Gillette W B, Van House R L
J Am Dent Assoc. 1980 Sep;101(3):476-80. doi: 10.14219/jada.archive.1980.0295.
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.
预防龋齿和牙龈疾病的工具使用不当也会产生有害影响。例如，牙线会导致炎症；牙刷可能会引发脓肿；而水冲洗装置可能会将异物挤入软组织。本报告讨论了不正确口腔卫生的影响、从业者应注意的迹象以及适当的纠正措施。尽管有效的口腔卫生对于保持牙齿和支持组织的健康至关重要，但对文献的分析和临床观察表明，六个问题领域可能与常见的口腔卫生措施有关。——刷牙用力过猛或使用与刷牙技巧不匹配的牙刷类型，往往会导致牙颈部磨损、牙龈刺激和牙龈退缩，或出现所有这些问题。——无节制或用力过猛使用牙线可能会导致牙龈刺激、溃疡或牙龈缺损。近中牙根表面很少被磨损。——牙膏、漱口水和口香糖可能会在易感人群中引发过敏或毒性反应。这些反应会造成各种创伤性损伤，尤其是在高压下使用时。或许，牙科人员在使用前应给予详细的个人指导。——牙龈组织脓肿可能由牙刷刷毛和牙签等口腔卫生辅助工具的碎片植入引起。——在某些口腔卫生措施期间，细菌可能会进入血液，尤其是在患有晚期慢性牙龈疾病的患者中。由于不同研究结果相互矛盾，发生率尚不清楚。这些菌血症对于患有风湿性心脏病、人工心脏瓣膜、人工关节以及肾透析分流器或肾透析中使用的瘘管的患者来说是令人担忧的。基于损伤和致病因素，提出了一种口腔卫生引起的疾病分类方法。
