Ill effects of improper oral hygeine procedure.

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.