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PubMed1990

The relative plaque removal effect of a prebrushing mouthrinse.

A total of 51 adult subjects participated in a three-period crossover trial to test plaque-removal effectiveness of a prebrushing mouthrinse. Subjects refrained from brushing to allow plaque to accumulate for 24 hours before the test. The accumulated plaque was graded using Turesky's method. The subjects then used one of three treatment regimens, were retested for accumulated plaque and regraded. The three treatments tested were a commercial prebrushing mouthrinse and no toothbrushing; a commercial prebrushing mouthrinse and brushing with a dentifrice for 30 seconds; a prebrushing water rinse and brushing with a dentifrice for 30 seconds. The analysis of the data found that both groups that brushed removed significantly more plaque than the group that did not brush. However, both the prebrushing rinse group and the water rinse group achieved the same amount of plaque removal through 30 seconds of toothbrushing with a dentifrice.

Analysis of Variance↗
PubMed1997

[Oral hygiene habits among Brazilian adults in an urban area of southern Brazil].

AIMS: This study sought to analyse the oral hygiene habits (toothbrushing frequency, use of toothpick and dental floss), of a group of Brazilian adults, in relation to socio-demographic variables. The level of dental plaque and number of teeth with gums bleeding after probing were also investigated. METHODOLOGY: The sample was composed of 234 women and 237 men, from two socioeconomic status. The age range was from 24 to 44 years. Data was collected through structured interviews and clinical examinations. RESULTS: Daily toothbrushing was frequent. The median and mode were three, and it was associated with sex and socio-economic status. The majority of the sample population (67.5%), reported using dental floss and its use was associated with sex and socio-economic status. The use of toothpicks was frequent: 54.6% of the study group used them, and their use was also associated with sex, age and social class. The majority of the sample population had a moderate level of dental plaque (62.6%). The level of dental plaque was associated with social class. A quarter of the subjects did not have teeth with gums bleeding after probing. Bleeding gums were associated with age and social class. CONCLUSION: Oral hygiene habits were considered good for most of the participants of the study. However, improvements, are necessary among men and members of low social class.

Adult↗
PubMed1979

Overjustification effects in token economies.

This study tested the relevance to clinical token economies of the overjustification hypothesis that tangible reward interferes with intrinsic interest in target behaviors and causes such behaviors to be less probable following a period of reinforcement than preceding such a period. The study was carried out in an ongoing token economy for chronic psychiatric patients. Alternated over an 8-week period were weeks of token and no-token reward for one of the program's target behaviors, toothbrushing. Two different amounts of token reward were employed in order to examine whether reward magnitude might influence the presence or extent of overjustification effects. Little evidence was found for the presence of overjustification effects in token economies. However, maintenance of toothbrushing was greater in no-token weeks following weeks of low amounts of token reward than in no-token weeks following weeks of higher amounts of reward. The importance of such complex functional relationships is discussed.

Adolescent↗
PubMed1978

The effect of an alexidine mouthwash on plaque and gingivitis.

A clinical study was conducted on the effects of an alexidine or placebo oral rinse on plaque and gingivitis. Forty-two male subjects rinsed for 54 days while continuing toothbrushing. This was followed by 4 days of mouthrinsing only. The alexidine mouthrinse significantly reduced the plaque index when used in conjunction with toothbrushing and also when brushing was discontinued. The gingivitis results were inconclusive.

Adult↗
PubMed1981

A clinical approach to gingival stimulation.

The role played by gingival stimulation has not yet been clearly explained. This experiment shows (1) that even with regular stimulation of the gingiva with a toothbrush, gingival inflammation indices (GI and SBI) increase when plaque (determined by PII) accumulates on tooth surfaces; and (2) that if one proceeds to routine plaque elimination from the tooth surfaces, gingival inflammation indices (GI and SBI) increase in the absence of regular mechanical stimulation of the gingiva with a toothbrush. In the latter case, inflammation may be related to plaque accumulation on the gingiva.

Dental Plaque↗
PubMed1981

Oral hygiene for the partially edentulous.

THE EFFECTIVENESS of a proximal brush on the interdental hygiene for partially edentulous individuals was investigated. Nineteen partially edentulous adults participated in a crossover study. Three groups were instructed to use the toothbrush alone or a toothbrush combined with either toothpicks or proximal brush. The effectiveness of the cleansing devices was measured by the amount of plaque remaining on the examined surfaces. The results indicated that the cleaning efficiency of the proximal brush is greater than that of the toothpicks on the proximal surfaces of teeth adjacent to edentulous areas. On the other hand, the toothpicks were more effective on the proximal surfaces of teeth in contact.

Adolescent↗
PubMed1983

Effects of oral hygiene on the results of periodontal surgery in beagle dogs with artificially created defects.

The effect of oral hygiene on periodontal surgery was evaluated clinically, radiographically and histologically during 24 months. In 13 beagle dogs artificial periodontal defects were created around the second, third and fourth premolars of the mandible. One week after removal of the plaque retention ligatures, periodontal surgery consisting of mucoperiosteal flaps and osseous recontouring was performed. Postoperatively, plaque accumulation was prevented by daily application of a 2% chlorhexidine solution for 2 weeks and daily toothbrushing for the next 2 weeks. Toothbrushing was continued in seven dogs; oral hygiene was discontinued in the other six. All dogs were scaled and polished at 1, 6, 12 and 18 months after surgery. Plaque accumulation in the nonbrushed dogs resulted in a heavy inflammation of the periodontium. Probing depths that had been reduced by the surgery increased and subsequently the clinical attachment level changed into a more apical level compared to the brushed dogs. Histometrically, however, no difference in attachment level could be recorded, indicating that oral hygiene did not affect the attachment level in the 2 years after surgery. It appears that oral hygiene stimulated bone formation and that the periodontal tissues had not matured in the 2 years after surgery.

Animals↗
PubMed1991

The effects of a cetylpyridinium chloride prebrushing rinse as an adjunct to oral hygiene and gingival health.

A NUMBER OF MOUTHWASH PRODUCTS containing cetylpyridinium chloride (CPC) are available. Data for individual products are limited, although overall the antiseptic has been shown to reduce plaque. Results for gingivitis reductions by CPC have been equivocal. This study was an active/placebo parallel group design to evaluate the use of a CPC mouthrinse as an adjunct to oral hygiene when used before toothbrushing. Plaque and gingivitis scores were recorded at baseline and after 6 weeks, following twice daily use of the active or placebo prebrushing rinses. Plaque and gingivitis were significantly reduced at 6 weeks in both groups with no significant treatment differences between the active and placebo formulations. Whether the order of rinsing to toothbrushing influenced these findings cannot be determined. However, the results further question the adjunctive benefits of CPC rinses to gingival health.

Cetylpyridinium↗
PubMed1994

A mistaken health belief resulting in gingival injury: a case report.

This case report describes extensive ulceration of the gingiva caused by harsh and repetitive toothbrushing. The lesions wee localized to several areas of the mouth. Despite considerable pain, the patient had persisted in the causative toothbrushing pattern. He had absorbed an invalid health belief that when pain or bleeding occurred, he should utilize consistent harsh brushing in the affected areas. Following re-education, this brushing behavior was discarded and healing ensued. The origin of his health belief and its relationship to the behavioral principle of self-efficacy are discussed.

Behavior Therapy↗
PubMed1999

Coronally advanced flap procedure for root coverage. Treatment of root surface: root planning versus polishing.

This clinical study was designed to determine if mechanical instrumentation (root planing) of the exposed root is useful in treating gingival recession caused by traumatic toothbrushing following a coronally advanced flap (CAF). Ten patients with high levels of oral hygiene (full-mouth plaque score <20%), from 25 to 57 years of age, were selected for the study. Each patient showed 2 bilateral Class I or II maxillary recessions. A total of 20 recessions were treated. The difference in the recessions was < or =1 mm. In each patient, one recession was randomly assigned to the test group and the contralateral one to the control group. In the test group, the exposed root surface was polished at slow speed with a rubber cup and prophylaxis paste for 60 seconds. In the control group, the exposed root surface was planed with a sharp curet. In both test and control groups, a trapezoidal full- and partial-thickness flap was elevated, coronally displaced, and sutured to cover the treated root surface. Before treatment, the mean recession depth in the test group (polishing) was 3.1+/-1.1 mm; and in the control group (root planing), 2.9+/-1.0 mm. Three months after the described procedures, the test group (polishing) showed a mean recession reduction of 2.6+/-0.6 mm; mean percent root coverage was 89+/-14%. In the control group (root planing), the mean recession reduction was 2.3+/-0.7 mm and mean percent root coverage was 83+/-16%. The difference of recession reduction between the test and control group was not statistically significant (P = 0.1405), even though the test group showed slightly better clinical results in terms of root coverage. This prospective clinical, controlled, randomized study shows that mechanical instrumentation (root planing) of the exposed root surfaces is not necessary when shallow recessions caused by traumatic toothbrushing are treated using a coronally advanced flap (CAF) in patients with high levels of oral hygiene.

Adult↗
PubMed2002

Dentin morphology and permeability after brushing with different toothpastes in the presence and absence of smear layer.

BACKGROUND: The purpose of this study was to evaluate the morphology and permeability of dentin after brushing with different toothpastes in the presence and absence of smear layers. METHODS: Dentin discs were prepared from extracted third molars. Dentin permeability was measured using a hydraulic pressure apparatus working at 70 cm H2O pressure. Dentin was treated with 0.5 M EDTA for 5 minutes and washed to remove a smear layer and to establish the maximum permeability of each dentin disc, which was expressed as 100%. A new smear layer was then created on the upper surface using a #400 carbide paper under water for 30 seconds. Dentin permeability of the smear layer-covered dentin was measured and expressed as a percentage of the maximum permeability of that specimen, permitting each specimen to serve as its own control. Each sample was then brushed by a mechanical device under water for 3 minutes with constant pressure of 250 g using a medium toothbrush and permeability remeasured. Finally, 1 of 5 different toothpastes was applied on the dentin and brushed for 3 minutes. In another group, the same procedures were performed with the exception of the smear layer production, so it was possible to calculate changes in the permeability of dentin with open tubules following brushing. Scanning electron microscopic (SEM) examination of dentin was obtained before and after treatments with brushing and toothpastes. RESULTS: Dentin permeability was reduced by brushing procedures when the smear layer was absent, but it was increased when the smear layer was present. Toothpaste application reduced dentin permeability when no smear layer was present on the top of the surface, but modified and increased permeability of samples with smear layers. SEM observations demonstrated the presence of dentifrice particles on dentin surfaces and inside dentinal tubules, and this may be responsible for the observed reductions in permeability. Smear plugs produced during dentin brushing were not removed by the dentifrices. CONCLUSIONS: Dentin permeability and morphology are significantly affected by toothbrushing and by the type of dentifrice used. The presence of smear plugs in the dentin may decrease severity.

Adult↗
PubMed2003

Lifestyle and psychosocial factors associated with chronic periodontitis in Taiwanese adults.

BACKGROUND: The development of chronic periodontitis (CP) is a multifactorial process and variation in severity cannot be explained by just a few risk factors. The aims of this study were: 1) to explore the lifestyle and psychosocial factors of CP patients and 2) to estimate the proportion of total CP cases attributable to one or more risk factors considered. METHODS: A case-control study of 250 cases of CP patients and 250 controls were matched by age (within 3 years) and gender. Complete dental examinations were performed based on the clinical criteria for CP for both groups. Structured questionnaires were conducted to collect lifestyle and psychosocial factors. Multivariate logistic regression was applied to assess the association between risk factors and chronic periodontitis. RESULTS: Conditional multivariable logistic regression analysis showed that toothbrushing frequency (odds ratio [OR]: 5.77, if rarely; OR: 3.50, if once a day), mental illness (OR: 5.32, if Chinese Health Questionnaire scores were > or = 6), and smoking (OR: 3.93, if pack years smoked was > 21) are significantly and independently associated with chronic periodontitis. In addition, all these variables reflected a dose-response effect (P trend = <0.001, 0.004, and 0.005, respectively). CONCLUSIONS: For Taiwanese adults, 36.10% of CP cases were presumably attributable to toothbrushing frequency, mental illness, and smoking. These three factors should be the first priorities in establishing a preventive program to improve the periodontal health status.

Adult↗
PubMed2005

Risk indicators for tooth loss due to periodontal disease.

BACKGROUND: Several risk indicators for periodontal disease severity have been identified. The association of these factors with tooth loss for periodontal reasons was investigated in this cross-sectional comparative study. METHODS: All extractions performed in 21 general dental practice clinics (25% of such clinics in Kuwait) over a 30-day period were recorded. Documented information included patient age and gender, medical history findings, dental maintenance history, toothbrushing frequency, types and numbers of extracted teeth, and the reason for the extraction. Reasons were divided into periodontal disease versus other reasons in univariate and binary logistic regression analyses. RESULTS: A total of 1,775 patients had 3,694 teeth extracted. More teeth per patient were lost due to periodontal disease than for other reasons (2.8 +/- 0.2 versus 1.8 +/- 0.1; P <0.001). Factors significantly associated with tooth loss due to periodontal reasons in logistic regression analysis were age >35 years (odds ratio [OR] 3.45; 95% confidence interval [CI] 2.79 to 4.26), male gender (OR 1.42; 95% CI 1.17 to 1.73), never having periodontal maintenance (OR 1.48; 95% CI 1.23 to 1.78), never using a toothbrush (OR 1.81; 95% CI 1.49 to 2.20), current or past smoking (OR 1.56; 95% CI 1.28 to 1.91), anterior tooth type (OR 3.23; 95% CI 2.57 to 4.05), and the presence of either of the following medical conditions: diabetes mellitus (OR 2.64; 95% CI 2.19 to 3.18), hypertension (OR 1.73; 95% CI 1.41 to 2.13), or rheumatoid arthritis (OR 4.19; 95% CI 2.17 to 8.11). CONCLUSION: Tooth loss due to periodontal disease is associated with the risk indicators of age, male gender, smoking, lack of professional maintenance, inadequate oral hygiene, diabetes mellitus, hypertension, rheumatoid arthritis, and anterior tooth type.

Adolescent↗
PubMed2005

Long-term outcome following treatment of multiple Miller class I and II recession defects in esthetic areas of the mouth.

BACKGROUND: Multiple recession defects can be successfully treated using envelope-type coronally advanced flaps. The aim of the present study was to evaluate the long-term (5 years) stability of clinical outcomes achieved with the surgery and the association between patient variables and long-term stability. METHODS: Seventy-three Miller Class I and II gingival recessions affecting 22 young, systemically healthy subjects were treated with coronally advanced flaps with no releasing incisions. All patients were instructed to perform a coronally directed roll technique to minimize the toothbrushing trauma to the gingival margin. The clinical reevaluation was made 1 year after the surgery. At this point, 13 patients took part in a supportive periodontal care program consisting of oral hygiene instructions, control of toothbrushing technique, and professional tooth cleaning every 4 months. The remaining nine patients did not participate and received only sporadic care by general dentists. At 5 years post-surgery, all patients were reexamined. RESULTS: At the 5-year examination, 94% of the root surfaces initially exposed due to gingival recession were still covered with soft tissue, and 85% of the treated recession defects showed complete coverage. Complete root coverage in all recessions was maintained in 15 out of 22 patients (68%). The long-term stability of the soft-tissue margin in the treated sites was significantly influenced by the patient's regular participation in the recall program and the susceptibility to gingival recession in other areas of the mouth. A statistically significant increase of keratinized tissue (0.80 +/- 0.64 mm) was observed between the 1- and 5-year observation visits, and the average increase of keratinized tissue between the baseline and the 5-year follow-up amounted to 1.38 +/- 0.90 mm. This increase was significantly affected by the baseline keratinized tissue (KT) and recession (REC) depth: in particular, the 5-year increase in the amount of keratinized tissue was greater in sites with a greater recession depth and lower amount of keratinized tissue at baseline. CONCLUSIONS: 1) The successful root coverage results obtained with the coronally advanced flap for multiple recession defects were well maintained over the 4-year observation period. 2) Negative patient characteristics such as a lack of compliance with a supportive care program and individual susceptibility to gingival recession were significantly associated with the recurrence in gingival recession. 3) The increase in keratinized tissue height that followed the coronally advanced flap procedure may be attributed to the tendency of the mucogingival line to regain its genetically determined position.

Adolescent↗
PubMed2006

Assessment of treatment responses to dental flossing in twins.

BACKGROUND: The purpose of this study was to assess treatment responses to dental flossing in twins. METHODS: The study was a two-treatment, examiner-blind, randomized parallel group, controlled study. Fifty-one twin pairs between 12 and 21 years of age were randomized to a 2-week supervised and unsupervised treatment regimen consisting of 1) tongue brushing and toothbrushing (TB) and 2) TB + flossing (TB + Fl). Clinical endpoints were gingival bleeding (papillary bleeding score [PBS]) and oral malodor (levels of volatile sulfur compounds [VSC]). Analysis of variance and covariance methodologies were employed to analyze the data. RESULTS: Baseline average PBS values were 1.352 and 1.345 for the TB + Fl and TB groups, respectively (P=0.937). After 2 weeks of treatment, the TB + Fl group had a statistically significant decrease in PBS values of 0.558 (41.5% versus baseline), whereas the TB group showed no improvement from baseline. The change from baseline for the TB + Fl group was superior to that for the TB group (P<0.001). Similar findings were observed for the number of baseline papillary bleeding sites. Baseline average intraoral halimeter values were 45.91 and 41.75 for the TB+Fl and TB groups, respectively (P=0.504). Both treatment regimens demonstrated highly statistically significant reductions in intraoral halimeter values versus baseline (all P<0.001) and the difference between treatment groups was not statistically significant (P=0.339). Similar findings were found for expired air. CONCLUSIONS: In a well-matched twin cohort, tongue and toothbrushing plus flossing significantly decreased gingival bleeding after 2 weeks.

Adolescent↗
PubMed1990

[Studies on O'Leary's plaque control record in initial periodontal treatment. 1. Relation between PCR and different brushing methods in 1982-1986].

The purpose of this study was to investigate the effects of different methods of brushing on plaque removal, using O'Leary's plaque Control Record during initial preparation. The results were as follows: 1. There were many 40-50 year-old patients and they showed a 63.0 percent first visit Plaque Control Record average. 2. Many of the patients entering the clinic had periodontal disease in mild stages. 3. In most cases the toothbrushing methods were the Rolling method and the Modified Stillman's method. Of the patients, 73.5% achieved Plaque Control scores at the 20 percent level. 4. Of the patients who had achieved a Plaque Control Record at the 20 percent level, half of the patients instructed to brush using the Rolling method had developed moderate forms of periodontal diseases, and half of the patients instructed to use the Modified Stillman's method had developed mild forms of periodontal disease. There is a close relationship between toothbrushing methods and the progression of diseases, and this shows that Plaque removal methods should be controlled.

Adult↗
PubMed1978

The effect of supervised tooth cleansing every second week on dental caries in Danish school children.

The purpose of the present study was to determine the effect of a program of regular plaque control carried out by a group of school children, supervised and assisted by dental personnel. Approximately 200 children 5--13 years of age were randomly assigned to two groups. Children in the experimental group performed supervised toothbrushing every second week during the school year, using a disclosing solution. Following this, a disclosing solution was reapplied and the remaining plaque removed by dental personnel. Both groups participated in fortnightly fluoride rinses, regular toothbrushing instruction and various educational activities. Mean dental caries increment at the precavitation level during the 2-year experimental period was 19 per cent lower in the experimental group than in the control group. At the cavitation level the difference was 17 per cent. None of these differences were statistically significant. The conclusion of the present study was that only limited effect of regular removal of dental plaque as performed by school children could be demonstrated.

Adolescent↗
PubMed1994

Evaluation of the antimicrobial effects of sodium benzoate and dichlorobenzyl alcohol against dental plaque microorganisms. An in vitro study.

Evaluation of antimicrobial agents is based on in vivo and in vitro studies. The minimum inhibitory concentrations (MICs) of sodium benzoate and dichlorobenzyl alcohol to 115 strains of plaque microorganisms were determined by a broth-dilution method. Sodium benzoate did not inhibit growth of any gram-positive cocci (MIC > 106,590 microM). MICs for Porphyromonas gingivalis and two strains of Treponema socranskii were 26,650 microM. The MIC of dichlorobenzyl alcohol to the reference strain of Actinobacillus actinomycetemcomitans was 723 microM and to P. gingivalis, two strains of T. socranskii, and Candida albicans 1,446 microM. MICs for other organisms were 2,892 to 5,784 microM. Saliva samples from 10 volunteers, collected at various times after toothbrushing with a dentifrice containing 10% sodium benzoate and 0.3% dichlorobenzyl alcohol, were analyzed gas-chromatographically. Immediately after toothbrushing mean levels of sodium benzoate and dichlorobenzyl alcohol were 372,626 microM and 7,529 microM, respectively. After 5 min mean levels were 38,700 microM and 734 microM. In conclusion, the concentrations of both antimicrobials dropped rapidly during the first 30 min, but for 5-10 min they were high enough to inhibit growth of potential periodontal pathogens.

Adult↗