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Chemical plaque control in
Periodontal Diseases –أمراض اللثة –الفرقة الخامسة
22 /3 /2020
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Phase I Therapy
The objective of Phase I therapy is to alter or
eliminate the microbial etiology and
contributing factors for gingival and
periodontal diseases.
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Phase I Therapy
Control or elimination of contributing local
factors including the following:
A. Treatment of poorly fitting restorations
B. Correction of poorly fitting prosthesis.
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Phase I Therapy
C. Restoration of carious lesions
D. Odontoplasty
E. Tooth movement
F. Treatment of food impaction areas
G. Treatment of occlusal trauma
H. Extraction of hopeless teeth
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Chemical plaque control
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Chemical plaque control Chemical plaque control (adjunctive aids)
are:
I. Disclosing agents
II. Supragingival and Subgingival
irrigating devices
III.Dentifrices
IV.Antiseptic mouth
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N.B. The use of chemotherapeutic agents
must be considered adjunctive therapy and
not a substitute for non-surgical or surgical
debridement
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Antiseptic mouth rinses
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Chemical plaque control
Ideal Properties of a Mouthwash
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Antiseptic agents as:-
◦ Chlorhexidine (mouth rinse, Periochip)
◦ Essential oil mouth rinse (thymol, menthol,
methyl salicylate)
◦ Sanguinarine
◦ Quaternary ammonia
◦ Stannous flouride
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Antiseptic mouth rinses
The American dental association (ADA)
has accepted two agents for treatment of
gingivitis: prescription solutions of
chlorhexidine digluconate mouthrinse and
nonprescription essential oil mouthrinse.
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Antiseptic agents could influence dental
plaque through following approaches:-
1. Act as antiadhesive agents to prevent the
bacterial attachement
2. Affect bacterial proliferation (anti-bacterial effect)
3. Removal of established dental plaque (chemical
tooth brush)
4. Alter the pathogenicity of bacterial species
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Chlorhexidine:-
It is most effective plaque inhibitory agent, it is
effective against both gram+ve, gram-ve, bacteria
& facultative aerobes and anaerobes
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Indications and uses
؟؟؟
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Mechanism of action:
???
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Therapeutic use of Chlorhexidine:-
Chlorhexidine is useful for short periods (up to 2
weeks) when oral hygiene may be difficult (NUG &
following periodontal surgery)
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The main side effects:-
◦ Staining of the teeth, tongue, resin restorations
◦ Its unpleasant taste, and may impair taste
perception.
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Essential oil mouth rinse
An antimicrobial mouthrinse where the active
ingredient is the fixed combination of four essential
oils (EO), thymol, menthol, eucalyptol and methyl
salicylate in a hydroalcohol solution (pharmaceutical
grade ethanol functions as a solvent, a vehicle for
the active ingredients and as a preservative in a
mouthrinse),
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Disclosing Agents
Disclosing agents are solutions or wafers
capable of staining bacterial biofilms on
the surfaces of teeth, tongue, and
gingiva.
These can be used as educational and
motivational tools to improve the
efficiency of plaque biofilm control
procedures7
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Other products
Triclosan
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Quaternary ammonia
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Sanguinarine
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Stannous fluoride
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