Article

The efficacy of interdental brushes on plaque and parameters of periodontal inflammation: a systematic review.

Department of Periodontology, Academic Centre for Dentistry Amsterdam, Louwesweg 1, Amsterdam,The Netherlands.
International Journal of Dental Hygiene (Impact Factor: 0.68). 12/2008; 6(4):253-64. DOI: 10.1111/j.1601-5037.2008.00330.x
Source: PubMed

ABSTRACT The aim of the study was to asses the effect of the use of interdental brushes (IDB) in patients as an adjunct to toothbrushing compared with toothbrushing alone or other interdental oral hygiene devices on plaque and the clinical parameters of periodontal inflammation.
MEDLINE-PubMed and the Cochrane Central register of controlled trials (CENTRAL) were searched through November 2007 to identify appropriate studies. Clinical parameters of periodontal inflammation such as plaque, gingivitis, bleeding and pockets were selected as outcome variables.
Independent screening of the titles and abstracts of 218 MEDLINE-PubMed and 116 Cochrane papers resulted in nine publications that met the eligibility criteria. Mean values and standard deviations were collected by data extraction. Descriptive comparisons are presented for brushing alone or brushing and woodsticks; meta-analyses were also performed for the floss comparison.
As an adjunct to brushing, the IDB removes more dental plaque than brushing alone. Studies showed a positive significant difference using IDB with respect to the plaque scores, bleeding scores and probing pocket depth. The majority of the studies presented a positive significant difference in the plaque index when using the IDB compared with floss.

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  • l Orthodontie Française 03/2010; DOI:10.1051/orthodfr/2010001
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    ABSTRACT: The present cross-sectional study aimed to assess oral health behaviour, dental and periodontal conditions, dental care, and their relationships among elderly dentate patients in Lithuania. The target population in the study were dentate patients aged 60 and older attending public dental services in Kedainiai, Lithuania. The data collection took place between the autumn of 1999 and the winter of 2001. Data were collected by means of a self-administered questionnaire for all (n=174) and a clinical examination targeting about half of the subjects (n=100). The questionnaire inquired about oral health behaviour, the life-first and also the most recent dental treatments, sources on and self-assessed knowledge of oral self-care, a self-reported number of teeth, and socio-demographic information. The clinical examination included basic dental and periodontal conditions. A total of 82 women and 92 men completed the questionnaire; their mean age was 69.2 and their average number of teeth was 16.2 (CI 95% 15.4-17.1). In all, 25% had 21 or more teeth and 32% indicated wearing removable dentures. The oral health behaviour, the participants reported, was poor: 30% reported twice daily toothbrushing, 57% responded that they always use fluoride toothpaste, 19% indicated daily interdental cleaning, nearly all said they take sugar in their coffee and tea, and 30% indicated going for check-ups. As the main source of information on oral self-care, the subjects indicated health professionals (82%), followed by social contacts (72%), broadcasted media (58%), and printed media (42%). A total of 34% assessed their knowledge of oral self-care as good, and their self-assessed knowledge correlated (r=0.52) with professional guidance they had received about oral self-care. In their most recent treatment, conservative (39%) and non-conservative (34%) treatments dominated, and preventive ones were the least reported (7%). Regarding guidance in oral self-care, 54% reported having received such about toothbrushing, 32% about interdental cleaning, and 33% had been given visual information. Clinical examinations revealed the presence of plaque, calculus, bleeding on probing and deepened pockets in all of the subjects; 70% of the subjects were diagnosed with pockets of 6mm and deeper, 94% with caries, and 73% with overhangs of restorations. Those subjects assessing their knowledge of oral self-care as good and reporting a higher intensity of guidance in oral self-care as received, indicated practicing the recommended oral self-care more frequently. Twice daily toothbrushing was associated with good self-assessed knowledge of oral self-care (OR 4.1, p<0.001) and a university education (OR 5.6, p<0.001). Those subjects with better oral health behaviour had a greater number of teeth. Having 21 or more teeth was associated with good self-assessed knowledge of oral self-care (OR 4.1, p=0.03). Better periodontal conditions were associated with a higher frequency of toothbrushing. The presence of periodontal pockets of 6mm and deeper was associated with the level of self-assessed knowledge of oral self-care being below good (OR=3.0, p=0.04) and the level of dental cleanliness being poor (OR=2.7, p=0.02). To conclude, oral health behaviour and conditions call for improvement in elderly subjects in Lithuania. To improve the oral health of their elderly dentate patients, dentists should apply all the available tools of chair-side prevention and active guidance. The latter would be an effective means of updating the knowledge of oral self-care and supporting recommended oral health behaviour. A preventive approach should be strongly emphasized in countries with limited resources for oral health care, such as Lithuania. Author’s address: Sonata Vyšniauskaite, Department of Oral Public Health, Institute of Dentistry, University of Helsinki, P.O.Box 41, FI-00014 Helsinki, Finland. E-mail: sonata.vysniauskaite@helsinki.fi Ikääntyneiden suunhoito ja suunterveys Liettuassa – ehkäisyn näkökulma Tutkimus selvitti omahoidon ja saadun hammashoidon sekä neuvonnan merkitystä ikääntyneiden suunterveydelle ja painottui ehkäisevän hoidon roolin arviointiin. Tutkitut olivat 60 vuotta täyttäneitä hampaallisia potilaita liettualaisen Kedainiain kaupungin julkisesta hammashuollosta. Kaikkiaan 174 henkeä täytti kyselylomakkeen, heistä 100 kutsuttiin kliiniseen tutkimukseen. Kyselyllä selvitettiin omahoitoa: hampaiden harjaaminen ja hammasvälien puhdistaminen, fluorin käyttö ja sokeroidun kahvin tai teen nauttiminen. Lisäksi kysyttiin hammastarkastukseen menemisestä. Hammashoidosta selvitettiin omahoidon ohjeiden ja neuvojen saaminen sekä viimeisimmän hoitosarjan sisältö. Tutkittavia pyydettiin myös kertomaan, mistä tietolähteistä he ovat saaneet omahoitoa koskevia tietoja sekä arvioimaan nykyinen tietotasonsa. Kliininen tutkimus selvitti hampaiden määrän sekä plakin, hammaskiven, ienverenvuodon, syventyneiden ientaskujen, karieksen ja paikkaylimäärien esiintymisen. Tutkitut olivat 60-85-vuotiaita (keskiarvo 69,2 vuotta), ja heillä oli keskimäärin 16,2 hammasta. Joka neljännellä oli vähintään 21 hammasta ja joka kolmas käytti hammasproteesia. Omahoito oli kovasti jäljessä suosituksista: vain joka kolmas sanoi harjaavansa hampaansa kahdesti päivässä ja fluorihammastahnaa käytti aina runsas puolet tutkituista. Lähes kaikki nauttivat kahvin tai teen sokeroituna, ja joka kolmas kävi hammaslääkärissä tarkastusta varten. Omahoidon tietolähteinään 82 % mainitsi terveydenhoidon ammattilaiset, näistä tärkeimpinä hammaslääkärit, 72 % mainitsi ystävät tai sukulaiset, 58 % radion tai TV:n sekä 42 % sanoma- tai kuvalehdet. Hammashoidossa käydessään 54 % oli saanut ohjeita harjaukseen ja 32 % hammasvälien puhdistukseen. Saadun neuvonnan määrä oli selvästi yhteydessä (r=0.52) tutkitun arvioimaan omahoidon tietotasoonsa, jonka 34 % katsoi hyväksi. Korjaava hoito (39 %) sekä poistot, ensiapu ja irtoproteesit luonnehtivat viimeisintä hoitosarjaa, ehkäisyn osuus oli vain 7 %. Kliinisen tutkimuksen mukaan suunterveys oli huono: kaikilla oli plakkia, hammaskiveä, ienverenvuotoa ja syventyneitä ientaskuja. Valtaosalla (70 %) oli 6 mm taskuja tai täyteylimääriä (73 %), lähes kaikilla (94 %) oli kariesta. Hammashoidossa saadun neuvonnan suurempi määrä ja omahoidon parempi tietotaso heijastuivat parempana terveyskäyttäytymisenä ja se taas parempana suunterveytenä. Tutkimus suosittaa hammaslääkäreitä antamaan ikääntyneille potilaille kliinisten ehkäisyhoitojen ohella aina myös suun omahoidon opastusta.
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    ABSTRACT: Objectives The aim of the present review was to analyze the impact of the hydrodynamic effects created by powered toothbrushes on biofilm removal in vitro. Materials and methods A MEDLINE search was performed for publications published by 20 May 2012; this search was complemented by a manual search. The study selection, data preparation, and validity assessment were conducted by two reviewers. Results Sixteen studies were included. The studies differed with respect to the methods of biofilm formation and brushing protocols. Eighteen different powered toothbrush models were evaluated. Toothbrushes with side-to-side action demonstrated biofilm removal without direct bristle contact to biofilms ranging from 38 to 99 %. Most studies found biofilm removal exceeding 50 %. Biofilm reduction using multidimensional toothbrushes was significantly lower than by those with the side-to-side mode. Detachment forces due to hydrodynamic phenomena, passing air–liquid interfaces, and acoustic energy transfer were suggested to cause reduction of the biofilm. Conclusion Noncontact biofilm reduction was obtained by the hydrodynamic effects of some powered toothbrushes in vitro. Clinical relevance Powered toothbrushes may have the potential to simplify self-performed oral hygiene. However, additional beneficial effects of higher amounts of noncontact biofilm removal in vitro have not been shown clinically, yet.
    Clinical Oral Investigations 09/2012; 17(3). DOI:10.1007/s00784-012-0836-8 · 2.29 Impact Factor