Mechanical Removal of Plaque and Calculus by the Patient
One of the most critical aspects of successful plaque removal and disease control is comprehension by the patient of the role of plaque and, equally important, its appearance. Educating the patient on the clinical appearance and location of plaque is as essential to preventing and treating periodontal diseases as the mechanical or chemical debridement techniques the patient uses. It is also important for the patient to understand the relationship of bleeding gums and periodontal deseases - being able to visualize the target of plaque control efforts will give direction to those efforts.

To the undeducated or uninspired patient, the concept of plaque accumulation is difficult to comprehend. These patients may brush their teeth without comprehending the goal of their plaque control efforts. They may not even know how healthy tissue or a clean mouth feels. This is in contrast to the motivated patient, who has knowledge of the structures of the mouth and can identify difficult areas where supragingival plaque accumulation my be a problem.

Initially, patients may be unable to visualize plaque accumulation on their teeth without the aid of special dyes. The use of plaque disclosants will enable the patient to determine the effectiveness of their plaque control, illustrating how much plaque is on the teeth and where it is located. When this is done at the beginning of oral hygiene instruction, it provides the patient and clinician with a baseline from which to evaluate the success of future plaque control efforts.
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Gone are the days when the dental professional can give patients a toothbrush, floss, and a manufacturer's brochure and expect them to be responsible for their oral hygiene. In place of this scenario, the dental professional has been inundated by oral hygiene products and dental devices, making the decision of what to recommend to patients difficult. Also, while it is often advantageous to have a patient use several different devices to meet his or her specific oral hygiene needs, few patients can assimilate the instructions, recommendations, and adaptations necessary to master all appropriate techniques in one appointment. This again indicates the need for a long-term strategy and a continuing commitment to oral health.


Copyright (c) 1994 by Quintessence Publishing Co, Inc. Reproduced with permission.