Perio: Supra- and Subgingival Irrigation (ch. 27)

What is a water flosser?

generic term for device that delivers a pulsating stream of water or solution between the teeth above and/or below the gingival margin

what does a water flosser use

Hydrokinetic Activity

What is Hydrokinetic Activity?

compression and decompression of tissue resulting in displaced biofilm

There is evidence to support that water flossers are more effective at cleaning _____ than other adjunct aids.

deeper pocketing

flushes debris from pockets

• biofilm disruption

• prevents biofilm from maturing

Water flossers allow patients to have a high level of ____.

and so what does this mean

compliance

• works well for special needs pts and geriatric pts

What type of patient should we be weary of using water flossers on? and whats the soultion

patients with elevated risk of endocarditis

• check with cardiologist

How deep do toothbrushes go subgingivally?

and whats the statstic

1-2mm

• no manual or power toothbrush has clinically proven subgingival access

How deep does oral rinsing go subgingivally?

what doe this mean and the side effect

2mm

• can reach less accessible areas, but minimally penetrates subgingival areas

How deep do toothpicks/wooden wedges go subgingivally?

when is it most effevive

depends on embrasure size

• effectiveness depends on sufficient interdental space

How deep do interdental brushes go subgingivally?

and when is it most effective

depends on embrasure size

• most effective with an open interdental space

How deep does dental floss go subgingivally?

3mm

• cannot reach into deeper pockets

How deep do Waterpiks go subgingivally?

6mm and beyond

• clinically proven to remove supra- and subgingival plaque biofilm and bacteria

What types of irrigant solutions can water flossers be used with?

• just water

• antimicrobials

○ diluted chlorhexidine

○ essential oil mouth rinses

What kinds of different irrigation tips are there for water flossers?

• standard irrigation tip (A)

• subgingival tip (B)

• orthodontic tip (C)

• filament tip (D)

how does an air flosser werk?

and what does it not replace

uses microburst of high velocity compressed air interspersed with micro droplets of liquid

• not a replacement for string floss

an air flosser can be used with

mouth rinse

benefit of air flosser

great for compliance

air flosser does not replace

string floss

What is professional subgingival irrigation?

the in-office irragation

What does the professional subgingival irrigation use ? material wise

using blunt-tipped syringe

• using an ultrasonic with a reservoir

cons of professional subgingival irrigation (3 of them)

very little research to support the practice of irrigation following periodontal instrumentation

• lack of concentration

• lack of duration -

What are the localized periodontal irrigation solutions that have mixed evidence for use as an irrigation solution?

• Povidone-Iodine

• Sodium Hypochlorite

What is Povodine-Iodine

• hydrogen iodine and elemental iodine

• it is a broad spectrum antimicrobial (affects gram + and - bacteria)

mechanism of Povodine-Iodine

• small size enters cell walls easily and oxidizes organelles

What is Sodium Hypochlorite and what is it used?

• NaOCl (bleach)

• highly potent against bacteria & fungi

how to prevent sodium hyopchlorite from being toxic

dilute below 5%

which localized periodontal irragtion soultion has •more promising for future use in mouth rinse

Sodium Hypochlorite