The efficacy of woodsticks on plaque and gingival inflammation: A systematic review

Department of Periodontology, Academic Centre of Dentistry Amsterdam, Louwesweg 1, Amsterdam, The Netherlands.
International Journal of Dental Hygiene (Impact Factor: 1.06). 12/2008; 6(4):280-9. DOI: 10.1111/j.1601-5037.2008.00335.x
Source: PubMed


To review the literature on whether a hand-held triangular woodstick, as compared with no adjunct or other interdental cleaning device in addition to daily toothbrushing, can improve clinical parameters of gingival inflammation.
MEDLINE and the Cochrane Central Register of Controlled Trials (CENTRAL) were searched through February 2008 to identify appropriate studies. Plaque and gingivitis were selected as outcome variables.
Independent screening of the titles and abstracts of 181 MEDLINE and 65 CENTRAL papers yielded seven publications with eight clinical experiments that met the eligibility criteria. The improvement in gingival health, as observed in seven studies, represents a significant incremental benefit realized by the use of triangular woodsticks. None of the studies that scored plaque demonstrated any significant advantage to the use of woodsticks, as opposed to alternative methods, in gingivitis patients.
Evidence from controlled trials, most of which were also randomized, shows that woodsticks do not have an additional effect on visible interdental plaque or gingival index, but do, however, provide an improvement in interdental gingival inflammation by reducing the bleeding tendency.

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    • "Recently, a systematic review was conducted to review the literature on whether a hand-held triangular wood-stick, as compared to no adjunct or other interdental cleaning device in addition to daily tooth brushing, could improve the clinical parameters of gingival inflammation. Evidence from the controlled trials, most of which were also randomized, showed that wood-sticks did not have an additional effect on visible interdental plaque or the gingival index, but did however, provide an improvement in interdental gingival inflammation by reducing the bleeding tendency.[24] "
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    ABSTRACT: It is now well established that removal of bacterial plaque can reduce the severity of chronic inflammatory periodontal disease. Periodontal disease is seen to progress faster interdentally and plaque control in these areas is of great importance. Various types of interdental cleaning aids have been developed in recent years. This study was aimed at evaluating the efficacy of a newly developed interdental cleaning aid, BrushPick, in a split mouth randomized clinical trial. This was a split mouth design study where the quadrant on one side of the oral cavity served as the control while another quadrant on the opposite side served as the test sample. Fifty-seven patients with mild-to-moderate periodontitis, presenting with open interdental embrasures, were selected for the study. After non-surgical periodontal therapy, they were asked to use the BrushPick in the embrasures on one side of the arch in a spilt mouth design study and the embrasures on the other side acted as controls. The Rustogi et al. modified Navy plaque index (RMNPI) and interdental bleeding index (IBI) were recorded at baseline, seven days, 14 days, and 28 days. The mean differences between test and control sites were compared using the studentt test. The mean difference was compared between different durations using analysis of variance (ANOVA). The mean RMNPI was significantly different between the test and control sites at P<0.001 on both days 14 and 28. At 28 days the mean IBI was 0.08 (SD=0.02) for the experimental sites and 0.28 (SD=0.11) for the control sites. The difference was statistically significant at P<0.001. ANOVA showed that the mean RMNPI scores and mean IBI scores showed a statistically significant difference when compared at different durations at the test sites (P<0.0001). But, at the control sites there was no significant change. This study suggested that BrushPick reduces plaque and gingival bleeding in open interdental embrasures. Further large sampled clinical trials and comparative studies using gold standard interdental cleaning aids are required to establish the efficacy of this device.
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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.
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    ABSTRACT: The most important preventive and therapeutic effort to reduce inflammation is to remove the dental plaque thoroughly. Oral self-care is thus of crucial importance to achieve and maintain oral health. There is a scarcity of scientific evidence on the most effective models for behavioural change aimed to improve oral hygiene. There is a need for randomized-controlled trials, based on behavioural sciences and performed with great methodological rigour, to investigate the usefulness of these proposed behavioural changes. Oral hygiene regimens for patients with natural teeth as well as dental implants should include brushing twice daily, inter-dental cleaning once daily and rinsing with efficient rinses as an adjunct to mechanical infection control. Power toothbrushes are preferable as they are more effective than manual toothbrushes. Inter-dental brushes seem to be most effective and useful for inter-dental cleaning. Scaling and root planing is effective in reducing inflammation and probing depths in patients with periodontitis.
    No preview · Article · Aug 2009 · Journal Of Clinical Periodontology
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