This disease is initiated, most commonly, by bacteria known as Streptococcus mutans. Bacteria thrives in a sticky matrix called plaque. The best way to prevent this disease is by manually removing the bacteria and plaque from the tooth surface; thereby preventing the acid challenge from the bacteria that dissolves the tooth structure. It takes an average of twenty-four hours for a tooth surface to have damage from the bacteria sitting on it. Plaque removal is recommended in the morning and before bed.
There are populations that are unable to clean their teeth properly due to various disabilities. This can include loss of function in the hands or loss of dexterity. This can impair the person's ability to manually remove the bacteria causing tooth decay. Assisted devices can improve a persons ability to remove the bacteria and plaque matrix therefore preventing dental caries.
Devices that improve oral health should be tailored to the patient needing assistance and the barrier the patient experiences. Following are examples of ways to improve oral health for people needing assistance.
Step 1: Electric Toothbrush
The electric tooth brush is a fantastic tool to help remove plaque from the tooth surface. It is designed to be held in place while the brush head turns thereby removing the sticky plaque from the tooth surface.
People with dexterity issues can find this useful. It is recommended to look at different products available. Things to look at when selecting an electric toothbrush are: weight, ease of depressing the power button, cost, and cost for replacement brush heads. Always select a brush with a timer to ensure the person is using the brush for a full two minutes in order to allow proper time for plaque removal. A pressure sensor is also a wonderful feature to consider because excessive force does not help clean teeth and instead can cause problems like receding gum tissue and premature erosion of the tooth surface.
The built in timer available on an electric tooth brush is separated into six units of time. These sections are to be broken into:
1- Upper right
2- Upper front
3- Upper left
4- Lower left
5- Lower front
6- Lower right
Be sure to put the brush on the cheek side, chewing surface, and tongue side of each sextant.
Step 2: Simple Modifications to Manual Tooth Brushes
A toothbrush grip is a common, reusable, and easy way to modify a handle for those with decreased grip strength hold on to a tooth brush. These can be made at home with various products like sugru or bought ready made from online retailers. A tennis ball can be added to the end. A bike handle can work too. Also a holder can be added made from elastics or velcro.
One recent instructable modifies a spoon that could also do the same with a toothbrush.
Another recent instructable modifies utensils including a toothbrush.
Step 3: Floss Holders
The proper way to allow floss to clean these surfaces and to put it in between the teeth and have it form a C-shape and scrape one tooth, then press it against the opposing tooth and scrape the other tooth.
Things to consider for floss holders are ease of use, cost, and if it is disposable. Fully disposable floss holder add to the landfill and are more expensive long term but are easier to use.
Step 4: Two Person Oral Hygiene
Step 5: Chemotheraputics
Fluoride treatments and toothpaste:
Professionally applied fluoride treatments have been proven time and time again to decrease the incidence of caries when completed in a regular interval. Chemically, the fluoride ion incorporates into the enamel on the tooth surface. This requires the initial pH of the acid bacteria discharges to be lower and more acidic in order for a cavitation to occur than on enamel that has not had fluoride ions incorporated. Fluoride is a natural ion found in many water sources.
All anticavity toothpastes available over the counter have fluoride in them. A prescription toothpaste has one hundred times the concentration of fluoride in it and has been proven to decrease cavities.
In the US, chlorohexidine is a prescription regulated drug but it is not so in other countries. This medication is a topical antibacterial that coats teeth and does not allow bacteria to stick to teeth thereby decreasing cavities. It can cause large deposits of calculus and tarter. If the person using it does not have regular visits for dental cleanings it is not a recommended product due to the potential for buildup.