The use of irrigators and dental floss as primary prevention of oral diseases.

Full Text

Introduction. As the analysis of statistical data for the last 10 years shows, diseases of the dental system in different age groups of the population of the Russian Federation remain one of the most common, despite the methods available to medical specialists to prevent their development. Probably, a number of problems complicate the situation, including a significant difference in the climatic and geographical conditions of our country, and a low content of fluorine and iodine in drinking water. The prevalence of oral diseases is influenced not only by environmental, but also by social factors, for example, occupational hazards, dietary habits, neglect of caries prevention, and others [3].

According to world statistics for 2023-2024 [1], 3.5 billion people suffer from various dental diseases, of which 98% of people over 25 years of age have at least one filling in permanent teeth, of which 19% suffer from severe periodontitis. Among adolescents, 80% have caries in permanent teeth; 80-90% of children with baby teeth have signs of developing caries.

Due to the development of the modern food industry, caries has become more common in children, and not only superficial, but also deep with damage to dentin and pulp. This is due to the high sugar content in food products and the lack of proper hygiene, leading to the accumulation of food in the interdental spaces, and pathogenic microorganisms located there oxidize carbohydrates in the process of their life activity with the formation of lactic or pyruvic acid, which is the main factor in the process of enamel demineralization [4].

The cause of periodontal disease is also poor dental care, more often found in people with fixed dentures. This leads to inflammation of the gums, their swelling, infection of the pulp, the formation of granulomas, suppuration, bone loss, loosening and possible loss of teeth. Among the population over 60 years old, 23% experience difficulties due to partial adentia, 7% of people under 25 have complete adentia.

This is due to the neglect of pathological processes in the oral cavity, traumatic lesions and untimely seeking dental care.

These and many other diseases are in most cases caused by improper hygiene due to lack of knowledge about proper oral care using irrigators and dental floss.

Currently, more and more people are learning about the need to use additional personal hygiene products, thanks to the development of modern dentistry and the emergence of such doctors as dental hygienists engaged in medical and preventive and sanitary and educational activities.

There are many means to maintain the integrity of teeth: various toothbrushes, pastes, floss and irrigators.

An irrigator is an auxiliary device for maintaining oral hygiene that generates a stream of liquid under pressure. It perfectly copes with the removal of food debris between the teeth, rinsing periodontal pockets, caring for braces, crowns, implants, bridges. In addition, the use of an irrigator helps to improve blood circulation in the gums, which helps to strengthen them and prevents inflammation [2].

Floss is a special thread for cleaning the space between the teeth from plaque and pieces of food. It allows you to remove plaque and pieces of food from the interdental spaces to prevent the occurrence of caries [2].

When using only a toothbrush, only the exposed surface of the tooth is cleaned, and the interdental spaces are not affected, since the bristles of the toothbrush are not able to penetrate into hard-to-reach places, as a result, bacteria continue to multiply, plaque remains and contributes to the further development of caries and other pathological processes.

The aim of the work was to study statistical data obtained by conducting a survey among people of different age and professional groups of the population of the city of Voronezh.

Materials and methods of the study. A survey was conducted with the participation of 146 people aged 15 to 35 years. Among the test subjects were students from schools of the Voronezh region, VSU, VSMU, VSTU.

The survey included 12 questions aimed at obtaining information about the level of awareness of the population about the rules of oral hygiene, as well as the use of such auxiliary means as an irrigator and dental floss.

To collect and analyze data, a survey was conducted on the electronic Internet platform Google Forms. The results obtained were interpreted using statistical methods.

Results of the study. The study found that 134 people (91.78%) have various oral diseases: caries, gingivitis, periodontitis, tartar, pulpitis, stomatitis. Among the respondents, 12 people (8.22%) claim that they do not have oral pathologies. This allows us to state that oral diseases are a common problem among the population, but we should also not exclude the possibility that a person may not be aware of their condition. The survey showed that 42 people (28.77%) visit the dentist once every six months, 89 (60.96%) - once a year and 15 (10.27%) do not visit dental clinics at all. Based on this, we can conclude that approximately 89% of respondents monitor their health and are aware of possible problems if personal oral hygiene is not observed. It was found that out of the total number of respondents, 12 people (8.22%) use dental floss and an irrigator, 38 (26.03%) use only dental floss, 8 (5.48%) use only an irrigator, and 88 (60.27%) do not use additional primary oral hygiene products. According to the results obtained, it can be concluded that more than 60% of people do not use additional oral care and prevention products.
The survey showed that oral diseases occur in the majority of the population, who are aware of their existence and preventive measures, but, due to non-compliance with the rules for using additional personal oral hygiene products, there are often various disorders in the oral cavity caused by untimely or poor-quality cleaning of teeth and gums after meals.

A reminder for the population
To ensure proper oral care using dental floss and an irrigator, you must follow these recommendations:
Recommendations for the use of dental floss
1. Choosing dental floss [4]. It is necessary to select dental floss that meets your needs and the characteristics of your teeth, especially for people with dentures, bridges, and braces. For example, waxed floss is recommended for sensitive teeth, and wax-free floss for more thorough cleaning. Pay attention to the presence of fluoride in the floss, which can help strengthen the enamel.
2. Using dental floss [2]. Use dental floss regularly, preferably after each meal. To prevent damage to the gums, it is necessary to follow the correct technique for using dental floss:
1) Cut off the required amount of floss, about 25-35 centimeters.
2) Overlap the ends of the floss onto the nail phalanges of the middle fingers.
3) Stretch a 3-8 centimeter long fragment between both hands, clamp it with the index fingers and thumbs, moving it up and down between the teeth. 4) When moving to the next tooth, you should gradually unwind the unused part of the floss from your finger. Do not use the same piece of floss twice, so as not to transfer plaque and microorganisms from the used piece. Do not make quick movements when using and removing dental floss.
Recommendations for using an irrigator [2, 5]
1. Before using, you should consult with your dentist. He will help you choose the most suitable products and familiarize you with the instructions. When using an irrigator, you should choose attachments that meet your needs. For example, tongue cleaning or gum massage attachments can be useful for maintaining oral health. Adjust the water pressure in the irrigator according to your feelings and the recommendations of your dentist.
2. Using an irrigator. You need to lean over the sink so that the liquid can freely flow out of the oral cavity. It is advisable to start with the back teeth, directing the water stream to the gum line at an angle of 90 degrees, lingering on each area for a few seconds to thoroughly clean it from plaque and food debris, paying special attention to hard-to-reach places. Children should use the irrigator only under adult supervision.
3. Training and practice. Training on the correct use of the irrigator can be taken in courses or online. Practice will help you consolidate the acquired knowledge and skills.
4. Regular check-ups. It is necessary to regularly visit the dentist to check the condition of the oral cavity and receive recommendations for its care.
5. Compliance with safety precautions. It is not advisable to use the irrigator if you have inflamed gums or other problems with the oral cavity without consulting a dentist.
6. Replacing nozzles. You should replace the irrigator nozzles, strictly following the manufacturer's recommendations. This will help prevent the proliferation of bacteria and ensure effective cleaning of the oral cavity. 

7. Storage. Keep irrigators out of the reach of children and follow the manufacturer's storage instructions.
By following these recommendations, you can ensure proper oral care and reduce the risk of developing dental problems.
Incorrect use of dental floss or an irrigator can lead to various pathophysiological disorders in the oral cavity:
Gum damage. Incorrect use of dental floss can lead to gum damage, which can cause bleeding and increase the risk of penetration of pathogenic microorganisms that can cause inflammation [4].
Irritation of the mucous membrane. Too much water pressure when using an irrigator or incorrect direction of the stream can cause irritation of the oral mucosa.
Spread of infection. Incorrect use of hygiene products can lead to the spread of bacteria and infections in the oral cavity.
Development of caries. If food debris and bacteria are not removed after using the irrigator, this can lead to the development of caries.
Changes in the microflora of the oral cavity. Regular use of an irrigator with inappropriate solutions or excessive use of dental floss can change the microflora of the oral cavity, which can lead to dysbacteriosis and other problems.
Enamel erosion. Using dental floss that is too hard or using the wrong brushing technique can lead to erosion of the tooth enamel.
Therefore, it is important to follow the rules for using dental floss and an irrigator, and if any problems arise, consult a dentist.
Conclusion. As a result of this study, it became clear that oral diseases are widespread and occur in people of all ages: in children who have baby teeth and in adults with permanent teeth. First of all, this is due to the lack of knowledge about oral hygiene. The reason for this is the low awareness of the population about the rules and methods of using additional oral hygiene products and insufficient popularization of their use. Secondly, untimely visits to a dental hygienist for professional teeth cleaning in order to remove tartar affect the condition of the oral cavity. Improper nutrition with high sugar and carbohydrate content, neglect of brushing teeth, bad habits such as smoking, stress increase the risk of dental problems. Combining all these factors, it becomes clear that oral health is affected by many reasons, therefore, to reduce the risk of pathological processes, it is necessary to use irrigators and dental floss for primary prevention of oral diseases.

About the authors

Alexandr Stanislavovich Sablin

Voronezh State Medical University named after N.N. Burdenko

Author for correspondence.
Email: sablin.AS@mail.ru
ORCID iD: 0009-0003-2162-0305

student

Russian Federation, 394036, Russia, Voronezh, st. Studencheskaya, 10

Alexandra Dmitrievna Polikarpova

Voronezh State Medical University named after N.N. Burdenko

Email: sasha090305@mail.ru
ORCID iD: 0009-0000-6628-4198

Student

Russian Federation, 394036, Russia, Voronezh, st. Studencheskaya, 10

Daria Andreevna Sinicina

Voronezh State Medical University named after. N.N. Burdenko

Email: d.a.sin@yandex.ru

Ph.D. assistant of the Department of Pathological Physiology

Russian Federation, 394036, Russia, Voronezh, st. Student, 10

References

Supplementary files

There are no supplementary files to display.