Plaque control measures in

pediatric dentistry
Definition Dental Plauque

 Newman, caranza: The soft deposits that

form the biofilm adhering to the tooth
surface or other hard surfaces in the oral
cavity including removable and fixed
restorations.
 Mechanical

 Chemical plaque control

Mechanical plaque control

 Tooth brush

 Manual 1857

 Powered 1939 – circular and elliptical and

combination motions.
 Two types of bristles
 Naturals bristles from hogs.
 Artificial filaments of nylon.

Bristle design
 Grouped in tufts
 3-4 rows, 5-12 tufts
 Rounded preferred than flat cut or coarse cut
 Diameter 0.007-0.012 inch for medium
 0.005 for kids
 Length for adults 0.406 inches for kids 0.344
inches
 Size of tooth brush head
 Length – 1-1.25 inch
 Width – 5/16- 3/8 inch
 Small children do not yet have the manual
dexterity to clean their teeth themselves. Up
to the age of 6, an adult should therefore
always give the teeth a final brush after the
child has finished. However, children should
be introduced as early as possible to the MOI
(masticatory , outer surface, inner surface)
brushing technique which uses systematic
movements suited to the abilities of children.
M = Masticatory O= Outer surfaces:
surfaces: brush with clean them with I = Inner surfaces:
small horizontal small circular use small up and
movements. Start at movements down movements
the back and brush
slowly towards the
front
 As small children learn a lot through imitation
it is a good idea to give your child a children's
toothbrush to play with at an early age and to
let him or her watch you while you brush your
teeth. The child's first attempts to imitate you
will be rather clumsy.
 But two- to three-year-olds can already clean
the masticatory surfaces with simple
horizontal (scrubbing) movements. After this
they learn the more difficult circular
movements for the outer surfaces and lastly
the small up and down movements for
cleaning the inside surfaces.
 TECHNIQUES FOR CHILDREN :

·             Normally the Scrubbing technique is advised

for very young children

·             brush for at least 2 minutes 

·             always use tooth brush with soft bristles and
fluoridated, flavoured toothpaste

·             A tooth brush with hard bristles can cause

gingival recession (i.e they will recede and move
backward) and if used with an abrasive toothpaste,
can cause tooth abrasion(loss of tooth substance)
Scrubbing technique
 Bass Technique ( 6-12)

·             Directly push the filaments toward roots of teeth
at 45 degree angle, press lightly but not enough to bend
filaments of brush and gently, brush forward and
backward in short vibratory movement, attempting to
press into gums margin

·             brush for at least 3 minutes

·             use soft toothbrush with fluoridated toothpaste

·             Modified bass technique:  add circular
movement which will cover gum as well as tooth
surface. It massages the gums

·             Roll technique: Position your tooth brush as

in bass technique , then roll downwards over tooth
surface, away from gum margins. Lift the brush,
position it and repeat. It is the most commonly used
method, it is an easy method but it neglects the gum
margins.
 Stillman technique: Position your tooth brush
as in bass technique, press the filaments of
your tooth brush till the gum blanches, turn
your wrist through an angle of 45 degree and
proceed to vibrate and roll against each tooth.
Wrist movement is required;it is an unpopular
technique because it is difficult. Also the gum
margin is often ignored
·           
   Fones technique (circular method): (3 – 6 )
Brush is placed perpendicular to teeth. Large
circular motion of brush over clenched teeth
to simultaneously cover both upper and lower
teeth. A soft tooth brush is used. It was
Previously popular but is not advised
nowadays as it has proven to cause tooth
abrasion
 Charter’s method : Brush is angled
45°downwards, with half the bristles of the
brush over the gum and half over the crown.
Vibratory movement along with a circular
motion is done.

·             Modified Charter’s method (12-19):

Modification is to include occlusal surfaces(i.e
bittting surfaces). Both these are difficult to
learn, hence unpopular
 How often should a toothbrush be replaced?

 A toothbrush should be replaced as soon as the

bristles are bent or sticking out since in this state
they are no longer able to clean thoroughly and
can also injure the gums. A toothbrush should
generally be replaced every 8–10 weeks.
However, as small children often chew on
toothbrushes and the bristles start to stick out
much earlier, children's toothbrushes should be
replaced more often.
Infants 0-1 with gauze

Toddlers (1-3) scrub technique

pre schoolars 3-6- fones or circular

school age 6-12 – horizontal scrub or bass technique

adoloscents12-19 – modified stillmen or charters method