Oral Hygiene

                                                                                      Definition

Oral hygiene is the practice of keeping the mouth and teeth clean to prevent dental problems, most commonly, dental cavities, gingivitis, periodontal (gum) diseases and bad breath. There are also oral pathologic conditions in which good oral hygiene is required for healing and regeneration of the oral tissues. These conditions include gingivitis,periodontitis, and dental trauma, such as subluxation, oral cysts, and following wisdom tooth extraction.

Oral hygiene is a care the mouth with or without use antiseptics to meet one needs personal hygiene clients .Simply oral hygiene to use the clean water , warm and mature .Oral hygiene can be done with in the treatment of hygiene another body as bathroom , mengosok teeth etc .Nurses need to help patients / family for the maintenance to enhance the role of active in giving care to victims

Good oral hygiene results in a mouth that looks and smells healthy. This means:

•           Your teeth are clean and free of debris

•           Gums are pink and do not hurt or bleed when you brush or floss

•           Bad breath is not a constant problem

The Purpose of Oral Hygiene

1. Prevent infection
2. Give a sense of comfortable in the area the mouth clients
3. Reduce pain excessive
4. Prevent complication

Equipment

1.      The solution dessert / antiseptic solution (Betadine liquid)

2.      Tong spatula wrapped with a layer of gauze

3.      Towel face, crooked

4.      Towel paper / tissue

5.      The glass with cold water / warm

Procedure

1.      Explain the procedure to the family of the patient / patient

2.      Wash your hands

3.      Place a towel over the bed table and or equipment

4.      Pull the curtains around the bed and close the door.

5.      Adjust the position of the client

6.      The location of the towels under the patient's face and bent under the chin sufferers

7.      Carefully stretch your upper and lower teeth of patients with tong spatula appropriately but gently, between the rear molars. Insert if the patient relax, whenever possible.

8.      Clean the patient's mouth using a spatula tong that has been soaked in water / dessert. Clean the surface of the teeth. Rub paltum mouth, lips, cheeks. Rub the tongue but avoid reflexes. Dampen a clean applicator with water and rub the mouth to wash. Repeat as needed. 

9.      Wash hands after performing the action.

10.  Write down the things that are required (eg, bleeding gums, tongue ruptured)

Prevent of Oral Disease

            Maintaining good oral hygiene is one of the most important things you can do for your teeth and gums. Healthy teeth not only enable you to look and feel good, they make it possible to eat and speak properly. Good oral health is important to your overall well-being.

            Daily preventive care, including proper brushing and flossing, will help stop problems before they develop and is much less painful, expensive, and worrisome than treating conditions that have been allowed to progress.

In between regular visits to the dentist, there are simple steps that each of us can take to greatly decrease the risk of developing tooth decay, gum disease and other dental problems. These include:

1. Cleaning of teeth

Teeth cleaning is the removal of dental plaque and tartar from teeth to prevent cavities, gingivitis, gum disease, and tooth decay. Severe gum disease causes at least one-third of adult tooth loss.

Tooth decay is the most common global disease. Over 80% of cavities occur inside pits and fissures on chewing surfaces where brushing cannot reach food left trapped after every meal or snack, and saliva or fluoride have no access to neutralise acid and remineralise demineralised teeth, unlike easy-to-reach surfaces, where fewer cavities occur.

Dental sealants, which are applied by dentists, cover and protect fissures and grooves in the chewing surfaces of back teeth, preventing food from becoming trapped thus halting the decaying process. An elastomer strip has been shown to force sealant deeper inside opposing chewing surfaces and can also force fluoride toothpaste inside chewing surfaces to aid in remineralising demineralised teeth.

Since before recorded history, a variety of oral hygiene measures have been used for teeth cleaning. This has been verified by various excavations done throughout the world, in which chew sticks, tree twigs, bird feathers, animal bones and porcupine quills were recovered. Many people used different forms of teeth cleaning tools. Indian medicine (Ayurveda) has used the neem tree, or daatun, and its products to create teeth cleaning twigs and similar products; a person chews one end of the neem twig until it somewhat resembles the bristles of a toothbrush, and then uses it to brush the teeth. In the Muslim world, the miswak, or siwak, made from a twig or root, has antiseptic properties and has been widely used since the Islamic Golden Age. Rubbing baking soda or chalk against the teeth was also common.

Generally, dentists recommend that teeth be cleaned professionally at least twice per year. Professional cleaning includes tooth scaling, tooth polishing, and, if tartar has accumulated, debridement; this is usually followed by a fluoride treatment. However, the American Dental Hygienists' Association (ADHA) publicly stated in 1998 that there is an absence of evidence that scaling and polishing provides therapeutic value. The Cochrane Oral Health Group reviewed nine studies but found them to be of insufficient quality and not enough evidence to support the claims of the benefits of regular tooth scaling or tooth polishing.

Between cleanings by a dental hygienist, good oral hygiene is essential for preventing tartar build-up which causes the problems mentioned above. This is done through careful, frequent brushing with a toothbrush, combined with the use of dental floss to prevent accumulation of plaque on the teeth.

2. Removing plaque

Plaque is a yellow sticky film that forms on the teeth and gums and can be seen at gum margins of teeth with disclosing tablets. The bacteria in plaque convert carbohydrates in food (such as sugar) into acid that demineralises teeth, eventually causing cavities. Daily brushing and flossing removes plaque and can prevent tartar from forming on the teeth.

Plaque can also cause inflammation of the gum (gingivitis), making it red, tender and can easily bleed when flossing or brushing your teeth. If this is not treated, bones around the teeth can be affected by the various inflammatory factors, eventually leading to bone resorption. This condition is called periodontitis, which is mostly seen in the adult population. If not treated, the loss of bone structure may cause teeth to become mobile. The treatment is to remove plaque inside the deep pockets between the tooth surface and the soft tissues using specialized dental equipment. If the treatment is successful, the gum will pull away from the teeth (receding gums) as a result of the cessation of the inflammatory swelling.

3. Flossing

The use of dental floss is an important element of oral hygiene, since it removes plaque and decaying food remaining stuck between the teeth. This food decay and plaque cause irritation to the gums, allowing the gum tissue to bleed more easily. Acidic foods left on the teeth can also demineralise teeth, eventually causing cavities.

Flossing for a proper inter-dental cleaning is recommended at least once per day, preferably before brushing so fluoride toothpaste has better access between teeth to help remineralise teeth, prevent receding gums, gum disease, and cavities on the surfaces between the teeth. For some people, flossing might be recommended after every meal. 

            A dental hygienist demonstrates dental flossing.

                                    It is recommended to use enough floss to enable easy use, usually ten or more inches with three to four inches of taut floss to put between teeth. Floss is then wrapped around the middle finger and/or index finger, and supported with the thumb on each hand. It is then held tightly to make taut, and then gently moved up and down between each tooth. It is important to floss under visible areas by curving the floss around each tooth instead of moving up and down on gums, which are much more sensitive than teeth. Bleeding gums are normal upon first usage of floss, but will stop as gums become healthier with use. One should use an unused section of the floss when moving around different teeth. Removing floss from between teeth requires using the same back-and-forth motion as flossing, but gently bringing the floss up and out of gaps between teeth.

4. Interdental brushes

An interdental brush, also called an interproximal brush or a proxy brush, is a small brush, typically disposable, either supplied with a reusable angled plastic handle or an integral handle, used for cleaning between teeth and between the wire of dental braces and the teeth. Brushes are available in a range of widths, color coded as per ISO 16409. Interdental brushes are classified according to ISO standard 16409:2006. The ISO brush sizes range from 1 to 7. The ISO brush size is determined by the PHD or Passage Hole Diameter in mm. This PHD is the minimum diameter of a hole that the interdental brush will pass through without deforming the brush wire stem. A peer-reviewed clinical study has found that using a toothbrush and an interdental brush more effectively removes plaque than using a toothbrush and dental floss.

5. Tongue cleaning

Cleaning the tongue removes the white/yellow bad-breath-generating coating of bacteria, decaying food particles, fungi (such as Candida), and dead cells from the dorsal area of the tongue. Tongue cleaning also removes some of the bacteria species which generate tooth decay and gum problems.

6. Food and drink

Foods that help muscles and bones also help teeth and gums. Breads and cereals are rich in vitamin B while fruits and vegetables contain vitamin C, both of which contribute to healthy gum tissue. Lean meat, fish, and poultry provide magnesium and zinc for teeth.

Eating a balanced diet and limiting snacks can prevent tooth decay and periodontal disease. The Fédération dentaire internationale (FDI World Dental Federation) has promoted foods such as raw vegetables, plain yogurt, cheese, or fruit as dentally beneficial this has been echoed by the American Dental Association (ADA).

Cause Damage Oral Disease

1.         Harmful foods

            Sugars are commonly associated with dental cavities. Other carbohydrates, especially cooked starches, e.g. crisps/potato chips, may also damage teeth, although to a lesser degree (and indirectly) since starch has to be converted to sugars by salivary amylase (an enzyme in the saliva) first. Sugars that are higher in the stickiness index, such as toffee, are likely to cause more damage to teeth than those that are lower in the stickiness index, such as certain forms of chocolate or most fruits.

            Acids contained in fruit juice, vinegar and soft drinks lower the pH level of the oral cavity which causes the enamel to remineralize. Drinking drinks such as orange juice or cola throughout the day raises the risk of dental cavities tremendously.

Another factor which affects the risk of developing cavities is the stickiness of foods. Some foods or sweets may stick to the teeth and so reduce the pH in the mouth for an extended time, particularly if they are sugary. It is important that teeth be cleaned at least twice a day, preferably with a toothbrush and fluoride toothpaste, to remove any food sticking to the teeth. Regular brushing and the use of dental floss also removes the dental plaque coating the tooth surface.

2.                         Chewing gum

Chewing gum assists oral irrigation between and around the teeth, cleaning and removing particles, but for teeth in poor condition it may damage or remove loose fillings as well. Chewing sugar free chewing gum that contains xylitol may be good for teeth. Dental chewing gums claim to improve dental health. Sugar-free chewing gum stimulates saliva production, and helps to clean the surface of the teeth.

3.                         Smoking

Smoking and chewing tobacco are both strongly linked with multiple dental diseases. Regular vomiting, as seen in bulimia nervosa, also causes significant damage. Caffeine products are known to cause teeth to stain, though this can usually be cleaned by drinking fresh water after a caffeinated drink and also at the dentist by surface cleaning.

Mouthwash or mouth rinse with saline (salty water), fluoridated solution or the antiseptic solution chlorhexidine gluconate can improve oral hygiene by removing some tooth decaying materials, in particular it will help to remove some foods you ate recently.

Systemic Diseases

Several recent clinical studies suggest oral disease and inflammation (oral bacteria & oral infections) may be a potential risk factor for serious systemic diseases, such as:

•           Cardiovascular Disease (Heart attack and Stroke)

•           Bacterial Pneumonia

•           Low birth weight/Extreme High Birth Weight

•           Diabetes complications