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PubMed2003

Oral health of patients with Parkinson's disease: factors related to their better dental status.

Contrary to intuitive preconceptions, patients with Parkinson's disease (PD) have been reported to have less carious teeth. The present study was undertaken to seek responsible factors for this unexpected finding. The PD patients consisted of 31 consecutive university hospital outpatients who were 60 years old or over, and the controls of 104 comparable outpatients at a dental clinic. They were inspected for their dental status, and interviewed on their toothbrushing habits and dietary preferences. Their unstimulated saliva samples were collected and their flow volume and pH were measured. The total numbers of carious teeth (DMFT: Decayed, Missing, and Filled Teeth) and other related variables were compared between the two groups by stratification. In total, the DMFT for the PD patients was significantly fewer than for the control. The salivary flow and pH were correlated to the DMFT, but the difference between the two groups was not significant. Frequency of toothbrushing was higher among the PD patients. The lower DMFT among the patients became insignificant when salivary pH was 6 or less, toothbrushing was 2 times a day or less, or the response was positive to the question on the habit of eating snacks between regular meals. In summary, the oral health of PD outpatients with mild symptoms was better than the controls. However, in cases with poor oral hygiene status, the PD patient's oral health was not different from the control. This suggests that they are not invariably protected from caries-associated factors. The generic property of PD may not fully explain the apparent difference in DMFT.

Age Factors↗
PubMed1975

Training mentally retarded adolescents to brush their teeth.

The need for self-care by retarded individuals in behaviors such as brushing teeth led to the development and evaluation of a comprehensive toothbrushing program that included a task analysis and training procedure specific to each component of the task analysis. Eight mentally retarded adolescents, in two groups, individually received acquisition training that included scheduled opportunities for independent performances, verbal instruction, modelling, demonstration, and physical assistance. The first group of four subjects received token plus social reinforcement; the second received only social reinforcement. All eight subjects showed improved toothbrushing behaviors when compared to baseline. Six of the eight subjects correctly performed all toothbrushing steps in two of three consecutive sessions. The study emphasizes the need for systematic program development and evaluation.

Adolescent↗
PubMed1989

Occurrence of gingival recession in adults.

The occurrence of gingival recession was investigated in adults by age and gender and in relation to their dental status and frequency of toothbrushing. A total of 258 dentate subjects were clinically examined. Their mean age was 46 years and they had an average of 19.4 natural teeth. Gingival recession was recorded as present if any root surface was clearly visible without retraction of the gingival tissue. Recession was found on at least one tooth surface in 68% of subjects. Mean number of surfaces with recession was 7.2 for women and 10.4 for men. Subjects with gingival recession had fewer natural teeth than did those without recession. The two groups did not differ from each other in the number of filled teeth and decayed teeth. Mandibular teeth had more surfaces with recession than did maxillary ones. Sites of recession occurred quite symmetrically. Frequent toothbrushers had, both in the maxilla and mandible, more surfaces with recession than had those brushing their teeth infrequently. Frequent toothbrushing had a greater association with recession among women and in the youngest age group.

Adult↗
PubMed1989

Comparative effectiveness of flossing and brushing in reducing interproximal bleeding.

This study assesses the comparative effectiveness of three types of dental floss and toothbrushing in reducing interproximal bleeding sites, measured by stimulation with wooden interdental cleaners using the interdental bleeding index assessment method. The 119 adult subjects with gingival inflammation were randomly assigned to one of four groups at the beginning of a supervised 2 week clinical trial. The toothbrushing only group achieved a 35% reduction in bleeding sites and the three flossing groups all demonstrated dramatic reductions of about 67%. The three varieties of dental flosses were about equally effective in reducing interproximal bleeding and doubly effective as toothbrushing alone. Compared to probing, the interdental bleeding index method is considered a simplified method of assessing interproximal gingival inflammation.

Adult↗
PubMed1994

A study of a pre-brushing mouthrinse as an adjunct to oral hygiene.

A previous clinical screening study demonstrated that a cetylpyridinium chloride (CPC) essential oil mouthrinse inhibited plaque regrowth to a significantly greater extent than a negative control or a triclosan/copolymer rinse when used without toothbrushing. The purpose of this study was to evaluate the same ingredient combination as a pre-brushing rinse over a 6-week period. The study employed a 4 group parallel design with a minimum of 50 subjects per group. Subjects with a minimum baseline plaque index of 1.95 were recruited. The formulations employed were two variations of a CPC/essential oil rinse, a triclosan/copolymer product, and a hydroalcohol negative control. Subjects were rendered plaque free at baseline and then rinsed twice daily before toothbrushing with their allocated product. Plaque was scored at 6 days and 6 weeks. Plaque scores were reduced at 6 days compared to baseline but there were no significant differences between any of the groups. At 6 weeks, plaque scores were significantly lower in both CPC/essential oil groups compared to control. Although both CPC/essential oil groups showed plaque scores which were lower than the triclosan group, in only one of the groups was the difference significant. The triclosan product was not significantly different from control. The results support the previous findings that a CPC/essential oil rinse could be a useful adjunct to oral hygiene when used prior to normal toothbrushing.

Adolescent↗
PubMed1995

The effectiveness of a disposable tooth cleansing device on plaque.

A disposable polyester foam sponge on a stick, impregnated with a non-foaming dentifrice, has been widely dispensed to hospitalized and nursing home patients for intraoral cleansing and refreshing. Since no information was found relative to tooth cleansing capabilities, we have evaluated its effectiveness in the removal of accumulated plaque and also in prevention of plaque accumulation. Removal of 72 hours of accumulated plaque was assessed in a cross-over design study comparing the device with a commercially-available toothbrush by two different groups of 13 and 29 adult, healthy subjects who used each instrument for 1 and 3 minutes respectively. No significant differences were found between mean scores assessed by Turesky's modification of the Quigley-Hein plaque index by either group using either instrument at either time period (P > 0.05). Prevention of plaque accumulation was assessed in a third group of 25 subjects who used each instrument an average of 3 times a day for 1 week in a cross-over study. While the toothbrush was found significantly more effective in retarding the accumulation of plaque from a plaque-free baseline on both facial and lingual surfaces (P < 0.02), the tooth cleansing device still retained plaque-preventive capabilities by maintaining plaque formation below 2 mm at the cervical margin of the tooth. Results of this study indicate the tooth cleansing device may be a viable alternative to conventional toothbrushes.

Adult↗
PubMed1998

Comparison of different approaches of interdental oral hygiene: interdental brushes versus dental floss.

The purpose of the present study was to compare in untreated patients suffering from moderate to severe periodontitis the efficacy of dental floss (DF) and interdental brushes (IDB) in the reduction of plaque, gingival inflammation, and probing depth in a 6-week period prior to subgingival debridement. Twenty-six patients (12 female, 14 male; mean age 37.4 years; range 27 to 72 years) were instructed to use DF for one side of the dentition and IDB for the other side as an adjunct to the daily toothbrushing for 6 weeks. Oral hygiene instructions for toothbrushing and the use of the two devices were given at baseline and at week 3. Measurements were carried out at baseline and at 6 weeks including plaque scores, probing depth, and 2 bleeding scores (periodontal pocket bleeding index and angulated bleeding index). With the IDB, the approximal plaque score at baseline of 3.09 reduced to 2.15 at 6 weeks and with DF from 3.10 to 2.47, respectively. IDB proved to remove significantly more plaque than DF. Baseline probing depth of 5.84 mm for IDB sites and 5.59 mm for DF sites was reduced to 5.01 mm at 6 weeks for both regimens. Analysis showed that the use of IDB resulted in a greater pocket reduction. Both bleeding indices were slightly reduced with IDB and DF, but no differences between devices were found. In relation to patient acceptance, more problems were observed with DF, and IDB were felt to be more efficacious. In conclusion, the results of the present study indicate that in combination with a manual toothbrush, the use of interdental brushes is more effective in removal of plaque and results in a larger reduction of probing depth than the use of dental floss. Although the differences were small, they indicate, in combination with patient preferences, that interdental brushes are to be considered preferable to floss for interdental plaque removal in patients suffering from moderate to severe periodontitis.

Adult↗
PubMed1998

Maintenance of prosthetic treatment in a geriatric patient--case report.

A 76-year old female patient came to the Specialized Clinic for Long-Lasting Dentures of the Dental School of Ribeirão Preto, USP, for prosthetic treatment for the correction of the absence of several teeth. The patient's medical history and examination revealed the presence of psoriasis that had progressed to a rheumatoid arthritis-like condition causing motor deficits such as difficulty in picking up and holding a toothbrush. We proposed two acrylic removable partial dentures, with a chromium-cobalt metal support planned for the lower denture. For the maintenance of oral hygiene we proposed an acrylic resin device coupled to the toothbrush in order to increase the volume of the toothbrush, and consequently facilitate tooth brushing. This device, although simple, has permitted the patient to have a more independent and healthy life style.

Aged↗
PubMed1998

Laboratory assessment of tooth whitening by sodium bicarbonate dentifrices.

The increasing emphasis on dental aesthetics has made tooth whitening an important function of a dentifrice. This laboratory study investigated the whitening effect of toothbrushing with sodium bicarbonate-based dentifrices compared with standard dentifrices that do not contain sodium bicarbonate. Six dentifrices and a distilled water control were tested for their ability to whiten teeth with intrinsic stain. The dentifrices contained different abrasive systems: (1) 45% NaHCO3; (2) 65% NaHCO3 (Arm and Hammer Dental Care); (3) 94% NaHCO3; (4) 94% NaHCO3 + 1.5% H2O2; (5) silica (Crest Regular Toothpaste); and (6) dicalcium phosphate (Colgate Regular Toothpaste). After a thorough rubber cup cleaning with a pumice slurry, the intrinsic color of the test teeth with a Vita shade of A3 or darker was measured with a spectrophotometer using the standard L*a*b* color scale. Measurements were taken on a total of 12 teeth per test dentifrice before treatment, and after 30, 60, 90 and 120 minutes of mechanical toothbrushing. No changes in L* (lightness/brightness) or a* (red-green hue) occurred, but significant differences in b* (yellow-blue hue) were observed over time. Compared to baseline tooth color, all four sodium bicarbonate-based dentifrices were significantly effective in removing the yellow intrinsic tooth stain, while the water control, silica dentifrice, and dicalcium phosphate dentifrice demonstrated no significant change. Between-group comparisons showed that the four dentifrices containing sodium bicarbonate were significantly more effective than the water and dicalcium phosphate dentifrice groups. The commercial dentifrice containing 65% sodium bicarbonate was also more effective than the commercial silica dentifrice. Although continued toothbrushing from 30 to 120 minutes resulted in additional stain removal, most of the tooth whitening by the sodium bicarbonate-based dentifrices occurred in the first 30 minutes of brushing. In the studies conducted, dentifrices containing high concentrations of sodium bicarbonate were more effective at removing intrinsic tooth stain than dentifrices that do not contain sodium bicarbonate.

Dentifrices↗
PubMed1976

Improved oral health of schoolchildren of 16 communities after 8 years of prevention. III. Gingival conditions and calculus.

In 1963, a "Caries-Preventive Program" was started in the canton of Zurich. Within this program supervised toothbrushing exercises (with fluoride preparations) were carried out at school. They were performed 3 times per year by specially trained former dental chairside assistants who also discussed the usefulness of toothbrushing (10 min at each class visit). The teachers were expected to perform 3 additional supervised toothbrushing exercises during the year. The total number of brushing exercises per year was between 4 and 6. A total of 7548 examinations of children were made in 16 communities in 1963/64 1967/68 and 1971/72. The occurrence of gingivitis was studied by considering the symptoms of edematous swelling and discoloration. The frequency of both symptoms decreased over the study period 1963/64 to 1971/72. The frequency of supragingival calculus lingually on lower incisors was also reduced, but this result was not consistently found in the communities. In a subsample, subgingival calculus was studied on bite-wing radiographs. The percentage of children 13 to 15 years of age with such deposits decreased from 9.27 to 3.22.

Adolescent↗
PubMed2000

Improving the oral hygiene of institutionalized mentally retarded clients.

PURPOSE: The quality of oral health care of persons with mental retardation has been reported in the literature to be less than that of their normal peers. The purpose of this study, set in a Midwest institution for persons with developmental retardation, was to determine if a change in policy followed by staff training and monitored by an interested third party would improve the oral hygiene of clients living on wards. METHODS: Methods used to train staff in proper toothbrushing were developed. Three living units were randomly selected for study: control, training plus accountability (experimental group I), and training without accountability (experimental group II). The direct care staff of both experimental groups were trained in proper toothbrushing techniques. Staff of the control group received no training. A dental hygienist visited the living unit periodically to evaluate and provide feedback on the plaque index scores taken by the caregivers in both experimental groups. RESULTS: The plaque indexes of group I showed significant improvement over the control group and group II. CONCLUSION: The results of this pilot study support the other findings of higher plaque indexes for residents with mental retardation and that modifying toothbrushing policies and staff training are not as critical to the improvement of the clients' oral hygiene as is the presence of an involved, interested third party.

Adult↗
PubMed1999

Effect of two common Nigerian chewing sticks on gingival health and oral hygiene.

This study was conducted with the objective of assessing the effect on gingival health and oral hygiene of two chewing sticks, commonly used in a Yoruba community in Nigeria. Sixty, 12-year old primary school pupils participated in the study. After baseline data were collected on the status of oral hygiene and gingival health, complete prophylaxis was carried out on all the children. They were then divided into three groups to which toothbrushes, Pako Ijebu (Massularia acuminata) and Orin Ayan (Distemonanthus benthamianus) were assigned. They received instructions and supervision appropriate to the implement they were provided with. At the expiration of the six weeks intervention period, post-intervention readings were taken. There was no significant difference in the oral hygiene status between those using the toothbrush and those using the chewing sticks. Slight improvements were detected in the gingival status of those using the chewing sticks relative to those in the group using toothbrush. The best score was recorded among those using the Orin Ayan (D. Benthamianus). These differences were however not statistically significant. Even though an association between gingival health and use of these chewing sticks could not be drawn, it is suggested that further studies be conducted in this area.

Child↗
PubMedDate not supplied

Gingival recession at the University College Hospital, Ibadan--prevalence and effect of some aetiological factors.

Four hundred and ninety-one consecutive patients comprising 259 (52.7%) males and 232 (47.3%) females who attended the periodontology clinic of the University College Hospital Dental Centre between May 1995 and May 1996, were recruited into this study. One hundred and thirty-seven patients comprising 101 males and 36 females were found to have gingival recession of at least one tooth surface representing 27.7%. The age range of the patients investigated was 16 years to 82 years; mean age was 39.2 +/- 14.4 for males and 34.1 +/- 14.4 for females. The peak incidence of gingival recession was in the 46-55 year age group. The incidence of gingival recession increases with advancing age with 0.04% in the 16-25 year age groups as compared to 58.5% in the 56-65 year age group. The aetiologic factors which appeared to be related to gingival recession were found in the following order of frequency: malalignment; chewing stick trauma; toothbrush trauma; calculus. Eighty-eight percent (88.8%) of malaligned teeth in the age range 66 years and above had recession. A higher percentage of the subjects who used chewing stick had recession (29.4%) when compared to those who used toothbrush alone (22%) P < 0.05--this is statistically significant. Of great concern is the prevalence of recession (58%) among those subjects who used toothbrush and chewing stick together, with majority of them having generalized gingival recession. The possible reasons for these different prevalence rates of recession are discussed, measures by which incidence of gingival recession can be reduced are briefly summarized.

Adolescent↗
PubMed2002

Efficacy and safety of BrushPicks, a new cleaning aid, compared to the use of Glide floss.

The objective of this double-blind, four-week clinical study was to evaluate the efficacy of BrushPicks, a new cleaning aid, and Glide floss on the reduction of plaque area, gingivitis and bleeding on probing, and to monitor safety when these products were used in addition to toothbrushing with an ADA-Accepted toothbrush (Oral-B P35) and an ADA-Accepted fluoride-containing dentifrice (Crest Regular). No special instructions on or supervision of product use was conducted, other than requesting twice-a-day (morning and evening) use of the assigned products. Following a baseline examination, 63 qualifying adult male and female subjects from the Philadelphia, Pennsylvania area were randomized into two groups. Subjects were also told to use their assigned dental aid after each toothbrushing. Examinations for efficacy and safety were repeated after two and four weeks' use of the products. Sixty-two subjects completed all aspects of the study. There were no untoward side effects attributed to product use, reported or observed, at the two- or four-week examination times. At baseline, there were no significant differences in plaque, gingivitis or bleeding on probing mean scores between the BrushPicks and Glide floss groups. At the two- and four-week evaluation times, both the BrushPicks and Glide floss had numerically lower plaque scores compared to baseline levels. The only statistically significant reduction (p < 0.01) was in the BrushPicks group, comparing the week two mean with the baseline value. Gingivitis (GI) at four weeks was statistically (p < 0.05) lower in the BrushPicks group as compared to the Glide floss mean value. When the changes in scores from baseline to two weeks and to four weeks were assessed, the mean GI score for the Glide floss group was significantly lower at two weeks (p < 0.01) compared to baseline, and also from two weeks to four weeks (p < 0.001). The change in mean GI score for the Glide floss group from baseline to four weeks was also significant statistically (p < 0.001). When the changes in mean GI scores for the BrushPicks group were assessed, there was a significant decrease from baseline to two weeks (p < 0.001), from two weeks to four weeks (p < 0.001), and from baseline to four weeks (p < 0.001). For bleeding on probing, when the baseline to two- and four-week mean values were compared, only the BrushPicks produced significant (p < 0.001) decreases. At two and four weeks, the BrushPicks group mean bleeding on probing scores were significantly (p < 0.05-0.01) lower than the Glide floss group scores. At the end of this four-week study, the BrushPicks product was significantly more effective than Glide floss in the reduction of gingivitis and bleeding on probing, important attributes of soft-tissue health.

Adolescent↗
PubMed2002

Comparative clinical trials and the changing marketplace for oral care: innovation, evidence and implications.

The development of a trayless bleaching system (Crest Whitestrips) and a novel battery-powered toothbrush (Crest SpinBrush) has fueled growth in the bleaching and power toothbrush markets. Beyond offering convenient, low-cost options for patients, the effectiveness of each product is supported by a robust clinical program. New comparative research involving these products expands evidence on the clinical meaningfulness of the benefits of this whitening system and powered toothbrush for patient care.

Clinical Trials as Topic↗
PubMed1992

[Dental hygiene in 10-to-18-year-old youths in Flanders. Results of a school survey].

This study is part of the cross-national Survey on Health and Lifestyles in School-aged children--a WHO collaborative study (HELENA). The aim of this report was to describe the oral health habits (oral hygiene, use of dental floss and fluoride, consumption of sugar snacks) in schoolchildren aged 10 to 18 in the Flemish-speaking community of Belgium. Toothbrushing was consistently less frequent among boys than among girls. There is a negative correlation between the frequency of toothbrushing and the consumption of soft drinks in both sexes, and between toothbrushing and sweets consumption in girls. The use of dental floss is still very rare. Efforts must be continued to reduce the consumption of sweets and soft drinks. No differences in oral health habits were noted among children from different school types. Parental profession did not influence oral health habits in this study.

Adolescent↗
PubMed2004

How home care is essential to ensuring successful orthodontic treatment outcomes.

Patients can significantly affect the outcome of their orthodontic treatment. A practice committed to developing the right systems, scripts, and educational materials will experience a more satisfied patient, increased efficiencies, and higher profits. Educating and motivating patients to maintain their oral health and providing recommendations or dispensing of home care tools such as a power toothbrush increases patient compliance, positively impacts treatment outcomes, enhances customer service, and generates a new revenue stream for the practice. In a tight economy and a highly competitive orthodontic market, a power toothbrush can positively impact your marketing and case close rate. Treatment and fees being relatively equal, patients will tend to accept treatment from a practice that can demonstrate concern for the patients' overall oral health and greater value-added components to the orthodontic case. Power toothbrushes as part of a comprehensive orthodontic treatment provide a great differentiating marketing strategy.

Child↗
PubMed2005

Plaque removal efficacy of a novel tooth wipe.

OBJECTIVE: This study was designed to evaluate the safety and plaque removal efficacy of a tooth wipe (Oral-B Brush-Ups) using a manual toothbrush as a control. METHODOLOGY: Twenty-five healthy subjects from a general population were enrolled in this randomized, single-use, crossover study. After 23-25 hours of no oral hygiene, oral hard and soft tissues were examined, and disclosed plaque was scored using the Turesky, et al. modification of the Quigley Hein Plaque Index. Subjects used their randomly assigned product for a timed period of one minute without instruction, after which hard and soft tissues and plaque scores were reassessed. Subjects returned to the clinic after a one-week washout period, and the clinical procedures were repeated before and after use of the alternate product. All clinical measurements were made by one examiner who was masked to treatment sequence. RESULTS: Both the tooth wipe and toothbrush were found to be safe, and significantly reduced plaque levels from whole mouth, facial, and lingual surfaces (p < 0.0001). The toothbrush removed significantly greater plaque than the tooth wipe (p < 0.0001) on whole mouth surfaces (49% vs. 29%), facial surfaces (71% vs. 44%), and lingual surfaces (25% vs. 13%). CONCLUSION: The tooth wipe provides an effective method of plaque removal when tooth brushing is not practical.

Adolescent↗