possible in supragingival regions and always accompanied by loss of substance,
is not necessary. With this new
technology, injury to the soft
tissue around the tooth and
the mucous membranes can
be avoided. Another big advantage is that all restorations and
prosthetics in the oral cavity
are cleaned and polished at the
same time without roughening
or damaging the materials.
7.2. Modern preservation
therapy (patient case)
In the case at hand, the bioilm
and discoloration made visible by staining were removed
in the upper jaw using airlow technology and erythritol
powder (Plus, EMS) above and
below the enamel cement border (Fig. 6, upper jaw). Only
by using the new technology is
it possible to quickly and easily achieve a perfect polish in
Fig. 6: Inspection after cleaning the upper jaw using a modern method
and the lower jaw using a classic method.
dificult-to-reach areas, which
are inaccessible with polishing cup and brush. In addition,
when using this technology,
the metal of orthodontic appliances can also be cleaned
without running the risk of
damaging it. Once the bioilm
has been removed, tartar and
any subgingival calculus become clearly visible and can
be selectively removed with a
very ine ultrasonic tip (EMS
Piezon/PS tip). This development in ultrasound technology is referred to as “Piezon No
Pain” in the new generation. It
is an intelligent technology that
enables lightning-fast, continuous power adjustment. The
EMS instrument measures the
resistance (approximately 125
times per second) provided
by hard deposits and feeds the
resistance value information
back to the built-in module in
the EMS device (continuous
feedback). The intensity of the
instrument tip is thus adjusted
to the “dificulty” of the hard
deposits that are to be removed.
Once the resistance (tartar, calculus) has been removed, the
device reduces the power automatically. This therefore enables gentle as well as eficient
work. Exposed, hypersensitive
cervical areas and root surfaces are treated in a painless
manner and patient comfort is
increased. Only in exceptional
cases is re-polishing with airlow technology and erytrithol
powder (Plus, EMS) necessary.
Since the patient had a hyperplastic gingiva, sulcular cleaning and polishing was necessary in this case. The aim was
to carry out successful bioilm
management here, too. It was
possible to do this very well
with the air-low technology
Plus (erytrithol) without traumatizing the tissue. The patient
thought the treatment was very
pleasant.
7.3 Classic treatment (patient
case)
The same initial situation was
at hand in the lower jaw, too.
Here conventional materials
were now used for cleaning (ultrasonic, hand tool, polishing
cup, polishing brush, polishing pastes CCS red and Proxyt
ine). With the help of mechanical and manual instruments,
hard and soft deposits were
removed in supragingival and
sulcular regions. Afterwards,
a pre-polishing of all areas followed using a polishing paste
(CCS red) and various soft
brushes of any form. The ine
polishing was carried out with
a soft polishing cup with a ine
polishing paste (Proxyt ine)
(Fig. 6, lower jaw). The dificulty compared to the air-low pol-
ishing therapy was that some
regions were very hard to reach
or not suficiently accessible.
Polishing and bioilm management cannot be carried out as
precisely in sulcular regions.
Minor injuries to the gingiva
were caused quicker. Especially in the region of the brackets,
the cleaning was more dificult
than using air-low polishing
and erytrithol (Plus). Compared to the treatment in the
upper jaw with Piezon No Pain
and air-low technology Plus,
more materials, tools and time
were needed for the lower jaw.
Cleaning with air-low technology Plus was more precise in
terms of cleaning success.
8. Control of the degree of perfection and chemical plaque
control (10 minutes)
Control of the cleaning perfection degree can be carried
out very well with a ine probe
(here: Hu Friedy EXD 3CH,
Frankfurt/Main) and magnifying glasses. It followed the
inspection by the dentist and
a chemical plaque control. As
a hyperplastic situation was at
hand, a 1% chlorhexamed gel
was applied. The luoridation
with Elmex Fluid was carried
out in the next session two days
later.
9. recall (2 minutes)
Regular professional care is a
basic element of prevention. It
is important to determine an
appropriate time for the followup appointment on the basis of
the respective indings. This
depends on many individual
factors. Here one has to differentiate according to risk groups
(individual, age-speciic, riskbased prophylaxis).
Conclusion
A paradigm shift is currently
taking place when it comes to
the procedures and implementation of professional preservation therapy, which makes it
necessary to critically re-think
old habits. The scientiic and
technical conditions are provided. It is time to start using
the simpliied, more eficient,
effective, comfortable and –
above all – substance-conserving treatment method for the
good and the health of our patients.
About the Author
Adina Maurer
Dental hygienist
Zahnklinik Berlin
Gropiuspassagen
Johannisthaler-Chaussee 295-327
12351 Berlin
www.zahnklinik-berlin.info
Instructor/Member of DG Paro e.V.
[5] =>
Untitled
[6] =>
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6D hygiene tribune
Dental tribune Middle East & Africa Edition | January-February 2016
Oral health and diabetes discussed
at premier event in Singapore
by Dental tribune international
S
ingaPOre:
Among
developed nations, Singapore has the secondhighest proportion of diabetics,
according to a recent report by
the International Diabetes Federation. As the condition continues to be a growing concern
owing to the increasingly sed-
entary lifestyle and high-calorie diets of Singaporeans, the
city-state was the ideal place
for the Joslin–Sunstar Diabetes
Education Initiative (JSDEI)
to hold its irst Diabetes, Oral
Health and Nutrition symposium in Asia.
The one-day event took place
last week at the Swissôtel The
Stamford. Attended by Singapore Chief Dental Oficer Patrick Tseng and Japanese Ambassador Haruhisa Takeuchi as
part of the SJ50 celebrations (a
number of events to commemorate 50 years of diplomatic ties
between Singapore and Japan),
it provided the latest information on the two-way relationship between diabetes and oral
health. Over 300 international
leading medical and dental
health care global experts,
including Dr George King,
Senior Vice President, Chief
Scientiic Oficer and Director
of Research at the Joslin Diabetes Center in Boston in the
US, among others, presented
the latest indings on the interrelationships, innovations and
Pixabay / Photo: mlarsson62
www.DTStudyClub.com
Y education everywhere
and anytime
Y live and interactive webinars
Y more than 500 archived courses
Y a focused discussion forum
Y free membership
Y no travel costs
Y no time away from the practice
Y interaction with colleagues and
experts across the globe
Y a growing database of
scientific articles and case reports
Y ADA CERP-recognized
credit administration
Register for
FREE!
ADA CERP is a service of the American Dental Association to assist dental professionals in identifying quality providersof continuing dental education.
ADA CERP does not approve or endorse individual courses or instructors, nor does it imply acceptance of credit hours by boards of dentistry.
interactions between periodontitis and diabetes.
Future strategies on oral and
systemic health, as well as how
JSDEI’s efforts at strengthening the ties between the medical and dental ields were also
discussed.
According to the initiative, increasing evidence supports the
existence of an association between periodontal disease and
diabetes. The latest research
has shown that not only are
people with diabetes more susceptible to serious periodontal
disease, but the condition may
also have the potential to affect blood glucose control and
contribute to the progression of
diabetes.
Recognising that early and
proper treatment of periodontal disease can have a profound effect on the control of
diabetes and its complications,
the Sunstar Foundation established the JSDEI in April 2008
with the Joslin Diabetes Center, the world’s largest diabetes research and clinical care
organisation dedicated to the
prevention, treatment and cure
of diabetes, afiliated with the
Harvard Medical School, to engage in education and research
to improve knowledge and
practices in this ield.
In addition to its symposium in
Asia, it has organised an annual event under the same name
in Europe.
Established almost 40 years
ago, the Sunstar Foundation
for Oral Health Promotion has
achieved international recognition for the signiicant beneits to society gained through its
efforts to improve oral care and
promote dental health through
various activities.
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[toc_titles] => Toothpaste app?
/ Middle East’s Dentist Meet Recommends Power Brushes for Improved Oral Hygiene
/ Classic versus modern: Comparison of new method of professional dental cleaning
/ Oral health and diabetes discussed at premier event in Singapore
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