PSMB (PCOS pt.2)

Oral hygiene

is the practice of keeping the mouth and teeth clean to prevent dental problems, most commonly, dental cavities, gingivitis, periodontal (gum) diseases and bad breath

prevent the build-up of plaque

Purpose of oral hygiene

Plaque

• the sticky substance formed by the attachment of bacteria coating that adheres to the pellicle, which is a thin acellular, glycoprotein

• when not removed within 24 hours, forms a substance called calculus or tartar

• calcifies when calcium salt precipitates from the saliva

calculus or tartar

• plaque, when not removed within 24 hours, forms a substance called __

Brushing

removes material from tooth before it hardens into calculus

caries (tooth decay)

The formation of __ is attributed to the action of acids obtained from oral bacterial metabolism of dietary carbohydrates.

plaque

The build-up of __ on the tooth surface usually aids the decay processby forming pockets or crevices on the teeth surface

• Flossing

• Brushing (accompanied by fluoride administration given Internally/ topically to the teeth)

2 Approach to caries prevention

Dentrifices

Products that enhance the removal of stains and plaque by the toothbrush

1. Toothpastes

2. Mouthwashes

3. Cosmetic whitening products

4. Mouth/Breath spray

5. Fluoride gel

5 Oral hygiene products

Toothpastes

• Used to decrease the incidence of dental caries, reduce mouth odors, and enhance personal appearance

• Brush with soft toothbrush for 2 minutes. No RINSING, EATING, or DRINKING for 20 minutes

1. Abrasives (aluminum oxides, silicates, sodium bicarbonate,)

2. Surfactants (sodium lauryl sulfate, sodium dodecyl benzene sulfonate)

3. Humectant (sorbitol, glycerin, propylene glycol)

4. Suspending agents (tragacanthm karaya gum, methylcellulose)

5. Flavoring agents (sorbitol, saccharin)

5 Most common ingredients in toothpastes

1. Pyrophosphates

2. Fluoride

3. Triclosan

4. Desensitizing agents

4 Special ingredients in toothpastes

Abrasives

• responsible in removing plaque

• High formulations are not advisable for long-term use as it may lead to eventual exposure to root surfaces

Surfactants

foaming agents that aid in the removal of debris. Most frequently used are sodium lauryl sulfate and sodium dodecyl benzene sulfonate

Humectant

prevents the drying of the preparation. Ex. Sorbitol, glycerin, and propylene glycol

Suspending agents

add thickness to the formulation. Ex. Methylcellulose, tragacanth, karaya gum

Flavoring agents

sorbitol or saccharin

Pyrophosphates

for tartar-control; retard the formation of tartar. However, they form an alkaline solution that can irritate skin and which is most often exhibit by rash around the mouth

Fluoride

anticariogenic; replaces the hydroxyl ion in hydroxyapatite with the fluoride ion, forming fluoroapatite on the surface of the enamel and hardens it, leading to a more acid-resistant enamel.

Triclosan

antimicrobial agent which helps prevent gingivitis, plaque, cavities, and tartar

Desensitizing agents (5% potassium nitrate)

reduce pain in sensitive teeth

Mouthwashes/ Oral Rinses

• Rinse two times a day with a capful. Rinse for 1 minute and spit. If used in conjunction with the toothpaste use the rinse first, then brush

• May contain astringents, demulcents, detergents, flavors, germicides, and fluoride

• Cosmetic mouthwashes

• Antiplaque mouth rinses

2 types of Mouthwashes/ Oral rinses

Cosmetic mouthwashes

to freshen breath; nontherapeutic and no antiseptic property. Classified based on ingredients, alcohol content, and appearance.

Antiplaque mouth rinses (Cetylpyridium chloride, chlorhexidine)

claim to prevent formation of tartar, having the same ingredients as tartar-control toothpaste.

Cetylpyridium chloride, chlorhexidine

staining is associated with the overuse of these two ingredients

• Carbamide peroxide 10%

• Hydrogen peroxide

2 cosmetic whitening product

Carbamide peroxide 10% (urea hydrogen peroxide)

• It is a tooth whitener, a mild anti-septic, perhydrit, hyperol, or perhydol, is an addition complex of hydrogen peroxide with urea, which has a mild effect.

hydrogen peroxide (34%) & urea

Reacts with water in saliva, carbamide peroxide dissociates to __

Haywood and Heymann

introduced bleaching of teeth with 10% carbamide peroxide gels placed in custom-built trays to be worn by patients at night for 2-6 weeks

Hydrogen peroxide

Active ingredient in some cosmetic whiteners in gel or liquid form

• Alteration of normal flora

• Tissue damage

• Tooth sensitivity

• Gingivitis

• Potentiation of carcinogenic effects of other agents

5 Possible risk in using cosmetic whitening products

Fluoride gel

• Prescribed high-concentrated topical agent (1-2%) intended either for professional applications in plastic/disposal trays 2- 4 times per year or self-applied with aid of a toothbrush once or twice per week

• The gels are flavored but contain no abrasive cleaning agents or preservatives.

• sodium fluoride

• acidulated phosphate fluoride or amine fluoride.

The formulations of fluoride gel are based on:

• decreases the solubility of enamel in acid

• has enzyme inhibitory properties

Fluoride’s action in inhibiting caries

systemic circulation

Oral route places fluoride into __ allowing fluoride to laid down in unerupted teeth as they are formed.

1. Sodium fluoride USP

2. Stannous fluoride USP

3. Pumice USP

3 specific ingredients

Sodium fluoride USP

• Occurs as a white, odorless powder which is soluble in water and insoluble in alcohol

• Officially used as dental prophylactic

• 2% aqueous sol’n is widely used topically. Usual procedure is a series of 4 treatments: beginning at the age of 3; ages 7, 11 and 13 as the permanent teeth erupts

Stannous fluoride USP (Tin Diflouride)

• occurs as a white crystalline powder and has a bitter salty taste. It melts at about 213 degrees Celsius

• Freely soluble in water; insoluble in alcohol, ether and chloroform

• extensively used for topical fluoride application

  • A simple application of a freshly prepared 8% solution at 6 to 12 months intervals is used

• it requires only 1 application per treatment as compared to a series of 4 application per treatment of NaF

  • solution is applied to a cleaned, dry teeth

Pumice USP (Pumice stone, Piedra Pomez)

• substance of volcanic origin; consisting chiefly of complex silicates of aluminum, potassium and sodium

• occurs as very light, hard, rough, porous grayish masses, or as a gritty gray powder

• is odorless and tasteless; stable in air; practically insoluble in water and is not attacked by acids.

1. Pumice flour or superfine

2. Fine pumice

3. Coarse pumice

Grades of fineness of pumice (Dental Abrasive)

Dental fluorosis (mottled enamel)

• too much fluoride present in the tissue fluids

  • teeth is chalky and soft

• occurs in areas where the fluoride concentration of drinking water exceeds 2 ppm

• only occurs during excessive ingestion of fluoride during the period of teeth development

• elevated levels of fluoride concentrations in plasma and urine after toothpaste use observed

2-5g

Lethal adult dose of fluoride

Maximum Permitted Concentration of Fluoride in toothpaste for

• OTC sales – 0.15%

• Pharmacies – 1.3%

Maximum Permitted Concentration of Fluoride in toothpaste for

• OTC sales –

• Pharmacies –

5 mg F/kg of body weight

The Probable Toxic Dose (PTD) of fluoride

Safety precautions of Fluoride

• Package size & especially, fluoride contents be controlled.

• Supervised toothpaste use by preschool children

• Manufacturers should be encouraged to include this advice in labels

Skeletal Fluorosis

• Not likely to occur with normal use of toothpaste/mouthwash

• With 8 ppm fluoride in drinking water, only older subjects revealed increased density in their bone structure with no symptoms of illness

It is a risk factor for fluorosis, particularly if brushing begins before the age of 2 years

What is the risk associated with preschool children using toothpaste with a mean fluoride concentration of 1,000 ppm?

12.9% prevalence

In a study where drinking water had low fluoride (< 0.1 ppm), what was the prevalence of dental fluorosis attributed to fluoridated toothpaste?

60% prevalence

What is the expected prevalence of dental fluorosis in areas where drinking water contains 1.0 mg fluoride per liter (and is the sole source of exposure)?

Starting to brush before the age of 2 years

According to the "Epidemiological Evidence," what factor increases the severity of lesions in children using fluoride toothpaste?

Abrasives

Essential component of toothpastes mechanical removal of stained tooth pellicle

• natural teeth

• dentine

2 relevant substrate in mechanical abrasion

• Abrasive particle size

• Other constituents of the toothpaste

2 Identification of the abrasive compound

Horizontal brushing

Brushing method in mechanical abrasion

• Epithelial peeling

• Mucosal ulceration & inflammation

• Gingivitis

• Petechiae

4 Acute Reactions Of The Oral Soft Tissues To Oral Hygiene Products

• a burning or stinging sensation

• soreness or pain

• staining of the teeth and tongue

In soft tissue reaction patients may complain of:

• Chlorhexidine mouthwash

• Benzethonium chloride (0.2%)

• Cetylpyridinium chloride

Local reactions to antimicrobial agents

Chlorhexidine Mouthwash

• Brown discoloration of the teeth and tongue and with altered taste sensation

• Superficial desquamation of the oral mucosa

Benzethonium chloride (0.2%)

• Caused desquamative lesions of the oral mucosa in 4 out of 5 subjects

• Discoloration of the tongue and around some of the teeth in 8 out of 12 subjects

Cetylpyridinium chloride

this causes a burning sensation when rinsed

• Improve and/or protect and maintain good health

• Enhance and change appearances and at the same time cover up defects

Decorative cosmetic products can be divided into those which aim to:

Considerations in decorative cosmetic products

• Performance

• User type

• Usage instructions

• Method of application

• Type of packaging that will hold the product

Facial make-up

are products that are used to color and highlight facial features. They can either directly add or alter color or can be applied over a foundation that serves to make the color even and smooth.

1. Talc

2. Kaolin

3. Zinc oxide

4. Calcium carbonate (Precipitated Chalk)

4 Ingredients of facial make-up

Talc

• It is the main component of face powders; in some products it could comprise up to 70% or 75% of the formulation

• used mainly because of outstanding spreadability (slip) and low covering power (translucency)

• grades of these should be judged on slip, smoothness, fineness, grit, density, colour and odour. In addition a check should be made for impurities such as carbonates and water-soluble iron and the talc must be free from asbestos.

Kaolin (China clay)

• a naturally occurring compound, is a hydrated aluminium silicate.

• It is almost white in colour. It has less slip than talc, and the product can end up with a harsh feel.

Zinc Oxide

It is occasionally used at moderately low levels in face powders because it has quite good covering power, is slightly astringent and a recognized skin protectorant; it therefore imparts soothing properties to the skin

Calcium Carbonate (Precipitated Chalk)

• is a mildly alkaline, white, odourless microcrystalline powder available in special grades with differing particle sizes and densities

• It is mainly used because of its excellent absorption characteristics. It is matte and can give a 'bloom' effect to the coating on the face.

• As a material, it has good absorption characteristics and, like kaolin, it may also be used to remove some of the inherent shine of talc

• Excessive use is not recommended (greater than 15%) because of its undesirable dry powdery feel and adverse effect on the slip of the product

• Magnesium carbonate

• Metallic soaps

• Starches

• Walnut flour

• Micronized plastics

• Mica

• Fumed silica

• Colorants

• Preservatives

• Fragrances

10 Other important ingredients of Facial Make-Ups

1. Foundation make-up

2. Face powders

3. Two Way Foundation Make-Up

4. Blushers

4 types of Facial make-up

Foundation Make-Up

• These are used to unify the colour of the skin, to cover blemishes and skin defects and to provide a basis for further enhancement by the application of lip and eye colour cosmetics.

• Many of these modern types are also used for their skin-care benefits, with additions such as sunscreens, natural extracts and vitamins, so that with pigmented products the consumer applies colour whilst looking after her skin

• Cake foundation make-up

• Liquid foundation make-up

2 forms of foundation

Cake foundation make-up

• It was modified and developed from that used in the theatre and film industries.

• The professionals used stick make-up which became Max Factor's Pan Sticks, the first products to become commercially available.

• They were a mixture of talc, kaolin, magnesium carbonate, titanium dioxide and iron oxides added to molten waxes and oils

Liquid foundation make-up

• These are a suspension of pigments in an emulsion base, the same types as those used for facial moisturizers.

• Traditionally they were based on either anionic or cationic emulsification systems.

• The major components of this type of system are: emollient oils; emulsifiers; humectants; pigment wetting agents; pigment suspending agents; pigments; pigment extenders, e.g. talc, kaolin; water; preservatives; fragrance; additives if required, e.g. vitamins, sunscreens, etc

Face Powders

• These are used to cover minor imperfections and reduce the shine that appears on the skin due to sebum or perspiration.

• They are required to give a matte, smooth finish to the skin and remain this way for as long as possible

• Loose face powders

• Compact face powders

2 forms of face powders

1. should have the required covering power to mask minor visible skin imperfections

2. should adhere to the skin and must not be completely dissipated in a short time

3. velvet or peachlike character

4. Shine on or around the nose must be completely eliminated.

5. sufficient slip to enable the powder to be applied to the skin with a suitable applicator

6. clown-like effect is impossible

Whatever the format, the face powder must have the following characteristics:

Two Way Foundation Make-Up

• These are a form of compact powder foundation that can be applied to the skin by use of either a wet or dry sponge.

• The overall function is to provide a natural-looking smooth finish.

• In many ways they combine the properties of a foundation with that of a face powder, with extended wear and the potential to minimize the appearance of wrinkles, blemishes and skin pores

Blushers (rouges)

• are applied to the cheeks, usually over a foundation make-up, to emphasize and highlight the cheek bones. They also give structure to the face.

• Most are now compressed powders or emulsions, but previously they have been available as aqueous gels that contained water-soluble dyes which actually stained the skin

• Pressed powder blushers

• Liquid blushers

• Wax-based blushers

• Bronzing powders

4 forms of blushers

Eye Products

• Eyes are the dominant features of theface, especially during conversation. They reflect emotional states as well as being indicative of our state of health.

• Modern eye make-up products include eye liners and pencils for the eyebrows and to contour the eyes, eyeshadows of different forms and mascara for the eyelashes.

• Eyeshadow

• Mascara

• Eyeliners

3 types of eye make-up

Eyeshadow

• is used to give colour and gloss to the eyelids.

• This is the most fashion conscious area of decorative cosmetics, the popular shades varying with the season and clothes that are in fashion at the time

• Pressed powder eyeshadow

• Cream eyeshadow

• Eyeshadow sticks

3 forms of eyeshadow

Pressed powder eyeshadow

• The commonest form of eyeshadows.

• These are sold as single colors in a small compact with or without an applicator, or as collections of colors that tone together in larger compacts or tins with a number of applicators.

• The base ingredients used in pressed powder eyeshadows are very similar to those used in face powder. Talc is the main constituent with zinc stearate to act as a powder binder and also give skin adhesion

Cream eyeshadow

This has to be of the correct consistency, such that it can spread easily on the skin, but not be greasy or crease during wear, and the pigments or pearls in the pot or tube in which they are sold remain suspended

Eyeshadow sticks

These are manufactured using similar ingredients and methods of production to lipsticks and other stick products

Mascara

The colour, thickness and length of eyelashes are enhanced by using suspensions of coloured pigments in a film-forming medium to which lengthening ingredients such as nylon flock can be added

• Cake mascara

• Cream mascaras

• Waterproof mascaras

3 forms of mascara

Cake mascara

• These were the first type of product to appear on the market in the 1920s and are still available today.

• Application is by wetting the brush and rubbing it onto the cake to pick up product, and then using the brush to transfer the product to the lashes.

• Most formulations of this type tend to have little water resistance and will smudge if the wearer cries or rubs her eyes. This is because they are based on a soap/wax/pigment blend which is emulsified when the wet brush is applied to the surface

Cream mascaras

• The most common type of mascara used today.

• This type is packaged in small thin plastic bottles with an integral applicator (or wand) incorporated into the cap.

• The formulations are either oil-in-water emulsions with a film-former incorporated, to give water and smudge resistance, or totally anhydrous, to give totally waterproof products

Waterproof mascaras

• The best way to make something waterproof is to exclude water from it totally and use ingredients that are insoluble in water.

• are therefore usually solvent-based systems. The basic solvent has to be volatile to give a quick-drying formulation

Eyeliners

These are applied to the rims of the eyelids following the eyeshadow to accentuate the shape of the eyes

• Liquid eyeliners

• Pen-type eyeliners

• Eye pencils

3 forms of eyeliners

Lip Products

• have been used since ancient times to enhance the appearance of the lips by imparting colour and gloss, and by re-defining the outline of the lips.

• The three most common products used to achieve this are lipsticks, lip glossesand lipliners, of which lipsticks are the most common

• Oils

• Waxes

• Colors

3 raw materials used in lip products

Oils

• Castor oil is the main oil used in lipsticks. It is very thick and maintains this viscosity when hot, making it ideal as a suspending medium for the colouring agents.

• Oleyl alcohol is a widely used co-solvent in lipsticks. It aids pigment dispersion and has a pleasant skin feel and virtually no taste or odour

Castor oil

is the main oil used in lipsticks. It is very thick and maintains this viscosity when hot, making it ideal as a suspending medium for the colouring agents