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Poor Oral Hygiene

An overview of Poor Oral Hygiene

Dental neglect causes many problems.

Figure 1: This patient has many signs of poor oral hygiene and dental neglect, including heavy plaque, enamel demineralization, stained teeth, large cavities (caries) and inflamed gums. All of these conditions are preventable with good oral hygiene, proper nutrition, and awareness counseling.


Failure to remove food debris and bacterial plaque from the teeth and other oral structures leads to gingivitis, tooth decay (caries), and eventually periodontal disease and tooth loss. These conditions, which are often accompanied by pain, infection, and halitosis; and which may cause general health problems are completely preventable, and account for significant unnecessary expense and discomfort.

It is common for children to overlook their oral hygiene, and they definitely require assistance with tooth brushing through the age where their fine motor skills allow them the dexterity to effectively clean their teeth; and they are capable of understanding the reasons for maintaining good oral hygiene. Their efforts should be monitored by a responsible adult through the age where they consistently perform adequate oral hygiene. Even adolescents can be difficult to motivate, and frequently require encouragement and reminders to take care of their mouths. Continued neglect can be devastating to the condition of the teeth (Figure 1).

How does the dentist diagnose Poor Oral Hygiene?

Note: ToothIQ.com contains general information. Only a dentist can properly diagnose your specific condition.

Poor oral hygiene is evident by the presence of bacterial plaque and food debris on the teeth. Even if the patient brushes and flosses away the deposits of food on exam day, the inflammation of the oral soft tissues, possible tooth decay (caries), and poor periodontal health can’t be hidden. Each of these is a bacterial illness.

How is Poor Oral Hygiene treated?

Treatment of periodontitis may involve one or more options.

Treatment of gingivitis commonly involves use of scaling instruments and ultrasonic cleaning devices, which remove plaque, calculus, and biofilm to establish a healthy oral environment.

Dental prophylaxis is performed to remove mineralized food deposits (calculus) and bacterial plaques from the teeth and soft tissues. Topical fluoride application may be recommended to provide some protections against development of tooth decay (caries), and to arrest early enamel demineralization. Dental sealants or prophylactic odontotomy may be recommended to eliminate the deep pits and fissures in teeth which account for some 80% of new cavities.

Cavities may need to be restored with fillings. X-ray images (radiographs) will normally be exposed to evaluate the teeth for decay that is not visually or tactilely evident. Diagnostic photographs can be useful to communicate with the patient about problem areas, as well as to document them.

If periodontal disease is diagnosed, either surgical or non-surgical periodontal treatment may be recommended. For early periodontal disease, scaling and root planing is generally the treatment of choice. It may be followed by localized antibiotic administration, and will generally require that the patient adhere to a regular schedule of periodontal maintenance intervals to keep the disease (which is not curable) from progressing.

If extensive decay or infection is present, it may be necessary to have root canal treatment (endodontics) or even tooth removal (simple tooth extractions and surgical tooth extractions). Teeth which have already been endodontically treated may require retreatment if the dental restoration over the root canal filling is compromised.

The patient (or their parent, in the case of children) should receive specific oral hygiene instructions aimed at proper toothbrushing and flossing techniques, and nutrition counseling to heighten the patient’s awareness of the causes of bacterial dental illness so that problems can be avoided.

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Author: Thomas J. Greany, D.D.S. / Editor: Ken Lambrecht

This page was last updated on March 6, 2018.

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