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PubMed1998

Oral hygiene and gingivitis in a Swedish adult population 1973, 1983 and 1993.

The periodontal condition of the inhabitants of Jönköping County, Sweden was followed for 20 years by means of 3 cross-sectional investigations performed in 1973, 1983, and 1993. The study comprised individuals in the age groups 20, 30, 40, 50, 60, and 70 years. The number of dentate individuals was 537 in 1973, 550 in 1983, and 552 in 1993. All individuals participating in the studies were examined clinically and radiographically. They also filled out a questionnaire about dental care habits, socio-economic status, and general health. A clear reduction in the plaque score was seen between 1973 and 1983 in all age groups. With one exception, no further significant change in plaque levels was found between 1983 and 1993: the increase in plaque among the 20-year-olds was significant. In 1993 the mean % of surfaces with plaque was between 30% and 40% in all age groups. Gingivitis values corresponded well with the values of dental plaque; the same pattern with a clear reduction in gingivitis score was seen in all age groups between 1973 and 1983, and an increase in the mean frequency of gingival inflammation between 1983 and 1993 was seen in the 20-year age group. 30% of the individuals in this age group had more than 50% gingivitis in 1993 compared with 9% of the individuals in 1983. The 20-year-olds were further analyzed in a linear regression model using gingivitis as a dependent variable against some socio-economic, general health, and dental care variables associated with poor oral hygiene and gingivitis. In 1993, the most important explanatory variable was gender: significantly more males than females had higher gingivitis scores. The second most important explanatory variable was toothbrushing habits. Together they explained 10.9% of the variance. The multivariate analysis did not reveal approximal cleaning habits to be significant, probably due to their strong connection to gender and toothbrushing habits. In the 1983 sample, no significant explanatory variables were found. It was concluded from this data that it is important not only to renew but also to direct preventive guidelines more towards young adults who have no previous extensive experience of oral disease so that they will not be excluded from dental care and their dental health thereby jeopardised. In addition to preventive programmes aimed at the population as a whole, individual programmes based on risk targeting are also necessary to reduce the number of people developing dental disease and to increase the quality of dental care.

Adult↗
PubMed2004

High and low brushing force in relation to efficacy and gingival abrasion.

OBJECTIVES: Does a high brushing force induce more gingival abrasion than a low (regular) brushing force? Furthermore, what is the effect of a low or high force on the efficacy? METHODS: Thirty-five non-dental students were selected. All received an appointment prior to which they abstained from oral hygiene for at least 48 h. At baseline the teeth and surrounding tissues were disclosed using Mira-2-Tone disclosing solution. Next, the examiner (PAV) evaluated the number of sites with gingival abrasion and the amount of dental plaque (Quigley & Hein) at 6 surfaces of each tooth. In the absence of this examiner, the subject's teeth were brushed by a hygienist (MP) using the Braun/Oral-B-D17 oscillating rotating toothbrush. Brushing was performed in two randomly selected contra-lateral quadrants for 60 s with either a low force (+/-1.5 N) or high force (+/-3.5 N) and in the opposing quadrants for 60 s with the alternative force. Visual feedback was given to control force. The brush was moved from the distal tooth to the central incisor perpendicular to the tooth surface with an angle of approximately 10-15 degrees towards the gingival margin. Next, the number of sites with abrasion and the remaining plaque were assessed again. RESULTS: The overall baseline gingival abrasion scores were 3.1 and 3.2 sites for high and low force, respectively, and increased to 5.0 and 5.9 sites respectively after brushing. There was no significant difference with respect to incidence of abrasion. At baseline, 48 h. plaque levels were 2.2. The reduction in plaque scores with the low force was 60% and with the high force 56%. This difference was significant. CONCLUSION: With the oscillating rotating power toothbrush (Braun/Oral-B D17) the use of high force (+/-3.5 N) is less efficacious as compared to a regular low force (+/-1.5 N) while the incidence of gingival abrasion sites was comparable.

Adolescent↗
PubMed2004

Effects of post-surgical cleansing protocols on early plaque control in periodontal and/or periimplant wound healing.

OBJECTIVE: The aim of this RCT was to evaluate early wound healing following specific post-surgical care protocols. MATERIAL AND METHODS: Following periodontal flap surgery, 60 patients were randomly assigned to follow one of two post-surgical protocols. Subjects smoking >20 cigarettes per day were excluded. Patients following the control protocol rinsed twice daily for 1 min with 0.1% of chlorhexidine (CHX) for 4 weeks. In addition to CHX rinsing, patients assigned to the test protocol applied CHX locally using a special very soft surgical toothbrush (Chirugia) from days 3 to 14, and a soft toothbrush (Ultrasuave) from days 14 to 28, twice daily. Baseline measurements included gingival crevicular fluid (GCF) flow rate, probing depth, probing attachment level, presence of bleeding on probing and full-mouth plaque score. Measurements were repeated at 1, 2 and 4 weeks after surgery. RESULTS: Both post-surgical protocols resulted in successful wound healing and optimal wound closure at 4 weeks. There were no statistical differences in the GCF flow rate between test and control protocols. There was a lower incidence of recession of > or =2 mm following the test protocol. CONCLUSION: The use of specific post-surgical cleansing protocols including the introduction of mechanical cleansing at day 3, using local application of CHX in addition to daily rinsing with CHX may be recommended.

Adult↗
PubMed2005

Brushing with and without dentifrice on gingival abrasion.

OBJECTIVES: This study was designed to evaluate two factors possibly influencing incidence of gingival abrasion during toothbrushing: (1) the abrasiveness of a dentifrice and (2) the possible influence of feedback of oral sensory perception. MATERIAL AND METHODS: For this purpose, two separate, single blind, randomized clinical experiments were performed. The two groups of subjects were requested not to brush their teeth 48 h, prior to the experiments. After staining with disclosing solution gingival abrasion sites were recorded as small (< or =5 mm) and large (>5 mm), both before and after brushing. The dentifrice experiment was a split-mouth design, including 36 subjects, brushing their teeth in two randomly selected contra-lateral quadrants, either with or without dentifrice, whereas the remaining two quadrants were brushed, using the alternative choice. The sensory perception feedback experiment was a full-mouth design, including 43 subjects and two separate brushing exercises with use of dentifrice. The first brushing-exercise was performed by a dental hygienist, excluding the feedback of oral sensory perception of the brusher. After a 4 weeks period of familiarization to the manual toothbrush, subjects brushed themselves in the same random order as the hygienist, using a fresh brush, thus including oral sensory perception. RESULTS: In the dentifrice experiment, the increment of small abrasion sites was 5.86 for brushing with and 5.75 without dentifrice. There was no statistically significant difference between brushing with and without dentifrice. Both with and without dentifrice, more small abrasions were found vestibular, (3.78 and 4.22, respectively) as compared with lingual (2.22 and 1.42, respectively) (p=0.027, p<0.001). In the sensory perception feedback experiment, the increment in small gingival abrasion sites was larger for the subjects brushing themselves (8.86) as compared with the professional brushing (2.94, p <0.0001). Subjects caused more abrasion on the vestibular surfaces (6.28) as compared with the lingual (0.60, p=0.0001), where the professional did not show this difference (vestibular: 1.88, lingual: 1.30, p=0. 1388). CONCLUSIONS: No statistically significant difference in the incidence of gingival abrasion was found between brushing with dentifrice or without dentifrice. Neither did oral sensory perception seem to affect the incidence of gingival abrasion.

Adolescent↗
PubMed1976

Prevalence of oral soft and hard tissue lesions related to mechanical toothcleansing procedures.

The prevalence of oral soft and hard tissue lesions related to mechanical oral hygiene procedures was recorded and correlated to toothbrushing habits and oral hygiene status in two selected samples. Fifty-one percent of 533 persons examined exhibited gingival retractions and 45% had wedge-shaped defects in the cervical area of one or several teeth. Both types of lesions were often seen in the same area, indicating a common etiologic factor. The subjects with a good oral hygiene status, as well as those who brushed more than twice daily, showed a high frequency of lesions. The various toothbrushing techniques did not, however, seem to influence the development of such lesions in the present material. Subjective symptoms were reported in a few cases only.

Adolescent↗
PubMed1987

Economic evaluation of community programs for the prevention of dental caries in Catalonia, Spain.

The purpose of the present study was to estimate the cost-effectiveness of three alternative community programs to prevent dental caries among Catalonia's schoolchildren. The programs were: fluoridation of the public water supply, fort-nightly 0.2% NaF mouthrinses administered in schools, and supervised toothbrushing with a fluoride toothpaste in schools. Caries prevalence data for Catalan children are given and the methodology for the study is described. The estimated cost of saving 1 DMFS with each program was: 53.40 Pts (US$ 0.39) with fluoridation of the water supply; 305.20 Pts (US$ 2.26) with fluoride mouthrinses; and 1498 Pts (US$ 11.09) with supervised toothbrushing. The feasibility of the programs in Catalonia and their educational values for the target population are considered.

Adolescent↗
PubMed1994

Dental health habits of young families from southwestern Finland.

The dental care habits of parents and children as well as the associations of these habits were investigated in a follow-up study conducted in the Southwest of Finland. The background factors of the child's use of night-time juice were also studied. The families of the study were a representative sample of local young families with their first child. The study sample was obtained using stratified randomized cluster sampling and confidential questionnaires. Both the mother's and the father's toothbrushing habits were significantly associated with the child's toothbrushing habits with a cumulative effect. The mother's use of sugar was significantly associated with the child's sugar use habit. Infectious diseases at the age of 9-17 months had an increasing effect on the use of juice at night. Fathers and the youngest mothers, especially, need additional support not only for the demanding task of the upbringing of their child but also for the care of their own teeth.

Adolescent↗
PubMed1995

Caries experience in Latvian nursery school children.

In 1993 the dental health was assessed in 631 Latvian 3--4-yr-old nursery school children. Forty-eight percent of the 3-yr-olds and 26% of the 4-yr-olds were caries free. The mean dmft for the total sample was 3.2 (2.2 and 3.8 in the 3-and 4-yr-olds, respectively). Molar caries, accounting for 66% of the total dmft score, was dominant in both age groups. Sixteen percent of the children had received restorations, 38% of which manifested recurrent caries. Recurrent caries was relatively more frequent in the younger children. Concomitant with a general increase in caries level, the polarization of the disease was less pronounced in the older children. The upper 25% of the distribution for 3- and 4-yr-olds contained 74% and 40% of the dmft, respectively. Daily toothbrushing was reported for 60% of the children. Of those, 38% used fluoride-containing dentifrice. No significant associations were found between caries experience and toothbrushing frequency, use of fluoride dentifrice or parents' education.

Age Factors↗
PubMed1998

The reliability of interview data for age at which infants' toothcleaning begins.

A number of studies have reported on the age at which toothbrushing started and drawn important conclusions. Such studies often relied on parental recall of a particular event that occurred some years previously, assuming the quality of retrospectively reported data. The present study aimed to investigate consistency of reporting the age at which toothcleaning began. Mothers from two different cultural backgrounds, 100 Caucasian and 150 Asian living in a deprived inner city area, were interviewed in their homes on two separate occasions, when the sample child was 6-24 months old and again at 3-4 years. Of the 39 Caucasian and 31 Asian mothers who specified an age at which toothbrushing commenced at both interviews, complete agreement occurred among 4 (10%) Caucasian and 2 (6%) Asian mothers, with a variation of +/- 2 months among 12 (31%) and 5 (16%) respectively. Intraclass correlation coefficients were -0.01 for Caucasian and -0.46 for Asian mothers. Kappa values were 0 and -0.09 respectively. Of the 139 mothers who stated that their children's teeth were not cleaned at the time of the first interview, 17 claimed an earlier age than this at the second interview. It was concluded that there was little agreement between the two interviews, although the extent of the variation differed between the two cultural groups. Although these findings represent relatively deprived population groups, caution is recommended in unquestioningly accepting the accuracy of retrospective reporting of oral hygiene practices in dental surveys until evidence of better reliability is available.

Age Factors↗
PubMed2004

Development of a standardized method for comparing fluoride ingested from toothpaste by 1.5-3.5-year-old children in seven European countries. Part 2: Ingestion results.

OBJECTIVES: To develop a standardized method for measuring the variables affecting fluoride ingestion from toothpaste in young children between the ages of 1.5 and 3.5 years, and to use the method at seven European sites. METHODS: Random samples of children were invited to take part in the study. Parents who gave consent were visited at home. The children brushed their teeth using the toothpaste brand and toothbrush type currently in use. The difference between the fluoride dispensed onto the toothbrush and the fluoride recovered after accounting for losses was deemed to be the fluoride ingested. Details of other oral health-care habits were collected by questionnaire. For each child, the fluoride concentration of the toothpaste used was measured in the laboratory, from which an estimate of total daily fluoride ingestion was made. RESULTS: There was considerable variation between countries in the types of toothpaste used and in the amounts of toothpaste applied and ingested. The amount of fluoride ingested ranged from 0.01 to 0.04 mg fluoride per kg of body weight per day. CONCLUSION: The amount of fluoride ingested that is likely to be a risk factor for the development of dental fluorosis during tooth formation is equivocal and was found to vary widely between European countries. There appears to be a need for clearer health messages regarding the use of fluoridated toothpaste by young children.

Analysis of Variance↗
PubMed2004

Stability of oral health-related behaviour in a Norwegian cohort between the ages of 15 and 23 years.

OBJECTIVE: To assess the stability in self-reported oral health behaviour in a Norwegian cohort between the ages of 15 and 23 years. METHODS: Self-administered questionnaires were used as part of a longitudinal cohort study. In 1992, a representative sample of 963 15-year-old adolescents participated, of which 676 (70%) and 567 (58%) remained in the study at ages 18 and 23 years. A total of 389 (40% of baseline) participated at each data collection, i.e. at ages 15, 18, 19, 21 and 23 years. RESULTS: General linear model (GLM) repeated-measures anova revealed statistically significant main effect of time with respect to soft drink and sweet consumption (F = 22.4, P < 0.001 and F = 4.3, P < 0.05, respectively). Adjusted mean scale scores of soft drink intake increased from 2.3 at age 15 years to 3.4 at age 23 years. The corresponding figures for consumption of sweets were 2.6 and 2.8. Two-way interactions achieved statistical significance with gender for soft drink consumption and toothbrushing. GLM repeated-measures with each gender revealed that soft drink consumption increased with time more extensively in boys (from 2.9 to 4.2, F = 13.5, P < 0.001) than in girls (from 1.9 to 2.6, F = 8.1, P < 0.001). Tracking or maintenance across time of the relative ranking at age 15 years occurred with all the four behaviours investigated. A total of 68-92% remained active and inactive regarding soft drink and sweet consumption, flossing and toothbrushing. CONCLUSION: The results provide evidence of tracking and early consolidation of oral health behaviour. This adds support for the assumption given for early intervention to prevent oral diseases.

Adolescent↗
PubMed2004

Teaching received in caries prevention and perceived need for Best Practice Guidelines among recent graduates in Finland.

The present study evaluated teaching that recent graduates in Finland had received in caries prevention and their perceived need for updated Best Practice Guidelines. A two-page questionnaire was mailed to all dentists in Finland who had graduated from 1995 to 1998 (n = 390). After one reminder, the response rate was 46%. The closed questions covered teaching in 14 caries-preventive methods and its suggestions as to when and on whom to apply such methods. Each dentist's own opinion on the three most important methods for caries prevention in patients with various types of dentition was sought in open questions. The respondents reported that at dental school, on average 12.5 (SD = 2.4) of 14 aspects of caries prevention were covered in theoretical teaching, 5.5 (SD = 3.8) in demonstrations and 8.5 (SD = 3.0) in clinical training. The top four methods teaching suggested for every patient were toothbrushing (100%), use of fluoridated toothpaste (99%), interdental cleaning (98%), and use of xylitol (97%); followed by fluoride varnish (77%) and fissure sealants (54%). The three caries-preventive methods the respondents felt to be most useful were the same for all types of dentitions, in order of importance: (i) toothbrushing and use of fluoridated toothpaste, (ii) supplementary use of fluorides at home and (iii) healthy dietary habits, in particular, avoidance of sucrose. As regards clinical work, such teaching had served the respondents' real-life needs in patients' caries prevention either extremely (44%) or moderately (54%) well; 91% said, however, that they would benefit from nationwide Best Practice Guidelines. In conclusion, the recent graduates' emphasis on patient-active methods in caries prevention may indicate a change in the current policy favouring patient-passive methods.

Adult↗
PubMed1991

Intraindividual variations in counts of mutans streptococci measured by "Strip mutans" method.

Intraindividual variations in the mutans streptococci measured by Strip mutans, in a 1-day and a 5-day period, as well as the effect of toothbrushing, were investigated. 30 subjects participated, and their levels of salivary mutans were estimated by a scale containing four steps. With the exception of three comparisons, time intervals of different lengths did not cause a deviation of more than one step. Comparisons made before and after toothbrushing yielded the same score in 22 cases, whereas two subjects showed a discrepancy of two steps. Clearly, in a short-term perspective, variations can certainly be found, but more pronounced discrepancies are rare.

Adult↗
PubMed1990

Comparative effects of toothpaste brushing and toothpaste rinsing on salivary bacterial counts.

The persistence of antimicrobial action of compounds and formulations in the mouth can be demonstrated by recording the magnitude and duration of the reduction of salivary bacterial counts following a single application. Such measures of substantivity appear to correlate with the plaque inhibitory properties of antimicrobial agents. For toothpastes, studies on the short-term inhibition of plaque formation use a number of delivery methods to measure the direct effect of the preparation divorced from toothbrushing. Such methods include paste slurries, paste in trays or cap splints. This study determined whether toothbrushing with a toothpaste produced the same effects on salivary bacterial counts compared to rinsing with a slurry. A group of 24 volunteers brushed or rinsed with a slurry of a commercial toothpaste. Each regimen was repeated twice on 4 separate days by all volunteers and salivary bacterial counts recorded at baseline and time periods to 7 hours. There were no significant differences between brushing or slurry rinsing on salivary bacterial counts and each method produced reproducible effects. This supports the use of the slurry method where the direct plaque inhibitory action of an antimicrobial toothpaste is to be assessed; and indicates that both methods equally make available and activate the relevant ingredients in formulations.

Adult↗
PubMed2004

Effect of amine fluoride/stannous fluoride toothpaste and mouthrinse on dental plaque accumulation and gingival health.

OBJECTIVE: The aim was to investigate the influence of amine fluoride (AmF)/stannous fluoride (SnF2) containing toothpaste and mouthrinse on plaque accumulation and gingival health of young adults after 4 weeks use. SUBJECT AND METHODS: Forty-two young adults (mean age: 28.33 +/- 7.19 years) were examined for the Plaque Index (PI; Silness and Löe, 1964) and Gingival Index (GI; Löe and Silness, 1963) scores, and divided randomly into two groups. Both groups used AmF/SnF2 containing toothpaste twice a day for 3 min toothbrushing, and one group after toothbrushing rinsed with AmF/SnF2 containing mouthrinse for 30 s. After 4 weeks the probands were re-examined. RESULTS: Statistically significant decrease in dental plaque (PI) and gingival (GI) index values were found at the end of the study. The reduction of PI and GI values was significant in all groups but it was higher in the combined (toothpaste + mouthrinsing) group, than using toothpaste only. CONCLUSION: The regular combined use of AmF/SnF2 toothpaste and mouthrinse was more effective in the reduction of plaque accumulation and maintenance of gingival health than the toothpaste alone.

Adult↗
PubMed1998

Comparison of wear-resistance of Class V restorative materials.

Compomers and resin-modified glass ionomers have been developed to improve the physical properties of traditional glass ionomer cements. This project compared the toothbrush wear-resistance of three compomers (Compoglass, Dyract, Hytac) and three resin-modified glass ionomer restorative materials (Fuji II LC, Photac-Fil, Vitremer) to that of two resin-based composites (Herculite XRV, Silux Plus). Specimens (n = 7) were prepared according to manufacturers' instructions and stored in a humidor for 48 hours prior to testing. The specimens were subjected to 120,000 strokes at 1.5 Hz, using a brush-head force of 200 g on a Manly V-8 cross-brushing machine. The slurry contained a 50:50 (w/w) mixture of toothpaste and deionized water. Abrasion-resistance was calculated by measuring specimen mass-loss prior to and subsequent to brushing. The data were analyzed using a one-way analysis of variance (ANOVA) and the Tukey-Kramer post-hoc test. Significant differences (p < .0001) in mass-loss were found, and loss ranged from 0.013 +/- 0.003 g (Hytac) to 0.061 +/- 0.009 g (Compoglass). No correlation (p = .959) between wear-resistance and experimentally determined filler content existed. This study showed that all but one hybrid resin-ionomer type material exhibited a resistance to toothbrush wear that was as good as or better than that of the two traditional resin-based composite materials.

Analysis of Variance↗
PubMed1992

Factors affecting the ingestion of fluoride dentifrice by children.

Several factors affecting the amount of fluoride ingested during toothbrushing by 2- to 7-year-old children were investigated. The specific purpose of this study was to determine the contribution of age, the amount of dentifrice used, and rinsing after brushing to the variation in the ingestion of fluoride dentifrice. Four hundred and five children brushed their teeth in front of a portable sink. The tubes of dentifrice in gel (0.24% NaF) were weighed before and after use to determine the amount of toothpaste used. The fluoride content of the collected liquids was determined with a fluoride-ion-specific electrode. The amount of fluoride ingested was derived by determining the difference between the amounts used and recovered. The amount of dentifrice used, the age, and the rinsing habits, entered in a multiple regression model, explained up to 66 percent of the total variation in the amount of fluoride ingested. The amount of dentifrice used accounted by itself for 60 percent of the total variation. Therefore, these results indicate that the quantity of dentifrice used was the most important factor affecting the ingestion of fluoride through toothbrushing by young children.

Age Factors↗
PubMed1998

Clinical sealant retention following two different tooth-cleaning techniques.

OBJECTIVES: This study compared the effectiveness of two different tooth-cleaning techniques on clinical sealant retention. METHODS: Seventy-four children in second and third grades at an elementary school in the rural town of Waverly, Tennessee, had sealants applied to four, noncarious, fully erupted, first permanent molar teeth. The teeth had been cleaned using a brush attached to a rotary instrument with fluoridated prophy paste, versus a toothbrush without paste (dry brushing). A split-mouth design was used, whereby one side (upper and lower) of the mouth was subject to one tooth-cleaning technique while the opposite side received the other technique. RESULTS: Twelve months after a single application of pit and fissure sealant, 63 children were available for recall. Exactly 252 teeth were examined and overall retention was high, with approximately 98 percent of sealants retained. Although the greatest loss of sealant occurred with the rotary instrument technique, the difference in proportions of missing sealant between techniques was not statistically significant. CONCLUSIONS: In this study, the tooth-cleaning technique of dry brushing with a toothbrush as a preparatory step in the sealant procedure yielded high clinical sealant retention at 12 months. This retention was comparable to that observed with rotary instrumentation. This finding suggests that dry brushing by the operator may be an acceptable alternative to using a rotary instrument with brush and paste.

Acid Etching, Dental↗