Topics of the day:

1. Tooth brushing and motivation
2. Tooth brushing and motivation
3. ESCO - The Electronic Study Club for Orthodontics


From: "Charles Ruff" <>
Subject: tooth brushing and motivation
Date: Mon, 23 Jan 2006 08:32:25 -0500

Original message:
To: " " < >
From: "Jeffrey Mastroianni" < >
Subject: Decalcification
Date: Thu, 12 Jan 2006 10:53:55 -0600

>>Despite giving thorough and repeated instructions on how to care for their braces, many of my younger patients still struggle to >>achieve proper hygiene. We evaluate them at their initial visit and show them how to brush properly, then we grade them at every >>visit and use a wooden nickel program to motivate them. If they don't have good OH then they don't get nickels.

>>Even on some of my better patients I have noticed some decalcification near the gingival margins. Could my etching technique >>make my patients more susceptible to decalcification? Sometimes I use self-etch primer, sometimes a standard etch technique. I >>have recently begun using Pro Seal to help combat the problem.

>>Does anyone have any suggestions for either motivating patients to become better brushers or how to improve my technique to >>make them less likely to harm their teeth. Also, any anecdotal thoughts on the efficacy of Pro Seal.

>>Jeff Mastroianni DMD MS
>>Glen Carbon, IL

you need to be aware of several things

1. wooden nickels are more a marketing effort than a motivational effort.  I think RS Nanda has published on this (or perhaps someone else at OK).  I tried finding it on the Medline but no luck. 2. Larry White has spoken on this subject and he feels that poor brushers are also our most "fragile" patients regarding discomfort.  They tend not to wear elastics because it hurts and they don't brush well because it hurts 3. I think the use of self etching pops tends to aggravate the problem.  I know my staff and I have found this to be true (anecdotal) 4. the best sealant is SAGA out of Oslo Norway.  Acetone based.  It will remain on the labial surface for at least 18 months.  Unfortunately, it is no longer available in the US because of air freight problems (safety) 5. I am using ProSeal just like you and I will take Paul Gange at face value that it is just as good as SAGA but time will tell 6. you might supplement what you are doing with a fluoride varnish 7. remember most kids are drinking everything supersized.  A real treat when I was a lad was a bottle of Coke (8oz).  Now McDonalds has the kids sucking on 24 or 32 oz products.  WOW 8. plan your treatment to be most efficient.  don't start too early.  

good luck
charlie ruff


From: "Charles Ruff" <>
Subject: tooth brushing and motivation
Date: Mon, 23 Jan 2006 08:57:22 -0500

Those articles I referred to are in the AO (1998). If you want a copy, just email me.

Charlie Ruff


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