Showing papers in "International Journal of Dental Hygiene in 2016"

The efficacy of powered toothbrushes following a brushing exercise: a systematic review.

Abstract: Aim: The primary objective was to determine, based on the available published evidence, the efficacy of powered toothbrushing following a brushing exercise and secondary to what magnitude this effect is dependent on the plaque index score, power supply and mode of action. Material and Methods: The PubMed–MEDLINE and Cochrane CENTRAL databases were searched through and up to August 2014 to identify appropriate studies. The outcome measurement was the weighted mean (WM) percentage plaque score reduction of a full-mouth assessment following subject brushing. Results: The search yielded 2420 titles and abstracts. Ultimately, 58 articles with 146 brushing exercises as separate legs were selected. The overall effect of a powered brushing exercise provides a 46% WM plaque score reduction. One hundred and six experiments provided data as assessed according to the Quigley and Hein plaque index. The WM reduction from baseline in plaque scores was 36%. A WM plaque score reduction of 65% was observed in 39 experiments using the Navy plaque index. Subanalysis on power supply and mode of action showed WM plaque score reductions ranging from 33% up to 71% depending on plaque index score. Conclusion: The efficacy in plaque removal following a brushing exercise using a powered toothbrush provides a WM plaque score reduction of 46% on average, with a range of 36–65% dependent on the index scale to score plaque. The available evidence indicates that the power supply (rechargeable or replaceable battery), mode of action, as well as brushing duration and type of instructions are factors which contribute to the variation in the observed efficacy.

The incidence of complications associated with lip and/or tongue piercings: a systematic review.

Abstract: Objective: This review determines the incidence of complications associated with lip and/or tongue piercings based on a systematic evaluation of the available literature. Material and Methods: MEDLINE–PubMed, Cochrane-CENTRAL and EMBASE databases were comprehensively searched through June 2014 to identify appropriate studies. The incidence of complications, as established by a dental professional associated with oral and peri-oral piercings, was evaluated in populations with lip and/or tongue piercings. The quality of the case–control studies was assessed using the Newcastle–Ottawa Scale. For case series studies, the risk of bias was assessed using the National Institute for Health and Clinical Excellence scale. Results: An independent screening of 1580 unique titles and abstracts revealed 15 publications that met the eligibility criteria. The incidence of gingival recessions appeared to be 50% in subjects with lip piercings and 44% in subjects with a tongue piercing. Tooth injuries were observed in 26% individuals with lip piercings and in up to 37% of individuals with tongue piercings. Subjects with a lip piercing were 4.14 times (P = 0.005) more likely to develop gingival recession than those without a lip piercing. Subjects with a tongue piercing were more likely than non-pierced subjects to experience gingival recession (relative risk (RR) 2.77; P = 0.00001) and tooth injuries (RR 2.44; P = 0.003). Conclusion: Both lip and tongue piercings are highly associated with the risk of gingival recession, and tongue piercings are also associated with tooth injuries.

A systematic review on the effects of air polishing devices on oral tissues

Abstract: Objectives Air-polishing devices are used for the instrumentation of the root surface. Their potential of harm to the hard and/or soft tissues needs to be considered during periodontal treatment. The objective of this systematic review was to analyse the effects of air polishing devices on oral tissues. Methods The electronic databases MEDLINE, EMBASE and the Cochrane Library were screened for studies published through 18 November 2013. The surface modifications on human cementum, dentine or gingiva after the instrumentation were considered as outcomes. Results Of the 1266 abstracts screened, 17 studies were included in the analysis. Different air polishing powders consisting of sodium bicarbonate, calcium carbonate, pumice or glycine were used in different ex vivo or in vitro settings. Thirteen publications reported data on the effects of air polishing devices on cementum and dentine. Hard tissue modifications, including defect depths and volume, caused by sodium bicarbonate or calcium carbonate powders were significantly greater compared to powders consisting of glycine. The soft tissue modifications using different modes of instrumentation were assessed in four publications. The data demonstrate less potential of harm to the gingiva after spraying with glycine powder compared to sodium bicarbonate powder or instrumentation with curettes. Conclusion Glycine powder air polishing may be safely applied to human root surfaces and gingivae.

Effect of adjunctive use of green tea dentifrice in periodontitis patients - A Randomized Controlled Pilot Study.

Abstract: Objectives: Green tea is known to possess antiinflammatory, antibacterial and antioxidant activities. This study evaluated the effect of a locally prepared green tea dentifrice on specific parameters assessing gingival inflammation and severity of periodontal disease, when used as an adjunct to scaling and root planing (SRP) in the management of chronic periodontitis by comparing with a fluoride–triclosan-containing control dentifrice. Materials and methods: Thirty patients, with mild to moderate chronic periodontitis, were randomly allocated into two treatment groups, ‘test’ and ‘control’ after initial SRP. The test group was given green tea dentifrice with instructions on method of brushing, while the control group received a commercially available fluoride and triclosan containing dentifrice. Clinical parameters of Gingival Index (GI), Plaque Index (PI), percentage of sites with bleeding on probing (BOP), probing depth (PD) and clinical attachment level (CAL) along with biochemical parameters of total antioxidant capacity (TAOC) and glutathione-S-transferase (GST) activity in gingival crevicular fluid (GCF) were recorded at baseline line and 4 weeks post-SRP. Results: Intragroup analysis at 4 weeks showed statistically significant improvements of GI, PI, BOP, PD, CAL and TAOC in both groups. GST activity however, was increased only in the test group. At the end of the study period, the test group showed statistically significant improvements in GI, BOP, CAL, TAOC and GST levels compared to the control group. Conclusion: On comparison with fluoride–triclosan dentifrice, green tea showed greater reduction of gingival inflammation and improved periodontal parameters. Green tea dentifrice may serve as a beneficial adjunct to non-surgical periodontal therapy.

Role of supportive maintenance therapy on implant survival: a university‐based 17 years retrospective analysis

Abstract: Objective The objective of this study was to determine whether professional maintenance appointments were related to a decrease on dental implant loss. Methods We performed a retrospective review (1995–2012) of 1020 patient dental charts to collect data including a cadre of different variables such as age, gender, race, diabetes, osteoporosis, jaw location, implant dimensions and professional maintenance therapy. As a patient may have multiple implants which are correlated, we selected one random implant per patient to assure independence of observations assumption of the Cox proportional hazards regression model. Data analysis was performed using Kaplan–Meier survival curves and multivariate analysis using Cox proportional hazards regression analysis. Results Our results demonstrate that subjects with no maintenance had the lowest cumulative survival rate as compared to subjects with regular maintenance. In a multivariate Cox regression model, regular maintenance patients had the dental implant failure rate reduced by 90% as compared to no maintenance (P = 0.001). If patients had less than one maintenance visit per year, the failure rate was reduced by 60% as compared to no maintenance, but the difference was not statistically significant (P = 0.08). Conclusion From this research, we conclude that a professional administered periodontal maintenance at least on an annual basis is a critical factor for implant survival.

A systematic review on the patient perception of periodontal treatment using air polishing devices

Abstract: Objectives Air polishing devices are used as an alternative to traditional instrumentation of the root surface. The objective of the systematic review was to analyse patient perception, that is pain and discomfort during treatment with air polishing devices in periodontal therapy. Methods The electronic databases MEDLINE, EMBASE and the Cochrane library were screened for studies published through 18th November 2013. Patient perception served as primary outcome. Results Of the 1266 abstracts screened, nine studies reporting data on patient perception using a visual analogue scale or a patient interview were included in the analysis. Different air polishing powders consisting of sodium bicarbonate, glycine or erythritol were used. Reported discomfort of non-surgical periodontal therapy was consistently equal or lower when air polishing powders consisting of glycine or erythritol were applied compared with root surface instrumentation using hand instruments or ultrasonic devices. Conclusion Air polishing with powders consisting of glycine seems to be associated with less discomfort during non-surgical periodontal therapy, that is supra- and subgingival air polishing.

Factors related to number of present teeth in Korean elderly adults aged 55–84 years

Abstract: Objectives The aim of this study was to determine the associations between the number of present teeth (NT) and socio-economic, demographic and oral health behavioural factors among Korean adults aged 55–84 years. Methods The total subjects comprised 3767 individuals who were examined and who answered the questions on socio-economic status and oral health behaviour from the fourth Korean National Health and Nutrition Examination Survey conducted from 2007 to 2009. The dependent variable was NT, with binary status divided by the median. Socio-economic and demographic factors included gender, educational level, parent's educational levels, region of residence, household income, type of health insurance and mother's economic activity. Oral health behaviours were as follows: daily toothbrushing frequency, smoking status, recent dental visit and illegal dental treatment. Multivariate logistic regression models were applied to explain the associations between NT and other variables. Results In a model adjusted by socio-economic, demographic and oral health behavioural variables, subjects who lived in urban areas were more likely to have larger NT compared to those in suburban areas (OR: 1.22, P = 0.025). Males were more likely to have larger NT (OR: 1.90, P < 0.001), and daily toothbrushing frequency was associated with NT (OR = 1.25, P = 0.023). Non-smokers (OR: 2.44, P < 0.001) and past smokers (OR: 1.70, P < 0.001) were more likely to have lager NT compared to current smokers. Subjects without illegal dental treatments were more likely to have lager NT compared to those with illegal dental treatments (OR = 2.21, P < 0.001). Conclusions Interventions aiming to preserve present teeth in elderly adults should consider socio-economic, demographic and oral health behavioural factors.

A home-based training programme improves family caregivers' oral care practices with stroke survivors: a randomized controlled trial.

Abstract: Objectives Stroke survivors experience poor oral health when discharged from the hospital to the community. The aim of this study was to evaluate the effectiveness of a home-based oral care training programme on knowledge, attitude, self-efficacy and practice behaviour of family caregivers. Methods A randomized controlled trial was conducted. The experimental group consisted of 48 family caregivers who received the home-based oral care training programme, and the control group consisted of 46 family caregivers who received routine oral care education. The outcomes were measured by the Knowledge of Oral Care, Attitude towards Oral Care, Self-Efficacy of Oral Care and Behaviour of Oral Care before the training programme, and at one and two months afterwards. The data were analysed using mixed model anova to determine differences in the outcomes between the two groups. Results The findings demonstrated that the intervention group had more knowledge (t = 8.80, P < 0. 001), greater self-efficacy (t = 3.53, P < 0.01) and better oral care behaviour (t = 11.93, P < 0.001) than the control group at one and two months, with statistically significant differences in oral care knowledge, self-efficacy and behaviour outcome over time. The attitude of the intervention group towards oral care practice was generally positive (mean of baseline and two month = 12.9 and 14.7), but no significant difference in attitude change between the control and intervention groups (t = 1.56, P = 0.12). The treatment interaction effect was significant for the family caregivers’ behaviour of oral care at one and two months of the intervention for both groups. Conclusion Our individualized home-based oral care education can achieve significant improvements in oral care knowledge and self-efficacy among family caregivers of stroke survivors, and it can sufficiently empower them to modify their oral care practices in a home-based healthcare environment.

Introducing loupes to clinical practice: dental hygienists experiences and opinions.

Abstract: Objectives Recent literature has identified a number of potential advantages in wearing loupes for dental hygienists, including improved quality of care and ergonomics. The aim of the study was to determine dental hygienists' opinions about wearing loupes. Methods A short online survey was distributed to all dental hygienists who had recently participated in a study investigating the efficacy of loupes on musculoskeletal disorders; all had only worn loupes for a 6-month period, and prior to the study had not worn loupes. All of those invited completed the survey (n = 12), achieving a 100% response rate. Results The majority of respondents noted that the loupes were adaptable to wear; however, only one-quarter of hygienists surveyed were wearing them often following the study. Respondents identified that the biggest advantage to loupes was calculus removal (91.7%), and most indicated that they felt the quality of their work increased when wearing loupes (75%). The biggest disadvantage to wearing loupes was the adjustment period (50%), with limited depth of vision, headache, vertigo and infection control noted by at least one-third of respondents. Conclusions This study revealed that hygienists identify both benefits and limitations to wearing loupes, and therefore, ongoing support may be required for hygienists adopting their use in clinical practice.

A pilot study of an HbA1c chairside screening protocol for diabetes in patients with chronic periodontitis: the dental hygienist's role.

Abstract: Objective To assess effectiveness, convenience and cost of point-of-care diabetes screenings performed by a dental hygienist for patients with periodontitis, using a diabetes risk questionnaire, periodontal findings and a glycosylated haemoglobin (HbA1c) analyser. Methods A purposive sample of 50 participants with periodontitis, never diagnosed with diabetes, reporting ≥one diabetes risk factor, were administered an HbA1c test. Spearman's correlation measured relationships between HbA1c and diabetes risk test scores, numbers of missing teeth, percentage of deep pockets ≥5 mm and percentage of bleeding sites (BOP). Cost and time were assessed. Analyses used 0.05 alpha levels. Results Thirty-two per cent (n = 16) of participants presented HbA1c values indicating prediabetes; one HbA1c value indicated type 2 diabetes, totalling 34% (N = 17). No relationships existed between HbA1c values and diabetes risk scores (rs = 0.153; P = 0.144), numbers of missing teeth (r = 0.190; P = 0.093), percentage of deep pockets (rs = −0.048; P = 0.370) or percentage of BOP sites (rs = 0.066, P = 0.324). Direct cost for each HbA1c was $9US, excluding follow-up medical diagnosis. Mean screening time including patient education was 14 min (SD = 6.2). Fifty-three per cent (n = 9 of 17) of participants with elevated HbA1c values contacted their primary healthcare provider within 2 weeks as recommended. Conclusion Point-of-care HbA1c screenings by dental hygienists were effective and convenient for identifying undiagnosed prediabetes and provide opportunity for interprofessional patient care; cost or lack of dental insurance may inhibit implementation. Identification of patients at risk for diabetes requires further evaluation.

The effect of different mouth rinse products on intra-oral halitosis.

Abstract: Aim: To evaluate the effect of different mouth rinses 12 h after rinsing on genuine intra-oral halitosis. Materials and methods: Twenty-four adults with halitosis were included in a double-blind, crossover, randomized clinical trial. Halitosis was evaluated 12 h after rinsing with placebo and five mouth rinse products containing zinc acetate and chlorhexidine diacetate; zinc lactate, chlorhexidine and cetylpyridinium chloride; zinc acetate and chlorhexidine diacetate with reduced amounts of mint and menthol; zinc chloride and essential oil; and chlorine dioxide using the organoleptic method and a gas chromatograph. Test periods were separated by 1 week. Results: Hydrogen sulphide (H2 S), methyl mercaptan (MM) and the organoleptic scores (OLS) were significantly reduced 12 h following rinsing with all substances compared to placebo (P < 0.05). H2 S was more effectively reduced after rinsing with zinc acetate and chlorhexidine diacetate and zinc acetate and chlorhexidine diacetate with reduced amounts of mint and menthol compared to rinsing with zinc chloride and essential oil (P < 0.05), and significantly lower values of MM were obtained after rinsing with zinc acetate and chlorhexidine diacetate compared to zinc lactate, chlorhexidine and cetylpyridinium chloride (P < 0.05). The percentage effectively treated individuals (H2 S (<112 ppb), MM (<26 ppb) and OLS score <2) varied from 58% percentage (zinc acetate and chlorhexidine diacetate) to 26% (zinc chloride and essential oil). Conclusion: All treatments resulted in reduction in halitosis 12 h after rinsing compared to placebo. H2 S and MM were most effectively reduced by zinc acetate and chlorhexidine diacetate.

Physical disruption of oral biofilms by sodium bicarbonate: an in vitro study.

Abstract: Objectives Sodium bicarbonate has been shown clinically to be efficacious at removing dental plaque; however, its effect of mechanism against biofilms has not been evaluated in vitro. Here, we used a well-established in vitro plaque biofilm model to investigate the disruption of dental plaque biofilms. Methods Biofilms were grown in a constant depth film fermentor for up to 14 days. The fermentor was inoculated with pooled human saliva and growth maintained with artificial saliva. After various time points, replicate biofilms were removed and subjected to treatment at varying concentrations of sodium bicarbonate. Disruption of the plaque was assessed by viable counts and microscopy. Results The viable count results showed that younger biofilms were less susceptible to the action of sodium bicarbonate; however, biofilms of 7 days and older were increasingly susceptible to the material with the oldest biofilms being the most susceptible. Sixty-seven percentage of sodium bicarbonate slurry was able to reduce the number of organisms present by approx. 3 log10. These quantitative data were corroborated qualitatively with both confocal and electron microscopy, which both showed substantial qualitative removal of mature biofilms. Conclusions The results from this study have shown that sodium bicarbonate is able to disrupt mature dental plaque grown in vitro and that its reported efficacy in maintaining oral hygiene may be related to this key factor.

A randomized clinical trial comparing plaque removal efficacy of an oscillating–rotating power toothbrush to a manual toothbrush by multiple examiners

Abstract: Objective To determine whether multiple examiners can demonstrate consistent plaque removal advantages for an oscillating–rotating power toothbrush versus a manual toothbrush. Methods This was a replicate-use, single brushing, examiner-blind, randomized, two-treatment, four-period crossover clinical trial involving four examiners. Subjects were randomized to one of four treatment sequences involving two toothbrushes: an oscillating–rotating power toothbrush or a manual toothbrush. At each of the four visits, subjects arrived having abstained from oral hygiene for 24 h prior, and brushed with their assigned toothbrush and a marketed fluoride dentifrice under supervision unaided by a mirror. Plaque was assessed by each examiner using the Turesky-Modified Quigley–Hein Plaque Index at each study period before and after brushing. Data was analysed separately for each examiner using the analysis of covariance for crossover design. Results Ninety-five subjects between the ages of 18 and 70 met the entrance criteria and were enrolled in the study. Eighty-seven subjects completed all four periods of the study. Both brushes delivered a significant plaque reduction when compared to baseline. Significant treatment differences were observed for all four examiners – ranging from 0.10 to 0.16 – in favor of the oscillating–rotating brush (P < 0.001). There were no adverse events reported or observed for either brush. Conclusions All four examiners demonstrated the power toothbrush removed significantly more plaque after a single brushing than the standard manual toothbrush. Both brushes were well tolerated.

Senior Smiles: preliminary results for a new model of oral health care utilizing the dental hygienist in residential aged care facilities.

Abstract: Objectives The aim of this study was to determine whether a qualified dental hygienist could improve oral health outcomes for residents living in residential aged care facilities on the Central Coast of New South Wales, Australia. Methods A qualified dental hygienist undertook a 24-week oral hygiene intervention in five residential aged care facilities to test the Senior Smiles, oral health model of care. The facilities were invited to take part in the research, which was funded by a grant from NSW Medicare Local, Erina. Residents were asked to consent to having oral health risk assessments, oral healthcare plans and to receiving referrals for treatment where needed. Pre- and post-intervention plaque scores were recorded for residents and P values calculated using a paired t-test. In addition, the number of residents examined, treated and referred for more complex dental care was recorded. Results The statistical analysis program, SPSS, was used to conduct a paired t-test to compare pre- and post-intervention plaque scores on residents from the 5 RACFs. A statistically significant result of P < 0.0001 showed the intervention of the dental hygienist was effective in reducing plaque scores in residents across the 5 RACFs. Conclusion The Senior Smiles model of care provided residents with preventive oral hygiene care, referral pathways for complex dental treatment needs and established a formal management programme for ongoing oral health care within the RACFs. The Senior Smiles model of care is successful and transportable.

Oral hygiene grade and quality of life in children with chemotherapy-related oral mucositis: a randomized study on the impact of a fluoride toothpaste with salivary enzymes, essential oils, proteins and colostrum extract versus a fluoride toothpaste without menthol.

Abstract: Aim The aim of this study was to assess the impact of the use of a fluoride toothpaste (Bioxtra®, Biopharm, Milan, Italy) with salivary enzymes, essential oils, proteins and colostrum extract versus a fluoride toothpaste without menthol on the oral hygiene grade and on the quality of life (QoL) of children with oral mucositis (OM) grade 1 or 2 receiving chemotherapy for Acute Lymphoblastic Leukaemia (ALL). Methods Patients between 6 and 14 years with OM were randomly assigned to two groups, group A (Bioxtra® toothpaste) and group B (fluoride toothpaste without menthol). The patients were instructed to brush their teeth at least twice a day using a soft toothbrush with a small head. Oral hygiene grade was assessed using the simplified oral hygiene index (OHI-s); quality of life was assessed using the short form of the Oral Health Impact Profile (OHIP-14) questionnaires. The patients were evaluated on day 1(diagnosis of OM-T0) and on day 8 (T1). Statistical analysis was performed. Results A total of 64 patients were enrolled. A significant difference (P < 0.001) between the mean of the OHI-s in group A (0.9 ± 1.2) and in group B (1.5 ± 1.3) was found; the overall OHIP-14 scores were not associated with the use of one or the other toothpaste (P = 0.33). Conclusions Although the use of Bioxtra® toothpaste does not affect the QoL of children undergoing chemotherapy, it may be recommended as clinically effective in improving the oral hygiene grade.

Comparative effect of a new mouthrinse containing chlorhexidine, triclosan and zinc on volatile sulphur compounds: a randomized, crossover, double‐blind study

Abstract: Aim The aims of this study were to compare the volatile sulphur compounds (VSC)-reducing effect of two commercial mouthrinses using a morning bad breath model and to assess the role of mechanical plaque control (MPC) when performed previously to mouthrinse use. Patients and methods Eleven volunteers with good oral health were enrolled in a double-blind, randomized, six-step crossover design study with a 7-day washout period. Two commercial mouthrinses were tested using a saline solution (NaCl 0.9%) as a negative control: one mouthrinse contained 0.05% chlorhexidine, 0.05% cetylpyridinium chloride and 0.14% zinc lactate (CHX-CPC-Zn), while the other contained 0.05% chlorhexidine, 0.15% triclosan and 0.18% zinc pidolate (CHX-triclosan-Zn). A portable sulphide monitor (Halimeter®) was used for VSC quantification. Measurements were made at baseline, and 1, 3 and 5 h after rinsing. Significant differences were detected by analysis of variance. Results No significant differences between groups were detected at baseline. We were unable to demonstrate a significant influence of mechanical plaque control on the reduction of VSC levels when performed before mouthrinse use (P = 0.631). Both mouthrinses effectively lowered VSC levels in all test intervals (P < 0.05). No statistically significant differences were found between mouthrinses in any of the test intervals (P = 0.629, 0.069 and 0.598 at 1, 3 and 5 h). Conclusion This study demonstrated that CHX-CPC-Zn and CHX-triclosan-Zn have significant and similar effects in reducing VSC levels, which persist for at least 5 h. Such effects were independent of previous MPC, which failed to improve on the results of mouthrinse use alone.

Prevalence of halitosis in elderly living in nursing homes.

Abstract: Objectives Halitosis is a concern for many people, but has sparsely been studied in elderly living in nursing homes. The aim of this investigation was to study the prevalence of halitosis in this particular group and factors that could be associated with this condition. Method and materials One hundred and twenty-four residents at three different nursing homes were included in the study. The level of halitosis was assessed using an organoleptic method based on a 6-graded scale. Oral status, including registrations of plaque, gingivitis and assessment of hyposalivation, was performed by two investigators who both examined all patients. Medical history, that is medication, neurological conditions, diabetes, cardiovascular disease, chronic obstructive pulmonary disease (COPD)/asthma, dementia and mental illness, was obtained from the patient files. Registrations of the use of oral hygiene aids, ADL (Activity of Daily Life) and the frequency of contact with dental services were included in the clinical examination. Results Halitosis occurred in over 50% of residents living in nursing homes and was found to be associated with the presence of hyposalivation, periodontal disease, calculus, fixed prosthodontics and dementia. Conclusion Halitosis was a common finding in the elderly living in Swedish nursing homes.

A comparison of a new alcohol-free 0.2% chlorhexidine oral rinse to an established 0.2% chlorhexidine rinse with alcohol for the control of dental plaque accumulation.

Abstract: Objectives To compare the clinical efficacy of two formulations (alcohol and alcohol free) of 0.2% chlorhexidine (CHX) rinses on plaque, gingivitis and discoloration of teeth. Methods This double-blind crossover study consisted of one group of 10 volunteer dental students that followed two 21-day experimental gingivitis test periods. During these periods, the subjects abstained from oral hygiene except for the oral rinse provided. The study started after an initial two-week preparation programme that included a professional prophylaxis and repeated oral hygiene instructions. This was repeated for the 14-day washout period between the two rinses, including prophylaxis as per the first stage of the study. A calibrated examiner performed the clinical measurements at the beginning (baseline) and end of each study stage. The presence and amount of plaque were recorded using the Silness and Loe plaque index (PI) and gingival inflammation by the gingival index (GI) while the discoloration index (DI) was recorded on the buccal and lingual surfaces of the six anterior teeth of both the mandible and maxilla. Results Mean PI increased similarly for both solutions; however, the differences between initial and final values were statistically significant only for CHLOREL®. Similarly, the mean values for the GI showed small increases over the course of the study periods, but not statistically significant for either solution. The mean DI increased significantly for both solutions. Regarding the comparison of the initial and final values ​​between the solutions, per index, no statistically significant differences were observed. Conclusion The non-alcoholic chlorhexidine rinse had comparable levels of action as the generally recognized gold standard alcoholic rinse.

The antimicrobial effect of chlorhexidine varnish on mutans streptococci in patients with fixed orthodontic appliances: a systematic review of clinical efficacy.

Abstract: Objective To conduct a systematic review aimed to determine the antimicrobial efficacy of chlorhexidine varnishes (CHX-V) on mutans streptococci (MS) in patients during orthodontic treatment with fixed appliances. Materials and Methods A systematic computerized database search was conducted using Ovid MEDLINE, Scopus and EMBASE up to September 2014. A Google search was also conducted to further identify articles that met the eligibility criteria. Clinical trials which used CHX-V alone as the intervention to investigate the antimicrobial effect of the varnish in subjects undergoing orthodontic treatment were included. Outcome measures included MS level reduction and/or decreased caries incidence from baseline data. Results Nineteen articles were identified for full-text reading; eleven articles met the criteria for inclusion in this review. Type and concentration of CHX-V, bacterial sampling method, application frequency, sampling schedule, risk of bias and study outcomes are presented. Conclusion A limited number of studies with low risk of bias were available to address the antimicrobial efficacy of CHX-V on MS in patients during orthodontic treatment with fixed appliances. Therefore, while the majority of studies found CHX-V to be an effective antimicrobial against MS at an interval of 3–4 weeks, the strength of the recommendation is weak. Longitudinal studies are needed to determine whether this antimicrobial effect will contribute to clinically significant caries reduction in patients undergoing orthodontic treatment with fixed appliances.

The professional role of a dental hygienist in Finland - educators' views

Abstract: Objectives To assess the role and envisioned professional identity of the dental hygienist in the eyes of their educators at the Finnish training institutes and to determine the need for any changes and improvements. Methods A cross-sectional explorative study used as its main method interviews conducted in 2012–2013 among educators of dental hygienists in Finland. Leading representatives of dental hygienist training at all vocational health institutes, dental schools and centres of health education were asked to participate in the study. The interviews consisted of two parts: a self-administered questionnaire and a semi-structured interview. The qualitative data were analysed with thematic analysis. The inductive theoretical approach served to categorize the data based on emergent themes and patterns. Results The educators held a general respect and appreciation for the dental hygienist profession. They felt that dental hygienists’ skills ought to see more use in orthodontics and in preventive care than is customary today, including in tobacco prevention and smoking cessation as well as in dietary instruction among adults. The traditional role of the dental hygienist and the evolving scope of dental practice seemed mismatched. Concern about the lack of clarity regarding the division of labour in clinical practice was expressed. The respondents were convinced of that the division of labour in the public sector differs from that in the private sector. Conclusion The educators thought that the role of the dental hygienist and the evolving scope of dental practice were partly mismatched. A reassessment of stakeholder involvement in the development of training curricula is urgently needed.

Oral malodour among adolescents and its association with health behaviour and oral health status

Abstract: Objective To assess oral malodour level and its association with health behaviour, oral health behaviour and oral health status among adolescents Method A questionnaire survey and clinical examination that included tongue coating and oral malodour status were conducted on 665 senior high school students in Saitama, Japan Analyses of Pearson chi-square, independent samples t-test and logistic regression were conducted using SPSS 190 with the significance level set at P < 005 Results There were 173 (260%) subjects who had oral malodour and 547% of subjects reported they were conscious of their own oral malodour Logistic regression analysis showed that subjects who skipped breakfast were 17 times more likely to have oral malodour than those who had breakfast Subjects who did not have the habit of cleaning their tongue daily were also 17 times more likely to have oral malodour compared to those who had the habit The odds of having oral malodour increased as the area of tongue coating widened Conclusion Tongue coating, daily tongue cleaning and breakfast are significant factors for oral malodour among adolescents Proper tongue coating management together with other healthy lifestyle behaviours, especially having breakfast, should be advocated in adolescents' health education

Does enhancing personal care assistants’ own oral health influence their attitudes and practices towards oral care for residents – a pilot study

Abstract: Objectives To investigate whether, within a residential care facility, increasing personal care assistants’ (PCAs) awareness of their own oral health status and self‐care skills would alter existing attitudes and behavioural intentions related to the oral health care of residents. Methods PCAs (n = 15) in the dementia care unit of a residential care facility in Melbourne, Australia, were invited to participate in a small research project that appeared to test the effectiveness of a work‐place oral health educational programme in enhancing their own oral health whilst masking the actual outcome of interest, namely its effect on PCAs oral healthcare attitudes and practices towards the residents. Results Post‐intervention, the self‐reported confidence of the PCAs to identify their personal risk for oral health problems, identifying common oral health conditions and determining the factors contributing to their personal oral health was increased significantly (P < 0.05). Post‐intervention, the self‐reported confidence of the PCAs to feeling confident to identify factors that could contribute to poor oral health of residents, identify resident's higher risk for poor oral health and feeling confident in identifying common oral health conditions in residents was also increased significantly (P < 0.05). Conclusion The results of this pilot study show that the educational intervention to increase the personal care assistants’ (PCAs) awareness of their own oral health status and self‐care skills increased the confidence of the carers to identify oral health risks in the residents, as well as increasing their self‐reported confidence in providing oral care to residents.

Effect of gallium aluminium arsenide diode laser therapy on Porphyromonas gingivalis in chronic periodontitis: a randomized controlled trial.

Abstract: Objectives The aim of this randomized, controlled trial was to evaluate the effects of 685-nm gallium aluminium arsenide (GaAlAs) diode laser therapy (1.6 J cm−2) as an adjunct to scaling and root planing in the treatment of chronic periodontitis. Methods Thirty-two patients aged 35–60 years old who had chronic periodontitis met the eligibility criteria. They were randomly assigned to two equal groups: scaling and root planing were performed in the SRP group, while scaling, root planing and laser irradiation of periodontal pockets were performed in the SRP + DL group. Subgingival plaque samples were subjected to polymerase chain reaction (PCR) to detect P. gingivalis-colonized sites, and common clinical indices were evaluated before and 2 months after treatment. Clinical examination included gingival index (GI), plaque index (PI), probing depth (PD), clinical attachment level (CAL) and gingival bleeding index (GBI), all of which were recorded. Results Data from 30 patients [19 women and 11 men; mean age, 48.4 (5.4) years old] were analysed. There were statistically significant improvements in GI, PD, CAL and GBI for the SRP + DL group compared to SRP group but no significant difference in PI between the groups. Additionally, the percentage of P. gingivalis-positive sites in the SRP + DL group decreased from 80% (12/15) to 20% (3/15) after laser irradiation (P < 0.05). No significant changes were noted in the SRP group. Conclusion GaAlAs diode laser irradiation of diseased periodontal pockets at 685 nm and 1.6 J cm−2 seemed to be an effective adjuvant to mechanical instrumentation to treat chronic periodontitis.

Chlorhexidine mouthwash and sodium lauryl sulphate dentifrice: do they mix effectively or interfere?

Abstract: Focused question What is the effectiveness of a chlorhexidine (CHX) mouthwash used in combination with a sodium lauryl sulphate (SLS) dentifrice on the parameters of plaque and gingivitis? Material and methods MEDLINE-PubMed, Cochrane-CENTRAL, EMBASE and other electronic databases were searched up to July 2014. The inclusion criteria were (randomized) controlled clinical trials, subjects ≥18 years of age with good general health. Papers evaluating the effect of CHX mouthwash used in combination with SLS dentifrice or a dentifrice slurry compared with CHX mouthwash as a single oral hygiene intervention or in combination with an SLS-free dentifrice were included. From the eligible studies, data were extracted, and a meta-analysis was performed when feasible. Results Independent screening of 83 unique papers resulted in four eligible publications, with nine comparisons. The meta-analysis showed that when an SLS dentifrice was used as a slurry rinse, the interference on the plaque-inhibiting effect of a CHX mouthwash was significantly decreased (MD 0.33; P ≤ 0.00001; 95% CI: ). No significant difference was observed when SLS dentifrice was applied as a paste in combination with CHX mouthwash (MD 0.08; P = 0.42; 95% CI: ). Descriptive and subgroup analyses support these findings. Moreover, the observed effect for the dentifrice paste occurred regardless of the order of use. Conclusion This review demonstrates that when CHX mouthwash is recommended, it can be used in combination with an SLS dentifrice without any interference regarding its inhibiting effect on dental plaque, regardless of the order of use. Consequently, the collective evidence indicates that the combined use of dentifrice and CHX mouthwash is not contraindicated. However, this recommendation has been graded as moderate taking into account a potential publication bias because three of the four included studies emerged from the same research group.

The effect of water on morning bad breath: a randomized clinical trial

Abstract: Objectives: To assess the effects of water on the parameters of ‘morning bad breath’ (MBB) and to evaluate whether there is a difference between rinsing with water and drinking a glass of water. Materials and methods: A total of 50 participants were recruited and were randomly divided into two equal groups. One group rinsed with 15 ml of water for 30 s, and another group drank 200 ml of water within 30 s. Clinical assessments were carried out during one visit between 7:30 am and 12:00 pm. Pre- and post-intervention measures were assessed organoleptically as primary outcome parameters, and a secondary outcome parameter was assessed using both the Halimeter® and OralChroma™ apparatuses to evaluate volatile sulphur compounds (VSCs), hydrogen sulphide (H2S), methyl mercaptan (CH3SH) and dimethyl sulphide ((CH3)2S). In addition, the presence of tongue coating (discoloration/thickness) and tongue fissures was assessed. Results: All 50 participants completed the study. In both groups, a significant reduction in the organoleptic score and the OralChroma™ H2S and CH3SH readings was obtained after the intervention. Both regimens resulted in a CH3SH reduction of approximately 60%, whereas the reduction in H2S was between 30% and 50%. The acceptable change between pre- and post-assessments of the clinical parameters was not significantly different between the drinking and rinsing groups. Conclusion: Rinsing with water or drinking a glass of water had a statistically significant effect on the MBB parameters. No significant difference was obtained between the two regimens.

Oral health care-related beliefs among Finnish geriatric home care nurses.

Abstract: Objectives The aim was to investigate beliefs about oral health care tasks among nursing staff caring for home-dwelling older people using the Nursing Dental Coping Beliefs (nursing DCBS) index. Methods The study population comprised nursing staff working at the homes and sheltered accommodations of older people in Ylivieska, Finland (N = 141). The data were collected using the nursing DCBS index (five-point Likert scale). Results On average, the nurses held moderate to high Oral health care beliefs, Internal locus of control beliefs and External locus of control beliefs, but low beliefs about Self-efficacy. The nurses with an earlier adjunct education scored lower for Oral health care beliefs on the factor Knowledge about preventing gum diseases (OR = 0.3, 95% CI: 0.1–0.9) than did the others. Regarding beliefs about External locus of control, the age group 31–49 years scored lower on the factor Retaining teeth as one ages (OR = 0.2, 95% CI: 0.1–0.7), but scored higher on the factor How to prevent dental diseases (OR = 5.6, 95% CI: 1.1–29.3) than did younger nurses (≤30 years). The nurses with only a nursing education showed significantly higher mean scores on the Self-efficacy factor Confidence of the need for dental knowledge than did those with an earlier adjunct education (P = 0.034). Conclusions The nursing staff mostly believed that oral diseases are preventable and teeth can be retained in advanced age, but failed to recognize the value of dental knowledge and had little confidence in their ability to manage oral diseases. Improving the oral health-related knowledge and self-efficacy beliefs of nursing staff will require additional oral health education.

Effect of periodontal dressing on non-surgical periodontal treatment outcomes: a systematic review

Abstract: Background Periodontal dressing has been advocated and showed some positive outcomes for placing over the surgical site after periodontal surgery. However, little is known about its effect on non-surgical therapy. Purpose The aim of this review was to assess the clinical effect of periodontal dressing when used after non-surgical therapy. Material and methods Two examiners performed an electronic search in several databases for relevant articles published in English up to November 2013. Selected studies were randomized human clinical trials (prospective or retrospective trials) with the clear aim of investigating the effect of periodontal dressing placement upon periodontal non-surgical mechanical therapy. Data were extracted from the included articles for analysis. Results Three randomized clinical trials fulfilled the inclusion criteria and thus were included in the data analysis. Statistical analysis could not be carried out due to the lack of clear data of the included studies. However, descriptive analysis showed its effectiveness in improving clinical parameters such as gain of clinical attachment level and reduction of probing pocket depth. Conclusion Placement of periodontal dressing right after non-surgical mechanical therapy can be beneficial in improving overall short-term clinical outcomes, although more controlled studies are still needed to validate this finding.

Comparison of two preventive interventions on dental caries among children in Democratic People's Republic of Korea.

Abstract: Objectives The aim was to compare the change in dental caries status in two different intervention groups of the Children's Oral Health Promotion Programme (COHPP). Methods A longitudinal study among 500 children who had participated into the COHPP for 6 years was conducted in Pyongyang, Democratic People's Republic of Korea (DPRK). Children in Group I received intensified school-based intervention and were clinically examined at the age of 7 years in 2007 (n = 250), 10 years in 2010 (n = 250) and 13 years in 2013 (n = 242). Children in Group II (n = 250) joined the programme at the age of 4 years in kindergarten in 2007, were provided with early preschool-based intervention and were clinically examined at the age of 7 years in 2010 and 10 years in 2013. Results Both the prevalence and the mean number of dt + DT decreased significantly in both groups during the follow-up. This was due to decrease in the number of dt, whereas the number of DT remained relatively constant. Poisson regression showed that the association between the group status and the change in the number of dt + DT was statistically significant when adjusted for gender but disappeared when the school was included in the analysis. Conclusions The decrease in dental caries may be partly due to the exfoliation of deciduous teeth and dental treatment received. However, the study gave some reference emphasizing the early starting of the prevention.

Do adolescents who are night owls have a higher risk of dental caries? – a case–control study

Abstract: OBJECTIVE: The aim was to evaluate the association between circadian rhythm and the risk of caries in adolescents, as well as their dietary and toothbrushing habits.METHODS: A group of 196 adolesce ...

Preventive care delivered within Public Dental Service after caries risk assessment of young adults.

Abstract: Objectives To study preventive care provided to young adults in relation to their estimated risk category over a 3-year period. Methods The amount and type of preventive treatment during 3 years was extracted from the digital dental records of 982 patients attending eight public dental clinics. The baseline caries risk assessment was carried out by the patient's regular team in four classes according to a predetermined model, and the team was responsible for all treatment decisions. Based on the variables ‘oral health information’, ‘additional fluoride’ and ‘professional tooth cleaning’, a cumulative score was constructed and dichotomized to ‘basic prevention’ and ‘additional prevention’. Results More additional preventive care was provided to the patients in the ‘low-risk’ and ‘some risk’ categories than to those classified as ‘high’ or ‘very high’ risk (OR = 2.0, 95% CI 1.4–3.0; P < 0.05). Professional tooth cleaning and additional fluorides were most frequently employed in the ‘low-risk’ and ‘some risk’ categories, respectively. Around 15% of the patients in the high-risk categories did not receive additional preventive measures over the 3-year period. There was an insignificant tendency that patients with additional prevention developed less caries than those that received basic prevention in all risk categories except for the ‘very high-risk’ group. Conclusion The caries risk assessment process was not accompanied by a corresponding targeted individual preventive care in a cohort of young adults attending public dental service. Further research is needed how to reach those with the greatest need of primary and secondary prevention.