(Iv) Preventive Dentistry: Effective and Yet Simple Tooth Brush Modifications
(Iv) Preventive Dentistry: Effective and Yet Simple Tooth Brush Modifications
(Iv) Preventive Dentistry: Effective and Yet Simple Tooth Brush Modifications
Brushing techniques:
Generally, the brushing techniques are the same as healthy adults. However , this is
sometimes difficult for the parents to perform.
2 minutes – 2 times per day
Simple technique that can be used: Horizontal scrub technique
o Using a soft tooth brush
o Brush is moved back and forth in horizontal strokes
C. Fluoride Exposure:
Use of systemic fluoride is important.
An analysis to determine the level is indicated.
Regardless of the systemic intake, topical fluoride should be applied after a regularly
scheduled professional prophylaxis.
5% neutral sodium fluoride varnishes have been shown to be beneficial.
An American Dental Association–accepted dentifrice containing a therapeutic fluoride
compound should also be used daily.
D. PREVENTIVE RESTORATIONS
Pit and fissure sealants and preventive resin restorations: reduce occlusal caries effectively.
For a patient who requires dental work under general anesthesia: restored with amalgam
or long-wearing composites to prevent further breakdown and decay.
Patients with severe bruxism and interproximal decay: restored with stainless steel crowns
to increase the longevity of the restorations.
professional prophylaxis
examination
topical fluoride application
Child is often apprehensive due to hospital visits or previous appointments with a physician.
Additional time must be spent with the parent and the child to establish rapport and relief the
child’s anxiety.
If patient cooperation cannot be obtained: the dentist must consider alternatives
protective stabilization
conscious sedation
general anesthesia
Certain neuromuscular disorders: need to diagnose and treat, as well as to protect the safety of the
patient, parent, staff and practitioner, may justify the use of stabilization. (AAPD)
Use of behavioral management or sedation can reduce the amount of stabilization required.
Stabilization can be performed by the dentist, staff, or parent, with or without the aid of a
stabilization device. (by lightly restraining the patient’s hand)
Parental consent:
Extremities:
1. Towel and tape on forearm
2. Posey strap
Wheelchair tilter to accommodate the patient’s own wheelchair for dental treatment.
o be used as punishment
o be used solely for the convenience of the staff.
o an informed consent
o the indications for use
o the type of stabilization used
o the duration of application.
The tightness and duration of stabilization must be monitored and reassessed at regular
intervals.
Stabilization around the extremities or chest must not actively restrict circulation or
respiration.
Indications:
• A patient who requires immediate diagnosis and/or limited treatment and cannot cooperate
because of lack of maturity, mental or physical disability.
• A patient who requires diagnosis or treatment and does not cooperate after other behavior
management techniques have failed and for whom pharmacological management is contra-
indicated.
• The safety of the patient, staff, parent or practitioner would be at risk without the use of
protective stabilization.
Contraindications:
• A cooperative non-sedated patient.
• Patients who have experienced previous physical or psychological trauma from protective
stabilization (unless no other alternatives are available).
Fearful child.