PATIENT INSTUCTIONS FOLLOWING SCALING AND ROOT PLANING

1. PATIENT INSTUCTIONS FOLLOWING SCALING AND ROOT PLANING • Following scale and root planning you can expect to notice less redness, less bleeding and less swelling of your gum tissue. Your mouth will taste better and feel better. Your gum health can be maintained with proper homecare and regular professional care.

2. DISCOMFORT • Discomfort or pain should not be acute and should subside in a few hours, definitely within a few days. Discomfort immediately after treatment is usually associated with slight aching and occasional may be uncomfortable. This discomfort usually subsides in about four hours. (For discomfort you may take Advil, Motrin, and Aleve.) Avoid Aspirin containing compounds as they may increase the amount of initial bleeding.

3. TOOTH SENSITIVITY • Teeth may be sensitive to temperature changes and/or sweets. Sensitivity to temperature may be noticeable the first several days and usually diminishes quickly. Application of desensitizing fluoride will be recommended. • BLEEDING • Some slight bleeding may occur during the next several brushings but should steadily decrease.

4. APPEARANCE • As the gums heal they might change their shape around the teeth. This is normal as they tighten up and shrink during healing. • INSTUCTIONS TO MINIMIZE SYMPTOMS • DIET/EATING • If extensive root planning was performed, chewing hard foods such as meet or raw vegetables may be uncomfortable; this should last no longer than a few days. A diet of softer consistency would be advised until chewing becomes more comfortable.

5. ORAL HYGIENE • For the first few days, brush and floss the areas lightly. By the end of the week, normal intensity of brushing and flossing should resume. • HEALING WILL NOT OCCUR IF PLAQUE AND BACTERIA ARE NOT REMOVED FROM TEETH ON A DAILY BASIS. Some bleeding and tenderness may be noted when cleaning your teeth during this period. This is a part of the normal healing process and should diminish within a few days

6. HYGIENE AIDS • Special hygiene aids were given to you at your first scaling and root planning visit. It is important to follow the instructions regarding use of these aids. We would be happy to review with you their proper usage at any time.

7. BASS METHOD OR SULCUS CLEANING METHODIt is the most widely accepted and most effective method for plaque removal.TechniqueBristles are placed at 45 degrees angle to the gingivae and moved in small circular motion. • Strokes are repeated around 20 times, 3 teeth at a time. • On the lingual aspect of the anterior teeth, the brush is inserted vertically and the heel of the brush is pressed into the gingival sulcus and proximal surface at 45 degrees angle, the bristles are then actuated.

8. The occlusal surfaces are cleansed by pressing the bristles firmly against the pits and fissures and then actuating the bristles. • AdvantagesIt is effective method for removing plaque adjacent to and directly beneath the gingival cervical areas and sulcus. • It provides good gingival stimulation. • It is easy to learn

9. . • DisadvantagesOverzealous brushing may cause injury to the gingiva. • It is time consuming. • Dexterity requirement is too high for certain patients. • FONES METHODIndicated for young children and others who do not have the muscle development for more complex technique. TechniqueThe child is asked to stretch his/her arm such that they are parallel to the floor

10. The child is then asked to make big circles which are reduced in diameter until very small circles are made in front of the mouth. • Now, brushing is done in circular motion in the teeth making sure that the teeth and the gums are covered. • AdvantagesIt has equal or better potential than the Bass technique for plaque removal. • It is easy to learn.

11. It takes shorter time. • Physically or emotionally handicapped individuals can use this technique. • It provided good gingival stimulation. • DisadvantagesIt can cause trauma of the gingival. • Interdental areas are not properly cleaned

12. Brushing techniques • BASS METHOD OR SULCUS CLEANING METHODIt is the most widely accepted and most effective method for plaque removal.TechniqueBristles are placed at 45 degrees angle to the gingivae and moved in small circular motion. • Strokes are repeated around 20 times, 3 teeth at a time. • On the lingual aspect of the anterior teeth, the brush is inserted vertically and the heel of the brush is pressed into the gingival sulcus and proximal surface at 45 degrees angle, the bristles are then actuated.

13. The occlusal surfaces are cleansed by pressing the bristles firmly against the pits and fissures and then actuating the bristles. • AdvantagesIt is effective method for removing plaque adjacent to and directly beneath the gingival cervical areas and sulcus. • It provides good gingival stimulation. • It is easy to learn. • DisadvantagesOverzealous brushing may cause injury to the gingiva. • It is time consuming. • Dexterity requirement is too high for certain patients

14. FONES METHODIndicated for young children and others who do not have the muscle development for more complex technique. TechniqueThe child is asked to stretch his/her arm such that they are parallel to the floor. • The child is then asked to make big circles which are reduced in diameter until very small circles are made in front of the mouth. • Now, brushing is done in circular motion in the teeth making sure that the teeth and the gums are covered

15. AdvantagesIt has equal or better potential than the Bass technique for plaque removal. • It is easy to learn. • It takes shorter time. • Physically or emotionally handicapped individuals can use this technique. • It provided good gingival stimulation. • DisadvantagesIt can cause trauma of the gingival. • Interdental areas are not properly cleaned

16. Dental floss • It is a type of interdental cleaning aid indicated to remove plaque from interproximal surfaces. Dental floss is available in various forms: Multifilament - twisted/nontwisted • Bonded/nonbonded • Thick/Thin • Waxed/Non-Waxed • Choice of the type of floss is based on individual preference but one should be aware that this method of interdental cleaning is time consuming, difficult from technical aspect and carries risk of tissue damage. Floss holders have been designed to make flossing easier.

17. Functions of Dental Floss : Removal of adherent plaque and food debris from the interproximal embrasure and under the pontiffs of fixed partial denture. • Polishing of tooth surface during removal of the plaque and debris • Stimulating and massaging the interdental papillae.

18. Improving oral hygiene. • Reducing gingival bleeding. • Dental floss is available in a wide range of wax coating levels, yarn deniers, and widths. There are also specialized flosses that have stiff, soft, and puff sections. Thin flosses are preferred by those who have tight contacting teeth without sharp edges from poor filling. The waxed flosses are generally easier to hold and slide readily between tight contacts.

19. Methods of using dental floss - Spool Method 18 inches long floss is taken. • 4inches from each hand is wound around the middle finger of each hand. • Floss is inserted into the interproximal space and moved in to and fro motion. • The process is repeated for all teeth • Other oral interdental hygiene aids commonly used are Wooden tips. • Interproximal brushes. • Powered interdental brushes. • Unituft brushes. • Irrigating devices (water pik)