Summary of Lecture # 3

Dental Caries
 Definition of tooth cavitation: localized , post-
eruptive pathological process involving bacterial
acid demineralization of hard tooth tissue resulting
in the formation of a cavity.
 Types of caries lesions
 Stages of dental caries
Dental Caries
 Progression of caries depends on:
1. Ions concentration
2. pH
3. Salivary flow
4. Buffering action
Dental Caries
 Ecology of dental caries:
- Before teeth eruption the number of MS is very
low
- The source of infection of infant by MS is from
caregiver (usually the mother) by mouth-to-
mouth transmission via kissing or sharing spoon
during feeding
Periodontal Disease
Toothbrushes and
Tooth-brushing Methods
October 24, 2007

Abdullah S. Al-Swuailem BDS, MS, MPH, Dr PH

Toothbrushes and
Tooth-brushing Methods
 History:
- Arabs used roots of Arak tree (Siwak)
- Chinese are credited for inventing the
toothbrushes consisting of a handle with
bristles (618-907 AD)
- Williams Addis (England, 1780)
manufactured the first modern toothbrush:
handle made of bone with holes for placement
of natural hog bristles
Toothbrushes and
Tooth-brushing Methods
 History:
- During World War II, nylon bristles
replaced natural bristles
- There was a variation of handle size,
angulation and length of the toothbrush
Toothbrushes and
Tooth-brushing Methods

 Replacement of toothbrushes at 3- to-4

months intervals is provoked by reports
of contamination of toothbrushes after
oral or medical bacterial /viral infection
Toothbrushes and
Tooth-brushing Methods
 Manual toothbrushes design:
- size: large, medium, and small
- Texture: hard, medium, soft or extra soft
- Bristle design: flat or multi-level bristles
(more effective)
- Bristles cut bluntly have sharp ends and
toothbrushes made with such bristles are
more abrasive than end-rounding tips
 Handle design:
 Toothbrushes and
Tooth-brushing Methods
 Powered toothbrushes
- More effective in plaque removal
- May result in gingival recession
- There is an increase in the use of
powered toothbrushes due reduction of
prices
- Heads are usually smaller than manual
toothbrushes
Toothbrushes and
Tooth-brushing Methods
 Patient’s motivation
Toothbrushes and
Tooth-brushing Methods
 Function of a toothbrush and
toothbrushing:
1. Carry dentifrice to tooth surfaces
2. Remove the dental plaque
3. Clean teeth of food, debris and stain
4. Massage the gingival tissues
Toothbrushes and
Tooth-brushing Methods
 Tooth-brushing Methods
- Bass, Stillman, Charters
- Roll or scrub
- Individualized tooth brushing techniques for
each patient
- Reciprocating horizontal scrub technique
- Rotary motion (Fones’s technique)
- Simple up- and – down motion (Leonard's
technique)
Toothbrushes and
Tooth-brushing Methods
 Tooth-brushing methods:
- Stillman technique: Stimulate gingival tissues
- Charters technique: toothbrushes placed at
90 degrees to long access of the teeth, so that
the bristles are gently forced between teeth
- Bass technique: the toothbrush is placed in
the gingival sulcus at a 45 degree angle to the
long access of teeth. Vibratory movement of
toothbrush (back-and-forth strokes)
Toothbrushes and
Tooth-brushing Methods
 Toothbrushing Time and Frequency:
- After every meal? Or regularly as
advised by American Dental Association
(ADA)?
- Patients tend always to overestimate
their brushing time and frequency
Toothbrushes and
Tooth-brushing Methods
 Toothrushing procedures:
- Occlusal surface
- Anterior lingual areas
 Techniques for young children
- Methods?
- Supervision
 Techniques for Adults