Section IV. OTHER SELF-CARE MEASURES
4-13. SUPPLEMENTARY SELF-CARE MEASURES
a. General. Other self-care measures may be used to supplement brushing and
flossing of the teeth. Thorough rinsing with water is used with all procedures.
Sometimes, it is used alone as a field expedient method when other materials are not
available. The cleaning of fixed partial dentures, removable dentures, and abutment
teeth may present individual hygiene problems. The dental officer will prescribe
supplemental measures, but the PDS should teach every patient all measures to
maintain oral health.
b. Toothpicks. Although toothpicks are a valuable adjunct when used properly,
their indiscriminate and careless use can cause irreparable damage to oral tissues
through trauma and lodgement of toothpick splinters in the gingiva and interdental and
subgingival areas. Recurring need for the use of toothpicks to dislodge food may
indicate the presence of a cavity or the need for peridontal treatment.
c. Mouthwashes. The unsupervised use of mouthwashes for any purpose
other than dislodging and rinsing of food particles from the mouth is of questionable
therapeutic benefit. The masking of odors and the sensation of comfort resulting from
the astringent action of mouthwash are temporary effects and do not constitute
treatment or real benefit.
d. Water-Jet Devices. Some studies indicate that water-jet devices are
effective in the removal of some plaque and debris from between the teeth for certain
types of patients. Those patients for whom a water-jet lavage should be recommended
are those wearing orthodontic bands, all patients with fixed partial prostheses, and all
patients who cannot use the customary oral hygiene procedures. Both the pulsating
and nonpulsating devices are available. The pulsating devices (mechanized type) are
recommended because of the fact that when jets of comparable force are directed on
tissues, those of the pulsating type produce less tissue pressure, are less traumatic,
and are more effective than the nonpulsating jets. When pulsating water-jet devices are
used, they should be adjusted so that the pressure switch is kept below the high level.
The jet stream should be directed at right angles to the tooth axis. It must be
remembered that these devices have not been proven effective in total plaque removal.