Showing papers on "Oral hygiene published in 1994"

Experimentally induced peri-implant mucositis. A clinical study in humans.

Abstract: The purpose of this study was to compare the clinical and microbiological (microscopic) parameters during the development of experimental gingigivitis and experimental peri-implant mucositis. Twenty partially edentulous patients were treated for moderate to advanced periodontal disease. Following active periodontal therapy consisting of motivation, instruction in oral hygiene practices, scaling and root planing and periodontal surgery where indicated, IMZ oral implants were incorporated in posterior edentulous areas. After 3 months of healing, the prosthetic abutments were connected, and the patients were closely supervised for another 2 months of healing. At this time, baseline data were obtained. Re-examinations were scheduled at 3 and 6 months. Following this, the patients were asked to refrain from oral hygiene practices for 3 weeks. At all examinations including the end of the period of no oral hygiene, the following clinical parameters were obtained: Plaque Index, Gingival Index and Sulcus Bleeding Index, all modified by Mombelli et al. (1987) probing pocket depths and recession in mm. Furthermore, submucosal/subgingival plaque samples were obtained and analyzed using phase contrast microscopy. At the end of the 3-week period of plaque accumulation: optimal oral hygiene was reinstituted. There were no statistically significant differences between the mean values of all parameters at implant compared to tooth sites at any observation periods. The period of no oral hygiene demonstrated a similar cause-effect relationship between the accumulation of bacteria1 plaque and the development of peri-implant mucositis as established for the gingival units by the experimental gingivitis model.

The prevalence and distribution of gingival recession in subjects with a high standard of oral hygiene

Abstract: The aim of this study was to evaluate the prevalence and the development/progression of attachment loss and gingival recession at buccal tooth surfaces in a population sample with a high standard of oral hygiene. An additional aim was to study the relationship between attachment loss and gingival recession. The subject sample examined comprised 225 regular dental care attendants at 12 community dental clinics in Sweden. All subjects were subjected to a baseline examination in 1977-78 and were re-examined after 5 years and 12 years. The clinical examinations involved assessment of plaque, gingivitis, probing depth, probing attachment loss and gingival recession. A full-mouth set of intraoral radiographs was obtained at each examination and used for determination of the height of periodontal bone support. The results of the cross-sectional and longitudinal analyses performed showed that in subjects with a high standard of oral hygiene (i) buccal gingival recession was a frequent finding, (ii) the proportion of subjects with recession increased with age, (iii) the prevalence as well as the incidence of recessions within the dentition showed different patterns depending on age, (iv) sites with recession showed susceptibility for additional apical displacement of the gingival margin and (v) loss of approximal periodontal support was associated with gingival recession at the buccal surface.

Experimental gingivitis during pregnancy and post‐partum: clinical, endocrinological, and microbiological aspects

Abstract: The purpose of this study was to assess whether an intensive oral hygiene regimen practised during pregnancy results in a clinically healthy gingival state, and to assess whether experimentally-induced gingivitis differs in severity during pregnancy as compared to post-partum. In addition, levels of black-pigmented Gram negative anaerobes at subgingival and oral mucosal sites and plasma concentrations of free estrogens and prosterone were determined. These parameters were studied during a 14-day episode of experimental gingivitis induced in the 25th week of pregnancy, and again 6 months post-partum. The subjects were selected on shallow pockets < or = 4 mm and interproximal loss of attachment not exceeding 2 mm. As a result of controlled oral hygiene, the gingival condition improved both during pregnancy and post-partum. At day 0 during pregnancy, however, gingival swelling, redness, and bleeding on probing were found to be higher than post-partum. Free plasma levels of estrogens and progesterone were found to be normal throughout the study. It was hypothesized that the increase in severity of gingival symptoms during pregnancy reflect microvascular physiologic effects of increased levels of these hormones. During pregnancy, more swelling, redness and bleeding on probing developed during experimental gingivitis than post-partum, whereas the amount of plaque was similar in both phases. This suggests that as a result of dental plaque accumulation, gingival inflammation develops superimposed on pregnancy-associated physiologic alterations. Microbiological evaluation showed that the mean proportions of Prevotella intermedia in subgingival plaque increased during experimental gingivitis performed during pregnancy, whereas no increase of this micro-organism was found post-partum.

Textbook of clinical cariology

Abstract: An introduction to the oral cavity saliva oral microbial ecology and dental caries metabolic activities or oral bacteria metabolism and structure of microbial deposits clinicial and pathological features of dental caries epidemiological features of dental caries recording dental caries and health statistics in Europe different concepts of dental caries and their implications oral hygiene and dental caries flouride in caries treatment mechanisms of action flouride in caries treatment - clinical implications diet, sugar and dental caries chemotherapeutic treatment of dental caries fissure sealants and dental caries caries activity tests vaccination and dental caries diagnosis of dental caries prognosis of dental caries can caries be predicted?

Prevention of oral mucositis in patients treated with high-dose chemotherapy and bone marrow transplantation: a randomised controlled trial comparing two protocols of dental care.

Abstract: Between February 1986 and November 1989, 166 patients who were candidates for a bone marrow transplantation entered a randomised controlled clinical trial to compare limited oral hygiene care (LIM) and intensive oral hygiene care (INT) in the prevention of mucositis. Randomisation was stratified on the initial oral status (good vs. bad IOS). Intensive oral hygiene care included an initial treatment of dental lesions and tooth and gum brushing during aplasia. Limited oral hygiene care excluded preventive dental treatment and gingival and tooth brushing. Mucositis was classified as absent, mild, moderate or severe, according to the clinical aspects of the different sites in the mouth and to two scales of pain evaluation. Of the 150 evaluable patients (75 in each group), 134 developed moderate/severe mucositis (64 in the INT group and 70 in the LIM group) (log-rank test P < 0.02). The superiority of intensive oral care was observed both in patients with and without total body irradiation (TBI) and in patients with a good or bad IOS; the observed risk of mucositis was reduced by 70% in each of these four subgroups. Duration of moderate/severe mucositis was, although not significantly, lower in the INT group (17 days, S.D. = 12) than in the LIM group (19 days, S.D. = 13). The median time of mucositis occurrence was 11 days in the INT group and 9 days in the LIM group. Contrary to a widespread belief, the percentage of documented septicaemia was not higher in patients who underwent intensive oral care. We conclude that, although statistically significant, the superiority of intensive oral hygiene care is not clinically impressive.(ABSTRACT TRUNCATED AT 250 WORDS)

Comparison of different approaches to assess bleeding on probing as indicators of gingivitis

Abstract: . The purpose of this study was to evaluate different methods of eliciting gingival bleeding as indicators of gingival inflammation in the experimental gingivitis model. Following a period of stringent oral hygiene, 103 dental students were scored for plaque and gingival bleeding assessed by 4 methods. From this group, 41 volunteers were randomly allocated to 2 treatment groups. Dental students with clean teeth and healthy gingivae were asked to abolish all mechanical tooth cleaning in the lower jaw for a period of 3-weeks. During the 21-day experimental period, chlorhexidine (Peridex®) or a placebo mouthrinse was applied to the lower jaw. Subjects brushed the upper jaw with a standard toothpaste. In principal, 2 different methods were employed to provoke bleeding: (1) at the marginal gingival tissue by running a probe along the soft tissue wall at the orifice of the pocket, and (2) by probing to the “bottom” of the pocket. Variations in the methods were based on angulation (AngBI, ParBI) of the probe in relation to the tooth surface and to the probing force (PPBI.25N, PPBI.757V). 1 randomly selected quadrant in the lower jaw was scored using the AngBI. The opposing quadrant was scored with a randomly-allocated bleeding index, either ParBI, PPBI.25N or PPBI.75N. The results of this study confirm earlier findings that the angulation of the probe determines the number of sites with bleeding observed. It also indicates that bleeding as elicited by probing to the bottom of the pocket is a poor indicator of early gingivitis. It is recommended that gingivitis should be assessed by probing the marginal gingiva.

Does dental health education affect inequalities in dental health

Abstract: The aim of the study was to evaluate the Lothian 1991 dental health campaigns on 5-year-old schoolchildren's oral hygiene and gingival health in relation to deprivation. A stratified random sample of 486 children was selected from 92 primary schools in the city of Edinburgh. Clinical examinations took place immediately before (T1), a month after (T2) and 4 months after the campaign (T3). A total of 342 (70 per cent) children received all 3 examinations. Oral hygiene and gingival health were examined using a modified Silness and Loe and the Ainamo and Bay Index. Toothbrushes and take-home materials were distributed to all children. Dental officers provided 20 minute information sessions for each class and encouraged teachers to continue dental health activities within the classes. For the purpose of the evaluation, schools were categorised as deprived and non-deprived according to established social indicators. The results showed a statistically significant improvement in plaque scores at T2 and T3 (P < 0.05, P < 0.01). Also gingival health improved at T2 and T3 (P < 0.01, P = 0.001). However, the improvements took place only in the non-deprived schools. Thirty-one per cent of children in non-deprived schools and 18 per cent in deprived schools had a total plaque score of 0 at T1 and 41 per cent and 19 per cent respectively at T3. The differences in gingival health scores between deprived and non-deprived schools were statistically significant at T2 and T3 but not at T1. The campaign was therefore successful when evaluating the population as a whole.(ABSTRACT TRUNCATED AT 250 WORDS)

The long-term effect of an oscillating/rotating electric toothbrush on gingivitis. An 8-month clinical study.

Abstract: The purpose of this study was to evaluate the safety and efficacy of the Braun Plak Control® for the removal of supragingival plaque and improving gingival health in a long-term clinical trial, and to compare it to a regular manual toothbrush. Assessed were plaque accumulation, amount of gingival inflammation, gingival bleeding on probing, and calculus. In total, 77 young individuals were selected on the basis of having moderate gingivitis'. They were monitored over 8 months and divided among 2 groups; a control group that used a manual toothbrush and a test group that used the Braun Plak Control. The clinical assessments were repeated after 1, 2, 5, and 8 months. At baseline, subjects were handed their assigned toothbrushes together with written oral hygiene instructions. They were instructed to brush for at least 2 min. 1 month after baseline examinations, all subjects received a professional prophylaxis and oral hygiene instruction from an experienced dental hygienist. Plaque removal was reinforced at the 2- and 5-month examination. In conclusion, results indicate that the Braun Plak Control is a safe and efficient home care device. At the end of this trial, this electric toothbrush proved to be more effective than a regular manual tooth brush.

Oral hygiene in relation to caries development and immigrant status in infants and toddlers.

Abstract: The purpose of this study was to describe oral hygiene factors in infants and toddlers living in Sweden with special reference to caries prevalence at 2 and 3 yr of age and to immigrant status. The study was designed as a prospective, longitudinal study starting with 671 children aged 1 yr. At 3 yr, all the children were invited to a further examination. A total of 298 children, randomly selected from the original group, were also examined at 2 yr. The accompanying parent was interviewed about the child's oral health habits. Children who were free of caries at 3 yr had had their teeth brushed more frequently at 1 and 2 yr of age, had used fluoride (F)-toothpaste more often at 2 yr of age, and had a lower prevalence of visible plaque at 1 and 2 yr of age than children with caries. Immigrant children had had their teeth brushed less frequently, had used less F-toothpaste, and had a higher prevalence of visible plaque at 1 yr of age than nonimmigrant children. Early establishment of good oral hygiene habits and regular use of F-toothpaste seem to be important for achieving good oral health in pre-schoolchildren.

Understanding Dental Service Use by Older Adults: Sociobehavioral Factors vs Need

Abstract: Objectives This study investigated correlates of dental care use in a representative sample of adults aged 70 and older throughout New England. Methods Data were collected in in-home interviews and dental examinations. Following Andersen's behavioral model of health services utilization, varied measures of sociodemographic characteristics, dental health attitudes and practices, perceived need for care, and need objectively determined by clinical examination were included as potential correlates. Results Recency of last visit was associated with positive attitudes toward dental care, regular dental hygiene, and having a usual source of care. Among dentulous subjects, recency of last visit also was related to sex and living arrangements. Frequency of visits for dentulous subjects was associated with the same variables, as well as with age and social class or education, in addition to need for care. For edentulous subjects, only a usual source of care and higher social class were associated with more frequent visits. Conclusions Perceived need and attitudes toward dental care are important influences on use of care. Older persons must be convinced of the importance of regular dental care.

Periodontal disease as a risk factor for heart disease.

Abstract: Many individuals with cardiovascular disease appear from epidemiologic studies to have either periodontal disease or to be edentulous. A Finnish group has provided evidence that after conventional risk factors for stroke and heart attacks have been accounted for, there still remains a significant relationship between dental disease and cardiovascular disease. A preliminary analysis of our own investigation of the interrelationship of medical and dental health shows that individuals with a high dental morbidity (ie, edentulous or with many missing teeth) have a high prevalence of coronary heart disease and stroke. A model based on how smoking can predispose to periodontal disease is used to explain how periodontal disease could be a potential risk factor for heart disease.

Long-term effect of two preventive programs on the incidence of plaque and gingivitis in adolescents.

Abstract: The efficacy of two oral hygiene training programs on the control of plaque and the prevention of gingival inflammation in adolescents was evaluated during a 3-year period. A population of 227 Brazilian schoolchildren were divided into 3 groups. The first group received a comprehensive program based on individual needs and included information sessions pertaining to the etiology and prevention of dental diseases together with extensive training in self-diagnosis and oral hygiene. In addition, an information session was arranged for parents and teachers of these children. The second group received a less comprehensive program consisting of conventional oral hygiene training. The third group (control) received no preventive program. The programs were presented through frequent initial training sessions ensued by infrequent follow-up visits. During the experimental period, the two oral hygiene training programs involved 3.5 and 1.5 hours per child, respectively. The children were examined clinically at baseline and annually over the next 3 years to assess plaque and gingival bleeding and the data were analyzed by a multi-level variance component analysis. All children showed a perpetual improvement in their oral hygiene and gingival state during the course of the study. However, the improvements observed in the comprehensive group were significantly better than that of the control group. Results from the less comprehensive group were not significantly different from the control group. Longer exposure to the programs appeared to produce more improvement; children with higher plaque and gingivitis scores prior to the program showed less favorable results; girls exhibited better results than boys.(ABSTRACT TRUNCATED AT 250 WORDS)

Compliance with oral hygiene recommendations following periodontal treatment in client-owned dogs.

Abstract: A telephone questionnaire survey of owners of 51 dogs was conducted. All 51 dogs had had periodontal treatment at VHUP six months or more previously. At that time, they had received a tooth brush, dentifrice, instructions and a demonstrations of brushing. The owners were asked to brush the dogs' teeth once daily. At the time of survey, 53% of the clients were still brushing several times a week and 38% were no longer brushing at all.

Periodontal status in an urban adult population in Sweden.

Abstract: The purpose was to describe the current periodontal status in a Swedish urban population aged 31-40 yr. 1681 individuals, 840 men and 841 women, participated in the study. 68.5% of the subjects had low amount of plaque, 82.8% low level of calculus and 28.9% healthy gingiva or mild gingivitis. 82.8% of the subjects had no pockets with probing depth (PD) > or = 5 mm. 4.9% of the subjects had one tooth with PD > or = 5 mm, 6.7% 2-5 teeth, 2.4% 6-9 teeth and 3.2% > or = 10 teeth with pockets. 55.8% of the subjects had no missing teeth, third molars excluded. 16.5% had one tooth missing, 23.8% 2-5 teeth, 2.7% 6-9 teeth and 1.2% > or = 10 teeth. 8.6% of the subjects had at least one front tooth missing, 28.7% one premolar and 24.1% one molar missing. Men had significantly higher scores than women for plaque (DI-S), calculus (CI-S), gingivitis (GI-M), and number and percent of remaining teeth with PD > or = 5 mm. Smokers had significantly higher scores than non-smokers for DI-S, CI-S, GI-M, number and percent of remaining teeth with PD > or = 5 mm, and number of missing teeth. The individuals who visited the dentist every year had better oral hygiene and gingival status than those who attended for > 3 yr. The multiple regression analysis showed that calculus (P = 0.0001) smoking (P = 0.001), and dental visits (P = 0.0284) were significantly correlated to the number of teeth with PD > or = 5 mm.

Lifestyle, dental caries and number of teeth.

Abstract: All 55-yr-old citizens (n = 1012) of Oulu (a middle-sized Finnish town) were invited to a clinical examination; 780 agreed to participate. The associations of lifestyle with decayed tooth surfaces and the number of teeth were studied in the 533 dentate subjects. Measures of lifestyle included dietary habits, a smoking habit, alcohol consumption and physical activity. When the associations of dental caries with lifestyle, sex, dental health behavior, social class and number of teeth were studied by logistic regression analysis, lifestyle was shown to have an independent association with dental caries. Further analysis of the data showed that dental caries increased with a more negative lifestyle in every social class, but most significantly in the lowest. Number of teeth was not associated with lifestyle, but subjects with lower social status had fewer teeth than those with higher social status. The association of lifestyle with dental caries supports the idea that behavior in a broader sense should be taken into consideration in caries prevention.

Periodontal status of teeth in contact with denture in removable partial denture wearers

Abstract: The aims of the study were to determine the periodontal status of the teeth in contact with removable partial dentures (RPDs) and to compare them with other teeth in the opposing arch not related to any prosthesis. The periodontal status was also assessed in relation to the age of the dentures. Four hundred and twenty-seven patients treated with RPDs from 1981 to 1986 were recalled for examination. Prior to prosthetic treatment they were given periodontal treatment and fillings when required. Initially all were given oral hygiene instructions and motivation. They were reviewed regularly only on a short-term basis. Eighteen patients were suitable for the present study comprising of eight males and 10 females whose mean age was 41 years. The RPDs were in use from 1.5 to 8 years (mean 4.6 years). The following parameters were assessed: Plaque index (P1I), Gingival index (GI), loss of attachment (LA) and tooth mobility. The wearing of RPDs resulted in higher P1I, GI and LA compared to the controls and these differences were statistically significant. There was an increased frequency of higher P1I, GI and LA with the increase in denture age. Minor changes in tooth mobility were observed. It was concluded that the wearing of RPDs was detrimental to periodontal health in patients whose oral hygiene was less than adequate.

The Effect of a Dentifrice Containing Chlorhexidine and Zinc on Plaque, Gingivitis, Calculus and Tooth Staining

Abstract: . In this 6 months randomized, stratified double-blind parallel study, plaque, gingivitis, calculus formation and tooth staining were assessed in 208 participants. The participants either used a 0.12% chlorhexidine rinse and a gum care dentifrice (positive control) or a placebo rinse and the gum care dentifrice (control) or the placebo rinse and an experimental dentifrice containing 0.4% chlorhexidine and 0.34% Zn2+ (experimental group). After 6 months product use, all groups had less plaque, less gingivitis and all developed calculus and tooth staining. For the positive control group and for the experimental group, significant reductions in plaque and gingivitis (gingival index and number of bleeding sites) were seen compared with the control group. Significantly more calculus developed in the positive control group, while the experimental group was not different from the control group. Finally, tooth staining was significantly higher for the groups using chlorhexidine containing products compared with the control group. The experimental dentifrice users however did develop significantly less staining compared with the positive control. It is concluded that the experimental dentifrice will contribute to a significant improvement in oral hygiene with less staining compared with using a 0.12% chlorhexidine rinse.

Oral Hygiene and Compliance as Risk Factors in Periodontitis

Abstract: Periodontitis is an inflammatory disease caused by microbial infection in the subgingival region. Risk factors associated with the development and progression of this disease are numerous, multifactorial, complex, and often not well defined across individuals and population groups. The focus of this paper is to provide an overview of existing information relevant to oral hygiene and compliance as risk factors in periodontitis and to present a 26-month prospective clinical study dealing with the same. The review of literature from epidemiological, clinical, and public health perspectives indicated that oral hygiene can be considered as risk indicator, risk factor, and/or risk predictor. The extent of oral hygiene contribution to the overall risk of individuals and population varies greatly across studies. Such variations may be attributed to population, personal and disease characteristics, research methodology used, and analytical strategies employed. The purpose of the study reported was to determine the role of self-reported daily oral hygiene practices and clinical plaque scores as risk factors in a middle-aged health-conscious population with early periodontitis. The group consisted of 174 subjects selected on the basis of putative bacterial risk markers and clinical indices. Medical, dental, behavioral, and clinical periodontal measurements including plaque, calculus, gingival inflammation, probing depth, bleeding on probing, and relative attachment level were obtained by one of two calibrated examiners at baseline, 14, 20, and 26 months. Data analyses revealed that some trends were seen relevant to self-reported oral hygiene and plaque scores favoring oral hygiene as a possible risk factor in periodontitis. Such trends, however, were neither clear nor consistent across various clinical parameters and observation intervals.(ABSTRACT TRUNCATED AT 250 WORDS)

Oral health assessment in dogs: parameters and methods.

Abstract: Periodontal disease is the most common disease of adult dogs. Yet, much research needs to be done to delineate the exact pathophysiology of this disease. This paper describes the development of indices to evaluate plaque, calculus, and stain and to evaluate traditional and non-traditional measures of oral hygiene in dogs. We describe and recommend specific indices that permit comparative testing of dental products so veterinarians can recommend those that are safe and have some effect on the substrates thought to contribute to or cause periodontal disease.

Dexterity Testing as a Predictor of Oral Care Ability

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

Effect of pre-experimental maintenance care duration on the development of gingivitis in a partial mouth experimental gingivitis model

Abstract: The present study was designed to evaluate if different periods of supervised oral hygiene prior to the experimental gingivitis trial have an effect on the amount of inflammation which develops in the ‘toothshield’ model. Two groups were compared. One group (Group A) was supervised over a 5-month period before experimental gingivitis. Six months later Group A participated in a second trial, this time receiving only a 1-month pretrial. A second group (Group B) which served as a control was supervised over a pre-trial period of 1-month prior to the start of the experimental gingivitis phase. During the pre-trial period all subjects undertook a regime of vigorous oral hygiene which included polishing of the test quadrant in the upper jaw and supervised subgingival brushing, interdental taping or the use of toothpicks. The presence of plaque and bleeding were assessed. Following the pre-trial period all plaque control measures in the experimental area were prevented during oral hygiene periods by the temporary placement of soft, loosely fitting vinyl toothshield guard. During this period they accumulated plaque rapidly and developed a generalized gingivitis. The results of this study indicate that, irrespective of the length of the pre-trial period, subjects by group develop a comparable mean level of plaque and gingival bleeding. However, the extent to which gingivitis develops differs among individuals and was for a number of subjects not consistent. Therefore, in designing an experimental gingivitis trial care should be taken to include a sufficient number of subjects to account for individual variation.

The effect of a new oral hygiene training program on approximal caries in 12-15-year-old Brazilian children: results after three years.

Abstract: This study evaluated the effects of a new oral hygiene training program on approximal caries in a population of 12-13-year-old Brazilian schoolchildren with a well-established habit of daily toothbrushing with a F dentifrice. Two hundred twenty-two children were randomly allocated into two test groups (I and II) and one control group (III). Group I subjects were trained to establish needs-related oral hygiene habits based on self-diagnosis and a new behavioral principle, the 'linking method', for establishment of habits. The first three visits (20 minutes each) were scheduled at two-day intervals. They were recalled for a monthly check-up during the first 4 months, and then every 3 months for reevaluation of the results based on self-diagnosis. Group II subjects were recalled at the same intervals for detailed oral hygiene instruction on how to clean every tooth surface using dental tape, toothbrush, and fluoride dentifrice. Group I developed significantly fewer (p < 0.001) new approximal manifest (dentin) caries lesions than groups II and III. The mean values (SEM) were 2.3 (0.29), 4.7 (0.59), and 5.3 (0.68), respectively. The conclusions from our study are: In a toothbrushing population using fluoride dentifrices and fluoridated drinking water, the oral hygiene training program with behavioral modification significantly reduced caries incidence on approximal surfaces. Frequent repetition of training in meticulous oral hygiene is almost redundant.

Estimates of time and propensity for dental treatment among institutionalised elders.

Abstract: The oral health and concerns of elderly residents were surveyed in a stratified random selection of 41 long-term care facilities in Vancouver. The residents who could participate were examined and interviewed to determine their oral health and concerns about dental treatment. The need and time required for treatment were estimated in six groups to reflect the propensity for treatment in dentate and edentate subjects. The propensity for treatment was high in about one-third of the participants whereas it was unlikely that one-tenth of those examined would ever use a dental service. In general, there was a widespread need for a diagnostic service because so few had been examined by a dentist in the previous year. Prosthodontics accounted for most of the treatment in all of the propensity groups, with substantially more time required by the dentate residents. There was also a substantial need for management of mucosal pathoses and oral hygiene and, to a lesser extent, for dental restorations and endodontics. Overall, our estimates indicate a substantial need for dental treatment among residents of long-term care facilities, although the need is reduced by half if the propensity for treatment is considered.

Effectiveness of adjunctive irrigation in early periodontitis: multi-center evaluation.

Abstract: The purpose of this study was to determine the effect of daily water irrigation versus regular oral hygiene alone on gingival and periodontal health in periodontitis patients receiving supportive periodontal treatment. The study also sought to determine if there are enhanced benefits from using an antiplaque zinc sulfate rinse as an irrigant. One hundred fifty-five patients who have had periodontitis and had been treated either surgically or non-surgically completed the 6-month multi-center multi-national study. Patients with at least two 5 mm sites demonstrating bleeding on probing were assigned to 3 equal groups by balanced randomization. In all centers Group A (n = 57) performed regular oral hygiene only, and Group B (n = 58) irrigated with 500 ml water once daily after regular oral hygiene. Group C (n = 40) patients irrigated with a total of 500 ml once daily; following irrigation with 300 ml water, the patients then irrigated with an additional 200 ml with a zinc sulfate solution. The irrigants were ...

Chlorhexidine Use After Two Decades of Over‐the‐Counter Availability

Abstract: Chlorhexidine (CHX) is a compound with plaque-inhibiting effects and available only by prescription in the United States. In Norway, however, CHX has been dispensed over-the-counter for over 20 years, and this study was undertaken to evaluate dentists' perceptions regarding its indications, usefulness, and side effects. A written questionnaire was sent to a sample of 10% of dentists registered in Norway, 78% of whom (354) responded. Additionally, representatives from 2% of all dental practices in Norway were contacted by telephone. Fourteen percent (14%) of the respondents reported that they never recommended CHX to their patients. Among those recommending the compound, 85% used it frequently after surgical periodontal procedures; 74% when treating acute gingivitis; 57% following oral surgery in general; and 35% during non-surgical periodontal therapy. It was used also as an adjunct to other treatment routines. Seventy-three percent (73%) reported frequent use of CHX when treating stomatitis and 54% in herpes simplex infections. As to side effects, 77% of the dentists indicated that staining of teeth, restorations, and the tongue was a major concern to patients; 12% reported inconveniences due to the bitter taste; and 6% reported other disturbances such as dryness of the mouth and development of oral ulcerations. The majority (94%) of the dentists recommended mouth rinsing, whereas 6% recommended a gel form. Only 4% of the dentists recommended rinsing with a patient-diluted 0.1% concentration, whereas 96% recommended the standard 0.2% formulation; 88% recommended using CHX mouthwash twice a day or more often.(ABSTRACT TRUNCATED AT 250 WORDS)

Trends in toothbrushing and utilization of dental services in Finland

Abstract: Prevention and control of common dental diseases highly depends on individual behavior, and during the last decades, individuals have increasingly been required to take responsibility for their own oral health. In Finland the rate of toothbrushing and dental visits were first surveyed nationwide in 1971 by interviews with a sample of 1063 individuals, drawn to represent the total population aged 15 yr and over. At the time, 68% of the 829 dentulous interviewees claimed to brush at least once a day. Using another sample of 1006 interviewees, drawn in the same manner, in 1990 the brushing rate was found to have increased to 91% in 853 dentulous subjects. Daily brushing was more frequent among women (98%) than men (83%). The most distinct positive change regarding brushing frequency was found among men and those with only elementary education. In 1971 the interval between the two most recent dental visits was 1 yr or less for 44% of all the interviewees and for 25% it was more than 5 yr. In 1990, 53% of the interviewees had visited a dentist within a year and the visiting interval was more than 5 yr for 16%. The youngest subjects were the most frequent visitors: 60% of them in 1971 and 74% in 1990. The results indicate a clear trend toward more frequent brushing in Finland. However, this trend regarding dental visits does not seem to be equally remarkable.

An 8-year study of changes in oral hygiene and periodontal health during adolescence

Abstract: This study reports data collected from a cohort of 405 South Wales adolescents examined at the ages of 11-12, 15-16 and 19-20 years. Dental plaque and gingivitis scores decreased markedly between the ages of 11-12 and 15-16 years, and to a lesser extent between 15-16 and 19-20 years. There was a decrease in the mean depth of the gingival sulcus between the ages of 11-12 and 15-16 years, perhaps reflecting a decrease in false pocketing and gingival oedema associated with puberty and tooth eruption. Conversely, there was an increase in the mean depth of the gingival sulcus between the ages of 15-16 and 19-20 years, possibly indicating the initiation of periodontal breakdown and the appearance of true pocketing. Gender was found to be an important determinant of the level of oral hygiene practised, the boys having consistently poorer oral hygiene than did the girls. At the commencement of adolescence this was not reflected in higher gingivitis scores, but by the age of 15-16 years the boys exhibited significantly more gingivitis than did the girls.

Plaque and gingivitis in the deciduous and permanent dentition.

Abstract: The aim of the present investigation was to monitor de novo plaque formation and associated alterations of the gingival conditions in the deciduous, mixed and permanent dentition in man. 31 volunteers, divided into 3 study groups participated in the trial. Group 1 was made up of 11 subjects, 4–6 years of age (deciduous dentition), group 2 comprised of 10 subjects, 8–9 years of age (mixed dentition) and group 3 included 10 subjects, 14–16 years of age (permanent dentition). After a screening examination, each participant received detailed instruction in a proper oral hygiene technique and was subjected to professional tooth cleaning. The professional debridement and the oral hygiene instruction were repeated after 1 week. After another week, a given day was termed Day 0 and a baseline examination was performed. This examination included assessments of plaque and gingivitis. Each subject received an additional, comprehensive professional tooth cleaning and was asked to abstain from all mechanical oral hygiene measures. Re-examinations were performed after 3 and 7 days. The findings demonstrated that: (i) during a 7-day period of no active oral hygiene, subjects with a mixed or a permanent dentition formed visible amounts of plaque and developed modest signs of gingivitis; (ii) during the 7 days of the trial, young subjects with a fully erupted deciduous dentition formed less plaque than the older subjects, and failed to respond to de novo plaque formation with enhanced signs of gingivitis; (iii) in subjects with a mixed dentition, the amount of plaque formed during the 7 days of experiment and the matching gingivitis development were similar in the deciduous and permanent tooth segments of the dentition.