Oral Irrigation Research Articles

Dental water jet efficacy in the plaque control of orthodontic patients wearing fixed appliance: A randomized controlled trial.

BackgroundDifferent studies assess the role of fixed orthodontic appliances in supragingival plaque accumulation. In patients wearing fixed orthodontic appliances a good management of oral hygiene is required in order to prevent complication like as decay, enamel demineralization, gingivitis, gingival hyperplasia and periodontitis. The aim of this Randomized Controlled Trial (RCT) is to evaluate the efficacy of the use of a DWJ in patients under orthodontic treatment with fixed multibracket appliance.Material and MethodsThe study design was single-blinded RCT with a split mouth protocol. Each patient followed a personal cleaning protocol using a DWJ in addition to traditional brushing only on one side while just brushing on the control side. The side on which was decided to use the DWJ was chosen randomly and the dental hygienist who took the measurements was blind. Plaque and gingival indexes were evaluated at baseline and at one, three and six-months follow-up.ResultsIt did not emerge any difference in the plaque and gingival indexes trend between the two groups. Patients initially reported an worsening of the indexes at one month evaluation, then they set at baseline levels at three and six months.ConclusionsThe dental water jet does not improve significantly the efficacy of home oral hygiene in orthodontic patients wearing a multi-bracket fixed appliance. Patients did not show the traditional worsening during the whole orthodontic therapy. Key words:Dental water jet, fixed orthodontics, plaque index, gingival index.

A cross sectional study to explore knowledge regarding use of oral hygiene aids among dental interns in India

Introduction: Oral health is strongly related to the general health of an individual. The most common oral diseases in developing countries are dental caries and periodontal disease. Dental plaque is the prime etiology for the periodontal disease. Plaque control in periodontics can be accomplished by mechanical and chemical methods. Various oral hygiene aids are available to maintain the oral health status. Aim: This study was undertaken to assess the knowledge of dental interns about use of different oral hygiene aids in particular situation. The study design was a cross-sectional, one point time, multi-center, questionnaire based survey constructed with 12 questions. Material and methods: A total of 393 subjects (male=160, female=233) with the mean age of 24.6 + 5 were selected using a random sampling techniques from among dental interns across the Dental Colleges in India. Result: The result of the present study revealed that dental interns have adequate knowledge towards the basic tool to maintain oral hygiene. They have less knowledge about the interdental aids in specific situation, dose and frequency of use for chlorhexidine and oral irrigation devices. Conclusion: Dental interns have basic knowledge about oral hygiene tools; still greater emphasis is needed on oral hygiene aids education in the dental schools to upgrade the knowledge of the students.

Polymer Brush Made By Ionic Liquids and the Inhibition Effects for Biofilm Formation

The polymer brush generally has high water repellency, adhesion, durability and antifouling properties. As for the last characteristics, it often works well to clean materials’ surfaces. Since it displays the lotus effect, it repels water. This water (which rolls off of the surface) picks up and carries away contaminants. What about its effect for biofilm? In this study, we seek the answer by using a polymer brush formed on glass. Biofilms are produced by bacterial activities. Usually, bacteria attach to tissues in human bodies, and also to solid materials, since organic compounds (which serve as their nutrition) exist there. When the number of bacteria attached to these interfaces increases and reaches the threshold value, then exopolymeric substances are excreted from their cells. Therefore bacteria on materials’ surfaces are surrounded by sticky water including various kinds of organic polymers (exopolymeric substances: EPS). At this point, biofilms form on materials. Generally speaking, bacteria in biofilms have a high tolerance against biocides and antibiotics. This means that biomaterials should have high anti-biofilm formation capabilities. The application of a polymer brush to the surface finishing of biomaterials may serve as a countermeasure to protect biomaterials against biofilm formation. In this study, a polymer brush was formed on glass specimens by living radical polymerization of ionic liquids (N,N-diethyl-N-(2-methacryloylethyl)-N-methylammonium bis imide(DEMM-TFSI). Also their inhibition effects against biofilm formation were investigated. The biofilm evaluation system was mainly composed of artificial biofilm production and various evaluation processes. In this study, the artificial biofilm formation was carried out by two different processes. One was a static process where specimens were placed in plastic wells filled with liquid cultures (LB and HI cultures) with and without bacteria (E.coli and S. epidermidis, respectively). The other was the process using a flow type Laboratory Biofilm Reactor (LBR). The specimen was suspended in a reservoir and fixed by a jig. And the same culture liquids, including bacteria in the reservoir, flowed by using a rotating stirrer. After a certain amount of time (a couple of days), each sample was taken out of the system and the specimen’s surface was observed by Raman spectroscopy and stained by crystal violet (0.1%) to check the extent of biofilm formation. The results were analyzed, compared, and discussed qualitatively and quantitatively. We confirmed that the polymer brush tended to control biofilm formation. The mechanism was considered in the following two ways. One of them would be the Lotus effect where the surface profile of a polymer brush might work well (Lotus effect). The other one was the antibacterial and anti-biofilm effects by ionic liquids. In this case, ionic liquid as a raw material was almost completely fixed and insoluble. However, a very small amount might dissolve at the tip of polymer brush.

Effect of supragingival oral irrigation as an adjunct to toothbrushing on plaque accumulation in chronic generalized gingivitis patients.

Aim:The aim of this study was to evaluate the efficacy of supragingival oral irrigation either with water or different concentrations of chlorhexidine (CHX) digluconate as an adjunct to toothbrushing on plaque accumulation in chronic generalized gingivitis patients.Materials and Methods:Fifty patients were randomly allocated into five groups. Group 1: toothbrushing alone, Group 2: toothbrushing with mouthwash, Group 3: toothbrushing with water irrigation, Group 4: toothbrushing with 0.0075% CHX digluconate (36 mg) supragingival irrigation, and Group 5: toothbrushing with 0.02% CHX digluconate (96 mg) supragingival irrigation. The collected data were subjected to statistical analysis.Statistical Analysis:Descriptive data were obtained for all outcome variables and reported as mean ± standard deviation. The Student's t-test, Chi-square test, and one-way analysis of variance (ANOVA) were applied for the statistical evaluation of means and comparisons of proportions, and post hoc Bonferroni test was used for multiple comparisons after the application of the ANOVA test for comparison within the groups.Results:When intergroup difference of the mean differences was compared for individuals using toothbrushing along with 0.0075% CHX digluconate irrigation and those using toothbrushing along with 0.02% CHX digluconate irrigation from BL-14, BL-28, and between 14 and 28 days, it was found to be statistically nonsignificant.Conclusions:In our study, the CHX digluconate concentration for mouthwash and oral irrigation in addition with toothbrushing was found to be same, i.e., <50 mg for improving the gingival health by reducing gingival inflammation.

Effectiveness of Plaque Control with Novel Pediatric Oral Hygiene Need Station (Modified Oral Irrigation Device) as Compared with Manual Brushing and Flossing: Randomized Controlled Pilot Trial.

Background:Establishing good hygiene habits are valuable for present and future oral health. Below 6 years, tooth brushing should be performed by parents, as increasing dexterity and cognition may permit supervised brushing until the child is capable of independent brushing.Aim and Objectives:The aim of the present study was to evaluate the effectiveness of modified oral irrigation device in children in terms of plaque control and to compare the effectiveness of plaque control with manual brushing with the modified oral irrigation device in children.Materials and Methods:A randomized clinical trial was performed on 12 subjects who were allocated to the two study groups. After obtaining the consent, the control group was instructed tooth brushing with regular pediatric commercially available toothbrush and the intervention group with modified oral irrigation device. Plaque scores in both groups were assessed pre- and post-brushing using modified navy plaque index.Results:The data were subjected to Descriptive statistics and Paired t-test using SPSS version 22. Intragroup comparison of mean difference of plaque score in control group and intervention group pre- and post-brushing was statistically significant. Intergroup comparison of manual brushing group with modified oral irrigation group shows P < 0.05 was statistically significant.Conclusion:Within the limitation of the present study, it has been found novel pediatric oral hygiene need Station is more effective than manual brushing since it combined the effect of brushing, flossing (water floss), and rinsing in children simultaneously and at the same time did not demand any special motor skill.

Oral Streptococcal Endocarditis, Oral Hygiene Habits, and Recent Dental Procedures: A Case-Control Study.

We aimed to compare oral hygiene habits, orodental status, and dental procedures in patients with infective endocarditis (IE) according to whether the IE-causing microorganism originated in the oral cavity. We conducted an assessor-blinded case-control study in 6 French tertiary-care hospitals. Oral hygiene habits were recorded using a self-administered questionnaire. Orodental status was analyzed by trained dental practitioners blinded to the microorganism, using standardized clinical examination and dental panoramic tomography. History of dental procedures was obtained through patient and dentist interviews. Microorganisms were categorized as oral streptococci or nonoral pathogens using an expert-validated list kept confidential during the course of the study. Cases and controls had definite IE caused either by oral streptococci or nonoral pathogens, respectively. Participants were enrolled between May 2008 and January 2013. Cases (n = 73) were more likely than controls (n = 192) to be aged <65 years (odds ratio [OR], 2.85; 95% CI, 1.41-5.76), to be female (OR, 2.62; 95% CI, 1.20-5.74), to have native valve disease (OR, 2.44; 95% CI, 1.16-5.13), to use toothpicks, dental water jet, interdental brush, and/or dental floss (OR, 3.48; 95% CI, 1.30-9.32), and to have had dental procedures during the prior 3 months (OR, 3.31; 95% CI, 1.18-9.29), whereas they were less likely to brush teeth after meals. The presence of gingival inflammation, calculus, and infectious dental diseases did not significantly differ between groups. Patients with IE caused by oral streptococci differ from patients with IE caused by nonoral pathogens regarding background characteristics, oral hygiene habits, and recent dental procedures, but not current orodental status.

Effectiveness of different mechanical bacterial plaque removal methods in patients with fixed orthodontic appliance: a systematic review/meta-analysis

the presence of a fixed orthodontic appliance and its accessories tends to affect bacterial plaque removal, resulting in inadequate cleaning being performed by the patient. Thus, the aim of this systematic review and meta-analysis was to answer the following focal question: are the mechanical methods of oral cleaning effective for the reduction of bacterial dental plaque in patients with a fixed orthodontic appliance? A systematic search of the literature was conducted in the following databases: Scopus, PubMed, Cochrane, Web of Science, Embase, and Medline, in addition to Controlled Trials and Grey Literature, without limitations of language and year of publication. Furthermore, searches were also conducted in the reference lists of the articles selected. Included in the present review were clinical studies with patients undergoing therapy with fixed orthodontic appliances, which would, by means of comparison, evaluate the effectiveness of different mechanical bacterial plaque removal methods. The methodological quality of the articles included was evaluated in accordance with the checklist prepared as methodological evaluation protocol, and was classified as high, moderate or low. In order to perform the meta-analysis, articles with high methodological quality were included. Analysis of sub-groups was performed according to the type of intervention. The plaque index was defined as the continuous outcome variable, using the fixed effect when there was homogeneity among the articles, and the random effect in cases of heterogeneity. 1815 articles were found, of which only 23 fulfilled the eligibility criteria, with 17 being of high methodological quality and 6 of moderate quality. Of these, 18 included an analysis of the effectiveness of the conventional manual brush, 4 of the manual orthodontic brush,15 of electric brushes, 3 of interdental brushes, 1 of dental floss and 4 or oral irrigation devices, and 1 of Siwak. In the qualitative evaluation of the studies, the use of these mechanical control methods was shown to be effective, with exception of the use of Siwak, which presented an increase in bacterial plaque. Moreover, the results of the meta-analysis indicated a significant reduction of -0.98 (IC 95%) in the plaque index for the use of conventional manual brushes in the period of one month (p<0.001). There is a body of evidence that proves the effectiveness of mechanical bacterial plaque removal in patients using orthodontic appliances and accessories. The findings of the meta-analysis proved the effectiveness of the conventional manual brush. Further studies with better standardization of samples are required to strengthen the evidences.

Evaluation of Effectiveness of Vacuum Oral Cleaner Developed for Patients with Limited Mobility

Purpose : The purpose of this study was to compare the plaque removal effects of vacuum oral cleaner developed for the patients with limited mobility with those of manual toothbrushes and high pressure injection oral cleaner (dental water jet). Meterials and methods : Thirty human subjects were measured with Patient Hygiene Performance index (PHP index) and O'Leary index before and after the use of toothbrush, high pressure injection oral cleaner and vacuum oral cleaner. These three different oral hygiene methods were conducted with seven-day intermittence. Then the statistical analysis was carried out to define plaque removal rate of three different oral hygiene methods (alpha=.05). Results : According to the efficacy analysis of plaque removal before and after the oral cleaning using each of three methods, significant reduction in plaque after the treatment compared to the previous state when using toothbrush, high pressure injection oral cleaner, and vacuum oral cleaner was observed (P &lt; 0.001). PHP index of tooth brushing was higher than that of the high pressure injection oral cleaner, while PHP index of vacuum oral cleaner did not show significant difference from either of the other two methods. There was no significance difference in O'Leary index among the three methods. Conclusion : Effect of plaque removal using the vacuum oral cleaner is comparable to that of manual tooth brush or high pressure injection oral cleaner, so it will be helpful for self-oral hygiene care of the patients with limited mobility.

The Gingival Subside Effect by Use of the High Pressure Dental Water Jet

The Gingival Subside Effect by Use of the High Pressure Dental Water Jet

Применение орального ирригатора у беременных с начальными формами воспалительных заболеваний пародонта

&lt;p class="p1"&gt;&lt;span class="s1"&gt;The article highlights therapeutic and preventive treatment for pregnant women with the initial forms of periodontitis. There was conducted a comparative analysis of the effectiveness of a toothbrush versus an oral irrigator. On the basis of the results certain recommendations were made. it is recommended to use oral irrigator As an additional means of personal hygiene prevent of in ammatory periodontal diseases. &lt;/span&gt;&lt;/p&gt;&lt;p class="p1"&gt;&lt;span class="s1"&gt;Our research has shown that in order to achieve maximum effectiveness in the early treatment of periodontitis of pregnant women it is necessary to conduct a professional hygiene every two month and exercise dentist supervision in the period of the pectoral rearing. Special attention must be given to raising stomatological awareness of the patients as well as their motivation to maintain oral health. &lt;/span&gt;&lt;/p&gt;

Predicting Oral Health Behavior using the Health Promotion Model among School Students: a Cross-sectional Survey

teeth and T=permanent teeth) has been increasing from 1957 to 2015 years in Iran. The current survey aimed to test the power of health promotion model for predicting the oral health behavior among high-school students. Materials and Methods: A cross-sectional study was conducted on 482 high school students in Gorgan city, Iran. Multi-cluster sampling was used to recruit the samples. A researcher-made questionnaire based on HPM was implemented to collect data. To analyze, SPSS-18 and statistical tests, including t-test, Pearson correlation coefficient and univariate and multivariate regression models were used. Results: A total of 482 high-school students including 255 (52.9%) male and 227 (47.1%) with mean age of 16.02 ± 0.5 were investigated. The highest and lowest prevalent positive oral health behavior were tooth brushing (73%) and using fluidized oral irrigator (3.6%), respectively. Except for perceived barriers (with negative correlation), all constructs of HBM were positively related to oral health behaviors. Self-efficacy was the strongest predictor of oral health behavior (β=0.653) (r=0.541, P<0.05). Conclusion: HPM seems likely beneficial to design and develop oral health behaviors among students. Self-efficacy and perceived benefits should also be noticed to promote students oral health behaviors.

Improving periodontal outcomes: merging clinical and behavioral science.

New data indicate that periodontal diseases are much more prevalent than previously thought, which means that there are large numbers of patients who will need to be diagnosed and treated for periodontal disease in a general dental practice. Oral hygiene procedures performed by patients between office visits are important for gingival health. No particular type of toothbrush has consistently been shown to have superior plaque-removal ability over another. Although studies on powered brushes have shown evidence for efficacy of biofilm removal and increased patient compliance, they are of short duration, making evaluation of long-term effects difficult to achieve. Interdental cleaning with dental floss can be effective but it is technique-sensitive. Interdental brushes have been shown to be superior to floss in plaque index scores, but not in gingival inflammation reduction. A systematic review of oral irrigation reported a beneficial adjunctive effect on bleeding and gingival indices and pocket depth. Antimicrobials in mouthrinses and toothpastes have shown significant reductions in plaque and gingivitis when used correctly. Even though it is considered essential for patients to utilize biofilm-removal techniques on a frequent basis, studies on adherence show that approximately 30-60% of health information is forgotten within 1h, and 50% of health recommendations are not followed. Incorporating psychosocial aspects of behavioral change, including well-established counseling strategies, such as motivational interviewing, may elicit improved patient outcomes.

Efficacy of inter-dental mechanical plaque control in managing gingivitis--a meta-review.

What is the effect of mechanical inter-dental plaque removal in addition to toothbrushing, on managing gingivitis using various formats of inter-dental self-care in adults based on evidence gathered from existing systematic reviews? Three Internet sources were searched by a strategy designed to include systematic reviews on inter-dental cleaning devices. Plaque and gingivitis scores were the primary parameters of interest. Characteristics of selected papers were extracted. The potential risk of bias was estimated and the acquired evidence was graded. Screening of 395 papers resulted in six systematic reviews. Two papers evaluated the efficacy of dental floss, two of inter-dental brushes (IDB), one of woodsticks and one of the oral irrigator. Weak evidence of unclear or small magnitude was retrieved that supported dental floss, woodsticks and the oral irrigator to reduce gingivitis in addition to toothbrushing. No concomitant evidence for an effect on plaque emerged. There is moderate evidence that IDBs in combination with toothbrushing reduce both plaque and gingivitis. Evidence suggests that inter-dental cleaning with IDBs is the most effective method for inter-dental plaque removal. The majority of available studies fail to demonstrate that flossing is generally effective in plaque removal. All investigated devices for inter-dental self-care seem to support the management of gingivitis, however, to a varying extend.

Decontamination methods using a dental water jet and dental floss for microthreaded implant fixtures in regenerative periimplantitis treatment.

This study evaluated decontamination methods using a dental water jet and dental floss on microthreaded implants for regenerative periimplantitis therapy. In 6 beagle dogs, experimental periimplantitis was induced, and decontamination procedures, including manual saline irrigation (control group), saline irrigation using a dental water jet (group 1) and saline irrigation using a dental water jet with dental flossing (group 2), were performed. After in situ decontamination procedures, some of the implant fixtures (n = 4 per group) were retrieved for analysis by SEM, whereas other fixtures (n = 4 per group) underwent regenerative therapy. After 3 months of healing, the animals were killed. The SEM examination indicated that decontamination of the implant surfaces was the most effective in group 2, with no changes in implant surface morphology. The histological examination also revealed that group 2 achieved significantly greater amounts of newly formed bone (6.75 ± 2.19 mm; P = 0.018), reosseointegration (1.88 ± 1.79 mm; P = 0.038), and vertical bone fill (26.69 ± 18.42%; P = 0.039). Decontamination using a dental water jet and dental floss on microthreaded implants showed positive mechanical debridement effects and positive bone regeneration effects.

Water jet with adjunct chlorhexidine gel for nonsurgical treatment of peri-implantitis.

Peri-implant disease following successful integration of an endosseous implant is the result of an imbalance between bacterial load and host defense, which may affect not only the peri-implant mucosa but also involve the supporting bone. The aim of this study was to evaluate the adjunctive effect of a dental water jet rinse mixed with chlorhexidine gel to the nonsurgical treatment for peri-implantitis. A prospective randomized interventional cohort study was conducted. Forty consecutive patients presenting with peri-implantitis were recruited and randomly assigned into two treatment groups. Initially all patients received scaling/surface debridement and oral hygiene instruction. Patients in the study group received a water jet device containing chlorhexidine gel (Silonite®) for home use twice daily while the control group performed the recommended oral hygiene measures with no water jet usage. Three months following baseline visit, patients were reevaluated clinically and radiographically. In total, 39 patients completed the study and were available for final examination. Three months following baseline visit the test group exhibited greater mean probing depth reduction (0.75 mm vs 0.27 mm; P = .029) as well as greater reduction in the number of sites presenting with bleeding on probing (2.26 vs 0.45 sites; P = .011). No significant change in bone level was observed at 3 months (mean bone gain was 0.18 mm). Water jet mixed with chlorhexidine gel might supplement the response to nonsurgical treatment for peri-implantitis lesions. Further, larger-cohort studies are warranted.

Study of the effects of oral irrigation and automatic tooth brush use in orthodontic patients with fixed appliances

Objective: To compare effectiveness of: 1) Conventional tooth brush alone (control) 2) Powered tooth brush alone 3) Conventional tooth brushing with oral irrigation device 4) Powered tooth brush with oral irrigation device, as home use oral hygiene methods in adult fixed orthodontic patients. Materials and methods: Sixty orthodontic patients with fixed orthodontic appliances were divided into four study groups: (A) brushing with automatic tooth brush twice daily ( n = 15); (B) oral irrigation with manual toothbrushing, ( n = 15); (C) oral irrigation with automatic tooth brushing, ( n = 15); (D) control group with continued normal tooth brushing only, ( n = 15). Gingival and plaque indices, bleeding after probing, and gingival sulcus depths were assessed at baseline, 1-month, and 2-month periods. Results: Paired t test was used for within group analysis. Tukey's honestly significant difference (HSD) statistical analysis was used for the inter-group multiple comparisons. Level of significance was at P P = 0.68) and group D ( P = 0.93) in the time period of 1 month to 2 months. After 1 to 2 months use of the automatic tooth brush, there was a significant reduction in plaque when compared with the control group who used only the manual tooth brush ( P = 0.04). For this population of orthodontic patients, powered brushes alone or along with oral irrigation do not have additional beneficial effect when comparisons are made with other groups. Conclusion: All plaque control methods evaluated in the study provides significant improvement in reduction of plaque accumulation and gingival inflammation. Powered brushes alone or along with oral irrigation do not seem to be additionally beneficial when comparisons are made with other groups.

Evidence on the Efficacy of Dental Floss, Interdental Brushes, Woodsticks, and Oral Irrigation on Reduction of Plaque and Gingivitis

Evidence on the Efficacy of Dental Floss, Interdental Brushes, Woodsticks, and Oral Irrigation on Reduction of Plaque and Gingivitis

구강소독제의 적용 시간 및 기계적 세척 여부에 따른 타액 내 세균 수의 감소 효과

Abstract Salivary Bacterial Counts on Application Time of Oral Antiseptic Agents and Mechanical Irrigation Hyoung-Sup Lim, Jae-Jin Kim 1 , Mija Kim 2 , Hak Kyun Kim 1 Department of Oral and Maxillofacial Surgery, School of Dentist ry, Chosun University, 1 Department of Oral and Maxillofacial Surgery, School of Medicine, Chungnam National University, Rese arch Institute for Medical Sciences, Chungnam National University, 2 Department of Nursing, Pai Chai UniversityPurpose: The purpose of this study is to establish the acceptable intraoral application time of antiseptic agents and evaluate the effect of mechanical irrigation. Methods: A total of 80 subjects were selected for this study. Saliva secreted at the resting state was taken. The subjects were divided into 8 experimental groups, and kept 10% povidone- iodine (PVI) or 0.2% chlorhexidine gluconate (CHX) for 20 or 40 seconds in their oral cavity with/without irrigation o f the oral cavity with sterilized normal saline, respectively. Then, the saliva was taken and diluted with phosphate buffered saline and then plated onto 5% sheep blood agar plates, which were incubated. Colony forming unit (CFU) was measured fo r the salivary bacterial counts.Results: After application of PVI and CHX, all the experimental groups showed statistically significant decrease in CFU (P＜0.01). Group 2 (PVI, 40 s) showed more significant reduction rate in C FU than group 4 (CHX, 40 s; P＜0.01). Group 6 (PVI, 40 s, irrigated) showed more significant reduction rate than gr oup 2 (PVI, 40 s; P＜0.01). Group 2 (PVI, 40 s) showed more significant reduction rate than group 1 (PVI, 20 s; P＜0.01). Conclusion: Application of PVI for 40 seconds and mechanical irrigation wi th sterilized normal saline showed the best result among the 8 groups in terms of the reduction rate of sal ivary bacterial counts.Key words:Povidone-iodine, Chlorhexidine, Irrigation, Bacteria

Periodontal self‐care: evidence‐based support

The focus of this review on periodontal self-care will be based primarily on the results of systematic reviews and meta-analyses. Based on the evidence gleaned from systematic reviews, it is notable that most authors of these reviews commented on the relatively small number of trials that could pass the quality-assessment inclusion in the systematic review. Interproximal devices, namely interproximal brushes, are more effective for reducing interproximal plaque and gingivitis than are flossing or brushing alone. Some added benefit may be attributed to the use of rotational oscillation powered toothbrushes over manual toothbrushes. Recommendations by the dentist and dental hygienist to add one or more chemotherapeutic agents to the typical oral hygiene regimen has been shown, in systematic reviews and meta-analyses, to reduce the level of plaque and gingival inflammation in patients. Oral irrigation does not seem to reduce visible plaque but does tend to reduce inflammation, determined by the presence of bleeding on probing, the gingival index score and probing depth measurements. To date, high-quality evidence is either lacking or weak in some areas regarding the efficacy of self-care and periodontal disease. Low educational attainment, smoking and socio-economic status are related to adverse periodontal health outcomes. Variation in self-esteem, self-confidence and perfectionism are associated with oral health status and oral health behaviors. Better understanding of the psychological factors associated with oral hygiene would be of benefit in further developing strategies to help patients improve their oral hygiene in addition to helping professionals design better programs on prevention and education.

Effect of a home telecare program on oral health among adults with tetraplegia: a pilot study

Study designone group pre- and post-test designObjectiveThe primary aim was to examine both the short- and long-term effects of an oral home telecare program on improving gingival health among adults with tetraplegia.MethodsEight adults with tetraplegia participated. The oral home telecare program consisted of individualized oral hygiene training in the use of assistive devices (powered toothbrush and adapted flosser and/or oral irrigator) using PC-based videoconferencing between each participant and an occupational therapist. Training was conducted on an average of five 15 to 30 min sessions across three months. During these training sessions, supervised practice of oral hygiene, and provision of immediate corrective feedback and positive reinforcement in the use of adaptive oral hygiene devices was emphasized. Gingival health assessment using the Löe-Silness gingival index (LSGI) was conducted at baseline, six months and 12 months.ResultsFrom baseline to six months, participants showed statistically significant differences (i.e., improvement with less gingival inflammation) in their LSGI scores (z=2.18, P=.03). From baseline to 12 months, participants also showed a statistically significant difference (i.e., improvement, z=2.03; P=.04) in their LSGI scores.ConclusionThis study indicates that preventive oral home telecare with repeated oral hygiene training in the use of adaptive devices improved gingival health at six and 12 months among adults with tetraplegia.