Gingivitis Scores Research Articles

Combined Efficacy of Advanced Oral Hygiene Aids and Active Reminders in Maintaining the Oral Hygiene of Patients with Fixed Orthodontic Appliances: A Randomized Clinical Trial

Objectives To evaluate the efficacy of water irrigating devices, powered toothbrushes, and active repeated oral hygiene reminders on oral hygiene of fixed orthodontic patients. Materials and Methods This was a randomized, examiner-blind clinical trial involving fixed orthodontic appliance patients. Patients were recruited within six months of bonding on both the arches. Eighty patients were randomly assigned to four groups; groups 1 and 3 subjects received standard oral hygiene procedures and used manual orthodontic toothbrushes, and subjects in groups 2 and 4 used powered toothbrushes and water irrigators for oral hygiene maintenance during the study period. In addition, repeated oral hygiene reminders via SMS were sent to subjects in groups 1 and 2, whereas groups 3 and 4 subjects received only oral motivation. The principal investigator assessed the plaque index (PI) and gingival index (GI) at baseline (T0) and after 2, 4, 8, and 12 weeks, that is, T1, T2, T3, and T4, respectively. Results Group 2 and group 4 subjects showed statistically significant reduction in PI ( p < .001) and GI ( p < .001) scores at the end of study interval; however, the magnitude of decrease was less in group 4 in comparison to group 2. Intergroup comparisons between group 1 versus group 3 and group 2 versus group 4 were made to evaluate the efficacy of reminders. Statistically significant reduction was observed in group 2 as compared to group 4 at T4 ( p < .001) when compared to T1 ( p < .87). Conclusion Using powered toothbrushes and oral irrigators resulted in a statistically more significant reduction in plaque and gingivitis scores than conventional procedures. Active reminders had a catalytic effect in improving the oral hygiene.

Effects of a novel dental chew on oral health outcomes, halitosis, and microbiota of adult dogs.

Halitosis in dogs is an initial indication of periodontitis, highlighting its significance as a vital marker for underlying problems. Moreover, the oral microbial population has a significant influence on periodontal disease. Measuring the oral microbiota may be used in addition to breath odor, dental plaque, and gingivitis scoring to assess the impact of dental chews on oral health. In this study, we aimed to determine the differences in breath odor, oral health outcomes, and oral microbiota of adult dogs consuming a novel dental chew compared with control dogs consuming only a diet. Twelve healthy adult female beagle dogs were used in a crossover design study. Treatments (n = 12/group) included: diet only (control) or the diet + a novel dental chew. Each day, one chew was provided 4h after mealtime. On days 1, 7, 14, 21, and 27, breath samples were analyzed for total volatile sulfur compound concentrations using a halimeter. On day 0 of each period, teeth were cleaned by a veterinary dentist blinded to treatments. Teeth were scored for plaque, calculus, and gingivitis by the same veterinary dentist on day 28 of each period. After scoring, subgingival and supragingival plaque samples were collected for microbiota analysis using Illumina MiSeq. All data were analyzed using SAS (version 9.4) using the Mixed Models procedure, with P < 0.05 being significant. Overall, the dental chews were well accepted. Dogs consuming the dental chews had lower calculus coverage, thickness, and scores, lower gingivitis scores, and less pocket bleeding than control dogs. Breath volatile sulfur compounds were lower in dogs consuming the dental chews. Bacterial alpha-diversity analysis demonstrated that control dogs had higher bacterial richness than dogs fed dental chews. Bacterial beta-diversity analysis demonstrated that samples clustered based on treatment. In subgingival and supragingival plaque, control dogs had higher relative abundances of potentially pathogenic bacteria (Pelistega, Desulfovibrio, Desulfomicrobium, Fretibacterium, Helcococcus, and Treponema) and lower relative abundances of genera associated with oral health (Neisseria, Actinomyces, and Corynebacterium). Our results suggest that the dental chew tested in this study may aid in reducing periodontal disease risk in dogs by beneficially shifting the microbiota population and inhabiting plaque buildup.

The Effect of Photobiomodulation Therapy on Inflammation Following Dental Prophylaxis.

To evaluate the effectiveness of photobiomodulation therapy (PBMT) in reducing gingivitis following professional dental prophylaxis in dogs in a prospective, randomly controlled, double-blind study. The study included 47 dogs (male n = 23, female n = 24), with a mean age of 6.5 ± 2.6 years and a bodyweight of 28.9 ± 5.3 kg. Breeds included: Belgian Malinois Shepherd Dogs (n = 23), German Shepherd Dogs (n = 14), Labrador Retriever (n = 4), and Dutch Shepherd Dogs (n = 3). The left side of the mouth was treated by performing dental prophylaxis (control group). The right side received dental prophylaxis and a single session of PBMT using a Class IV therapeutic laser (treatment group). Each side was graded individually for periodontal disease (PD), gingivitis, and calculus. Follow-up observations were conducted on days 1, 3, 8, and 15 post-treatment. Results were compared using a Mann-Whitney Test. Multiple regression was run to predict PD, gingivitis, and calculus scores using age, sex, and breed. A p < .05 was considered significant. The PBMT group (PG) showed significantly lower gingivitis scores from day 1 to 15 post-treatment. PD had an increasing prevalence with age. Age and breed contributed to the prediction of PD, gingivitis, and calculus grading. This study showed that PBMT significantly reduced the grade of gingivitis following dental prophylaxis, and may be a useful adjuvant procedure following dental prophylaxis.

Does the use of miswak reduce plaque and gingivitis among adults?

Data sources Searches were performed using broad search terms and suitable Boolean operators and Medical Subject Headings terms on the electronic databases PubMed (US National Library archive), EBSCOHost (Dentistry and Oral Sciences) (US Corporate Research Database), Scopus (Elsevier Archive) and the Cochrane Database for Systematic Reviews with no relevant time limit.Study selection Randomised control trials were included where adults were participants and using miswak sticks to brush was the independent variable. The primary outcome reviewed was the effect on periodontal health, with secondary outcomes including oral health practices. Exclusion criteria were applied to studies including patients with orthodontic appliances.Data extraction and synthesis Data extraction was led by a single author, with further authors (where necessary) assessing accuracy and appropriateness. Data extracted included first author, publication year, study design and setting, sample size, description of the participant, the intervention and comparison, clinical measurements, assessment interval and wash-out period. An I2 test with confidence intervals was performed, showing the included studies to display heterogeneity in methodology and outcome measures. As such, a random effects model was used for the meta-analysis of effect size. Further subgroup analysis of the included papers was completed and presented in a forest plot format. The Cochrane risk of bias tool was employed.Results In total, 150 abstracts were screened, with ten RCTs included and nine utilised in a descriptive meta-analysis. The findings claimed that miswak offered similar outcomes to toothbrushing when considering mean plaque score (p = 0.08; SMD: 0.39 and 95% CI: 0.05-0.83) and mean gingivitis score (p = 0.37; SMD: 0.13, and 95% CI: 0.16-0.43). A further significant secondary outcome was noted, showing reduced mean plaque scores (p = 0.01; SMD: 0.68, and 95% CI: 0.14-1.22) and reduced gingivitis score (p = 0.04; SMD: 0.66, and 95% CI: 0.03-1.29) when miswak was used in addition to toothbrushing.Conclusions Miswak sticks may offer similar plaque reduction to brushing and may reduce plaque-induced gingivitis when used as an adjunct to toothbrushing. However, more evidence is required in this area.

A randomized controlled trial to evaluate the effectiveness of a novel mouth rinse in patients with gingivitis

BackgroundThis single-center, randomized controlled trial aimed to determine the effectiveness of a novel, biofilm-disrupting, mouth rinse that combines Cetylpyridinium chloride (CPC) and essential oils in preventing re-accumulation of supragingival plaque and supragingival microbiome in patients with gingivitis after dental prophylaxis.MethodsOne hundred eighteen participants were randomly assigned in a 1:1 ratio to receive twice-daily test mouth rinse (59) or carrier rinse control (59) for 12 weeks after dental prophylaxis.ResultsIn a per-protocol analysis that included patients who completed the intervention, the treatment group (39) had significantly lower supragingival plaque scores at 6 and 12 weeks compared to the control group (41; p = 0.022). Both groups showed similar improvement in gingivitis score, but neither group had improvement in bleeding score or probing depth. Thirty-eight (29%) patients did not complete the study due to loss of follow-up (17) or early discontinuation of the assigned intervention (21). Microbiome sequencing showed that the treatment rinse significantly depleted abundant and prevalent members of the supragingival plaque microbiome consortium.ConclusionsAmong patients with gingivitis, the novel mouth rinse significantly reduced re-accumulation of supragingival plaque following dental prophylaxis by depleting supragingival plaque microbiome. However, long-term adherence to the rinse may be limited by adverse effects (ClinicalTrials.gov number, NCT03154021).

109 Effects of a Novel Dental Chew on the Oral Health Outcomes and Malodor of Adult Dogs

Abstract Periodontal disease is a common oral health condition occurring in adult dogs, yet it is a preventable disease. The objective of this study was to evaluate the efficacy of a novel dental chew in adult dogs. All animal care and experimental procedures were approved by the University of Illinois Institutional Animal Care and Use Committee prior to experimentation. Twelve female beagles (mean age = 3.50 yr; mean BW = 8.77 kg) were used in a crossover design consisting of two 28-d periods. All dogs consumed the same commercial kibble diet throughout the study. Control dogs were offered only diet, while the treatment group received the diet plus a daily dental chew (Authority Dental Chew Orashield system formula containing sodium hexametaphosphate and texture) 4 h after their meal. On d0 of each period, teeth were cleaned by a veterinary dentist. Teeth were then scored for plaque, calculus, and gingivitis by the same veterinary dentist that was blinded to treatments on d28 of each period. Breath samples were measured for breath halitosis (volatile sulfur compounds) using a halimeter on d1, 7, 14, 21, and 27 of each period. All tooth scoring data were analyzed using the Mixed Models procedures of SAS. Halimeter data were analyzed using repeated measures using Mixed Models procedures. Oral calculus coverage and thickness were less (P&amp;lt; 0.05) in dogs consuming the novel chew than control dogs, while plaque was not different among groups. Gingivitis scores and gingival bleeding were also less (P&amp;lt; 0.05) in dogs consuming the novel chew compared with control dogs. Breath volatile sulfur compound concentrations were reduced (P&amp;lt; 0.05) in dogs consuming the novel chew than control dogs. Our results suggest that the novel dental chew tested in the study may aid in reducing the risk of periodontal disease in dogs.

The Utility of Salivary Heme to Stratify Healthy Volunteers from Individuals with Gingivitis and Periodontitis: a Pilot Study

Summary&#x0D; Gingival bleeding due to poor oral hygiene is reported globally. Assessment of blood in saliva may improve diagnostics, serve as an outcome measure in clinical trials and support patient education through point-of-care tests. This work analyzed salivary heme using a rapid test format and separately using a lateral flow immunoassay assay [LF] for chair-side implementation. Clinical examinations stratified adult subjects into healthy, gingivitis or periodontitis groups at baseline. Healthy subjects presented no periodontal pockets and whole mouth gingivitis scores of less than 1.0. Gingivitis subjects registered gingival index scores greater than 1.0. Included in the periodontal disease group were subjects with periodontal pockets greater than 4 mm. The rapid test is based on the peroxidase activity salivary heme converting a colourless probe to a coloured compound for spectrophotometric analysis. For the LF assay, saliva was placed in the test window of the device with reactions scored after room temperature incubation. Average salivary heme concentrations in the healthy, gingivitis and periodontal disease groups were 27, 201 and 326 nM respectively, by the rapid test, representing significant differences by analysis of variance and Tukey’s-multiple comparison tests (p&lt;0.05). Similarly, results in the LF assay demonstrated increasing band intensity from the healthy to the periodontal disease groups and was quantifiable by image analysis. This pilot study emphasizes the potential efficacy of rapid heme measurement in investigations of oral health.&#x0D; Accepted for publication: April 25, 2022&#x0D; Published online: April 26, 2022

The Utility of Salivary Heme to Stratify Healthy Volunteers from Individuals with Gingivitis and Periodontitis: a Pilot Study.

Gingival bleeding due to poor oral hygiene is reported globally. Assessment of blood in saliva may improve diagnostics, serve as an outcome measure in clinical trials and support patient education through point-of-care tests. This work analyzed salivary heme using a rapid test format and separately using a lateral flow immunoassay assay [LF] for chair-side implementation. Clinical examinations stratified adult subjects into healthy, gingivitis or periodontitis groups at baseline. Healthy subjects presented no periodontal pockets and whole mouth gingivitis scores of less than 1.0. Gingivitis subjects registered gingival index scores greater than 1.0. Included in the periodontal disease group were subjects with periodontal pockets greater than 4 mm. The rapid test is based on the peroxidase activity salivary heme converting a colourless probe to a coloured compound for spectrophotometric analysis. For the LF assay, saliva was placed in the test window of the device with reactions scored after room temperature incubation. Average salivary heme concentrations in the healthy, gingivitis and periodontal disease groups were 27, 201 and 326 nM respectively, by the rapid test, representing significant differences by analysis of variance and Tukey's-multiple comparison tests (p<0.05). Similarly, results in the LF assay demonstrated increasing band intensity from the healthy to the periodontal disease groups and was quantifiable by image analysis. This pilot study emphasizes the potential efficacy of rapid heme measurement in investigations of oral health.

Salivary MMP-9 Levels in Chronic Periodontitis Patients with Type-II Diabetes Mellitus.

Chronic periodontitis and diabetes mellitus share a two-way relationship, the common factor being the inflammatory-mediated pathway, and various cytokines are released during this inflammatory cascade, one of which being matrix metalloproteinase-9. The aim of this study was to identify whether the levels of matrix metalloproteinase-9 are increased due to type-II diabetes mellitus in chronic periodontitis patients. It was an observational, analytical, case-control study. Thirty subjects were recruited in the test group, who were suffering from type-II diabetes mellitus and chronic periodontitis, and 30 subjects in the control group, who were subjects with chronic periodontitis but systemically healthy. Periodontal parameters, including the plaque score, gingival bleeding index, probing pocket depth and clinical attachment level of the subjects, were measured, saliva samples of all of the subjects were collected and salivary matrix metalloproteinase-9 levels were analyzed by an enzyme-linked immunosorbent assay (ELISA) technique. The statistical analysis was performed using SPSS 24. Overall, the matrix metalloproteinase-9 levels of the diabetic patients with chronic periodontitis were increased almost twofold (156.95 ± 29.80 ng/mL) compared to the levels in the controls (74.96 ± 6.32 ng/mL) (p < 0.001). Similarly, the periodontal parameters were far worse in diabetics with chronic periodontitis compared to the controls. The average gingivitis score for the test subjects was 78.45 ± 8.93%), compared to 29.32 ± 12.96% in the controls (p < 0.001). The mean probing pocket depth for the test group was 5.39 ± 0.60 mm, and, for the control group, it was 4.35 ± 0.31 mm (p < 0.001). For the test subjects, the average clinical attachment level was 5.86 ± 0.58 mm, and it was 4.66 ± 0.32 mm for the controls (p < 0.001). It was ascertained that there is a two-fold increase in the levels of salivary matrix metalloproteinase-9 in the test group compared to the control group. In addition, the level of periodontal apparatus destruction was greater in the test group. This proved that type-II diabetes mellitus influences the levels of matrix metalloproteinase-9 in humans and elevates them, causing further periodontal destruction.

Antiplaque Efficacy of a Novel Moringa oleifera Dentifrice: A Randomized Clinical Crossover Study.

The use of herbal dentifrices has grown exponentially over the years. They are categorically referred to as ethnomedicines. Various agents have been tried with contradicting findings based on phytopharmacological analysis. Miswak is one agent which has been used over the years. A novel Moringa oleifera-based dentifrice has shown promising results in terms of its cytotoxicity, biocompatibility, and as a potent anti-inflammatory agent. Therefore, the present study aims to compare the efficacy of two commercially available miswak- and moringa-based herbal dentifrices on the reduction of plaque and gingivitis scores. This randomized clinical crossover study included 20 subjects with mild to moderate gingivitis. The study was conducted over a total examination period of 20 days with a wash-out period of 2 weeks between the use of both the toothpastes. The plaque index and gingival index of the study subjects were recorded at the designated time intervals throughout the study period. The data collected were entered on Microsoft Excel, and statistical analysis using SPSS software (SPSS version 28, IBM Corp, Armonk, New York, United States) was done. The statistical test used was the Wilcoxon signed-rank test. Moreover, p ≤0.05 was considered significant. The results showed that the reduction in mean gingival index scores from baseline to day 3 was more statistically significant in the moringa-based dentifrice. Similarly, the plaque index scores showed statistically significant reduction following the use of the moringa-based dentifrice when compared with the miswak dentifrice. This study reveals that the moringa dentifrice is a safe and effective agent in reducing plaque accumulation and treating gingival inflammation. The current study aims to provide an insight into the possible role of moringa dentifrice as a possible adjunctive oral hygiene aid.

Using an mHealth App (iGAM) to Reduce Gingivitis Remotely (Part 2): Prospective Observational Study.

BackgroundGingivitis is a nonpainful, inflammatory condition that can be managed at home. Left untreated, gingivitis can lead to tooth loss. Periodic dental examinations are important for early diagnosis and treatment of gum diseases. To contain the spread of the coronavirus, governments, including in Israel, have restricted movements of their citizens which might have caused routine dental checkups to be postponed.ObjectiveThis study aimed to examine the ability of a mobile health app, iGAM, to reduce gingivitis, and to determine the most effective interval between photograph submissions.MethodsA prospective observational cohort study with 160 unpaid participants divided into 2 equal groups using the iGAM app was performed. The intervention group photographed their gums weekly for 8 weeks. The wait-list control group photographed their gums at the time of recruitment and 8 weeks later. After photo submission, the participants received the same message “we recommended that you read the information in the app regarding oral hygiene habits.” A single-blinded researcher examined all the images and scored them according to the Modified Gingival Index (MGI).ResultsThe average age of the intervention group was 26.77 (SD 7.43) and 28.53 (SD 10.44) for the wait-list control group. Most participants were male (intervention group: 56/75,74.7%; wait-list control group: 34/51, 66.7%) and described themselves as “secular”; most were “single” non-smokers (intervention group: 56/75, 74.7%; wait-list control group: 40/51, 78.4%), and did not take medications (intervention group: 64/75, 85.3%; wait-list control group: 40/51, 78.4%). A total of 126 subjects completed the study. A statistically significant difference (P<.001) was found in the dependent variable (MGI). Improvements in gingival health were noted over time, and the average gingivitis scores were significantly lower in the intervention group (mean 1.16, SD 1.18) than in the wait-list control group (mean 2.16, SD 1.49) after 8 weeks. Those with more recent dental visits had a lower MGI (P=.04). No association was found between knowledge and behavior. Most participants were familiar with the recommendations for maintaining oral health, yet they only performed some of them.ConclusionsA dental selfie taken once a week using an mobile health app (iGAM) reduced the signs of gingivitis and promoted oral health. Selfies taken less frequently yielded poorer results. During the current pandemic, where social distancing recommendations may be causing people to avoid dental clinics, this app can remotely promote gum health.

Effect of mixed chlorhexidine and hydrogen peroxide mouthrinses on developing plaque and stain in gingivitis patients: a randomized clinical trial.

To evaluate the effects of mixed chlorhexidine (CHX)/hydrogen peroxide (H2O2) mouthrinses compared with CHX mouthrinse alone on plaque, tooth stain, and gingivitis. This study was a double-blind, randomized two group parallel experiment, using a 14-day non-brushing half-mouth model. The test group was randomly assigned to the mixed 0.12% CHX and 1.5% H2O2 mouthrinse, whereas the control group used 0.12% CHX. Sixty healthy volunteers were enrolled in the study and received scaling and polishing 2weeks prior to the experiment and then rinsed with the allocated mouthrinses twice daily for 2weeks. The plaque, stain, and gingivitis scores were evaluated and recorded by a calibrated investigator. Fifty-two subjects completed the study (CHX + H2O2n = 25/CHX n = 27). There were significant differences between the control and test groups for plaque index (CHX 0.64 ± 0.41 vs. CHX + H2O2 0.46 ± 0.36, p = 0.035) and stain intensity at proximal areas (CHX 0.26 ± 0.36 vs. CHX + H2O2 0.09 ± 0.14, p = 0.019) at the end of the experimental non-brushing side. However, the gingival indices did not differ significantly (CHX 0.61 ± 0.34 vs. CHX + H2O2 0.62 ± 0.31, p = 0.938) between groups. In the absence of oral hygiene practice, the mixed CHX + H2O2 mouthrinse was slightly superior in reducing plaque scores and stain compared with CHX alone. The clinical effectiveness of CHX + H2O2 is comparable with CHX mouthwash alone. Therefore, the use of the mixed mouthrinse is beneficial compared with CHX for minimizing biofilm and tooth staining.

Mechanical plaque removal of periodontal maintenance patients: A systematic review and network meta-analysis.

This systematic review synthesizes the available clinical evidence concerning efficacy of mechanical oral hygiene devices in periodontal maintenance patients. Three databases were searched up to October 2019 for clinical trials conducted in adult patients in periodontal maintenance which evaluated the effect of toothbrushes or an interdental device on plaque removal and parameters of periodontal diseases. Descriptive analysis and network meta-analysis (NMA) were performed. Sixteen eligible publications, including 17 relevant comparisons, were retrieved. Four out of five comparisons found no clinical difference between a manual and power toothbrush. Of the interdental cleaning devices, the interdental brushes (IDBs) reduced plaque scores more effectively than a manual toothbrush alone. For the oral irrigator, two out of three comparisons indicated a positive effect on gingivitis scores, and probing pocket depth. The NMA demonstrated that for plaque removal the adjuvant use of IDBs was significantly more effective than the manual toothbrush alone. For the reduction of gingival inflammation, no product ranked higher than the manual toothbrush. Due to the scarcity of studies that met the inclusion criteria for each of the oral hygiene devices and the low certainty of the resultant evidence, no strong "evidence-based" conclusion can be drawn concerning any specific oral hygiene device for patient self-care in periodontal maintenance.

THE EFFECT OF SUPPLEMENTATION OF MICROALGAE SCHIZOCHYTRIUM SP. AS A SOURCE OF DOCOSAHEXAENOIC ACID (DHA) ON DOGS WITH NATURALLY OCCURRING GINGIVITIS

The objective of this study was to evaluate the effects of the microalgae Schizochytrium sp., as a dietary source of docosahexaenoic acid (DHA), on dogs with gingivitis. Two diets containing 0 and 0.4% of microalgae Schizochytrium sp. were offered for 30 days to 12 randomly distributed adult Beagles to determine gingivitis. Gingivitis score and area were analyzed on days 0 and 30. Prior to the analysis, the area was gently cleaned with cotton wool on the surface of the crown of the teeth. There was no change in the gingivitis score (P>0.05). However, there was a reduction (P<0.05) in the area affected by gingivitis (day 30 - day 0) in animals supplemented with 0.4% microalgae Schizochytrium sp. The addition of 0.4% dietary microalgae reduced the area of gingivitis on dogs.

Plaque control and reduction of gingivitis: The evidence for dentifrices.

This paper focuses on plaque control and the management of gingivitis in adults and summarizes the evidence of commercially available dentifrices as gathered from existing systematic reviews. Three internet sources were used to search for appropriate papers (up to and including February 2017). The search strategy was designed to include any systematic review published on dentifrices that also included an evaluation of plaque and gingivitis scores. Characteristics of the individual reviews, such as methodological aspects, quantitative data and conclusions, were extracted. The potential risk of bias was estimated and the acquired evidence was graded. Independent screening of 205 unique reviews resulted in 10 published and eligible systematic reviews. One publication evaluated the mechanical contribution of dentifrice to plaque removal. Eight papers were identified that evaluated the efficacy of a proposed single active ingredients, of which two reviewed more than one potentially active ingredient. One study compared two active ingredients. This meta‐review appraised the current state of evidence and found that toothbrushing with a standard fluoride dentifrice does not provide an added effect for the mechanical removal of dental plaque. Evidence suggests that compared with a standard dentifrice, those containing triclosan or stannous fluoride have benefits with respect to gingival health and control of dental plaque.

PREVALENSI GINGIVITIS PADA IBU HAMIL BERDASARKAN USIA KEHAMILAN, PEKERJAAN, DAN PENDIDIKAN DI RSUD KLUNGKUNG TAHUN 2017

Background: Pregnant women usually suffer from gingivitis due to an increase in progesterone and estrogen hormones followed by hypervascularization. As the result, gingiva becomes more sensitive to plaque and calculus. Pregnant women in Trimester II began to experience gingivitis and would get worse in the trimester III. As known, gingivitis in pregnant women may be affected by age of pregnancy, occupation and education level. The aim of the study was to describe the prevalence of gingivitis in pregnant women at RSUD Klungkung, related to age of pregnancy, occupation and education. Methods: This research was a descriptive study using cross sectional study approach. Sample in this study was 85 people using consecutive sampling technique. Data collection was done by giving questionnaire and screening to pregnant women to know their gingival score. Result: The results of this study showed that most of pregnant women in trimester I experienced gingivitis score 1 (57,9%), trimester II gingivitis score 2 (65,5%), and trimester III gingivitis score 3 (83,8%). Pregnant women who did not work had more gingivitis (42%) than pregnant women who worked (37.1%). Pregnant women with lower education level experienced more gingivitis (92.8%) than pregnant women with higher education level (75%). Conclusion: The number of gingivitis in pregnant women is increasing as their age of pregnancy, where the ginggivitis score in trimester I is better than trimester III. This result also correlated with age of pregnancy, occupation and educationlevel.

Do total or partial etching procedures effect the rate of white spot lesion formation? A single-center, randomized, controlled clinical trial.

To determine whether total or partial etching procedures influence the appearance of white spot lesions (WSLs). This split-mouth, double-blind, controlled, randomized study included 20 patients (mean age 16.75 years), who had class I malocclusion, mild crowding, and satisfactory oral hygiene. A total of 40 maxillary quadrants were randomly allocated to be treated using a total etching (TE) or partial etching (PE) protocol. Quantitative light fluorescence images were captured at the beginning and at 3 (T1) and 6 (T2) months after beginning orthodontic treatmen, as well as when the debonding phase of orthodontic treatment was complete (T3). The presence of pre- and posttreatment WSLs was assessed with quantitative light fluorescence software and analyzed with Student's t-test. The analyses showed that, at T2, the total etching group had significantly higher ΔQ and A scores than the partial etching group ( P < .05). The ΔF scores increased significantly at all timepoints in the TE group, but only at T1 and T3 in the PE group. However, no differences were noted at T3 between the TE and PE groups ( P > .05). The inclusion of only right-handed people may have limited the generalizability of the findings. The absence of analyses of the plaque and gingivitis scores of patients was another limitation of this study. WSL formation was observed mostly in maxillary lateral incisor teeth irrespective of the etching technique. Although PE seems to be more successful in the first 6 months, no difference was observed between PE and TE in the long term for WSL formation.

Salivary levels of cariogenic bacterial species during orthodontic treatment with thermoplastic aligners or fixed appliances: a prospective cohort study

BackgroundFixed orthodontic appliances might be associated with intraoral adverse effects on enamel, due to plaque accumulation and their colonization by oral microbes. At the same time, the demand for esthetic alternatives to orthodontic treatment, like thermoplastic aligners, is growing. However, thermoplastic aligners may behave differently intraorally than fixed appliances in terms of bacterial colonization and biofilm formation. Therefore, the aim of this prospective cohort study was to assess the salivary prevalence of the cariogenic bacteria Streptococcus mutans, Lactobacillus acidophilus, and Streptococcus sanguinis among adolescents treated orthodontically with thermoplastic aligners or fixed appliances.MethodsThirty adolescent patients (17 girls/13 boys; mean age 13.8 years old) were assigned to treatment with either (i) self-ligating fixed appliances with nickel-titanium archwires or (ii) aligners constructed from clear transparent polyethylenterephthalat-glycol copolyester (PET-G) thermoplastic sheets. Whole stimulated saliva was collected from each patient at three time points: at baseline (before bonding and initiation of orthodontic therapy or before insertion of the thermoplastic aligners), after 2 weeks, and after 1 month. A simplified plaque index, a simplified gingival index, and the decayed, missing, and filled teeth (DMFT) index were assessed from the clinical examination of the patients. Microbiological analysis of salivary bacteria was performed by quantitative polymerase chain reaction, followed by descriptive and inferential statistics at the 5% level.ResultsAlthough patients treated with aligners had significantly lower plaque and gingivitis scores throughout treatment compared to patients treated with fixed appliances, no significant difference could be found between the S. mutans counts of the two groups at any time through treatment (P > 0.05). On the other hand, patients treated with aligners had significantly lower salivary S. sanguinis counts at all time points than patients treated with fixed appliances (P < 0.05). Finally, almost no L. acidophilus were identified in the collected saliva samples in either of the treated samples.ConclusionsWithin the limitations of this study, there were no differences in the salivary counts of S. mutans or L. acidophilus among adolescent patients treated for 1 month with thermoplastic aligners or self-ligating appliances. On the other hand, patients treated with aligners had lower salivary levels of S. sanguinis compared to those treated with self-ligating appliances.

Effect of virgin olive oil pulling and chlorhexidine mouth washon plaque and gingivitis: a randomized controlled trial

Aim: The objective of this study is to compare the efficacy of oil pulling with virgin olive oil and chlorhexidine mouthwash in reducing plaque and gingivitis.Material and Methods: A total of sixty subjects satisfying the inclusion criteria were selected. The subjects were then randomly divided into two groups of thirty each. Group I used oil pulling with olive oil and Group II used 0.2% chlorhexidine as mouthwash. The plaque index and modified gingival index scores were measured at baseline, first week and second week.Results: The results showed that there was statistically significant reduction of mean plaque and gingivitis scores from baseline to first week and second week in both olive oil (p&lt;0.05) and chlorhexidine group (p&lt;0.05). There was significant difference in mean plaque scores between olive oil group and chlorhexidine group at second week (p&lt;0.05). There was no significant difference in mean gingivitis scores between olive oil group and chlorhexidine group at second week (p&lt;0.05).Conclusions: Oil pulling with virgin olive oil was found to be effective in reducing plaque and gingivitis. Regular and proper oil pulling with virgin olive oil can therefore be recommended as a routine home-based practice in promoting oral health.

Will a chlorhexidine‐fluoride mouthwash reduce plaque and gingivitis?

What is the efficacy of a chlorhexidine (CHX) mouthwash (MW) containing sodium fluoride (NaF) compared to a CHX-MW alone on the parameters of plaque, gingivitis and discoloration? MEDLINE-PubMed, Cochrane-CENTRAL, and EMBASE were searched for papers from inception to December 2017. The inclusion criteria were (randomized) controlled clinical trials conducted in human subjects with good general health and without removable prosthesis. Papers evaluating the effect of a MW containing CHX+NaF compared to a CHX alone were included. From the eligible studies, data were extracted, a descriptive analysis was performed and a meta-analysis when feasible. Independent screening of 412 unique papers resulted in 9 eligible publications presenting 10 clinical trials comparing the effect of CHX+NaF to CHX-MW and provided 13 comparisons. Five evaluated the MW as an adjunct to brushing and 8 were non-brushing comparisons of which 4 used an experimental gingivitis model. No significant difference was observed for plaque score reduction in the brushing studies the end scores (diffM; -0.04, P=.36; 95%CI: [-0.13, 0.05]) nor the differences (diffM; 0.11, P=.33; 95%CI: [-0.12, 0.24]). In the descriptive analysis, none of the experiments demonstrated a statistical significant difference regarding Gingival Index (GI), Bleeding Score and Discoloration Scores. For the GI, a meta-analysis of the difference of Means was not significant when included experimental gingivitis model studies end scores (0.01, P=.78; 95%CI: [-0.08, 0.11]) and the difference (0.01, P=.81; 9 5%CI: [-0.08, 0.10]) either for the end scores of brushing studies (diffM; -0.01, P=.82; 95%CI: [-0.10, 0.08]). From this study, it can be concluded that NaF and CHX may be present in the same MW without reducing CHX efficacy with respect to plaque and gingivitis scores. Moreover, no difference in the development of tooth discoloration was observed.