You can try selecting from a similar category, click on the author's name, or use the search box above to find your book. Click on the cover image above to read some pages of this book! Cruising down the Amazon River, three vacationing couples become ensnared in a family feud with deadly overtones. The ship's purser is poisoned, the ship's electrical system is sabotaged, and diners are alarmed to see a fellow passenger slump from his chair during a festive dinner. Professional gospel singer Charles Warner snaps a photo of the waiters and inadvertently reveals the culprit.
Policeman Bret Brandon draws on his investigative experience to help the distraught captain regain control of events. Photojournalist Steve Roberts senses a major news story about to break and enlists the support of the ship's young radio operator.
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Their wives, Sallie, Betty, and Kathi try to maintain their sanity by attending aquacise classes, participating in bridge tournaments, and joining the ribald festivities crossing the equator. Though the majority of adults are affected by gingivitis, gingivitis fortunately does not always develop into periodontal disease. In most cases, periodontal disease responds to treatment and although the destruction is largely irreversible its progression can be halted. The rate of progression of periodontal disease in an individual is dependent on the virulence or strength of attack of the bacterial plaque and on the efficiency of the local and systemic immunoinflammatory responses in the person host.
Current research suggests that host responses are influenced by specific environmental and genetic factors which can determine the general susceptibility of the host or the local susceptibility of a site tooth within the mouth to periodontal disease. In this regard, it is common for more severe forms of periodontal disease to present in individuals with compromised immune systems, e.
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Smoking and diabetes are well-established risk factors for periodontal disease. As already stated, the vast majority of gum diseases can be easily prevented by daily thorough plaque removal. However, irregularities around the teeth such as overhanging edges on fillings, poorly contoured fillings, and some types of partial denture designs make tooth cleaning difficult and encourage the accumulation of plaque. The presence of calculus tartar — plaque that has calcified and hardened — may also cause plaque to accumulate more readily and requires professional removal scaling.
For the majority of the population, however, periodontal health can be effectively maintained by proper oral hygiene practices as well as avoidance of behavioural and environmental risk factors e. Because periodontal disease is linked to an increased susceptibility to systemic disease e.
Plaque control is the most important method of limiting periodontal disease and maintaining gingival health. From age 2 years, a peasized amount of toothpaste containing 1,—1, ppm fluoride is recommended. Parents should ensure that the first permanent molar teeth, which appear at the back of the mouth at about this time, are included in the brushing routine as soon as they appear. Toothbrushing skills should be taught to people of all ages. The precise technique is less important than the result, which is that plaque is removed effectively every day without causing damage to the teeth or gums.
Thus, careful use of a gentle scrub method using a toothbrush with densely packed, round-ended synthetic filaments of soft to medium texture should be encouraged for effective plaque removal.
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A toothbrush with a small brush head may also be recommended, as a small brush head enables better access to the back of the mouth and to tooth surfaces than a large brush head. Faulty toothbrushing techniques involving excessive pressure may considerably increase gingival recession i.
Holding the toothbrush in a pen grip using just the thumb and forefinger, as opposed to resting the toothbrush in the palm of the hand and gripping with four fingers, results in less pressure being applied when toothbrushing and is recommended.
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Plaque disclosing agents colour plaque to make it easily visible and are a useful aid for improving plaque control. Dental floss and other interdental cleaning aids are of value if used correctly, which usually requires professional advice and instruction. An additional method of plaque control is the use of antiseptics, of which chlorhexidine is the most effective. Although chlorhexidine is available over the counter in Ireland in the form of mouthrinses and gels, its tendency to stain teeth and impair taste makes its long-term use generally unacceptable.
Toothpastes and mouthrinses containing other antiseptic agents, while less effective than chlorhexidine, do not have these side effects and are of some value to gingival health. Starting with clean hands, break off about 45 cm 18 inches of dental floss from its dispenser. Wind one end of the floss around a middle finger of one hand.
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With the floss held tightly between thumb and forefinger or using your interdental flosser, use a gentle sawing motion to guide the floss between adjacent teeth. Take care not to snap the floss against the gums when doing this to avoid injury.
When the floss reaches the gum line, curve it into a C shape against one tooth and gently slide it into the space between the gum and the tooth. With the floss kept tight against the side of the tooth, gently move the floss away from the gum with up and down motions.
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Repeat this scrubbing action to clean plaque off the adjacent tooth.
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