oral health assessment

• brush 2 x daily, brushing for 2 minutes 
• brushing before bed and any other time of the day 
• if using mouthwash use t a different time to brushing 
• do not rinse mouth after brushing, only spit 
• use interdental cleaning as would be missing 40% of tooth surface if not done, advise floss, tepe, floss picks, flossets 
• there is no evidence to suggest any method of brushiing is better, but there is evidence to suggests that an elctric toothbrush removes more plaque 
• make sure brushing with a fluoride toothpaste 

• do a demonstration of brushing on model with patient, ask them if they use a manual or electric toothbrush
• ask patient to show you how they brush their teeth on a model and then you do it on a model, brushing at a 45 degree angle toward the gum line and holding on each tooth for a few seconds 
• demonstrate how to floss with the patient, get a long bit of floss and wrap around middle fingers and use thumb and index finger ti move the floss around the tooth warpping it around like a C on each tooth 

smoking- it is advised to stop smoking, there is support to help stop that we can refer the patinet to if they need help quiting.

• there is a higher risk of periodontal disease
• staining 
• higher risk of treatment failure
• complications
• losing teeth 
• mobile teeth
• oral cancer

Alcohol- recomended guide lines are 14 units per week, this is advise to spread over 3 days of the week or more not all in one go

• ask the patinet how much alcohol they consume in a week, make them aware of the guidelines 
• ask if the patinet smokes and if yes how much and have they tried to cut down or stop

drinks 

• ask patinet what drink they go for when they are thirsty
• advice to try and only drink water and milk
• make patient aware that fizzy drinks are not good for the teeth and can cause erosion to the teeth which cannot be reversed but may result in fillings in the future.

food

• advise not to eat before bedtime as when we sleep the saliva flow reduces taking it longer for the mouth to reminerilise and become a neutral PH level which can result in the breakdown of the dentine and cause erosion. 
• stick to 3 meals a day and no snacking between meals 
• try and stay to around 3-4 acid attacks a day 

• you should have a toothpaste that has fluoride in it
• fluroide helps prevent decay
• when looking for a toothpaste you should look at the back of the toothpaste and aim to have a toothpaste that has 1,350ppm -1,500ppm, you dont want anythig below 1,350ppm.
• for a child you should have a toothpaste that is above 1,000ppm (parts per million)
• you should use mouthwash a different time to toothbrushing as it washes away the fluoride 

• face the patinet
• be in front of the patient
• don't wear any ppe or a mask to cover your mouth
• open body language 
• smiley 
• ask if the patient has any questions
• give constructive feedback
• demonstrate, give leaflets, use models 
• recomend the patinet sees the dentist reguarly
• give information in a nice friendly way