Showing papers on "Oral hygiene published in 1991"

On the prevention of caries and periodontal disease. Results of a 15-year longitudinal study in adults.

Abstract: In 1971–72, a total of 375 adult subjects were recruited for a clinical trial aimed at assessing the effect of a preventive program, based on plaque control and topical application of fluoride, on the incidence of caries and periodontal disease. After a baseline examination, the volunteers were subjected to scaling, root planing and conventional caries therapy. During the course of the subsequent 6 years, they were recalled for preventive measures once every 2–3 months. After the 6–year follow-up examination, however, it was decided to extend the interval between the preventive sessions. Thus, during the next 9–year period, about 95% of the participants returned for preventive measures only 1 to 2 times per year. A small subgroup of about 15 subjects, who, during the initial 6 years had developed new caries lesions or had exhibited additional periodontal attachment loss, however, were also during the following 9 years recalled 3–6 times per year for oral hygiene control and preventive therapy. The re-examination performed in 1987 disclosed that the 317 subjects, who participated during the entire 15-year period, had a low incidence of caries and almost no further loss of periodontal tissue support. It was suggested that improved self performed oral hygiene, daily use of fluoridated dentifrice and regularly repeated professional tooth cleaning effectively prevented recurrence of dental disease.

Mouthwash Use and Oral Conditions in the Risk of Oral and Pharyngeal Cancer

Abstract: Interviews with 866 patients with cancer of the oral cavity and pharynx and 1249 controls of similar age and sex from the general population in four areas of the United States revealed increased risks associated with the regular use of mouthwash. Risks of oral cancer were elevated by 40% among male and 60% among female mouthwash users, after adjusting for tobacco and alcohol consumption. Risks among both sexes generally increased in proportion to duration and frequency of mouthwash use. The increased risks were confined to users of mouthwash high in alcohol content, consistent with the elevated risks associated with drinking alcoholic beverages. Except for a higher prevalence of leukoplakia among cases, little relationship was found with oral or dental conditions, although denture wearing was reported more often by patients with cancer of the gums. These findings, together with other studies, provide further incentive for clarifying the association between mouthwash use and oral cancer.

The dental status of cerebral palsied children.

Abstract: The prevalence of dental disease, the types and quality of dental care, and the provision of services were assessed for 150 cerebral palsied children (mean age 10.25 years) attending special schools in Leeds and compared with a matched control group of 191 children (mean age 10.39 years). Similar dental caries experience existed in the two groups, but study children had more extracted and unrestored teeth, and fewer and poorer quality restorations than control children. Oral hygiene and gingival health were worse in the study group, which also exhibited delayed eruption and higher levels of tooth wear. Significantly greater overjet (5.1 mm compared with 2.5 mm) and less crowding occurred in the study group than in the control group. All parents had favorable attitudes toward dentistry and were satisfied with their children's dental care. More study children received treatment from the community dental service, while the general dental services were used more commonly by the control group.

Epidemiology and prevention of periodontal disease in individuals with diabetes.

Abstract: Objective This article reviews the epidemiological evidence of the relationship between diabetes and periodontal disease, possible physiological mechanisms for the association, and effects of interventions on the occurrence and severity of periodontal disease among individuals with diabetes. Research Design And Methods A comprehensive qualitative review of published literature in the area was performed. Results Much of the research in this area was found to contain methodological problems, such as failing to specify the type of diabetes, small sample sizes, and inadequate control of covariates such as age or duration of diabetes. Conclusions Trends indicate that periodontal disease is more prevalent and more severe among individuals with diabetes. This trend may be modified by factors such as oral hygiene, duration of diabetes, age, and degree of metabolic control of diabetes. Generally, poor oral hygiene, a long history of diabetes, greater age, and poor metabolic control are associated with more severe periodontal disease. The association of diabetes and periodontal disease may be due to numerous physiological phenomena found in diabetes, such as impaired resistance, vascular changes, altered oral microflora, and abnormal collagen metabolism. With some modifications, the same prevention and treatment procedures for periodontal disease recommended for the general population are appropriate for those with diabetes. People with diabetes who appear to be particularly susceptible to periodontal disease include those who do not maintain good oral hygiene or good metabolic control of their diabetes, those with diabetes of long duration or with other complications of diabetes, and teenagers and pregnant women.

Oral Health Knowledge and Habits of Senior Elementary School Students

Abstract: Despite improvements in children's dental health, and significant resource allocation to health education programs, few recent studies have investigated the associations of oral health knowledge, behaviors, and status This study of 11-year-old children (N = 6,329) in northeastern Ontario used a supervised self-complete questionnaire and a clinical examination to gather baseline data on, and test associations of, caries and periodontal knowledge, self-reported oral health behaviors and source of knowledge, and oral health status Results show the children had poor knowledge of caries preventive measures such as water fluoridation, dental sealants, and choice of snack foods Periodontal knowledge was better, but children confused plaque and calculus Respondents claimed good oral health habits, with 73 percent claiming to brush at least twice daily, 88 percent claiming to use toothpaste, 42 percent claim to floss at least twice weekly, and 84 percent claiming an annual dental visit Children with the best knowledge claimed dentist and school as the sources High knowledge was associated with good oral health habits (P less than 001) and low DMFT score (P less than 001) Good habits were not related to DMFT score (P = 1095) Logistic regression showed high knowledge was associated with English cultural status, urban school area, good habits, having a dental sealant, and attending a fluoride-rinse school (P less than 05) Findings suggest a need to reinforce caries preventive teaching, to investigate the effect of cultural status, dental experience, and residence status on oral health knowledge, and to further test the efficacy of different oral health education programs delivered by different sources

Anti-plaque agents. Rationale and prospects for prevention of gingivitis and periodontal disease.

Abstract: Oral health surveys have shown that even in countries with established patterns of oral hygiene habits, most individuals have relatively poor gingival health. This is due to a low interest in complying with oral health procedures. A number of factors are apparent when investigating compliance to oral hygiene habits, viz only approximately 50% of the population brushes twice a day or more, brushing time is probably much too short and use of dental floss is not very prevalent. Studies of the effect of motivation on oral hygiene suggest that improvements can be achieved, but these are not maintained unless motivation is continuously reinforced. This suggests that topically applied anti-plaque agents should be used to augment mechanical plaque control. A number of product forms are available to delivery anti-plaque agents i.e., mouthrinses, dentifrices, aqueous gels, and additionally floss, chewing gum and lozenges. Any product form should provide a physically, chemically and microbiologically stable environment for the agent concerned. It should facilitate optimal bioavailability of the agents at the site of action and encourage patient compliance. Anti-plaque agents for topical administration should have the following properties: high intrinsic efficacy against a broad spectrum of oral organisms, toxicological and ecological safety, oral substantivity, no adverse reactions and good chemical stability. A number of classes of anti-plaque agents have been identified such as positively charged organic molecules, metal salts, phenols, enzymes, peroxides, sugar substitutes, fluorides and surface modifying agents. In order to achieve optimal bioavailability, the agent to be dosed should be compatible with the product form used. The 2 major product forms are rinses and dentifrices.(ABSTRACT TRUNCATED AT 250 WORDS)

Dental bacterial plaques. Nature and role in periodontal disease.

Abstract: Antony van Leeuwenhoek first described oral bacteria. However, not until almost 200 years later was the famous Koch postulate introduced. Since then, research has extensively been performed regarding the development and microbiology of dental plaques. In spite of the complexity of the developing flora of supragingival plaque, culture studies have shown a remarkably orderly succession of organisms. Lately, the concept of microbial specificity in the etiology of periodontal diseases has been widely suggested, i.e., that different forms of periodontal disease are associated with qualitatively distinct dental plaques. Cross-sectional and longitudinal studies of the predominant cultivable microflora reveal that only a small number of the over 300 species found in human subgingival plaques are associated with periodontal disease. Among the commonly mentioned are: Actinobacillus actinomycetemcomitans, Bacteroides gingivalis, Bacteroides intermedius, Capnocytophaga sp., Eikenella corrodens, Fusobacterium nucleatum, and Wolinella recta, as well as certain gram-positive bacteria such as Eubacterium species. Anti-infective therapy for many systemic infections equals the use of antimicrobial drugs. However, for localized infections like periodontal diseases, treatment may consist of a combination of mechanical wound debridement and the application of an antimicrobial agent. The general effectiveness of mechanical anti-infective therapy and successful oral hygiene in the management of periodontal disease is well established in the literature and has met the test of success in clinical practice for most cases of periodontitis in adults. The definition of periodontal pathogens as either opportunistic pathogens, or as exogenous pathogens carries with it significant implications.(ABSTRACT TRUNCATED AT 250 WORDS)

Relationship of dental coping beliefs and oral hygiene.

Abstract: Previous research has found varying relationships between dental beliefs and oral hygiene. In this study a recently developed questionnaire, the Dental Coping Beliefs Scale (DCBS), was used to study the relationship between plaque index and dental beliefs. The DCBS was administered to 99 subjects; at the same time, the standard of oral hygiene was determined by the use of the Plaque Index scoring system. The rating dentist had an established test-retest reliability of 0.91 in estimating plaque index. Correlations were obtained between each of the DCBS's 44 items and plaque index scores. Ten items were significantly correlated with plaque index, with r's from -0.19 (P less than 0.05) to -0.33 (P less than 0.001). The DCBS data was then analyzed by performing an oblique principal component cluster analysis to determine the major health belief composing the DCBS. Four clusters explained 38% of the total variance. The clusters were labeled Internal Locus of Control (15 items). External Locus of Control (15 items), Self Efficacy (8 items), and Oral Health Beliefs (6 items). Nine of the 10 items significantly correlated with plaque index were members of the External Locus of Control component. Thus, beliefs relating to increased external locus of control were related to higher plaque index.

The significance of maintaining the stability of the natural microflora of the mouth.

Abstract: The mouth, like other areas of the digestive tract, possesses a natural microflora, the presence of which confers several beneficial properties to the host. However, in the absence of adequate oral hygiene, dental plaque can accumulate beyond levels compatible with oral health. This leads to shifts in the balance of the predominant bacteria away from those associated with health; such shifts can predispose a site to caries or periodontal diseases. Treatment should be designed, therefore, to control rather than to eliminate dental plaque. Possible strategies to maintain the stability and beneficial properties of the natural oral microflora include the stimulation of saliva flow for an extended period directly after a meal, the avoidance of fermentable carbohydrates during between-meal periods, and improvements to oral hygiene, for example, by using products containing antiplaque or antimicrobial agents.

Periodontal treatment needs among Saudi Arabian adults and their relationship to the use of the Miswak.

Abstract: The main aims of this study were, first, to estimate the need for periodontal care among adult residents of Saudi Arabia using the community periodontal index of treatment need (CPITN) and, second, to quantify the relationship between the frequency of using the 'Miswak' and the need for periodontal care. The Miswak is a stick made from the roots of the Arak tree (Salvadora persica) and is used for oral hygiene purposes by many cultures. A total sample of 480 adults aged 35 to 44 years and 65 years and older from the cities of Mecca and Jeddah was included in the study. The findings indicate that the level of need for periodontal care in the sample chosen is low when compared with the findings of similar studies undertaken in other countries. The frequent use of the 'Miswak' was associated with a lower need for treatment.

Common misconceptions about oral health in the older adult: nursing practices

Abstract: A survey of nurses, director-supervisors, and nursing home health aides who provide home care in Iowa showed that many misconceptions exist about what constitutes appropriate oral and dental care practices for the older adult. Despite differences in formal education among these nursing personnel, several misunderstandings about dental problems among older adults were common to all three employment groups. These misconceptions represented a broad range of topics from the characteristics of oral cancer lesions to the appropriate use of denture adhesives; two dealt specifically with the recognition of potential oral cancer lesions. This paper describes attitudes and misinformation held by the respondents, and suggests ways to correct these fallacies through in-service training programs.

The effect of a cognitive behavioral intervention on oral hygiene.

Abstract: Several medical areas that require patient compliance have successfully used psychological interventions emphasizing cognitive behavioral components. However, there are no published reports on the effect of cognitive behavioral interventions on oral hygiene in adults using an experimental design. For this study, 100 male veterans age 21-65 years were randomly assigned to 4 groups (cognitive behavioral, education, attention control, and control); to compare the effectiveness of these interventions on oral hygiene, a 5-week pre-test-post-test design was utilized. The dependent variables were self-report of brushing and flossing behavior and dental plaque levels utilizing the plaque index. After the interventions, there was only one significant difference between the control and the experimental groups for brushing frequency. There were no significant differences among the experimental groups for this intervention. The self-report of flossing frequency significantly increased in all 3 treatment groups, but there were no significant differences between these groups. In addition, plaque levels decreased significantly in all 3 experimental groups. Plaque levels in the cognitive behavioral group were significantly lower than those of the educational group. It was not possible to determine whether the greater plaque reduction in the cognitive-behavioral group could be attributed to the nature of the intervention or to the extra time spent with patients in the cognitive behavioral group.

Dental health in a group of drug addicts in Italy

Abstract: The caries prevalence, periodontal health, and oral hygiene status were assessed in 124 drug addicts aged 18–34 yr in Mercato San Severino (Salerno), Italy. The years of drug addiction ranged from 1 to 15 yr. The majority used heroin (96%) but all the subjects indicated that they had used more than one drug. The percentage of drug addicts caries Free was 6.5%, ranging From no caries Free subjects in the group over 29 yr of age, to 11.4% in the group aged 26–29 yr old. Mean DM FT and DMFS scores For all age groups were 12.9 and 36.2, respectively; mean Periodontal Index (PI) and mean Simplified Oral Hygiene Index (OHI-S) scores were 1.37 and 1.71, respectively. The poor dental health in this target group indicates the need for more extensive collaboration between the social and dental health care sectors.

Results of a 3-year oral hygiene programme, including amine fluoride products, in patients treated with fixed orthodontic appliances

Abstract: This paper reports the results of a 3-year study on children treated with fixed orthodontic appliances. They were all regularly instructed in oral hygiene maintenance and used a standardized fluoride-free toothpaste during the course of the study. The patients were divided into three groups. Groups one and two, respectively, had a fluoride gel and fluoride fluid (Elmex amine fluoride products, GABA International Ltd, Basle, Switzerland) applied. Group three used only the toothpaste supplied, had oral hygiene instruction, but not topical applications. Caries increments were lowest and gingival health best in the two groups using amine fluorides, especially the gel group.

Comparison of an herbal toothpaste with a fluoride toothpaste on plaque and gingivitis.

Abstract: An herbal/bicarbonate toothpaste has received some attention from the public and profession following a number of studies which have reported beneficial effects of the paste on both plaque and gingivitis. The present study, one of several ongoing clinical trials, evaluated the toothpaste in mouthrinse form using a 19-day, no oral hygiene, triple-crossover design in which it was compared with a commercial fluoride toothpaste rinse and the antiplaque mouthrinse chlorhexidine. Over the three periods of the study an increase in plaque and gingivitis was seen for all three products. However, while significant reductions in both parameters were seen with chlorhexidine compared to the toothpastes, there were no significant differences between the herbal and fluoride toothpaste. From these findings it can be concluded that in the long term, the herbal/bicarbonate toothpaste may not exert significant therapeutic effects on plaque and gingivitis beyond that of a conventional commercial paste. Nevertheless, where there is a demand for a natural product, the herbal/bicarbonate paste may be a worthwhile alternative.

Dental health and dental care requirements for young handicapped adults in Wessex.

Abstract: The dental health status and treatment requirements of 195 young handicapped adults living in the Wessex Health Region are reported. These young adults, aged 25-34 years, attended adult training centres on a daily basis in each of the districts in Wessex Region. The amount of untreated caries was higher and the periodontal status worse for this group than would normally be expected in young adults in this age range. The dental care received was related to the ability of the subject to comprehend and co-operate with the operator. Nearly half the subjects could receive routine treatment in a normal surgery and about a quarter were likely to require hospitalisation and general anaesthesia to achieve any treatment. The community dental service should play an important role in organising and supervising preventive strategies, with the aim of improving oral hygiene for these young handicapped adults, which should materially improve their periodontal health.

Oral health care for the patient with schizophrenia

Abstract: Schizophrenia is a psychiatric disorder affecting 1%of the United States population. Conceptualizing the disorder as consisting of “positive” and “negative” symptoms has led to improved treatment modalities. Medications used in managing the “positive” symptoms have numerous systemic and orofacial adverse side effects that must be recognized by the dentist. Dental treatment strategies for the identification and management of these side effects art! described. “Negative” symptoms are responsible for chronicity of the disorder and frequently impede rehabilitation. These symptoms are potentially devastating to oral health as they impair a patient's desire and ability to invoke preventive oral hygiene. Treatment strategies to improve compliance with oral hygiene techniques are outlined. A medication specifically indicated for patients with treatment- resistent disease and marked “negative” symp toms has recently been approved for use in the United States. The systemic and orofacial adverse side effects of this medication and its influence on dental management are reviewed.

Relationship between general health, social factors and oral health in women at the age of retirement.

Abstract: Relationships between some medical, psychological, social factors and oral health were analyzed within a comprehensive study of women around the age of retirement. The study was performed in Malmo in 1985-1986 and included 165 women retiring from work between 851201 and 870131. Women in qualified professional positions and with high prosperity indices had an average significantly more remaining teeth and were less often edentulous than the others. The same applied to unmarried women compared to divorcees and widows. There were significant correlations between full blood glucose and serum urate concentrations and number of teeth, DFT and DFS. The mean number of prescribed drugs was negatively related to the number of remaining teeth and high drug consumption was positively related to oral dryness. Women complaining of strain, overwork, restlessness and difficulty in relaxing reported more often problems with oral dryness. Oral dryness was also related to high blood values of calcium, urate and triglycerides, while the serum levels of cholesterol were low. There were no differences between smokers and non-smokers concerning any of the studied tooth-related variables, oral dryness, hypertension or bodyweight. The results indicate a close relationship between general health, social factors and oral health.

Hexetidine mouthrinse in the management of minor aphthous ulceration and as an adjunct to oral hygiene.

Abstract: A number of compounds have been used in the management of recurrent oral ulceration, including antimicrobials. This was a double-blind placebo-controlled cross-over study to assess the value of a 0.1% hexetidine mouthwash in the management of minor aphthous ulceration and as an adjunct to oral hygiene. Forty patients with a catalogued history of ulceration took part. Patients were randomly allocated to active/placebo or vice versa order of mouthwashes, which were used as 15 ml volumes three times a day. Treatment periods were 6 weeks with a 3 week washout. During each period patients kept daily records of the number, site, and duration of ulcers, together with pain scores. Plaque and gingivitis were scored at baseline and end of treatment periods. Thirty-eight patients completed the study, with no significant treatment differences between active and placebo rinses on any ulcer parameter. Additionally, the hexetidine rinse provided no significant benefit to oral hygiene or gingival health. However, there was a significant period effect, with considerable ulcer improvements during the second period, irrespective of treatment. In conclusion, the hexetidine rinse appeared to offer no benefits to these patients, but professional supervision of ulcer treatment does appear to result in a worthwhile placebo effect.

Oral hygiene practices, oral cleanliness and periodontal treatment needs in 12-year old urban and rural school children in Ghana.

Abstract: The aim of the present study was to inquire into oral cleaning practices, and to determine levels of oral cleanliness and periodontal treatment need among 12-year-old Ghanaian school children living in urban and rural areas. Of the 985 children examined, 38 per cent claimed to use a toothbrush, 31 per cent chewing sticks, 17 per cent plantain and 14 per cent the chewing sponge. In rural areas, traditional methods were preferred, and only 8 per cent used a toothbrush. On examination, oral debris was present in 84 per cent of the sample, and more than three quarters had calculus deposits. Children in urban areas, and particularly those attending private schools, had the cleanest mouths and the lowest periodontal treatment need. Multiple regression analysis showed that the social class background of the child, which reflects motivation and awareness for good oral health, was the most significant predictor for levels of oral cleanliness and CPITN, whereas the method or frequency of cleaning employed were not significant variables.

Risk factors associated with abundant dental caries and periodontal pocketing.

Abstract: An adult population of 1275 subjects aged 25, 35, 50, and 65 yr were examined clinically with respect to their periodontal and caries situation. An interview and questionnaire were used to chart the following variables: dietary and oral hygiene habits, social factors, appreciation of natural teeth, and use and availability of dental services. The associations between the risk factors and the probability of periodontal pocketing (greater than or equal to 4 mm) or abundant dental caries (greater than or equal to 7 lesions) among the dentate population were examined using a logistic regression model. The final model correctly classified periodontal pocketing in 65% of the cases and abundant caries in 76%. In addition to social variables, behavioral factors were found to be significantly associated with periodontal pocketing and abundant untreated dental caries.

Cross-sectional assessment of caries and periodontitis risk within the same subject.

Abstract: Dental caries and chronic periodontitis may be synergistically associated, negatively associated, or completely independent. The present report examines this relationship by comparing the susceptibility to chronic periodontitis and caries within the same individual. From an 800-patient sample, a periodontitis risk score was derived by radiographic assessment of bone loss in quarters of optimum bone height and obtaining for each subject a mean score based on all measurable surfaces. Similarly the caries risk was determined radiographically from the total decayed and filled teeth (DFT), as a percentage of the total teeth measured. The Mantel-Haenszel technique was used for analysis of the relationship between periodontitis and caries and data was stratified on four categories of age, sex, and numbers of teeth present. This analysis revealed no systematic patterns, indicating that the risks of caries and periodontal diseases are unrelated (chi 2 = 0.00; 1 df; P greater than 0.50). In addition, a regression analysis, which was controlled for sex and age, indicated a marked lack of association between caries and periodontitis (P = 0.94). Thus, although these common diseases share putative etiologic factors such as oral hygiene practices and dental attendance pattern, the major risk factors are probably quite different.

The relationship between chewing sticks (Miswak) and periodontal health. 3. Relationship to gingival recession.

Abstract: Aggressive or improper toothbrushing techniques may have a detrimental impact on the gingiva. The purpose of this study was to examine the relationship between chewing sticks (Miswak) and gingival recession. Gingival recession was measured on the mid facial surfaces of the incisors, canines, and premolars in 238 patients presenting for routine dental appointments. All patients had been interviewed previously regarding their oral hygiene habits and use of Miswak. Patients were divided into three groups: Miswak group, toothbrush group, and Miswak/toothbrush group. The Miswak users had significantly more (P less than or equal to .05) sites gingival recession than did the toothbrush users. Furthermore, the severity of the recession was significantly more (P less than or equal to .05) pronounced in the Miswak users than it was in the toothbrush users.

Oral hygiene practices and periodontal health in primary school children in Nairobi, Kenya.

Abstract: The purpose of this study was to obtain data on the oral hygiene practices, oral hygiene status, and periodontal health among primary school children in Nairobi. The study group consisted of 513 children, 262 aged 6-8 years and 251 aged 13-15 years. The children were from 6 schools randomly selected among the 154 public primary schools in the city. The clinical examination was performed in a room with natural daylight, using the WHO (1980) criteria. Although most of the children reported brushing habits, 75% of the index tooth surfaces in the younger and 55% in the older age group had visible plaque. In both age groups about 25% of the index sites had gingivitis. Moderate amounts of calculus were recorded among the older children. Only two children had periodontal pockets greater than or equal to 4 mm. There was no statistically significant difference (p greater than 0.05) between males and females recorded with plaque and gingivitis in the younger age group. In the older group, however, a significantly higher proportion of males (p less than 0.05) were recorded with plaque and gingivitis. The oral hygiene practices and oral hygiene status were poorer among children from low than from high socioeconomic status. Provision of dental health education for children in Nairobi is recommended.

The importance of oral hygiene on variation in dental caries in adults

Abstract: The aim of the present study was to analyze the relative importance of oral hygiene and other selected independent variables on the number of carious surfaces in a random sample of 35-year-old Oslo citizens. In addition to oral hygiene status (OHI-S), the independent variables frequency of tooth cleaning, regular dental visits, years at school, sex, and number of filled and missing surfaces were included in the analyses. Multiple Classification Analysis (MCA) was used for statistical evaluation of the results. The results indicate that oral hygiene status was the most important predictor in explaining variation in the number of carious surfaces. The total explanation factor was, however, low (R2 = 0.146).

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

Abstract: 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. J Periodontol 1991; 62:562–564.