Patient-Applied Home Irrigation
This Chapter examines the role of supragingival and subgingival irrigation
in the treatment of periodontal disease. The main goal swpragingival irrigation to reduce the inflammation of the gums, disrupting bacterial biofilms coronal to the gingival margin
. The purpose swfogingival irrigation is to reduce the number of bacteria in the periodontal pocket space.
1. What is a dental water jet? Dental water jet is a General term for a device that provides a pulse irrigation water or other solutions and between the teeth (supragingivally) and in the gingival sulcus or periodontal pocket (subgingivally). This process is usually called a house or oral irrigation. Dental water jet may also be related to the dentist water irrigator, home irrigator, or water flosser.
A. the mechanism of action of dental water jet
1. Dental water jet creates the pulsating flow of liquid for washing the area with water or antimicrobial agent. Fig. 27-1 shows examples of devices used for the house of irrigation mouth.
a. In the pulsating fluid delivered dental water jet includes compression and decompression phase, which effectively replaces biofilms, bacteria and debris [1,2].
B. Pulsating fluid creates two zones fluid movement called hydrokinetic activity (Fig. 27-2).
1) near the mouth of the initial contact of liquid, called zone of influence.
2) the depth of penetration of a liquid in subgingival grooves or pocket called washing areas .
2. Hydrokinetic movement of fluid results in subgingival and interdental liquid.
1. Dental water jet produces subgingival penetration of a liquid regardless of the type of tip or attachment [4,5].
2. Dental water jet, has the greatest potential to reach deeper into the furrow or pocket compared with other types of devices, including toothbrushes and interdental AIDS (PL. 27-1) [4,5].
2. Home advantage irrigation mouth. Studies show that dental water jet clinically proven to remove the biofilm and to reduce hemorrhage, gingivitis, periodontal pathogens, and inflammation mediators [6-20].
A. remove Biofilms
1. Research in the early 1970-ies demonstrate biofilms removal of dental water jet . Research under the scanning electron microscope has confirmed that three seconds the use of water ripple on average pressure using standard irrigation Council or orthodontic tip removes 99% of plaque biofilm retrieved from teeth (Fig. 27-3 and 27-4) .
2. Dental water jet is used in combination with manual tooth brushing removes the film, as well as traditional brushing and flossing .
B. reduce the bleeding. Studies consistently show that dental water jets -
a valuable tool to assist patients to reduce bleeding [6-10,13,14,18,19].
1. Dental water jet is used in combination with manual cleaning of the teeth is more effective to reduce bleeding than manual tooth brushing and flossing .
2. Daily irrigation water is significantly reduced bleeding within 14 days .
3. Daily irrigation water was much better than washing 0.12% chlorhexidine to reduce marginal bleeding and bleeding on probing .