Oral Irrigators - Yay or Nay? Part 4
Daily Use & Maintenance of the Unit
Oral irrigators have become increasingly popular because of their success in disturbing plaque biofilm. Patients must receive proper instruction regarding their use and maintenance to prevent injury and infection. Below are guidelines for daily use and maintenance.
- Recommend the Proper Tip- there are many tips available for use with an oral irrigator. The recommended tip is based on the patient’s condition and failing to use the suggested tip can cause injury.
- Periodontal Tip Usage- Patients with periodontal disease should be instructed on how to use a periodontal tip which is designed to allow access up to 90% of the pocket depth. It’s inserted subgingivally and has a soft rubber tip with a small opening that controls the amount and pressure of the water and antimicrobial entering the pocket. Before turning the unit on, place the tip gently into the pocket at a 45-degree angle, and then turn it on low pressure.
- Add the Recommended Microbial- an antimicrobial increases the effectiveness of irrigation and can be used full strength or diluted with water. Recommendations depend on the patient’s condition and tolerance.
- Proper Use- the patient should be shown how to position the appropriate tip at a ninety-degree angle to the long axis of the tooth and three millimeters from the gingiva. The tip should be swept along the gumline and paused for five seconds interproximally. This process should be followed on the facial/buccal and lingual surfaces. The tip should never be pointed down into the gingiva unless using a periodontal tip.
- Water Pressure – most devices have adjustable water pressure. Patients must begin using a lower pressure (about 3-4) to get accustomed to irrigation. After one week, they should be able to increase the pressure (7-10). However, those with sensitive gums or using a periodontal tip will need to use less pressure.
- Choose the Right Unit- there are many different units available on the market and guidance is necessary to ensure that the patient purchases one that matches their needs.
- Irrigate Daily- Consistency is the key in improving oral health. Microbes form very quickly, and they must be fought daily for maximum benefit.
- Mind the Mess- A water jet causes a huge mess if not used correctly. Placing the tip in the mouth and against the tongue before turning it on is necessary to avoid a disaster. Also, keeping the head down during the entire session will help diminish the mess. Some models have a water control button on the handle which helps tremendously.
- Don’t Forget to Brush and Floss- An oral irrigator is an adjunctive therapy. Brushing at least three times and flossing at least once per day is crucial for maintaining a healthy mouth.
Maintenance of the device on a monthly basis is necessary to establish the irrigator is safe for daily use. Bacteria, fungi, and viruses can easily contaminate the unit if it’s not cleaned on a regular basis. Also, using tap water can cause mineral and other unwanted deposits to build up over time. Certain parts can be placed in the dishwasher to achieve disinfection. Below are the steps to clean a countertop device. Portable or cordless models should be cleaned monthly by following the manufacturer's instructions.
- Clean the exterior with a non-abrasive product and a soft cloth.
- Clean the reservoir by removing it if it’s detachable. If it has a removable valve, take it out and rub gently under warm water. The reservoir can be placed in the top rack of the dishwasher and air dried. Don’t place the valve in the dishwasher.
- Clean the internal pieces by placing 16oz of warm water with two tablespoons of white vinegar into the reservoir and turning it on high pressure until all the solution is flushed through.
- Clean the handle by soaking it in one-part white vinegar and two parts water for 7-10 minutes.
- Clean the flosser tip(s) by removing it from the flosser and soaking in one-part peroxide and two parts water for about 5 minutes.
- The flosser tip should be replaced every 3-6 months depending on the hardness of the tap water.
- Never leave water in the reservoir overnight.
- Always run some hot water through the unit after each use.
An oral irrigator is a great investment for every patient provided they’re instructed on usage and maintenance from a dental professional. Patients with orthodontic appliances, implants, crown and bridge, diabetes, gingivitis, periodontal disease, and those whose oral and overall health is less than ideal can certainly benefit from daily use.