CATEGORY 80 AUSTRALASIAN DENTIST Proper interdental cleaning is still neglected by the majority of people – even those who are truly interested in their oral health. It is estimated that more than 80% of the population is not cleaning their interdental spaces, and therefore su ering from gum bleeding and approximal caries. is statistic is alarming, and it should be our main mission and responsibility, as dental professionals, to stress the importance of proper and regular interdental cleaning – not only for patients who already have developed gum disease, but also for those with current good health. We will guide you through the whole process of how to motivate your patients to clean their interdental spaces correctly, regularly and e ciently. Step 1: Explain why neglected interdental spaces are a problem If your patient has doubts about the importance of interdental cleaning, you can provide them with the fact that an overwhelming number of 16 billion bacteria can live in just one interdental site. is abundant bacteria will settle, thicken, and eventually turn to plaque. A build-up of toxic bacteria and plaque causes halitosis (bad breath). at may be considered only a social, or cosmetic problem, but the true danger lies elsewhere. Over time, plaque attacks the gums, causing in ammation, gum recession, gingivitis and then periodontitis with eventual tooth loss. Plaque leads to tooth decay too, and many other serious problems. Various studies have successfully proven that periodontitis can be linked to more than fty other diseases and conditions, including chronic kidney disease, Alzheimer’s Disease, rheumatoid arthritis and certain types of cancer. It is, therefore, essential to educate patients about these serious potential consequences of insu cient oral care and stress the importance not only of proper home toothbrushing, but also regular cleaning of interdental spaces. Step 2: Use the evidence to prove why healthy patients need to use interdental brushes According to a clinical trial by Bourgeois et al, it has been proven that the presence of periodontal pathogens in the interdental bio lm of young, periodontally-healthy adults demonstrates the need for daily interdental brushing. Initially, 68% of the adolescents’ interdental spaces bled on interdental brushing. After three months of daily interdental brushing, interdental bleeding decreased to 10%, which means an overall bleeding reduction of 85%. What is very interesting, is that the quantity of bacteria within the bio lm from the yellow and purple Socransky complexes (associated with periodontal health) increased, while the quantity of red and orange Socransky complexes (associated with periodontal pathogens) decreased. According to the trial’s conclusion, the use of calibrated-diameter IDBs appears to be a key factor in disturbing the interdental bio lm and restoring the symbiotic oral microbiome. erefore, it is very important to see interdental brushing as an e ective form of prevention in healthy patients. Step 3: Explain the difference between interdental cleaning and flossing It has been stressed for many years that ossing should be incorporated into daily oral-hygiene routines. However, ossing is only e ective in very narrow spaces between the teeth, such as between very tightly set teeth where there are practically zero other nooks and crannies. When it comes to the interdental spaces between the majority of teeth, it is much more e ective to use an appropriately sized interdental brush. Floss is too thin to e ectively reach all the hidden spaces and surfaces between the various shapes and sizes of our teeth, whereas interdental brushes (IDBs) – of the appropriate size for every patient – fan out to reach all hidden spots, and therefore clean very e ectively. According to Bourgeois et al, adherence How to get your patients into the routine of proper interdental brushing Explaining, measuring and instructing is the key. CLINICAL
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