Plaque Index Scores Research Articles

Vitamin D Levels and Oral Health in Stroke Patients During Inpatient Rehabilitation.

Stroke is a severe that restricts the individual's functions, effects the oral health. The aim of this study was to investigate the relationship between oral health and vitamin D levels in stroke patients in rehabilitation units. Participants with stroke, and age- and sex-matched healthy controls were recruited for the study. Oral Health Impact Scale-14 (OHIP-14), Decayed, Missing, Filled Teeth (DMFT) Index, Community Periodontal Index of Treatment Needs (CPITN), Gingival Index (GI), and Plaque Index (PI) were assesed for all participants. Barthel Index (BI), and Brunnstrom Recovery Scale (BRS), and Modified Ashworth Scale (MAS) assessed for the stroke patients. Vitamin D levels of each participant were recorded. The stroke patients' DMFT index and OHIP-14 values were higher than those of the healthy controls (p<0.05). However, no significant differences were observed in terms of CPTIN, PI, or GI scores (p>0.05). No statistically significant difference was determined in the DMFT index, OHIP-14 scores, Community Periodontal Index of Treatment Needs (CPITN), PI (Plaque Index), and GI (Gingival Index) scores according to vitamin D levels among the stroke patients (p>0.05). Stroke patients' functional scores (BRS, MAS, and BI), vitamin D levels, and oral health status (OHIP-14, DMFT, CPITN, PI, and GI) were subjected to correlation analysis. This revealed significant negative correlation between BRS (arm, hand, and leg), and BI and OHIP-14 scores (p<0.05). Although the DMFT index and health-related quality of life were adversely affected in stroke patients, no relationship was found between vitamin D and oral health status.

Difference of Two Antiseptic Gels for the Treatment of Peri-Implant Mucositis on Plaque Index and Bleeding Score: A Randomized Controlled Clinical Study

Aim: To analyze and compare the effectiveness of two antibacterial gels in the treatment of mucositis. Methods: After signing the informed consent, in accordance with the Helsinki Declaration of 1975, revised in 2000, 21 patients were included in the study and divided by randomization into two groups. At the baseline, the modified bleeding index (mBI) and plaque index (PI) values were measured, and an oral hygiene and implant disinfection session was carried out. The session was repeated at 7, 15, and 30 days and after 2 and 3 months from the baseline. Two products were used—a bioadhesive gel in the test group and a 1% chlorhexidine gel in the control group. Results: Due to three dropouts, the final sample was composed of 18 patients. An improvement in periodontal indices was observed, similar to mBI and PI values, in both groups. There were no complications except for the appearance of pigmentations in the control group. Conclusions: The antibacterial power and effectiveness of the two gels are comparable. Considering the small sample size of the study cohort, further studies are needed to validate the results obtained from this pilot study.

The state of oral health in patients with haemophilia in the Netherlands.

Previous studies show contradictory outcomes regarding dental, gingival and periodontal status in persons with haemophilia (PWH) compared to healthy controls. PWH may experience disease-specific barriers to access dental care due to their bleeding tendency, which may lead to delays in oral care and severe dental problems. To determine the current subjective and objective oral health status in adult PWH. Randomly selected PWH of the Erasmus MC Haemophilia Treatment Center (HTC), Rotterdam, the Netherlands, were invited to participate. Data was collected using the Oral Health Impact Profile (OHIP-14NL) and personal interviews. A dentist used the DMFT index, the Dutch Periodontal Screening index (DPSI), plaque and bleeding index to score the dental status. Forty-eight adult PWH were included in this study, 20 mild, 15 moderate-severe and 13 severe haemophilia with a mean age of 44.7. PWH scored low on the OHIP-14 questionnaire (median total score 1.0; IQR .0-3.0), indicating a high self-rating oral health status. The number of bleeding events, bleeding- and plaque index score was not statistically significant between patients with mild, moderate or severe haemophilia. The mean number of decayed, missing, and filled teeth (DMFT-score) was significantly lower in the group of patients with severe haemophilia (median 2.0) compared to mild haemophilia (median 16.0) (p=.04). Twenty-five patients (52.1%) reported to have encountered bleeding problems during or after dental interventions during their lifetime. Dutch adult PWH A/B have good dental status and oral health status.

Siyah Diş Renklenmesi Olan Çocukların Renklenme Şiddetine ve Etkilenen Süt Dişi Sayısına Göre Değerlendirilmesi: Bir Kesitsel Çalışma

Objective: The present study aimed to evaluate a group of Turkish children with black tooth stain (BTS) according to the severity of stains (SBST) and number of black stained primary teeth (NBST). Material and Methods: The children with BTS aged 4-6 years who met the inclusion criteria were selected. Teeth were examined for SBST, NBST, caries and plaque index. The demographic factors, medical and birth history, nutritional status, habits in infancy, using of iron supplements, oral hygiene habits, presence of BTS in parents/siblings, and dietary habits were compared according to SBST and NBST. The data were analyzed with the SPSS program. Results: A total of 120 patients (53 females, 67 males) were included. It was found that NBST increased with age. NBST and severe BTS were found to be higher in children born by cesarean section compared to those born by vaginal delivery (p=0.014; p=0.004). The children who fed with nursing bottles less than 6 months have lower NBST (p<0.001). The mild BTS was more common in children who used no iron supplements (81%). Children with plaque index score 0 and 1 did not have severe BTS, while 94.4% of children with plaque index 3 had severe BTS (p<0.001). The difference between decayed, missing, and filled teeth according to SBTS was not found significant (p=0.232). Conclusion: In conclusion, it was found that both the NBST and SBST were differed according to age, type of birth, breastfeeding, using nursing bottles, using iron supplements, consumption of cariogenic foods, and presence of BTS in parents/siblings.

Dysfunctional Internet Behavior Patterns and its Relation to Oral Health Status among Adolescents in Coimbatore: A Cross-sectional Study

Aim: The aim is to assess dysfunctional Internet behavior patterns and their influence on oral health status among adolescents. Methodology: A descriptive cross-sectional study was designed and conducted among college-going adolescents in the Coimbatore district. The estimated sample size was 196. This sample was drawn from across the city through a simple random sampling methodology. Data were collected on a specially designed pro forma, which contained three parts. Statistical Analysis: Descriptive analysis was carried out. The Chi-square test was used to test statistical significance. Univariate logistic regression analysis of factors associated with risk at Internet Addiction Test in the study population was carried out. P &lt; 0.05 was considered statistically significant. Results: There was a difference in the proportion of oral hygiene index scores (χ2 = 52.06), plaque index scores, and gingival index scores across Internet Addiction Tests and were statistically significant (P &lt; 0.05), whereas the Decayed Missing Filled Teeth index scores across Internet Addiction Test was statistically not significant (P = 0.54). Univariate regression analysis revealed that compared to good oral hygiene, the odds of risk at the Internet Addiction Test was 2.7 (95% confidence interval [CI] = 0.8–8.7) times in fair and the association was statistically not significant (P &gt; 0.05). The odds of risk at Internet Addiction Test in poor oral hygiene was 15.5 (95% CI = 4.16–58.11) times, and the association was statistically significant (P &lt; 0.05). Conclusion: Our results have indicated that the time spent on the Internet, which is otherwise labeled as “Addiction” in adolescents, is related to the risk of oral health problems.

Effect of Coconut Oil Pulling on Plaque-Induced Gingivitis: A Prospective Clinical Study

Context: Oil pulling carried out with coconut oil plays a vital role in treating plaque, gingivitis and eradicating dental caries. Aims: The study was conducted to assess the effect of coconut oil pulling on plaque formation and plaque-related gingivitis. Settings and Design: A prospective clinical study was conducted at a Dental College and Hospital to assess the effect of coconut oil pulling on plaque formation and plaque-related gingivitis. Subjects and Methods: The study was conducted among 75 students, aged between 19 and 21 years. All the subjects were advised to perform oil pulling with 5 ml of edible coconut oil every morning for 5 min on empty stomach and before tooth brushing. The data for plaque and gingival index-scores were assessed periodically at baseline, 15th day, and 30th day. Statistical Analysis Used: The collected data were analyzed using student paired t-test with SPSS software version 22. Results: Among 75 enrolled patients, the reduction of means of Gingival Index scores at baseline was (1.178 ± 0.124), at 15th day was (1.076 ± 0.051) and at 30th day was (1.023 ± 0.020) and reduction of means of plaque Index scores at baseline was (1.518 ± 0.084), at 15th day was (1.257 ± 0.062) and at 30th day was (1.090 ± 0.054). A positive correlation between Gingival and Plaque Index scores was found between periods. The result for both was found to highly statistically significant, (P &lt; 0.001). Conclusions: Coconut oil pulling when used as an adjunctive oral hygiene aid is effective in decreasing plaque formation and subsequent plaque-induced gingivitis.

Comparison of Three Different Calcium Channel Blockers on Gingival Overgrowth in Hypertensive Patients

Introduction: Calcium Channel Blockers (CCBs) like Nifedipine is the most widely used drug in many countries in the management of hypertension, with other drugs also in use like Amlodipine, and Felodipine. Gingival hyperplasia is the common adverse effect of the three classes of CCBs used commonly as dihydropyridine calcium antagonists. Aim: To compare the effect of three different CBCs on gingival overgrowth in hypertensive patients. Materials and Methods: The present cross-sectional study was carried out in the Department of Periodontics, Sibar Institute of Dental Sciences, Guntur, Andhra Pradesh. The study was conducted between September 2020 and February 2022. A total of 206 patients with hypertension taking CCBs, were enrolled and divided into three groups based on the patient’s medication as Group-I (nifedipine; n=83), Group-II (amlodipine; n=71) and Group-III (felodipine; n=52). Gingival Overgrowth (GOG) was graded and periodontal parameters like Plaque Index (PI), Gingival Index (GI), and Probing Pocket Depth (PPD) were recorded. One-way analysis of variance and Tukey’s post-hoc test were done to evaluate and compare between the groups. Results: Mean age of the patients in group-I was 60.81±4.13 years, in group-II was 62.70±4.19 years, and in group-III was 59.54±3.42 years. No significant difference in PI scores and GI scores was seen between the groups. The mean score for PPD in group-I was 5.91±0.14 mm, in group-II score was 5.76±0.14 mm and in group-III the score was 5.13±0.22 mm. A statistically significant difference (p&lt;0.001) was observed in group-I when compared with group-II and group-III. The mean GOG scores in group-I, group-II, and group-III were 3.49±0.22, 2.98±0.3, and 2.74±0.16. A statistically significant (p=0.001) increase in GOG scores was observed in group-I followed by group-II and group-III. Conclusion: Nifedipine was the most prescribed drug with high amount of gingival overgrowth in patients with hypertension, compared with amlodipine and felodipine.

Comparative Evaluation of the Efficacy of Gingival Crevicular Blood with Finger Capillary Blood and Venous Capillary Blood to Assess Blood Glucose Levels for Screening of Diabetes Mellitus in Chronic Periodontits Patients: A Cross-sectional Study

Introduction: Diabetes mellitus is defined as a clinically and genetically diverse cluster of illnesses involving conflict in carbohydrate and protein metabolism. Periodontitis is a complex condition with several causes. The interaction between these two conditions appears to be cyclical as well as bidirectional. Gingival crevicular blood obtained through routine periodontal oral assessment could be utilised for blood glucose estimation. Aim: To examine the efficacy of gingival crevicular blood elicited during routine periodontal probing as a reliable source for screening of diabetes mellitus, and to compare it with finger capillary blood and venous capillary blood in chronic periodontitis patients. Materials and Methods: This cross-sectional, in-vivo, clinical study was conducted in the Department of Periodontology at Karnavati School of Dentistry, Gandhinagar, Gujarat, India, from January 2021 to January 2022. The study included 50 patients, who were diagnosed with chronic periodontitis in the age range ≥30 years, and met the inclusion and exclusion criteria. A prior detailed history was compiled. The clinical parameters recorded were sulcus bleeding index, plaque index, gingival index, probing pocket depth, and clinical attachment level. Each patient’s blood samples were collected from three different sites, Gingival Crevicular Blood (GCB) collected from gingival crevice, Finger Capillary Blood (FCB) collected from finger bed and and Venous Capillary Blood (VCB) collected from forearm for determining the blood glucose levels. Glucose levels were compared by oneway Analysis of Variance (ANOVA). Karl Pearson’s correlation was used for the comparison. Statistical Package for Social Sciences (SPSS) version 26.0 was used for statistical analysis and p-value ≤0.05 was considered as statistically significant. Results: The mean Probing Pocket Depth (PPD) and Clinical Attachment Level (CAL) was 5.5±0.61 mm and 6.76±0.82 mm, respectively. The mean Plaque Index (PI) and Gingival Index (GI) score was 1.41±0.25 and 1.45±0.21, respectively. The mean GCB, FCB, and VCB glucose level of the subjects were 171.58±85.63 mg/dL, 179.14 ±80.31 mg/dL and 186.96±87.57 mg/dL, respectively. There was no statistical difference seen among the three methods thus, either of the methods can be used for measuring blood glucose levels for screening of diabetes mellitus in chronic periodontitis patients (p-value= 0.66). Posistive correlation between FCB and VCB (r-value=0.976, p-value&lt;0.001). VCB and GCB when correlated showed strong positive and highly statistically significant results (r-value= 0.934, p-value&lt;0.001). Similarly, GCB and FCB showed a positive correlation (r-value=0.920, p-value&lt;0.001) which was statistically highly significant. Conclusion: The results suggested that the efficacy of gingival crevicular blood when compared with finger capillary blood and venous capillary blood glucose levels showed positive correlation, suggesting either can be used in dental clinics for diabetic screening purpose without any extra invasive procedures.

A prospective multicenter clinical study on the efficiency of detachable ball- and spring-retained implant prosthesis.

This prospective clinical study was conducted to evaluate the clinical usefulness of the freely detachable zirconia ball- and spring-retained implant prosthesis (BSRP) through a comparative analysis of screw- and cement-retained implant prosthesis (SCRP). A multi-center, randomized, prospective clinical study evaluating the clinical usefulness of the detachable zirconia ball- and spring-retained implant prostheses was conducted. Sixty-four implant prostheses in 64 patients were examined. Periodic observational studies were conducted at 0, 3, 6, and 12 months after delivery of the implant prosthesis. Factors such as implant success rate, marginal bone resorption, periodontal pocket depth, plaque and bleeding index, and prosthetic complications were evaluated, respectively. During the 1-year observation period, all implants survived without functional problems and clinical mobility, showing a 100% implant success rate. Marginal bone resorption was significantly higher in the SCRP group than in the BSRP group only at the time of implant prosthesis delivery (P = .043). In all observation periods, periodontal pocket depth was slightly higher in the BSRP group than in the SCRP group, but there was no significant difference (P > .05). The modified plaque index (mPI) scores of both groups were moderate. Higher ratio of a score 2 in modified sulcus bleeding index (mBI) was observed in the BSRP group in the 6- and 12-months observation. Within the limitations of this study, the newly developed zirconia ball- and spring-retained implant prosthesis could be considered as an applicable and predictable treatment method along with the existing screw- and cement-retained prosthesis.

Evaluation of Effects of Scaling with and without Polishing on Oral Hygiene Clinical Parameters – A Concurrent Parallel Randomized Trial

Introduction: Good oral health is a crucial indicator of overall well-being. Oral hygiene maintenance and care is the practice of keeping the oral cavity clean and disease free. The main objective of this study was to evaluate the effects of scaling and polishing on oral hygiene clinical parameters at different intervals. Materials and Methods: A concurrent parallel randomized trial was carried out among 60 college students in the Namakkal district. Subjects were randomly assigned into two groups, the scaling followed by the polishing group and the scaling without polishing group. This was a three-point assessment (baseline, 2nd week, and 3rd week) for plaque, gingival, and marginal line calculus index scores. Data were analyzed using parametric tests: independent t-test and repeated measures ANOVA. Results: A statistically significant difference was found for all three clinical parameters at the final 3rd-week follow-up between the two groups. Between the intervals, both the groups had a significant difference (P &lt; 0.05) for plaque, gingival, and calculus index. Conclusion: Scaling followed by polishing had better results when compared to scaling without polishing. Microlocal irregularities, caused by scaling procedures, might be the cause for further accumulation of debris which can be reduced by polishing procedures.

A Clinical Trial Examined the Effectiveness of Curcumin and Vitamin C Sheets as Local Medicine Delivery Agents in Addition to Scaling and Root Planning

Abstract Aim: The aim of this study was to assess the effectiveness of using Vitamin C and curcumin sheets applied subgingivally in combination with scaling and root planing (SRP). Patients age between 35 and 60 would be included, a total of 45 sites divided into three groups which are distributed as follows: Group I – (SRP) alone, Group II (SRP) with Vitamin C sheet, and Group III (SRP) with curcumin sheet Results: The mean gingival index (GI) scores for Group I were 2.60, 0.51, 0.93, 0.26, and 1.00, respectively, at baseline, 15 days, and 30 days. At baseline, the mean GI score in Group II decreased from 2.53 ± 0.52 to 0.67 ± 0.49 at 45 days. In line with this, Group III saw a decrease in the mean GI score from 3.00 ± 0.00 at baseline to 0.20 ± 0.41 at 45 days. At different points, each group showed a statistically significant difference. In Group III, the mean plaque index score dropped from 3.00 ± 0.00 at baseline to 0.27 ± 0.46 at 30 days. Only Group III showed a statistically significant difference at various periods. Probing pocket depth intergroup comparisons for all groups were found to be statistically significant. Conclusion: According to the study’s findings, SRP in combination with Vitamin C and curcumin sheets improved periodontal markers and had a positive impact on individuals with chronic periodontitis.

Evaluation of Efficacy of 4% Ocimum sanctum Gel in the Management of Chronic Periodontitis

ABSTRACT Aim: The present experimental study was performed with the aim of assessing the efficacy of Ocimum sanctum (OS) gel as an adjunct to scaling and root planing (SRP) in the management of chronic periodontitis. Materials and Methods: Minimum inhibitory concentrations and minimum bactericidal concentration of OS on Porphyromonas gingivalis, Prevotella intermedia (Pi), Fusobacteria nucleatum, and Aggregatibacter actinomycetemcomitans was carried out as a pilot study. Further, a total of 60 patients (mean age of 34.5 ± 8.3 years) were enrolled in this study (n = 30 in each group). In the control group (A), Phase I periodontal therapy was performed, whereas in the test group (B), 4% OS gel was inserted into the pockets at baseline after the same. The clinical parameters recorded included plaque index (PI), sulcus bleeding index, probing depth, and clinical attachment level were recorded at baseline and after 45 days. Results: The results obtained by in vivo assessment following the placement of 4% OS gel demonstrated that the mean PI score at baseline was 2.29 ± 0.21, which was reduced to 0.97 ± 0.293 at the 45th day (P = 0.001) for Group A, whereas it was 2.18 ± 0.22, which was reduced to 1.46 ± 0.29 at the 45th day (P = 0.001) for Group B. The mean Modified Sulcular Bleeding Index score at baseline was 3.56 ± 0.77, which was reduced to 1.55 ± 0.62 at the 45th day after local drug delivery of OS gel for Group A, whereas it was 3.08 ± 0.69, which was reduced to 1.45 ± 0.51 at the 45th day (P &lt; 0.001). The difference between Group A and Group B was statistically not significant (P &gt; 0.05). The mean probing depth at baseline was 8.07 ± 1.60, which was reduced to 4.83 ± 1.38 for Group A (P &lt; 0.001), whereas it was 7.50 ± 1.63 at baseline and 5.68 ± 1.29 at the 45th day for Group B (P &lt; 0.001). The mean clinical attachment level at baseline was 4.26 ± 1.02, which was reduced to 2.78 ± 0.84 for Group A at the 45th day (P &lt; 0.001), whereas it was 4.05 ± 1.08 at baseline and 3.27 ± 0.97at the 45th day for Group B (P &lt; 0.001). The difference between Group A and Group B was statistically highly significant (P &lt; 0.01). Conclusions: The subgingival delivery of 4% OS gel can be used as an adjunct to SRP for superior clinical outcomes in chronic periodontitis cases as compared to SRP alone. CLINICAL RELEVANCE TO INTERDISCIPLINARY DENTISTRY This study emphasizes the anti-inflammatory role of Ocimum sanctum in nonsurgical management of periodontal infection which need to be tackled before any other procedures of orthodontics, prosthetic or restorative dentistry.

Evaluation of Local Drug Delivery System Containing 1% (W/V) Chitosan Gel Used as an Adjunct to Scaling and Root Planning in Chronic Periodontitis– A Split Mouth Study

Introduction: Periodontitis is defined as an inflammatory disease of supporting tissues of teeth,In the treatment of periodontitis systemic antibiotics has potential side effect such as the development of resistant bacteria. These limitations can be avoided by application of the antimicrobials in local drug delivery (LDD) systems directly into the periodontal pocket. Natural polymer chitosan which is found in abundance in nature has antibacterial, antiinflammatory properties and is biodegradable and biocompatible. Materials and Method: A randomized controlled split-mouth study was designed. 30 patients were randomly selected.A resorbable chitosan gel of 1% (w/v) was placed in the selected test sites one week after scaling and root planing (SRP). Gel was injected into the periodontal pockets using a blunt cannula till the pocket was completely filled. Periodontal dressing was applied after placement of the gel. The ancillary parameters were assessed. Results: Statistically significant difference was present in mean plaque index scores and modified gingival index scores at 1 month and 3 months from baseline in both the groups as chitosan shows a strong activity in reducing dental plaque against various periodontal pathogens. Statistically significant difference was present in pocket depth between group I and group II at 1 month and 3 month. Statistically, significant difference was present in Relative Attachment Level between group I and group II at 1 months and 3 months. Discussion: In this study Chitosan biopolymer, used in a gel form, (1% w/v) demonstrated the effectiveness for treatment of localized pockets in patients with chronic periodontitis.the results suggest chitosan has its own properties which causes reduction of pocket depth. Conclusion: Chitosan is an effective local drug delivery agent for chronic periodontitis patients.

Comparison of periodontal status and salivary IL-15 and -18 levels in cigarette-smokers and individuals using electronic nicotine delivery systems

BackgroundIt is hypothesized that periodontal status is compromised and whole salivary (WS) interleukin (IL)-15 and IL-18 levels are higher among cigarette-smokers and electronic-nicotine-delivery-systems (ENDS)-users than never-smokers. The aim of the present case–control study was to compare the periodontal status and WS IL-15 and -18 levels among cigarette-smokers, ENDS-users and controls (never-smokers).MethodsParticipants were divided into 4 groups as follows: Group-1:Current cigarette-smokers; Group-2:ENDS-users; Group-3:Never-smokers with periodontitis; and Group-4: Never-smokers without periodontitis. Demographic data was collected and plaque index (PI), gingival index (GI), probing-depth (PD), clinical attachment-loss (AL), and marginal bone loss (MBL) were measured. Number of missing teeth were recorded and WS IL-15 and IL-18 levels were determined. Group-comparisons were done and P < 0.01 was selected as an indicator of statistical analysis.ResultsNineteen, 18, 19 and 19 individuals were enrolled in groups 1, 2, 3 and 4, respectively. Scores of PI, clinical AL, PD, and number of missing-teeth were elevated in groups 1(P < 0.001), 2 (P < 0.001) and 3 (P < 0.001) than -4. Scores of PI, clinical AL, PD, MBL and missing teeth were comparable among patients in groups 1, 2 and 3. Levels of IL-15 and IL-18 were elevated in groups 1 (P < 0.001) and 2 (P < 0.001) than groups 3 and 4. The levels of IL-15 and -18 were higher in Group-3 than in Group-4 (P < 0.001).ConclusionClinically, cigarette-smokers and never-smokers demonstrate similar periodontal statuses; however, WS immunoinflammatory biomarkers (IL-15 and -18) are elevated in these individuals than non-smokers.

Antimicrobial Activity of Chlorhexidine and Herbal Mouthwash Against the Adherence of Microorganism to Sutures After Periodontal Surgery: A Clinical Microbiological Study.

Introduction: Chemical plaque control agents assist to eliminate plaque microorganisms. Therefore, the purpose of this research was to compare the effectiveness of a herbal mouthwash (HiOraTM) and a mouthwash containing 0.2% chlorhexidine in preventing bacteria from adhering to sutures in participants who had had periodontal flap surgery. Material and methods: 75 patients with chronic periodontitis were included in the study and divided into three groups. Plain water, herbal, and chlorhexidine mouthwashes were given after periodontal surgery, and sutures were removed on the eighthpostoperative day and sent for microbial analysis. Further plaque index (PI) and gingival index (GI) were recorded at baseline and on the eighthpostoperative day. Results: Different aerobic bacterial species were isolated, namely Staphylococcus aureus (S. aureus), coagulase-negative staphylococci (Cons), Escherechia coli (E. coli), Klebsiella bacteroides, and Streptococcus mutans (S. mutans). Significant differences were found among colony-forming units (CFUs) of bacterial species in different groups, and it is found that chlorhexidine mouthwash is quite effective against the adherence of microorganisms to sutures after periodontal surgery as compared to the control group and herbal mouthwash group. Herbal mouthwash has less antimicrobial activity when compared to chlorhexidine, but herbal mouthwash is highly effective against microbial adherence to sutures when compared to the control group (plain water). Significant variations between groups are shown in the PI and GI scores, indicating that chlorhexidine is successful in lowering the PI and GI scores and that herbal rinse is also helpful in reducing these scores, but to a lesser extent than chlorhexidine. Conclusion: According to the findings of this research, sutures are at risk for developing bacterial infections. However, the adhesion of microbes to sutures may be decreased with the adjunctive use of antimicrobial medicines such as chlorhexidine and herbal mouthwashes, which will result in improved wound healing. Herbal mouth rinses are effective in killing germs. However, chlorhexidine is far more effective in this regard.

A Randomized Controlled Trial for Evaluation of the Effectiveness of Oral Irrigator and Interdental Floss for Plaque Control in Children with Visual Impairment.

To evaluate the effectiveness of oral irrigator and interdental floss as adjuncts to manual tooth brushing in 8-16 years old children with visual impairment. A three-arm, parallel-group randomized controlled trial with blinded outcome assessment was carried out with the inclusion of 90 institutionalized children with visual impairment of age 8-16 years. They were equally allocated to three groups: group I: tooth brushing along with interdental flossing, group II: brushing along with a powered oral irrigator, and group III: brushing alone (control). Baseline oral hygiene index-simplified (OHI-S), gingival index (GI), and plaque index (PI) scores were recorded for all the samples and compared with post-intervention scores at 14 and 28 days intervals. Repeated measures of analysis of variance (ANOVA), one-way ANOVA, and post hoc Tukey tests were used for statistical analysis. At 28 days interval, children in group II showed a highly statistically significant reduction in OHI-S (0.46; p = 0.0001), PI (0.16; p = 0.0001), and GI (0.24; p = 0.0001) scores compared to control group. They also showed a significant reduction in OHI-S (0.25; p = 0.018), PI (0.15; p = 0.011), and GI (0.15; p = 0.0001) scores compared to group I. There is no significant reduction in the scores of children of group I compared to control group except for the GI score (0.08; p = 0.02). Oral hygiene maintenance using oral irrigator along with brushing was found to be more effective in visually challenged children. Interdental flossing, along with brushing and brushing alone was found to be less effective. This study underlines the fact that comprehensive oral hygiene care should include interdental cleaning aids for effective plaque control to prevent dental diseases in children with visual impairment. Since these children have less manual dexterity to perform good oral hygiene practices, electrically driven interdental cleaning aids like oral irrigator may help them to overcome the problem. Deepika V, Chandrasekhar R, Uloopi KS, et al. A Randomized Controlled Trial for Evaluation of the Effectiveness of Oral Irrigator and Interdental Floss for Plaque Control in Children with Visual Impairment. Int J Clin Pediatr Dent 2022;15(4):389-393.

Association of the self-reported socioeconomic and health status with untreated dental caries and the oral hygiene level in adult patients.

Dental caries is a multifactorial disease and its management requires a thorough analysis of its etiological factors. The present study used a multivariate approach to investigate the associations of socioeconomic and health-related determinants with untreated tooth decay and level of oral hygiene in adult individuals. A cross-sectional study involved 597 adult patients. Health and socioeconomic status were assessed using a self-administered structured questionnaire. The presence of decayed teeth was recorded clinically using the World Health Organization diagnostic thresholds. Oral hygiene level was estimated using the plaque index. Multiple linear regression analysis was used to explore the associations of socioeconomic and health-related variables with the number of decayed teeth and level of oral hygiene. Socioeconomic and health-related variables explained 34.1% of the observed variation in the number of decayed teeth (p < 0.001) and 19.2% of the observed variation in the plaque index (p < 0.001). Analysis revealed several significant associations for both decayed teeth and plaque index scores. Males had 2.3 more untreated decayed teeth than women and an increased plaque index score of 0.3 units (unique contributions of 6.6 and 4.2%, respectively). An increase in self-assessed household economic status decreased the average number of decayed teeth by 1.3 and the plaque level score by 0.13 (unique contributions of 3.13% and 1.46%, respectively). Smokers presented with 1.78 more decayed teeth than non-smokers (unique contribution of 2.1%) and an increase in the plaque index by 0.48 units (unique contribution of 8.5%). Untreated dental caries and dental plaque severity share the same socioeconomic and health-related determinants.

Comparison of the Anti-Plaque Effect of Miswak (Salvadora Persica) and Dandasa (Juglan Regia) on gingival health

Background: Anti-bacterial effect of Miswak on microorganism has already been proven in previous researches. The Dandasa is used by most women in Saudi Arabia, India and Pakistan as a toothbrush for cleaning the teeth. Aim: This study was done for the comparison between the effect of Miswak and Dandasa in improving gingival health, as both has anti-plaque action and absence of plaque is directly proportional to gingival health. Methods: A prospective cohort study was carried out at the Department of Periodontology, Dr.Ishrat-ul-Ebad Khan Institute of Oral Health Sciences, Karachi for a period of 6 months. Total 90 patients fulfilling the inclusion criteria were included into two Groups. In group-A habitual user of miswak were taken and in group-B habitual user of dandasa were taken. The Plaque score and gingival index were made zero before the start of observation by conducting ultrasonic scaling. Results: In Group A 57.8% participants were using miswak once a day and 42.2% twice a day. In group B 44.4% participants were using Dandasa once a day 44.2% and 55.6% twice a day. Mean post-gingival index score was 1.95±0.52 in group A and 1.08±0.28 in group B. Mean post plaque index score in Group A was 1.97±0.69 and Group B was 1.15±0.36. The results portrayed significant discrepancy in pre and post gingival index. The conclusion also depicted prominent variability in pre-post-plaque index. Both indices showed that the dandasa was better at plaque control as compare to Miswak Conclusion: Mean Gingival Index (GI) and Plaque Index (PI) scores in dandasa group was prominently less as compared to Miswak group. Keywords: Gingival Index, Plaque index, Dandasa, Miswak

Clinical Evaluation of Toothbrushes for Elderly Patients: A Crossover Study

The aim of this study was to evaluate the efficacy of 2 newly designed toothbrushes used by elderly individuals based on plaque removal and gingival inflammation reduction compared with 2 commercially available toothbrushes. This was a randomised, controlled, single-blind, 4-period crossover clinical trial. Thirty elderly participants meeting the inclusion criteria were randomly allocated into 4 groups, which determined the sequence of the 4 toothbrushes: CUdent/extra soft, CUdent/soft, GoodAge, and Colgate. The participants' baseline bleeding on probing (BOP) and plaque index (PI) were assessed by one blinded calibrated examiner, then their teeth were professionally cleaned. The participants were assigned to use the tested toothbrush and were recalled for postbrushing examination 2 weeks later to evaluate their BOP and PI. At the end of each test period, the participants used their own toothbrush during the 2-week washout period before using the next tested toothbrush. The mean age of the 30 participants was 63.2 years. The mean baseline BOP score was 44.4%, and mean baseline PI was 2.7. Three participants dropped out; thus, 27 participants (15 females and 12 males) provided data throughout the study period. The participant characteristics and baseline data between the groups were similar. CUdent/extra soft and CUdent/soft demonstrated significantly better PI scores at the buccal surfaces than GoodAge (P < .05). CUdent/soft had the lowest PI scores and Colgate presented the lowest BOP score in every comparison for other areas; however, the differences were not significant. No signs of tissue trauma or abrasion were observed. The newly designed toothbrushes were comparable to the commercially available toothbrushes in plaque removal efficacy and reducing gingival inflammation. CUdent/extra soft and soft were significantly more effective in plaque removal in the buccal regions than GoodAge.

Increase in the level of oral neutrophils with gingival inflammation – A population survey

ObjectivesHost responses to oral inflammation include a continuous and substantive response with the influx of polymorphonuclear leukocytes (PMN). PMN, referred to as first responders, migrate rapidly from the circulatory system through the connective tissue to mitigate stimuli and localize in the saliva. This study examined the relationship between the well-established clinical indices of gingivitis and dental plaque and the PMN level. Materials and MethodsThis study enrolled adults aged 18–75 years, who provided voluntary informed consent. Oral rinse samples were collected from 159 participants to estimate the PMN levels prior to the full-mouth assessment for gingivitis and dental plaque using the respective clinical indices. ResultsThe gingival index and dental plaque index scores were in the range of 0.098–2.71 and 0.73–4.78, respectively. Regardless of the age and gender, higher number of PMN was observed with higher gingival index and dental plaque index scores. Our analyses indicated a significant correlation between the oral PMN level and gingival index with a correlation coefficient of 0.66 (p < 0.0001). Similarly, the correlation between the PMN level and dental plaque index was statistically significant with a correlation coefficient of 0.57 (p < 0.0001). Regression analysis identified a significant relationship between the PMN level and clinical indices (p < 0.0005). ConclusionsIncrease in the PMN levels with increasing clinical scores (gingival and dental plaque indices) reflect the oral inflammatory burden, irrespective of age or gender. These observations warrant future studies on participants stratified by health status and research directed toward examining the effects of interventions.