Oral Hygiene Honor - advanced

Science & Health

Requirements

1. Have the Oral Hygiene Honor.

   Answer: You must present to the instructor the duly signed card of the Oral Hygiene (basic) Honor as a prerequisite for starting Advanced Oral Hygiene, proving that basic oral care concepts (brushing, dental floss, diet, decay prevention, and regular dentist visits) have already been studied and approved as required by the official Seventh-day Adventist Pathfinder program currently in force. — The basic Honor forms the foundation of personal care — without it, the advanced one (detailed anatomy, periodontal problems, fluoridation, trauma) would be difficult to assimilate. Oral hygiene is a priority in the Adventist program based on the principle of caring for the body as the temple of the Holy Spirit (1 Corinthians 6:19-20). The card is the official document of the Adventist program.

2. Know how to identify the following parts of the tooth, describing the function of each one: enamel, dentin, pulp, gum, cementum, and periodontal ligament.

   Answer: Identify and describe the function of each part: 1) Enamel — the white, shiny outer layer, the hardest tissue in the body; protects the tooth against wear, acids, and decay. 2) Dentin — the yellowish layer just below the enamel; supports the enamel and conducts thermal and pain stimuli to the pulp through microchannels (tubules). 3) Pulp — soft tissue at the center of the tooth, with blood vessels and nerves; nourishes the tooth and provides sensitivity (the 'living part'). 4) Gum — soft pinkish tissue that covers the bone and protects the base/neck of the teeth against bacteria. 5) Cementum — a thin mineralized layer that covers the root; serves as an anchor for the fibers that attach the tooth to the bone. 6) Periodontal ligament — a bundle of fibers that links the cementum of the root to the alveolar bone; it fixes the tooth, absorbs chewing impacts, and acts as a shock absorber. — Enamel is the hardest tissue in the human body (harder than bone) — made of hydroxyapatite crystals (96% mineral). When damaged, it does not regenerate. The pulp contains the nerve (hence toothache) and blood vessels. Cementum and ligament anchor the tooth; when they deteriorate, the tooth falls out. Knowing this anatomy helps in understanding periodontal problems.

3. Describe the following oral problems:
   • Plaque
   • Tartar
   • Gingivitis
   • Periodontitis

   Answer: 1) Plaque: a sticky biofilm of bacteria and food debris that adheres to the teeth, mainly near the gum; it is colorless and removable with proper brushing and flossing. 2) Tartar: plaque that has hardened through mineralization with the calcium in saliva, forming a yellowish/brown crust; it can only be removed by scaling with the dentist's instruments. 3) Gingivitis: inflammation of the gum caused by the accumulation of plaque and tartar, with redness, swelling, and bleeding when brushing; it is reversible with good oral hygiene. 4) Periodontitis: an advanced stage of untreated gum disease, in which the inflammation reaches the bone and the tissues that support the tooth; it causes gum recession, the formation of pockets, mobility, and even tooth loss, requiring professional treatment. — These 4 problems form a cascade: plaque → tartar → gingivitis → periodontitis. Good hygiene stops the cycle right at the start. Periodontitis affects about 50% of adults over 30 worldwide, according to the WHO. In Brazil, 1 in every 10 adults loses teeth due to periodontitis. Periodic professional cleaning is essential to stop the progression.

4. What is prophylactic paste?

   Answer: You must present to the instructor that prophylactic paste is a specialized abrasive paste used by dentists during prophylaxis (professional cleaning) to remove extrinsic stains, dental plaque, and residual tartar after scaling, and to polish the enamel surface, leaving the tooth smooth and shiny. — Prophylactic paste is different from common toothpaste: it has a stronger abrasive and only dentists use it. Types: simple prophylaxis (pumice), with fluoride (preventive), with whitening agents (cosmetic). After use, the dental surface is polished and more resistant to the adhesion of new plaque. Indication: professional cleaning every 6 months for most adult patients.

5. Describe how to perform fluoridation, explaining each of the steps to be followed.

   Answer: You must describe to the instructor the steps of topical fluoridation in the office: 1) Prior prophylaxis (cleaning the teeth with prophylactic paste to remove plaque); 2) Isolation and drying (move the lips and cheeks aside, dry the teeth with gauze); 3) Application of the fluoride (gel or varnish with 1.23% or 5% fluoride, in a tray or with a brush, for 1 to 4 minutes depending on the product). — Fluoride strengthens the enamel by replacing hydroxyapatite with fluorapatite — more resistant to the acid from bacteria. Topical fluoridation reduces decay by 30-40% in children. In Brazil, it has been standard practice in the public health network (SUS) since the 1980s. Fluoride varnish is more used in children because it adheres well; acidulated gel is more used in adults at high risk.

6. What should be done when a tooth is traumatized as a result of a fall?

   Answer: Dental trauma protocol after a fall: 1) Stay calm and assess the severity of the trauma — check whether the tooth is just cracked, broken (fractured), displaced/loosened or avulsed (knocked out whole), and whether there is bleeding or a cut on the lips/gums. 2) Control the bleeding — press the area with gauze or a clean cloth and apply ice on the outside (on the cheek/lip) to reduce pain and swelling. 3) If the tooth came out whole (avulsion) and it is a permanent tooth: ALWAYS hold it by the crown (the white part), NEVER by the root; if it is dirty, rinse it quickly with milk or saline solution WITHOUT scrubbing or using soap; try to reimplant it back into the socket (alveolus) in the correct position and bite on a piece of gauze to hold it. 4) If you cannot reimplant it, keep the tooth moist in milk, saline solution or in saliva itself (inside the mouth, in the cheek, if the person is conscious) — NEVER in plain water or dry. 5) A baby tooth (small child) should NOT be reimplanted. 6) If the tooth only broke/cracked, also keep the piece in milk/saline. 7) Seek a dentist or dental emergency room URGENTLY — the success of the reimplant depends on the first 30 to 60 minutes. 8) Check the tetanus vaccine if there was contact with soil/dirt. — Time is critical in dental trauma: avulsed teeth reimplanted within 30 minutes have more than a 90% chance of survival; after 1 hour, it drops to less than 30%. Milk is the best transport medium (osmolarity similar to oral tissue). Never wash the root with a brush or alcohol — it destroys the periodontal ligament. Knowing the protocol saves teeth in common falls and sports accidents.

7. What causes sensitivity in the teeth? How can this problem be resolved?

   Answer: Dental sensitivity is caused by the exposure of the dentin (the yellow layer beneath the enamel), whose microchannels (tubules) conduct thermal and painful stimuli directly to the nerve. Causes: erosion/wear of the enamel (acidic foods and drinks, overly aggressive brushing or a hard-bristled brush), gum recession (exposes the root, which has no enamel), cavities, and bruxism (teeth grinding). HOW TO RESOLVE: 1) use desensitizing toothpaste (for sensitive teeth) and a fluoride mouthwash; 2) brush with a soft-bristled brush and a gentle technique, without force; 3) avoid/reduce acidic foods and drinks; 4) application of fluoride or varnishes/sealants by the dentist to seal the tubules; 5) treat the underlying cause at the dentist — restore cavities, treat gum recession, and use a bite guard (for bruxism) at night when there is teeth grinding. — Dentin has small microscopic tubules that connect to the nerve. Healthy enamel blocks them, exposed dentin lets the cold/heat through — hence the pain with cold or sweet things. Pastes like Sensodyne occlude the tubules. Bruxism (grinding the teeth) is a common cause in stressed adults, and the use of a nighttime bite guard helps a great deal to resolve it.

8. What additional oral hygiene care should a person who wears orthodontic braces take?

   Answer: You must present to the instructor extra care for those who wear orthodontic braces: brush the teeth after every meal (3-4 times a day) with a brush specific for braces (V-shaped bristles); use an interdental brush or a floss threader with a rigid needle to clean between wires and brackets. — Orthodontic braces retain a lot of plaque, and poor hygiene leads to white spots (decalcification), decay, and gingivitis. Specific V-shaped or interdental brushes reach where the normal one cannot. Floss-threader picks make it easier to clean between the wires. Permanent white spots remain even after removing the braces — hence the importance of daily discipline in care during treatment.

9. What additional oral hygiene care should a person who wears dentures take?

   Answer: You should present to the instructor the care of dentures: brush the denture daily with a specific brush and mild soap (never ordinary toothpaste, which scratches it); rinse after each meal; soak the denture in a disinfectant solution (a proper effervescent one) for 15-20 minutes at least once a day; remove it at night to rest the gums and keep it in water or solution. — A poorly cleaned denture accumulates plaque and biofilm, causing oral candidiasis (thrush), inflammations and bad breath. Ordinary toothpaste has abrasives that scratch the acrylic, creating porosities where bacteria lodge. A specific disinfectant solution (Corega Tabs, for example) eliminates microbes without causing damage. Elderly people with dentures need extra attention to hydration and regular dental examination.

10. Create a story that illustrates the ways to prevent tooth decay and present it, in a creative way, to a group of children.

    Answer: You must present to the instructor a creative children's story that illustrates decay prevention, shown to a group of children. For example: 'The Kingdom of the Little Mouth' — where the Teeth Soldiers (enamel) fight against the Bacteria Villains (plaque) with Magic-Brush and Speedy-Floss weapons, eating healthy foods like heroes (fruits, milk, whole-grain bread) and avoiding sweet enemies (candy, soda). — Stories and characters are effective teaching tools for children, especially up to age 8. Repeating a message with a visual element fixes the learning. Programs like 'Turma do Sorriso' (Colgate) and 'Sorria com a Mônica' use this strategy. Children who learn early develop habits for life — hence the importance of early childhood oral health education.