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PubMed2002

Dentine hypersensitivity: the effects of brushing toothpaste on etched and unetched dentine in vitro.

Although many people have exposed dentine, only a percentage exhibit symptoms of dentine hypersensitivity. This has been ascribed to opening and closing of the dentinal tubules by for example, smear layer changes or tubular occlusion. The aims of this study were to examine the surface morphological changes of etched and unetched dentine in vitro, attributed to the effects of toothbrushing with and without toothpastes designed for the alleviation of dentine hypersensitivity. A total of 96 etched and 96 unetched human dentine specimens were brushed with various toothpastes and water for 1, 2, 5 or 10-min periods in a toothbrushing machine and subsequently examined under scanning electron microscopy for surface changes. Analyses of brushed etched specimens demonstrated that time and treatment were significant variables (P < 0.05) for tubule occlusion. Further, the interaction between time and treatment was significant (P < 0.05). The artificial silica based paste was significantly better for all time intervals at occluding the dentine tubules. All toothpastes investigated caused dynamic changes to the smear layer of the unetched dentine, opening tubules. However, the artificial silica based paste resulted in occluded rather than patent tubules. All of the pastes evaluated had the capacity to remove the smear layer but some could then occlude tubules through the contained abrasives.

Acid Etching, Dental↗
PubMed2005

Caries-preventive effect of an oral health program for preschool children in a low socio-economic, multicultural area in Sweden: results after one year.

The aim of this study was to evaluate the caries-preventive effect of an oral health program for preschool children living in a multicultural, low socio-economic area. In total, 804 2-year-old children were invited and recalled every 3rd month to an outreach facility for parent education and toothbrushing instruction. In addition, fluoride tablets (0.25 mg/day) were provided free of charge. A clinical examination and questionnaire were completed at baseline and at age 3 years. The results of the intervention were compared with a non-intervention Reference group of 3-year-old children (n=217) from the same area. In the Intervention group, the 1-year attrition rate was 8.2%, and more than 90% of the children attended at least 4 of their scheduled appointments. The parents' daily assistance with toothbrushing and the use of fluoride toothpaste and tablets improved significantly during the intervention. Compared with the Reference group when the children were 3 years old, the number of children in the Intervention group who consumed frequent in-between meals and sweet drinks at night was significantly lower. Caries prevalence at age 3 was significantly lower in the Intervention group than in the Reference group (3.0 deft versus 4.4 deft; p<0.01). The number of caries-free children after the 1-year intervention was 37% in the Intervention group compared with 15% in the Reference group. The relative risk (RR) was calculated to be 2.5 (95% CI 1.8-3.4) and the number needed to treat (NNT) 4.6. In conclusion, this study demonstrated that the oral health program significantly affected the prevalence of caries and various risk factors for caries development.

Arabs↗
PubMed2006

Risk factors and risk indicators associated with high caries experience in Swedish 19-year-olds.

OBJECTIVE: To study the risk factors and risk indicators associated with high caries experience (DMFS >or= 10) in 19-year-olds. MATERIAL AND METHODS: The subjects (n=800) lived in seven suburbs of Stockholm and answered a structured questionnaire about their parents' education, occupation, and country of birth, as well as their dietary habits, oral hygiene habits, and attitudes to dental care. Dental caries was assessed by clinical and radiographic examination using the decayed, missing, filled teeth (DMFT), and surfaces (DMFS) indices. Dental plaque (VPI%) and gingival bleeding (GBI%) indices were recorded. RESULTS: A total of 696 subjects (364 M, 332 F) participated in the study. The mean DMFT and DMFS were 3.9 and 5.1, respectively. In 81% of subjects, the DMFT was >or= 1 and 15% had DMFS >or= 10. In the multivariate analysis, the variables significantly associated with high caries experience were: dental fear (p<0.001, odds ratio (OR) 2.8), GBI >or= 15% (p=0.003, OR 2.1), mother born abroad (p=0.007, OR 2.0) and irregular toothbrushing at night (p=0.008, OR 1.9). When all significant variables in the multivariate analysis were present, the cumulative probability of DMFS >or= 10 was 52%. CONCLUSIONS: Dental fear, gingival inflammation, a foreign-born mother, and irregular toothbrushing at night are variables that are strongly associated with high caries experience in 19-year olds. The study indicates that foreign-born parents, oral hygiene habits, and behavioral factors still have a strong impact on dental health in late adolescence.

Adult↗
PubMed1998

Periodontal disease and diet in domestic pets.

Periodontal disease is the most common oral condition seen in domestic pets. In addition to the discomfort caused in the affected animal, there is strong circumstantial evidence to show that a focus of infection in the mouth may cause disease of distant organs. Consequently, prevention of periodontal disease is of paramount importance for the general health and well-being of pets. The presence of plaque on the tooth surfaces is the primary cause of periodontal disease. However, the mechanisms by which disease develops are by no means fully understood. Dietary texture does have an effect on the accumulation of dental deposits and consequently on disease development and progression. Daily toothbrushing remains the single most effective means of removing plaque, thus preventing periodontal disease. On the basis of current knowledge, the best way to maintain healthy periodontal tissues in our pets is frequent toothbrushing. The use of a dental hygiene chew and/or a diet designed to reduce dental deposits can be useful adjunctive measures and should be recommended.

Animals↗
PubMed1991

Effects of type of value appealed to and valence of appeal on children's dental health behavior.

Examined the effects of the type of value appealed to and valence of appeal on children's intentions to engage in toothbrushing, their self-report of toothbrushing frequency, and their plaque level. 98 fifth-grade students served as the participants. Slide shows appealed to either health- or socially oriented values and also differed with respect to valence (positive vs. negative). A control group received a message that provided basic dental health information. Group comparisons revealed that children who received the negative social appeal showed a significant improvement in plaque level. Only the negative social appeal group differed significantly from the control group on the dependent measures.

Child↗
PubMed2004

Influence of a SLS-containing dentifrice on the anti-plaque efficacy of a chlorhexidine mouthrinse.

BACKGROUND: Chlorhexidine (CHX) and sodium lauryl sulphate (SLS), the most widely used detergent in dentifrice, may counteract. Consequently, studies about this interaction suggested that care is required when combining both these compounds, even when they are introduced separately into the oral cavity. The purpose of the present study was to investigate the effect of toothbrushing with a SLS-containing dentifrice in one jaw, on the plaque inhibition of a CHX mouthrinse in the opposite jaw during a 4-day study period. METHODS: The study was an examiner-blind, randomised two-cell, crossover design. It used a 4-day plaque accumulation model to compare two different oral hygiene regimens with a washout period of 17 days. Sixteen healthy volunteers were enrolled in the study and received a thorough dental prophylaxis at the beginning of each 4-day test period. One jaw (upper or lower) was randomly assigned as the "study" jaw. The opposite jaw was assigned as the "dentifrice" jaw and served only to introduce the effect of brushing with a dentifrice in the study model. Two oral hygiene regimens were evaluated. During one randomly assigned test period, the "dentifrice" jaw was treated by toothbrushing with a 1.5% SLS-containing dentifrice and rinsed together with the "study" jaw with 0.2% CHX, thus forming regimen 1. As a control during the other test period, both the "dentifrice" jaw and "study" jaw were only rinsed with 0.2% CHX, forming regimen 2. No other oral hygiene methods were allowed. After 4 days of undisturbed plaque accumulation, the amount of plaque was evaluated (Silness & Löe 1964). The "study" jaw was used to study the effect of the two regimens on the level of plaque accumulation at the end of the 4-day period. RESULTS: The overall plaque index was 0.36 for regimen 1 and 0.34 for regimen 2. There was no significant difference in plaque accumulation between the two regimens. CONCLUSIONS: Within the limitations of the present study design, it can be concluded that ordinary brushing with a 1.5% SLS-containing dentifrice (Colgate Bi-Fluor), followed by rinsing with water does not appear to reduce the level of plaque inhibition offered by a post-brushing CHX rinse.

Adult↗
PubMed2004

Impact of tongue cleansers on microbial load and taste.

OBJECTIVES: Tongue cleaning has been advocated to improve oral malodor and to reduce reinfection of periodontal niches by eliminating tongue coating and/or reducing putrefaction by bacteria. MATERIAL AND METHODS: This cross-over, single-blind study on periodontitis-free, non-smoking, subjects with habitual oral hygiene (n=16), evaluated the effect of tongue cleaning (with either plastic scraper or nylon multi-tufted toothbrush), on the microbial load of the tongue dorsum (anterior and posterior of the sulcus terminalis), the extent of tongue coating, and taste sensation for bitter, sweet, salt, and sour. Both devices had been used twice daily for 2 weeks (toothbrush three forward-backward movements along the linea mediana and for each longitudinal third of the tongue; two strokes with the scraper along the linea mediana and along the borders of the tongue). RESULTS: Two weeks of tongue brushing or scraping resulted in only negligible reductions in aerobic and anaerobic bacteria on the tongue (reductions <0.5 log). The amount of tongue coating, however, decreased significantly (p<0.05), with both devices. The taste sensation improved after 2 weeks of tongue cleaning, especially with the scraper (significant improvements for quinine and sodium chloride). CONCLUSION: Tongue cleaning improves taste sensation and seems to reduce the substrata for putrefaction, rather than the bacterial load.

Adult↗
PubMed1996

The effect of topical fluoride agents on saliva secretion.

The aim of this study was to assess the possible influence of various topical fluoride agents on the rate of saliva secretion. Fifteen healthy volunteers, both males and females, aged 20-60 years, participated in this study. Aminfluorides and monofluorophosphate products in gel, toothpaste and rinse states were used. Each subject brushed or rinsed the teeth and mouth for 2 minutes. Secreted saliva was collected for 5 minutes. Salivary secretion was significantly greater after toothbrushing with aminfluoride compounds as compared to toothbrushing with monofluorophosphate. There was a tendency for an increased saliva flow rate with higher fluoride concentration of the aminfluoride.

Adult↗
PubMed1994

Dexterity testing as a predictor of oral care ability.

OBJECTIVE: To examine a spectrum of elderly people to determine if hand function/dexterity measures can predict oral care ability. DESIGN: A series of dental, hand function, and dexterity measures were assessed by blinded examiners. Plaque scores were used as the criterion standard to assess plaque removal ability. PATIENTS: A convenience sample of 52, predominately male, elderly patients were recruited from the patient population of the Portland Veteran Affairs Medical Center and a community nursing home. Entry into the study required that the patient be able to give consent, be age 65 or older, have a minimum of six contiguous teeth or a minimum of 12 teeth total, be medically stable, have grossly adequate vision, and be able to hear and understand spoken instructions. OUTCOME MEASURES: The primary outcome measure was plaque score, as defined by the Turesky modification of the Quigley-Hein index. This was related to four dexterity tests (Jebsen-Taylor Hand Function test, Nine-hole Peg test, Box and Block test, Toothbrushing Ability test), a grip strength measure, and a cognitive measure (Allen Cognitive Level Test). RESULTS: Oral hygiene was significantly impaired among institutionalized elderly compared with outpatient elderly (P < 0.001), as was dexterity (P < 0.001). All dexterity tests correlated significantly with plaque score (Spearman rho: 0.49-0.77; P < 0.000). Forward stepwise regression analysis identified the Toothbrushing Ability Test (P < 0.0001) and the time spent brushing (P = 0.007) as the most significant predictors of plaque score. CONCLUSIONS: Results suggest oral hygiene ability is decreased among long term care residents, that dexterity tests can help identify patients unable to perform adequate oral self-care, and that these tests could be used to estimate brushing ability among elderly compromised patients.

Aged↗
PubMed1975

The effect of a chlorhexidine-containing gel on oral cleanliness and gingival health in young adults.

Students at a vocational school participated in a double-blind, cross-over study to test the effect of brushing with a 1% chlorhexidine-containing gel once a day. In the control period, a placebo gel was used. Each treatment period lasted for 4 weeks. This was subsequently followed by 4 weeks of ordinary toothbrushing. Any toothbrushing additional to the therapeutic brushing was performed with a standard commercial dentifrice without abrasives. In addition to the treatment groups, containing a total of 24 subjects, another group of 12 subjects received standardized oral hygiene instruction. Oral hygiene and gingival condition were assessed in all groups throughout the study. The chlorhexidine-containing gel seemed to have no effect on gingivitis and only a slight inhibitory effect on plaque formation. Furthermore, an increase in the degree and frequency of staining of the tooth surfaces related to the use of active gel were observed.

Adolescent↗
PubMed1977

Periodontal treatment needs of 35-year-old citizens in Oslo.

The periodontal condition was evaluated according to the PI and the Periodontal Treatment Need System (PTNS) in a random sample of 35-year-old citizens of Oslo. The study demonstrated that periodontal disease was a major dental health problem despite the fact that 88.9% of the subjects visited a dentist regularly. No statistically significant differences were found in PI, PTNS and OHI-S values among the different sexes and educational groups. Although the majority of the subjects (77.8%) brushed their teeth more than once a day, the oral hygiene status was not satisfactory (mean OHI-S 1.56). The frequency of toothbrushing did not influence the mean PI scores. Dental hard and soft tissue lesions related to toothbrushing were found in 30.0 and 6.8% of the subjects respectively, and more often among persons brushing more than once a day than among persons brushing less frequently.

Adult↗
PubMed1978

Effect of the Water Pik device on plaque accumulation and development of gingivitis.

The influence of the water irrigating device, Water Pik, on the accumulation of plaque and development of gingivitis has been studied using the model, "experimental gingivitis in man". The investigation was carried out on 41 patient volunteers whose teeth were thoroughly scaled and polished during a 4-week period of intensive oral hygiene preceding each experimental period. Gingival exudation, Plaque Index and Gingival Index were registered at the beginning of the experimental periods. The participants were then divided into four groups. Groups A and B abandoned all forms of active oral hygiene. Group A, however, were given Water Pik devices as the only oral hygiene aid. Groups C and D continued to clean their teeth using a toothbrush and Group C were given Water Pik devices as a supplementary aid. After 14 days, gingival exudation, Plaque Index, Gingival Index and soft tissue injuries were registered. The results showed that , while both groups A and B demonstrated extensive plaque deposits and gingivitis, these were present to a significantly lesser degree in Water Pik users. The toothbrushing groups (C and D) failed to demonstrate any further reduction of plaque or gingivitis when Water Pik was introduced as an additional measure. No soft tissue injuries were found.

Dental Devices, Home Care↗
PubMed1979

Establishing and maintaining clinically healthy gingivae in Rhesus monkeys.

The aim of the present investigation was to determine a method and a minimal frequency of plaque removal for the establishment and maintenance of clinically healthy gingivae in Rhesus monkeys. Six adult, male monkeys were used and divided into three groups. In each group different methods were used for plaque removal. Frequencies of plaque removal of one, two and three times per week for consecutive weeks were tested. The results showed that gingival health could be established and maintained with any of the methods used (toothbrushing and interdental flossing: toothbrushing and a 3-min application of 2% chlorhexidine gluconate) but only when plaque was removed 3 times a week. This frequency of plaque removal sessions is discussed in relation to the necessity for sedation of the animals with possible adverse side effects.

Animals↗
PubMed1986

The occurrence of gingival brushing lesions during 3 phases of the menstrual cycle.

Since hormonal changes during the menstrual cycle may alter the vulnerability of the female gingiva, the present study was undertaken to investigate whether there are any differences in the number of toothbrushing lesions occurring during different phases of the menstrual cycle. 45 women of 20-35 years of age and with healthy gingiva were examined for overt signs of gingival laceration or ulceration. Such signs were recorded as a brushing injury. Dental plaque was assessed using the visible plaque index (VPI) and gingival inflammation using the gingival bleeding index (GBI). The examinations were made on the 1st day of menstruation (MD), on the estimated ovulation day (OD), and on the day with the predominance of progesterone secretion (PD). The examinations were made during 1-3 menstrual cycles for each individual; the study includes 78 cycles. No statistically significant differences were found between the numbers of brushing injuries on the 3 days of examination (MD, OD, & PD). During PD, a significantly positive correlation (p less than 0.01) was observed between VPI and GBI scores, but on OD and MD, the correlations were highly significant (p less than 0.001). A weak significant positive correlation (p less than 0.05) was found between GBI scores and the number of brushing injuries on the 1st day of menstruation, while during other phases of the menstrual cycle, no such correlation was found. The present study gave little evidence that the hormonal status of women could be of clinical significance in the development of soft tissue trauma from habitual toothbrushing.

Adult↗
PubMed1989

The effect of a systemically-administered non-steroidal anti-inflammatory drug (flurbiprofen) on experimental gingivitis in humans.

Non-steroidal anti-inflammatory drugs reduce the acute inflammatory reaction and alveolar bone loss of experimental periodontitis in dogs by mechanism thought to be associated with the inhibition of prostaglandin synthesis. 25 healthy volunteers abstained from tooth cleaning for 21 days. Experimental gingivitis developed in all subjects. On day 21, the subjects were divided into 3 treatment groups: oral flurbiprofen (100 mg/day)/toothbrushing (A), placebo+toothbrushing (B) and oral flurbiprofen (100 mg/day) only (C). Treatment continued for 6 days. Plaque indices (PI), gingival indices (GI) and probing pocket depths (PPD) were recorded at 6 points on each of 6 maxillary teeth on days 1. 22, 23, 24 and 27. Crevicular fluid flow (CFF) was quantified with a Periotron on days 1, 22 and 27 in groups A and B, and on days 1 and 27 in group C. There were no changes in PPD throughout the study. A reduction of GI occurred between days 22 and 27 for all treatment groups. CFF was also reduced between days 22 and 27 in groups A and B. The differences between the 3 treatments were very small. It is concluded that systemic flurbiprofen (100 mg/day) can reduce the signs of an experimental gingivitis over 6 days. This effect may be seen when the drug is used alone and as an adjunct to toothbrushing.

Administration, Oral↗
PubMed1992

The immediate- and medium-term effects of Meswak on the composition of mixed saliva.

Chewing sticks or Meswaks are used for teeth cleaning in many parts of the world. They contain substances that may reduce caries and periodontal disease. The present study consisted of 2 parts. In a short-term experiment, volunteers chewed on an inert eliciting agent (pyrogen-free rubber) and then a piece of Meswak, each for 5 min. For the medium-term experiment, volunteers brushed with either Meswak or a conventional toothbrush 5 x a day for 2 weeks. Saliva produced immediately after chewing Meswak showed statistically significant increases in calcium and chloride, but decreases in phosphate and pH as compared with controls. In the medium-term experiment, saliva samples collected 4 h after the last use of Meswak or toothbrush showed no significant differences in any of the components examined (calcium, magnesium, chloride, phosphate, IgA, IgG, lactate dehydrogenase and aspartate transaminase). Gingival and plaque indices, however, were significantly lower after brushing with Meswak. Salivary calcium promotes mineralization of tooth enamel and chloride inhibits calculus formation. Our results thus indicate that Meswak releases substances into saliva that could improve oral health. Calcium and chloride values were similar to those of controls after 4 h and thus frequent use of Meswak may be necessary to maintain a favorable salivary environment.

Bacteria↗
PubMed1992

The effect of using a pre-brushing mouthwash (Plax) on oral hygiene in man.

The aim of this study was to investigate whether the use of a pre-brushing mouthwash (Plax) improved subjects' oral hygiene over a 2-week period. In a double-blind placebo controlled cross-over study, 33 adult subjects (mean age 35.3 years) used either Plax or a placebo mouthwash for 30 s prior to toothbrushing during a 2-week period. After a washout period of 4 weeks, the subjects used the other mouthwash in the same way. The modified plaque index of Quigley and Hein (QHI) was recorded for 16 teeth (16, 14, 13, 11, 21, 23, 24, 26, 36, 34, 33, 31, 41, 43, 44, 46) at each visit. The bleeding index (BI) was recorded at the beginning and end of the study. Results were analysed using a paired one-tailed t-test. Neither plax nor placebo mouthwashes reduced plaque scores significantly (p > 0.05) below baseline. There was no statistically significant difference between the mean BI at the beginning of the trial (0.42) and at the end (0.44). These results suggest that the routine use of Plax is not a useful adjunct to toothbrushing.

Aged↗
PubMed1997

A short-term clinical study design to investigate the chemical plaque inhibitory properties of mouthrinses when used as adjuncts to toothpastes: applied to chlorhexidine.

The removal of plaque by toothbrushing with toothpaste is the most common form of plaque control in the developed world. However, the use of chemical adjuncts such as mouthrinses is increasing. In practice mouthrinses and toothpaste are used together, however, in many clinical trials, employed to assess mouthrinse activity, toothpaste use is suspended. This fails to measure the effect of chemical interactions which are known to occur between toothpaste ingredients and mouthrinses. The objective of this trial was to develop a methodology which would assess the adjunctive chemical plaque inhibitory action of mouthrinses, when used with toothpaste but without the indeterminate variable of toothbrushing. The study was a single blind, randomised, 7-way crossover design, based on a variation of a 4 day plaque regrowth model. The 2 x daily rinsing regimens produced increasing plaque scores in the following order: (1) water/chlorhexidine, (2) chlorhexidine/water, (3) chlorhexidine/toothpaste slurry, (4) toothpaste slurry/chlorhexidine, (5) water/toothpaste slurry, (6) toothpaste slurry/water, (7) water/water. Chlorhexidine and water or chlorhexidine and toothpaste slurry combinations produced significantly lower plaque scores than water alone. Slurry and water combinations resulted in less plaque than water alone, but differences were not significant. Toothpaste slurry and chlorhexidine produced significantly increased plaque scores compared to chlorhexidine and water. The study suggests that, outside the Hawthorne effect, chlorhexidine rinses would be less effective in reducing plaque when used with toothpaste than when used alone. The methodology could be employed as a screening tool for the evaluation of mouthrinses expected to be used as adjuncts to normal oral hygiene methods. The same could be used to optimise oral hygiene regimens which include the use of mouthrinses.

Adult↗