DTUK1710

W e all know what’s good for us; eat well, exercise more, but there always seems to be a reason why we’re unable to make the changes we’d like to see in our lives. This is no different for our patients when it comes to maintaining a good oral healthcare habit. When it comes to interdental care, although many know the importance of removing the plaque that builds up unseen between teeth and below the gum line, there is still a lack of motivation to adopt a regular interdental routine. According to a survey conducted in 1998, over half the adult population is suffering from periodontitis. As most dental practitioners know, the empha- sis of the recent Steele Report was the need to improve oral health as a pre- ventative method for the more serious complaints seen everyday in practices across the country. The challenge for dental profession- als is how to achieve and maintain bet- ter rates of compliance with oral health- care routines by patients. Although 22 per cent of adults claim to floss regu- larly, is there good reason to be suspi- cious of this claim, and what might be the reasons for the low take-up? Flossing is by no means a recent invention. Since the 1800s the notion of passing a silk thread between the teeth to loosen collected matter has been advocated as being an effective way of preventing tooth decay, but there’s evi- dence dating back to prehistoric times of such methods being employed. Since the 1970s flossing has become an inte- gral part of oral healthcare, and yet it’s still undertaken by a relatively small fraction of the population. Interdental brushing vs flossing One reason may be that many dental practitioners find effective flossing difficult to teach, and patients often find it a tricky technique to master. For those with poor manual dexter- ity, limited mouth opening or a strong gag reflex, alternatives to flossing (such as interdental brushing) should be sought. Only requiring one hand to perform the task of plaque removal is certainly an advantage for many patients, regardless of their manual dexterity, especially when the han- dles are ergonomically designed for greater manoeuvrability. There is evidence supporting the view that interdental brushing is a better option for patients. A three- month trial found that not only did the people become proficient in using the brushes more quickly than floss, but also plaque and gingival inflamma- tion was reduced more. It’s been recognised that flossing may not always be the most effective tool for removing interproximal bio- film, and that flossing becomes pro- gressively less effective in interdental areas that have slight to moderate re- cession or complete loss of the inter- dental papillae. In contrast, interdental brushes of- fer the flexibility of a range of filament thicknesses and lengths, meaning that regardless of the gap, there is a brush suited to best reach the recesses, mak- ing the process more effective: As evidenced, because the filaments are soft there is less risk of damaging the delicate gum membrane, causing the pain and bleeding which will often de-motivate the patient from persever- ing with the oral healthcare routine. Maintaining motivation Dental professionals, particularly den- tal hygienists, are at the forefront of oral healthcare education. With the shift in focus in NHS dentistry set to change, and a recommended restructuring of the payment structure to reflect the practice’s efforts to improve oral health, motivating the patient to adopt and then maintain an oral healthcare rou- tine should be in the minds of practice managers. The question is how. Explain the risks: the connection between gum disease and heart dis- ease has long been anecdotally sus- pected, but recent research has con- firmed the link. It’s now understood that people with periodontal disease are almost twice as likely to suffer from coronary artery disease as those without periodontal disease. Patients who are pregnant ought to be made aware that there is a re- lationship between periodontal infec- tions and low birth rate. Setting goals is a useful tool. Often a patient will claim a lack of time as being the reason for not maintain- ing a healthcare routine that involves flossing. One suggestion is to negoti- ate with the patient to produce a writ- ten healthcare plan. One advantage of interdental brushe is their ease of use. The er- gonomic grip makes reaching the trickiest of interdental spaces easy to reach with one hand, making it feasi- ble to clean the gaps between teeth at times convenient to the patient; whilst watching television at home or on the move. The handy-sized brushes can be kept in a bag or purse to be used anytime or anywhere. By creating a written plan the pa- tient is far more likely to maintain an oral health routine, especially when another person (such as a dental hygi- enist) monitors their progress. With more than 30 years of experi- ence in designing interdental brushes, Curapxox have created the most dura- ble and effective brushes now on the market. With ergonomic grips provid- ing excellent manoeuvrability and con- trol, patients will soon see an improve- ment in their oral health. DT How to achieve better inter- dental healthcare routines perio Tribune Clare Southard looks at the use of the interdental brushes in patients’ oral healthcare regimes EverClear™ a triumph in clarity For details of Carl Zeiss and our wide range of other dental products contact: See what you are missing... Carl Zeiss EyeMag Smart 2.5x loupes Carl Zeiss GTX Carl Zeiss EyeMag Pro prismatic loupes Carl Zeiss OPMI® Pico Nuview Ltd, Vine House, Selsley Road, North Woodchester, Gloucestershire GL5 5NN Tel: 01453 872266 Fax: 01453 872288 E-mail: info@nuview-ltd.com Web: www.voroscopes.co.uk •Floorstand, ceiling or wall mounted •Photoport for digital camera •Five step magnification •Superlux 180 Xenon daylight illumination V2 LED Illumination perio Tribuneperio Tribuneperio Tribune pages 15-16page 14 Liviu Steier discusses a paper re- garding latest developments in perio So, where have all the periodontists gone? Louis Malcmacher discusses Liviu Steier details an implant case involving soft tissue aesthetics Using resorbable barriers to make root recession coverage predictable Live perio Q&A Case study Recession Coverage pages 17-18 pages 19-20 perio Tribune Christou V et al, Comparison of different approaches of interdental oral hygiene: interdental brushes versus dental floss. Journal of Periodontology, 1998. Chicago – June 18, 1997 – The American Academy of Periodontology. Asikainen, S et al, Can one acquire periodontal bacteria and periodontitis from a family member? J Am Dent Assoc. 1997