Interdental Plaque Research Articles

The Effect of Different Electric Toothbrush Technologies on Interdental Plaque Removal: A Systematic Review with a Meta-Analysis.

The removal of dental plaque from the gingival margins of the teeth is essential to maintaining periodontal health. Whilst it has been established that electric toothbrushes demonstrate a greater ability to remove plaque, no systematic review has specifically investigated which technology is better for removing plaque from the interdental tooth surfaces, where plaque control may be more difficult. Three databases were searched until October 2023: MEDLINE and DOSSS via EBSCOhost and Embase. Data extraction was carried out on studies which met the inclusion criteria, and a risk of bias assessment was completed. The study findings were combined via a narrative synthesis and a meta-analysis where appropriate. A total of 77 studies were found, out of which 14 were selected and included in the analysis. The mean difference in interproximal plaque reduction, measured using the Rustogi Modified Naval Plaque Index (RMNPI) at 8 weeks, was 0.09 (p < 0.00001) in favor of the oscillating-rotating toothbrush. At 6 and 12 weeks, the mean difference in plaque reduction (RMNPI) was 0.05 (p = 0.0008) and 0.04 (p = 0.0001) in favor of the oscillating-rotating toothbrush, respectively. The studies show a tendency for oscillating-rotating toothbrushes to remove more interproximal plaque than oscillating toothbrushes, especially in a short time (8 weeks).

Effect of 5-aminolevulinic acid-mediated photodynamic therapy against Fusobacterium nucleatum in periodontitis prevention

Periodontitis, a chronic infectious disease leading to gingival atrophy and potential tooth loss through alveolar bone resorption, is closely linked to the oral microbiome. Fusobacterium nucleatum, known to facilitate late-stage bacterial colonization in the oral microbiome, plays a crucial role in the onset of periodontitis. Controlling F. nucleatum abundance is vital for preventing and treating periodontal disease. Photodynamic therapy combined with 5-aminolevulinic acid (ALA-PDT) has been reported to be bactericidal against Pseudomonas aeruginosa and Staphylococcus aureus. We aimed to investigate the bactericidal potential of ALA-PDT against F. nucleatum, which was evaluated by examining the impact of varying 5-ALA concentrations, culture time, and light intensity. After ALA-PDT treatment, DNA was extracted from interdental plaque samples collected from 10 volunteers and sequenced using the Illumina MiSeq platform. To further elucidate the bactericidal mechanism of ALA-PDT, porphyrins were extracted from F. nucleatum following cultivation with 5-ALA and subsequently analyzed using fluorescence spectra. ALA-PDT showed a significant bactericidal effect against F. nucleatum. Its bactericidal activity demonstrated a positive correlation with culture time and light intensity. Microbiota analysis revealed no significant alteration in α-diversity within the ALA-PDT group, although there was a noteworthy reduction in the proportion of the genus Fusobacterium. Furthermore, fluorescence spectral analysis indicated that F. nucleatum produced an excitable photosensitive substance following the addition of 5-ALA. Overall, if further studies confirm these results, this combined therapy could be an effective strategy for reducing the prevalence of periodontitis.

Comparison of The Effectiveness of Fones and Modified Bass Teeth Brushing Methods on Reducing Plaque Index in Autism Spectrum Disorders Children Aged 6-12 Years

Children with special needs, such as Autism Spectrum Disorders (ASD), are at a higher risk of developing caries. Brushing teeth is the most effective preventive measure to avoid the risk of developing dental and oral diseases. The Fones teeth brushing method has been proven to reduce dental plaque in ASD patients due to its simplicity. The modified Bass method is also reported to be effective in removing interdental plaque. This study is to investigate whether there is a difference in the effectiveness of teeth brushing techniques, specifically the Fones method and the modified Bass method, in reducing the plaque index in children with ASD. A quasi-experimental study with a pre-test and post-test design was conducted, with 24 ASD participants aged between 6-12 years. The Loe and Silness Plaque Index was used to measure the plaque index. Data analysis was conducted by comparing the two methods using a Paired t-test and a one-way ANOVA test. Indicate that there is a significant difference between the two treatments with a significance value of 0.039 (P&lt;0.05). The average plaque index from the Fones method was found to be 0.444 greater than the modified Bass method. In conclusion: There is a difference in effectiveness between the Fones teeth brushing method and the modified Bass teeth brushing method in reducing the plaque index in children with ASD aged 6-12 years.

Evaluation of the efficacy of inter-dental brush and dental floss for peri-implant mucositis: A crossover randomized clinical trial.

To evaluate the most effective method for mechanical inter-dental plaque removal between inter-dental brushes (IDB) and dental floss (DF), in addition to toothbrushing in patients affected by peri-implant mucositis (PIM); to identify possible factors related to the patient or to the single implant-supported element that could influence plaque accumulation and inflammation of peri-implant tissues. Forty patients with PIM were recruited. They were randomly assigned to two different groups depending on inter-dental device used (IDB or DF). At baseline (T0), interproximal area (IA), interproximal emergence angle of the implant crown (A°) and manual dexterity (evaluated with Purdue Pegboard) have been recorded. At 14 days (T1), the inter-dental cleaning devices have been inverted between groups. After 14 days (T2), the Plaque Index (PI) and Gingival Index (GI) have been recorded. A questionnaire has been submitted to a patient for the analysis of preferences at T0, T1 and T2. Both inter-dental cleaning devices were effective in reducing PI and GI in the inter-dental area after 14 days of use. GI reduction was influenced by manual dexterity of the dominant hand. No significant differences were found for PI and GI at the variation of IA and A°. IDB was the most effective method for inter-dental plaque removal in all subjects regardless of their manual dexterity. DF seems to be more effective than IDB only in subjects with good dexterity.

Quantitative Light-Induced Fluorescence (QLF) in Assessing the Efficacy of Dental Floss as An Adjunct to Toothbrushing

Objectives: The objective of this was to determine the of adjunctive usage of interdental mechanical aids along with educational, preventive and motivational actions on plaque reduction using Quantitative Light- induced Fluorescence (QLF-D) in motivated and non- motivated individuals. Materials and Method: 25 dental students were selected for this study, clinical indices, and QLF-D scores were recorded for all, after which they were divided into two groups. All the participants were given standardized toothbrushes and toothpaste. One group was asked to follow the regular oral hygiene methods while the other group was asked to use toothbrushes and floss along with instructions to use them for three weeks. After said period, the participants reported to the clinic and clinical indices and QLF-D scores were recorded again. The data was collected and subjected to statistical analysis. Results: The statistically significant intragroup difference was noted in groups. When comparing the plaque reduction three weeks post-intervention, the Simple Plaque Score (SPS) score showed a significant difference, whereas, the red fluorescence did not show any significant difference. Conclusion: According to the results obtained, we can conclude that patient education using QLF-D was effective as interdental plaque can be visualized by the patients and effectively cleaned using interdental aids like floss, which is difficult with clinical indices alone. So QLF- D can be an effective educational and motivational tool.

Interdental cleaning aids are beneficial for oral health at 7-year follow-up: Results from the Study of Health in Pomerania (SHIP-TREND).

To estimate association between the use of interdental cleaning aids (IDAs) and type on 7-year follow-up levels of interdental plaque, interdental gingival inflammation, interdental periodontitis severity, the number of interdental sound surfaces and the number of missing teeth in a population-based cohort study. We used 7-year follow-up data of 2224 participants from the Study of Health in Pomerania (SHIP-TREND). We applied generalized linear and ordinal logistic models, adjusting for confounding and selection bias using inverse probability treatment weighting and multiple imputation. Flossers were 32% less likely to have higher interdental plaque (iPlaque) levels than non-users of IDAs (odds ratio [OR] = 0.68; 95% confidence interval [CI]: 0.50-0.94); flossing resulted in 5% lower means of iPlaque. Effects on interdental bleeding on probing (iBOP), mean interdental probing depths and mean interdental clinical attachment levels were direction-consistent but statistically non-significant. Interdental brushing was associated with lower follow-up levels for interdental plaque (OR = 0.73; 95% CI: 0.57-0.93) and iBOP (OR = 0.69; 95% CI: 0.53-0.89). IDAs were more effective in reducing iPlaque in participants with periodontitis, whereas iBOP reduction was more pronounced in participants with no or mild periodontitis. The analyses did not suggest that the use of IDAs affected caries. Finally, applying change score analyses, flossing reduced tooth loss incidence (incidence rate ratio [IRR] = 0.71) compared with non-users of IDAs. Recommending flossing and interdental brushing in dental practices represents an approach to the prevention of gingivitis and consequently periodontitis.

Effects of interdental aids on clinical periodontal indices.

Removal of plaque and food particle between teeth represent interdental cleaning. Every patient's self-care program includes plaque removal efficiently and systematically. Periodontal disease, tooth decay and tooth loss may result from the absence of interdental cleaning or even an irregular and unsuccessful interdental cleaning. The aim of the current study was to assess the effect of inter-dental aids, including dental floss and toothpicks, on gingival and plaque indices. A questionnaire including age, gender, education level and other information was obtained from 150 male subjects who were systemically and periodontally healthy. Clinical periodontal parameters (including plaque index and gingival index) were taken from each subject. The participants were categorized into different groups according to the use of inter-dental aids (dental floss, dental picks and without any interdental aids). The participants were divided into the toothbrush-alone group, including participants who did not use either dental floss or toothpicks; the dental floss group, including participants who used dental floss; and the toothpick group including participants who used toothpicks. Plaque and gingival indices compared among groups. Statistical analysis showed that the maximum mean of Plaque index was found in the toothbrush-alone group (1.09 ± 0.43), while the lowest mean of Plaque index was found in the dental floss group (0.87 ± 0.39). Plaque index of the toothpick group was (0.99 ± 0.41) with statistically significant difference among groups (p-value = 0.04*). In conclusion, dental floss is the most effective mean of removing interdental plaque.

Comparing the effectiveness of water flosser and dental floss in plaque reduction among adults: A systematic review.

Interdental aids such as dental floss and water flossers have been found to be effective in removing interdental plaque. This systematic review aimed to compare the available data on the efficacy of dental floss and water flossers in plaque removal among adults. Five databases: PubMed, Scopus, Cochrane, ScienceDirect, Lilac, and Google Scholar were searched from January 1, 2002, to October 31, 2022, to obtain the relevant articles. Based on the search strategy, the titles of the studies were screened independently by two reviewers. Randomized controlled trials were included in the review, in which the study participants were given either dental floss or water flosser. Reduction in plaque scores was the outcome that was assessed. Seven articles met the eligibility criteria and were further processed for qualitative analysis. The majority of the studies favored water flossers over dental floss in plaque reduction. Water flosser was also found to be effective in removing plaque from inaccessible interproximal areas of the tooth surfaces as compared to dental floss. Based on the scope of this review, results suggest that water flossers can be used as an effective alternative to dental floss in patients with manual dexterity, patients undergoing orthodontic treatment, and patients with dental prostheses.

Dental floss as an adjuvant of the toothbrush helps gingival health.

Design and aim This randomised controlled clinical trial assessed the efficacy of using dental floss in addition to toothbrushing in reducing gingival and plaque indices.Intervention The participants received oral hygiene instruction and supervised personal and professional plaque removal every week for two months. The research team instructed the participants to perform toothbrushing twice daily - groups 'toothbrushing and flossing' (TB + DF) and 'toothbrushing alone' - and use dental floss once daily - group TB + DF. Gingival index (GI) and plaque idex (PI) were evaluated at baseline and after one and two months.Case selection The authors invited the participants via the Federal University of Santa Maria screening service, social media and public posters. The participants were 18 years and older, without interproximal clinical attachment loss, with papillae completely filling the interproximal space and with at least 24 teeth remaining. The participants were included if they had a gingival index score of two at more than 15% of the interproximal sites. The authors excluded dental students, patients with xerostomia or diabetes, pregnant women, smokers, patients with orthodontic appliances and restraints, patients requiring antimicrobial prophylaxis, patients having used antibiotics/anti-inflammatory agents within the last three months and those with psychomotor disorders.Experimental groups and data analysis The authors used a block randomisation sequence with block sizes of ten. Randomisation confidentiality was maintained using serially sealed, numbered, opaque envelopes. At baseline, all the participants received oral prophylaxis and their GI, probing depth (PD), clinical attachment loss (CAL) and bleeding on probing (BOP) were assessed. A clinical staff member disclosed the experimental group assignments, distributed scheduled oral hygiene materials and conducted assigned study interventions. Each participant received a soft toothbrush (Colgate Twister Compact Head, New York, NY, USA) and fluoride dentifrice (Colgate Triple Action, 90 g, New York, NY, USA). Patients were instructed to brush their teeth twice daily. Subjects from the TB + DF group also received dental floss and were asked to use it once daily (Colgate, Tarpaulin, New York, NY, USA). The research team supervised the oral hygiene practices at day zero and recalled the patients to provide them with personalised oral hygiene instruction and dental plaque removal. Individual patients were considered as units of analysis. PI, GI, CAL, PD, gingival bleeding (GI = 2), BOP and percentage sites with different GI scores were presented as means, standard deviations and standard errors. The authors used multiple imputations to replace missing data and mixed linear models to analyse and compare the experimental groups.Results In total, 75 participants were randomised. Both groups showed a significant reduction in gingival inflammation (GI = 2) in the first month, albeit no change was seen in the second month. Adding flossing to toothbrushing significantly reduced the GI = 2 by the end of the first month (37.7 to 15.9%), maintaining optimised overall oral health through day 60 (15.1%) compared with toothbrushing alone. No significant differences were noted between the two groups from the first to the second month. Interproximal dental plaque was reduced for both groups from baseline to day 30 with no marked change from then to day 60. Plaque reduction was similar in both groups.Conclusions Toothbrushing reduces interdental plaque build-up and halts its progression while improving gingival health in adults with no interdental attachment loss. Dental flossing as an adjuvant to toothbrushing also enhances these benefits.

Plaque Control Efficacy: Interdental Brushes versus Dental Floss

Aims: In this study, we compared plaque control efficacy between interdental brushes &amp; dental floss for the prevention of periodontal disease (gingivitis). We also investigated the convenient method for plaque control among these two interdental cleaning methods in routine.&#x0D; Study Design: Randomized clinical trial&#x0D; Place and Duration of Study: Department of Periodontology at Fatima Jinnah Dental College and Hospital, Karachi, Pakistan from Jan 2019 to July 2020.&#x0D; Methodology: The sample size of 180 was calculated using OpenEpi software each group (Interdental brush &amp; Dental floss) carried 90 patients respectively at 95% confidence interval and 80% power of the test. Probability sampling technique was used. The Clinical trial was registered at ClinicalTrial.gov (Identifier: NCT05439785). Ethical approval was taken from the Ethical Review Committee of Ziauddin University (1130519MSOM). SPSS version 20 was used to analyze the study data. P-value ≤ 0.05 was considered as significant.&#x0D; Results: The statistical results showed significant improvement in the plaque score and bleeding index among patients pre and post intervention (p &lt;0.001). Moreover, this study stated that interdental brush was slightly better in reducing interproximal plaque accumulation in patients of gingivitis (p &lt;0.001). The symptom of bleeding from the gingival tissue was also improved by using both interdental cleaning methods. The posterior region appeared to be a difficult site to use both the intervention (interdental brushes or dental floss). Both interdental cleaning methods assisted in the improvement of other symptoms like sensitivity, halitosis, and food impaction in the patients.&#x0D; Conclusion: The findings of our research revealed that both interdental cleaning methods had a statistically significant effect in removing interdental plaque, with little variation in plaque removal seen between interdental brush and dental floss when compared to baseline. This study endorses better outcome of interdental brush in reducing dental plaque accumulation than dental floss in the gingivitis patients.

Efficacy of concentrated growth factor with low-level laser for the regeneration of interdental papilla defects.

Gingival "black triangle" is common in clinical which due to interdental papilla recession. The cause of the loss of papilla is multi-factorial and it may be caused by the absorption of interdental alveolar bone or abnormal tooth position. Besides, it is a common complication after orthodontics and implant surgery. Recession of gingival papilla influences interdental plaque control, increasing food impaction and alveolar bone absorption, causing aesthetic and pronunciation problems. Thus, the way of reducing or eliminating the gingival "black triangle" has become one of the most essential problems for dentists. Concentrated growth factor (CGF) and low-level-laser therapy have been widely used, respectively, and CGF was considered as the only self-substance which has soft tissue regeneration function. This study aims to evaluate the efficacy of regenerating interdental papilla by Liquid phase concentrated growth factor (LPCGF) injection with low-level-laser therapy (LLLT).

Interdental plaque reduction after the use of different devices in patients with periodontitis and interdental recession: A randomized clinical trial.

ObjectivesTo determine the efficacy of four different oral hygiene protocols involving adjunctive interdental devices in terms of plaque and bleeding scores in periodontitis‐affected patients.Material and methodsThis was a randomized clinical trial with a 5‐week follow‐up, including previously treated periodontitis patients not undergoing any supportive care. Patients were randomly allocated to 4 groups: manual toothbrush (group TB); toothbrush plus dental floss (group TB/F); toothbrush plus interdental brushes (group TB/IDB) and toothbrush plus rubber interdental picks (group TB/RIDB). Oral hygiene instructions (OHI) were provided at baseline (T‐7) and at T0 (1‐week) then bi‐weekly (T14/T28). At T0, supragingival professional cleaning was delivered. Plaque and bleeding indexes were taken at all timepoints by a single calibrated examiner, blind to group allocation.ResultsAt T‐7, patients were comparable for age, body mass index (BMI) and all clinical parameters, exceptions for the Interdental Angulated Bleeding Index. At T28, significant reductions of plaque and gingival inflammation were noted in all groups (p < 0.001) and within the expected ranges. Intergroup comparisons identified that group TB/IDB and group TB/RIDB achieved lower levels of plaque and inflammation than group TB (p < 0.05). Group TB/IDB and group TB/RIDB showed lower levels of plaque and lower inflammation as measured by angulated bleeding index than group TB/RIDB (p < 0.05).ConclusionInterdental brushes and rubber interdental picks were more efficient than toothbrushing alone and toothbrushing and floss in reducing plaque and gingival inflammation measured in a periodontitis‐affected population.

Effect of dissolving xylitol chewable tablets versus xylitol chewing gum on bacterial count and salivary pH in geriatric bedridden patients: A randomized clinical trial

Aim: To evaluate the effectiveness of using dissolving xylitol chewable tablets versus xylitol chewing gum in geriatric bedridden patients in decreasing bacterial count in both saliva and interdental plaque as well as in increasing salivary pH. Materials and Methods: Overall, 98 patients were included in this randomized clinical trial and they were divided into two groups (n = 49). Group 1 (intervention group) received xylitol chewable tablets (Listerine Ready Tabs), and group 2 (Control group) received xylitol chewing gum (Trident Original). The primary outcome was salivary mutans streptococci count, and secondary outcomes were interdental plaque mutans streptococci count (both were assessed through plate culturing on MSBA media) and salivary pH (measured by a pH meter). All outcomes were assessed at baseline, after 5 min, and after 15 days. Friedmann test was used to show the effect of follow-up periods followed by a multiple comparison with Dunn Bonferroni correction. Mann-Whitney test was used to compare between tested groups for all examined variables. Result: Regarding MS count in both saliva and interdental plaque, there was a statistically significant difference between both groups at baseline and after 5 min; however, after 15 days, there was no statistically significant difference between both groups. Regarding salivary pH, there was no statistically significant difference at baseline and after 5 min between both groups; however, after 15 days, there was a statistically significant difference between both groups. Conclusion: Both xylitol dissolving chewable tablet and xylitol chewing gum have potent antibacterial effects and enhanced salivary pH in geriatric bedridden patients.

Retrospective Study Regarding Orthodontic Retention Complications in Clinical Practice

At the end of any orthodontic treatment, retention is a necessary phase. Unfortunately, the current retention devices and the lack of proper oral hygiene on the part of patients lead to the accumulation of dental plaque, periodontal inflammation, and gingival retraction. Our retrospective study included 116 adult patients wearing various types of orthodontic retainers. To quantitatively determine the accumulation of dental plaque, we used the Quigley–Hein plaque index modified by Turesky and the Navy plaque index modified by Rustogi. Another studied parameter was related to the gingival recession associated with retention devices. We had investigated the correctness of patients’ dental hygiene, their preferences for auxiliary means of oral hygiene, the consistency with which they wear the mobile retainers, and respect the orthodontist’s instructions; we also investigated the inconveniences and the accidents that may occur during the retention period. Statistical analysis showed that plaque accumulation is significantly lower in the case of mobile retainer than fixed retainer wearers; the exception was the Hawley plate, where the interdental plaque was more than in all the other studied retainers. Periodontal recessions were more frequent in the case of fixed retainer wearing. Flossing was the most commonly used auxiliary mean for oral hygiene. The compliance of women in wearing vacuum-formed retainers was better than that of men. Patients with a class III history had more plaque accumulation, and class II/1 had the most problems related to detachment/damage of fixed retainers. Mobile retainers proved better results for oral hygiene, but fixed retainers cannot be waved.

Comparison of Antibacterial Effect of Probiotic Yogurt and Xylitol-Containing Chewing Gum in Geriatric Patients: A Randomized Controlled Clinical Trial.

ObjectivesTo evaluate the effect of probiotic bacteria in yogurt on Streptococcus mutans (MS) count, plaque adherence and salivary pH compared to xylitol-containing chewing gum in geriatric patients.Materials and methodsTotal number of 96 high caries risk geriatric patients were randomized into two equal groups (n=48). Group 1 (intervention group) received probiotic yogurt (Activia, Danone) once per day, and group 2 (control group) received xylitol chewing gum (Trident original) three times per day. The primary outcome was salivary Streptococcus mutans count and secondary outcomes were interdental plaque Streptococcus mutans count, salivary pH and bacterial adherence.ResultsFor Streptococcus mutans count in saliva and plaque, a statistically significant reduction in the level of MS over all the examined follow up periods of the study in probiotic yogurt group as well as xylitol gum group was found. An intergroup comparison for salivary MS count showed statistically significant difference between the two materials in a two week and a three month period of time and there was no statistically significant difference between both materials at one month time period. Salivary pH results showed statistically significant increase in pH in both groups along the follow-up periods. Bacterial adherence results showed statistically significant reduction in both groups.ConclusionsProbiotic yogurt is an effective antibacterial agent against salivary and plaque bacteria in geriatric patients.

Interdental Plaque Microbial Community Changes under In Vitro Violet LED Irradiation.

Oral microbiome dysbiosis has important links to human health and disease. Although photodynamic therapy influences microbiome diversity, the specific effect of violet light irradiation remains largely unknown. In this study, we analyzed the effect of violet light-emitting diode (LED) irradiation on interdental plaque microbiota. Interdental plaque was collected from 12 human subjects, exposed to violet LED irradiation, and cultured in a specialized growth medium. Next-generation sequencing of the 16S ribosomal RNA genes revealed that α-diversity decreased, whereas β-diversity exhibited a continuous change with violet LED irradiation doses. In addition, we identified several operational taxonomic units that exhibited significant shifts during violet LED irradiation. Specifically, violet LED irradiation led to a significant reduction in the relative abundance of Fusobacterium species, but a significant increase in several species of oral bacteria, such as Veillonella and Campylobacter. Our study provides an overview of oral plaque microbiota changes under violet LED irradiation, and highlights the potential of this method for adjusting the balance of the oral microbiome without inducing antibiotic resistance.

Necrotizing Gingivitis: Microbial Diversity and Quantification of Protein Secretion in Necrotizing Gingivitis.

Necrotizing gingivitis (NG) is a necrotizing periodontal disease that differs from chronic gingivitis (CG). To date, both the microbiological causes and the involved host cytokine response of NG still remain unclear. Here, we investigated corresponding interdental plaque and serum samples from two groups of Chinese patients with CG (n = 21) or NG (n = 21). The microbiota were studied by 16S rRNA Illumina MiSeq sequencing of the microbial metagenome and by assessing quantitatively the abundance of the phylum Bacteroidetes, the genus Prevotella and the species T. forsythia, P. endodontalis, and P. gingivalis using fluorescence in situ hybridization (FISH). With respect to the associated host response, the levels of 30 inflammatory mediators were quantified by multiplex immunoassay analysis. Differential microbial abundance analysis of the two disease groups revealed at the phylum level that Proteobacteria accounted for 67% of the differentially abundant organisms, followed by organisms of Firmicutes (21%) and Actinobacteria (9%). At the species level, significant differences in abundance were seen for 75 species of which 58 species were significantly more abundant in CG patients. Notably, the FISH analysis revealed that Bacteroidetes was the most prevalent phylum in NG. The multiplex cytokine assay showed significant quantitative differences between the disease groups for eight analytes (GM–CSF, G–CSF, IFN–α, IL–4, IL–13, TNF–α, MIG, and HGF). The G–CSF was found to be the most significantly increased inflammatory protein marker in NG. The next-generation sequencing (NGS) data supported the understanding of NG as a multi-microbial infection with distinct differences to CG in regard to the microbial composition.

Interdental and subgingival microbiota may affect the tongue microbial ecology and oral malodour in health, gingivitis and periodontitis.

Oral malodour is often observed in gingivitis and chronic periodontitis patients, and the tongue microbiota is thought to play a major role in malodorous gas production, including volatile sulphur compounds (VSCs) such as hydrogen sulphide (H2 S) and methanethiol (CH3 SH). This study aimed to examine the link between the presence of VSCs in mouth air (as a marker of oral malodour) and the oral bacterial ecology in the tongue and periodontal niches of healthy, gingivitis and periodontitis patients. Participants were clinically assessed using plaque index, bleeding on probing (BOP) and periodontal probing depths, and VSC concentrations in their oral cavity measured using a portable gas chromatograph. Tongue scrapings, subgingival and interdental plaque were collected from healthy individuals (n=22), and those with gingivitis (n=14) or chronic periodontitis (n=15). The bacterial 16S rRNA gene region V3-V4 in these samples was sequenced, and the sequences were analysed using the minimum entropy decomposition pipeline. Elevated VSC concentrations and CH3 SH:H2 S were observed in periodontitis compared with health. Significant ecological differences were observed in the tongue microbiota of healthy subjects with high plaque scores compared to low plaque scores, suggesting a possible connection between the microbiota of the tongue and the periodontium and that key dysbiotic changes may be initiated in the clinically healthy individuals who have higher dental plaque accumulation. Greater subgingival bacterial diversity was positively associated with H2 S in mouth air. Periodontopathic bacteria known to be prolific VSC producers increased in abundance on the tongue associated with increased bleeding on probing (BOP) and total percentage of periodontal pockets >6mm, supporting the suggestion that the tongue may become a reservoir for periodontopathogens. This study highlights the importance of the periodontal microbiota in malodour and has detected dysbiotic changes in the tongue microbiota in periodontitis.

Research and application progress of mechanical measures for oral plaque control

Effective removal of dental plaque is a key measure to prevent and control common oral diseases and to maintain the long-term effect of dental prostheses. The methods of oral plaque control are mainly depending on mechanical measures, including regular toothbrushing, interdental cleaning and oral irrigation. Toothbrushing is the most common and effective method for mechanical removal of dental plaque.How ever the effect of toothbrushing alone to remove dental plaque is limited. It is necessary to control the interdental plaque using tools such as dental floss and interdental brushes. Oral irrigation is an assistant method to improve oral hygiene. Toothbrushing combined with the use of oral irrigator can significantly improve the removal rate of dental plaque. The present article reviews the research progress of the mechanical plaque control methods and their application results.

Comparison between water flosser and regular floss in the efficacy of plaque removal in patients after single use

ObjectiveThe objective was to compare water flosser and regular floss in the efficacy of plaque removal in patients after single use. Materials and MethodsA randomized controlled clinical trial was conducted to compare the plaque removal efficacy of water flosser and regular floss. Eighty three subjects who met the inclusion criteria were recruited from dental clinic. Silness and Löe plaque index was measured for all the subjects prior to and after the intervention by an examiner who was blind to the type of aid used. The type of floss used was randomly assigned to each side of the oral cavity; unflavored waxed regular floss (oral B) used on one side, while a water flosser (Waterpik® Cordless Plus Water Flosser) was used on the other side. A trained investigator used either unflavored waxed regular floss or water flosser as assigned. Paired t-test was used to compare between the two groups. ResultsThe mean plaque scores at baseline were 1.10(±0.38) and 0.94(±0.38) respectively for regular floss and water flosser. The mean plaque scores were 0.12(±0.13) and 0.12(±0.15) respectively for regular floss and water flosser. There was no statistically significant difference in the plaque scores (p = 0.58) between the groups after the use of respective interdental aids. There was a statistically significant difference in the plaque scores before and after use of interdental aids for both the groups (p < 0.001). Reduction in plaque scores for regular floss and water flosser groups was 89.09% and 87.23% respectively. ConclusionThe results showed that water flosser was as efficient as regular floss in removing interdental plaque on single use. Water flosser could be recommended for subjects lacking manual dexterity, by care takers for better plaque control and subjects with fixed prostheses or undergoing orthodontic treatment.