The Right and Wrong Ways to Brush

Most people start brushing their teeth as toddlers, so one might think that by the time we reached adulthood, we’d be professionals at it. Assuming one brushes twice a day for 20 years, that’s approximately 14,600 practice sessions. But each of us has probably seen our share of patients whose teeth make it evident that those 14,600 brushings have been done the wrong way. We are often asked about sensitive teeth and what can be done to manage the condition. Excessive tooth wear and gingival recession, which can lead to dentin hypersensitivity, are just a few of the problems we see resulting from overzealous brushing. How can such a seemingly simple act trip up so many people? How can we help our patients learn and maintain the proper technique?
We know there are multiple factors in brushing that can contribute to tooth wear, and it is not always evident which factor, or combination of factors, is responsible when we see a patient with obvious abrasion or recession. In these cases, hygienists should review the list of possible causes with the patient in order to identify the culprit(s). The list can be difficult to remember, but we can give our brains a helping hand with a simple mnemonic device: “Make Brushing Feel Truly Fantastic Again.” Each of these words corresponds to a factor in the proper toothbrushing checklist.
 

MOTION

The brushing motion most associated with tooth wear is the horizontal technique,¹ which seems to be the default setting for many patients. This can be a difficult factor

NON INFECTIOUS HEALTH HAZARDS IN DENTISTRY

Dental professionals may be at risk for exposure to numerous workplace hazards. There are currently no specific standards for dentistry, but rather workplace hazards that may apply to dentistry are addressed to the entire healthcare industry.¹ However, there are numerous different materials, chemicals, and supplies commonly used in the general dentist’s office that are left out of the expansive collection of workplace hazards.
Concerns arose about the health risks from dental materials since at least the 1960s. The medical literature and government agencies have both examined and made recommendations to reduce risk of miscarriage, birth defects, and reduced female fertility at different levels of exposure to several hazards (materials, chemicals, supplies, radiation, etc).² Fortunately, several steps can be taken to control the level of exposure from these agents, either voluntarily or under the regulations of the Occupational Safety and Health Administration (OSHA). These include, but are not limited to, handling the agents properly, monitoring the levels of exposure, using devices to lower the levels, and properly disposing of the agents.

Mercury
Mercury, the main component in dental amalgam, has been used for more than 150 years in hundreds of millions of patients. Amalgam fillings are composed of a mixture of metal alloys and liquid mercury, with 50% of this mixture being elemental mercury.In 2009, the Food and Drug Administration issued a final ruling that classified dental amalgam as

DISINFECTING CLINICAL SURFACES

Dental operatory surfaces and equipment can become contaminated with patients’ blood and other oral fluids through contact with dental healthcare personnel’s (DHCP) gloved hands; spray and splash created by dental instruments such as handpieces, air/water syringes, and ultrasonic scalers; and through contact with contaminated instruments placed on various surfaces. Determining the management of environmental surfaces in the dental setting requires attention to the areas and objects that may become contaminated during patient treatment and classification of disinfectants and surfaces to guide DHCP in proper technique and materials for disinfection.

 

Classification of Disinfectants

E.H. Spaulding, a pioneer in healthcare disinfection and sterilization, identified three classifications of disinfectants, based on the product’s ability to kill certain organisms.¹ High-level disinfectants are capable of killing all microorganisms, including resistant

Oral Malodor: Causes, Assessment, and Treatment

Oral malodor has been recognized in the literature since ancient times. However, in the last 5 to 6 years, it has come to the forefront of public and dental professional awareness. Oral malodor is caused mainly by facultative bacteria on the tongue that produce volatile organic compounds. Traditional assessment methods include organoleptic measurements and gas chromatography. Newer techniques make diagnosis more convenient, and the electronic nose is in the early stages of development. After assessment, active practices of using proper oral hygiene products and making small lifestyle changes can reduce the amount of oral malodor significantly for an individual. Understanding causes, assessment, and treatment of oral malodor can help dental professionals find ways to decrease its prevalence and increase their patients’ well-being.
More than 50% of the general population has oral malodor,¹ commonly known as “bad breath.” Present-day research has shown sulfur-producing anaerobic bacteria on the tongue form certain volatile organic compounds (VOCs) that produce unpleasant odors in the mouth. Numerous methods are used for assessing oral malodor severity. Traditional oral malodor assessment methods include organoleptic measurements and gas chromatography, while advanced technology has given rise to machines that make diagnosing oral malodor in dental clinics more convenient.
Diagnosis is only the first step in treatment. On consultation by dental professionals, patients must take further action to control and manage oral malodor in their daily lives. They can accomplish this either mechanically or chemically. Each case is treated differently, depending on its origin. By having a holistic grasp of where oral malodor originates and how to analyze and treat it, future dental products can be made to better cater to these patients. The consequences of having oral malodor are twofold. Oral malodor not only makes the individual feel uncomfortable in public places but also can be an indication of the individual’s overall well-being. Thus, careful analysis of oral malodor can be used as an approach in diagnosing systemic diseases and understanding how lifestyle habits affect oral health.