Improper use of the tools that prevent tooth decay and
gingival disease can also produce harmful effects. For example,
dental floss can cause
inflammation; toothbrushes could cause
abscesses; and water-irrigation devices might drive foreign material into soft tissue. This report discusses the effects of incorrect
oral hygiene, the signs the practioner should notice, and the proper corrective steps. Although effective
oral hygiene is essential for the maintenance of healthy teeth and supporting tissues, analysis of the literature and clinical observation suggested that six problem areas may be associated with common
oral hygiene measures. --Overly vigorous
toothbrushing or using the wrong type of brush for the technique often leads to cervical
tooth abrasion, gingival irritation, and
gingival recession, or all of these problems. --Uncontrolled or overly vigorous dental flossing may lead to irritation, ulceration, or defects of the gingiva. Proximal root surfaces are rarely abraded. --
Dentifrices,
mouthwashes, and
chewing gum may elicit allergic or toxic reactions in susceptible persons. These reactions take a variety of traumatic
injuries, especially if used at high pressure. Perhaps, detailed individual instruction should be given by dental personnel before use. --
Abscess of gingival tissues may occur from implantation of fragments of such
oral hygiene aids as toothbrush bristles and toothpicks. --Bacteria may enter the bloodstream during certain
oral hygiene measures, especially in patients with advanced chronic
gingival disease. The rate of occurrence is unknown because of conflicting results in different studies. These
bacteremias are of concern to patients who have
rheumatic heart disease, prosthetic heart valves, prosthetic joints, and
renal dialysis shunts, or
fistulas used in
renal dialysis. A classification of
oral hygiene-caused disorders is proposed, based on the injury and the causative agent.