 Hello everyone, welcome back to a new session on Dentistry and More. So today we have a topic, black control which is a continuation of epidemiology of periodontal disease. This comes under the prevention of periodontal disease. So we have learned what is agent host and environmental factors for the periodontal disease especially the black and its hypothesis. So in this video, I will be explaining about the various measures of black control, what are the mechanical and chemical black control strategies, materials, compounds we are using. So let's see what is black control. So by definition, it is the regular removal of microbial black and the prevention of its accumulation on the teeth adjacent to the surface. So as we all know, microbial black is a major etiology of periodontal diseases but the patient cooperation is a fundamental key for a long term success. So we have mechanical and chemical black control measures and mechanical, the most common is toothbrushes and interdental cleaning aids. As in chemical it is chloroxidine, essential oils and other few products are there. So toothbrushes are started by Chinese in 1600 BC. So hypocrites even mentioned about removing the deposits from teeth. So the first bristle toothbrush was introduced by Chinese. So in mechanical black control, we remove the biofilm via toothbrush. The most common use is a manual toothbrush. So well designed to remove black from the facial, lingual and occlusion surfaces. So the toothbrushes are designed to remove black from the facial surfaces, lingual surfaces and occlusion surfaces. So basically every toothbrush has to follow these specifications given by American Dental Association. Its head should be 1 to 1.25 inches long and 2 to 4 rows of bristles, 5 by 16 to 3 by 8 inches wide, 5 to 12 teffs per row and 80 to 86 bristles per teff. So depending upon the hardness we can classify as soft, medium, hard and extra hard. What is 0.007 to 0.009 inches, 0.010 to 0.012 inches is medium and 1 3 to 1 4 is hard and 0.15 is extra hard. See commonly we use medium to bristles, for sensitive teeth we can suggest soft to bristles. So we have very common method that is modified bass technique we suggest for patients to follow that is apical 45 degree to the long axis. It helps circular cleaning of abdominal health. Steelman it is different directed apically and it is similar to bass method but it placed partly on cervical portion of teeth and partly on adjacent ginger. It is most commonly used in ginger recession. Charter's method is exactly opposite of these two because its angulation is towards the crown not towards apex. So it is for orthodontics and surgical sites to not disturb the ginger. So roll stroke is nothing but directed apically and rolled occlusively. Fonds technique we apply for kits that is a circular motion. So power tooth pressures are came into market in 1939. So we can suggest for people with lack of fine motor skills and small children's or handicapped even hospitalized patients with orthodontic appliances and some may prefer it. So we have various types of motion and power tooth pressures like reciprocal that is back and forth, circular or elliptical for a combination. So dentifaces are the next part of black control and mechanical black control. So these are the aids for cleaning and polishing teeth. They can be used in powders based on tools. So it has composition. The first one is abrasive calcium carbonate or calcium phosphate, humectants like glycerin, sobitol, mannitol, it creates a form thickening agent is sodium carboxymethyl cellulose. So this humectant it retains a humidity and forming agent is sodium laurel sulfate. So humectant is actually property which retains humidity that is a wet ability. So when we use a toothpaste it is very easy to apply compared to the tooth powder. So that is humectant we can use a glycerin, sobitol or mannitol. So forming agent sodium laurel sulfate preservative benzoic acid there will be flavoring agent like peppermint, saccharin, desensitizing agent like potassium nitrate or sodium fluoride anti-carousage and sodium monofluorophosphate and even anti-calculation which is pyrophosphates or zinc compounds. So we have various interdental aids. This is basically a simple chapter because tooth brush so we know tooth brush we see it a daily to daily in our daily life. So we can't easily correlate all the products. So tooth brushes actually doesn't remove the interdental plaque. So dental flows and other interdental aids such as wooden or plastic tips or interdental pressures can be used to remove the interdental food debris. So how we can use a interdental aid based upon the type of interdental papilla that is type 1, type 2, type 3. Type 1 is very close, precious over it has always advised to use a dental flows. Type 2 there is a papillary recession so miniature interdental pressure or wooden tips can be used. Type 3 is complete loss of papilla so unit after precious can be used. So dental flows is nothing but nylon filament or plastic which may be waxed and waxed or thick tint. So unwaxed is always preferred. So it is two method can be applied by spool method and loop method. Spool method is 12 to 18 inches taken and 4 inches around the middle finger as you see the picture 1 to 2 inches held tightly between the index finger, index finger then as the picture seen you can apply it. This is spool method. Loop method is different. Loops of loose is made about 12 to 18 inches with 3 knots passed between the contact area. So that is loop method. So interdental brushes are in various size and shape can be conical or tapered. So designed to be inserted into plastic reusable handle that is there will be handle always we can reuse it. So these results always inserted at 90 degree as you see the pictures. Move in and out motions and wooden tips can use it. It will be triangular in cross section base of the triangle oriented towards the gingiva. So this base should shoot the gingiva and the small sharp edge should be towards the coronal side. So unit after brushes can be used for type 2 and type 3 embrasures, gingival massages will help for improved circulation, keratinization and epithelial thickening. It should be pointed 45 degree coronally the rubber tip should be pointed like that. So water irrigation devices we hardly seen this, valuable supplement for mechanical plaque control because it removes unattached plaque and debris. So it looks like this picture is shown here. So it has a built-in pump and a reservoir. So next we move on to chemical plaque control. Most companies Clorexidene, then essential oil, antibiotics, quaternary, ammonium compounds and enzymes. Clorexidene is a cationic bispeganite it has a superior anti plaque activity it is known as substantivity because it retains to the oral structures for a period of time. We use at low concentration it is bacteriostatic and bacteriocidal in high concentration. So single rinse will be having an antibacterial activity for at least 5 hours. So it prevents actually pellicle formation by blocking the acidic groups on glycoprotein and reducing the glycoprotein adsorption on both surfaces and prevent adsorption of bacterial cell wall on tooth surface by binding it to the bacteria. So it binds to the bacteria and it prevents adsorption of the cell wall to get attached to the tooth surface and it prevents binding of mature plaque by precipitating agglutination factors in saliva and displacing calcium from plaque matrix. So essential oil is very has very long history of use and safety demonstrated plaque reduction in very long term clinical trial. Examples are listerine, thymolucaliptole, menthol, antibiotics are vancomycin, erythromycin like that but bacterial resistance and hypersensitivity are some problems enzymes would be able to break down already found matrix of plaque and calculus. And certain proteolytic enzymes are bacteriocidal to microorganisms like mucinase. So quaternary ammonium compounds are effective against developing plaque posterior organism like benzytonium chloride. So these molecules react with negatively charged membrane phosphatase, destruct cell wall of microorganisms. And some other agents are like trichlosan it is a phenol derivative, broad spectrum activity against both gram positive and negative and which act so on microbial cytoplasmic membrane and causes leakage of cellular constituents and it also delays plaque maturation and inhibits formation of prostragalantins and leukotrines. Telmopelan also it is a ethanol derivative it interferes with plaque matrix formation and reduce bacterial adherence. It used as a pre-pressing nutrients. So that's all about plaque control. We have two types of plaque control one is mechanical and another is chemical plaque control. So it comes under prevention of, prevention of pyridontalysis. So we have learned prevention of pyridontalysis under primary, secondary and tertiary. So this plaque control comes in primary prevention. So we are using it for primary prevention of pyridontalysis and various levels that is individual professional and community level. So at even individual and professional level it can be applied. So thank you. We'll come up with a new video on Tentistry and Moral.