Toothbrushing to address gingivitis

Abstract

Background.—The toothbrush is the most widely used homecare method for controlling plaque, with a twice daily regimen commonly considered the best approach. The toothbrush achieves mechanical disruption, with fluoridated toothpastes used to address infectious agents and remineralization needs. A meta-review, which contains just systematic reviews, provides more evidence that separate empirical studies and is highly appropriate for determining if the current evidence base is complete or incomplete through a synthesis of the information. A meta-review was undertaken to summarize the contemporary synthesized evidence regarding the safety and efficacy of home mechanical plaque removal using a toothbrush to manage plaque and gingivitis. Methods.—The National Library of Medicine, the Cochrane Library, and the American Dental Association Center for Evidence-based Dentistry databases were searched to identify studies that satisfied the requirements for this meta-review. Plaque scores and gingivitis scores were the primary parameter, with safety considered as an important contributor to efficacy. The study also determined risk of bias and graded the evidence using the GRADE system. Results.—Ten evaluations were included in the review. Most of the systematic reviews were judged to have low to moderate risk of bias, with two having a substantial to high risk of bias. A meta-analysis was not done in view of the heterogeneity of the reviews