Quigley-Hein Index Research Articles

The Effect of the Continuous Care Model on Oral Health, Self-Efficacy, and Self-Care in Patients With Head and Neck Cancer Undergoing Radiotherapy: A Study Protocol for a Quasi-Experimental Study.

Head and neck cancer, with its unique challenges, often involves radiotherapy as a primary treatment. This can lead to complications affecting patients' well-being. A continuous care model offers potential benefits, but its effectiveness requires validation through rigorous studies. This protocol aims to evaluate its impact on patients undergoing head and neck cancer radiotherapy, contributing to improved care strategies and well-being. The study is a double-arm and parallel-group quasi experimental study in which a 4-week intervention will be compared with usual care. A total of 70 eligible patients with head and neck cancer who are undergoing radiotherapy will be recruited to the intervention or control group. The patients in the intervention group will receive a continues care model designed for head and neck cancer patients in four phases of Orientation, Sensitization, Control, and Evaluation. The primary outcomes include dental plaque and gingival index, which will be measured by an approved dentist using The Gingival and Quigley-Hein index. The secondary outcomes are Oral hygiene self-efficacy and Dental and Oral Health Self-Care Behavior which will be assessed by the Oral and Dental Health Self-Efficacy and Dental and Oral Health Self-Care Behavior Questionnaires. Descriptive statistics will be used to describe variables. According to the types of variables, appropriate statistical tests, including two-sample t-tests, Χ 2, analysis of covariance, or linear regression will be performed. In conclusion, this study aims to evaluate the impact of a continuous care model on head and neck cancer patients undergoing radiotherapy. Findings will contribute to enhancing care strategies and well-being in this population. The trial has been approved by the Research Ethics Committees of Zahedan University Of Medical Sciences. In this study, written consent will be obtained from all participants. The results will be presented to representative groups and published in peer-reviewed journals.

DeepPlaq: Dental plaque indexing based on deep neural networks.

The selection of treatment for dental plaque is closely related to the condition of the plaque on different teeth. This study validated the ability of CNN models in assessing the dental plaque indices. In 70 (20 male and 50 female) healthy adults (18 to 55 years old), frontal and lateral view intraoral images (210) of plaque disclosing agent stained permanent and deciduous dentitions were obtained. A three-stage method was employed, where the You Look Only Once version 8 (YOLOv8) model was first used to detect the target teeth, followed by the prompt-based Segment Anything Model (SAM) segmentation algorithm to segment teeth. A new single-tooth dataset consisting of 1400 photographs was obtained after applying a two-stage method. Finally, a multi-class classification model DeepPlaq was trained and evaluated on the accuracy of dental plaque indexing based on the Quigley-Hein Index (QHI) scoring system. Classification performance was measured using accuracy, recall, precision, and F1-score. The teeth detector exhibited an accuracy (mean average precision, mAP) of approximately 0.941 ± 0.005 in identifying teeth with plaque disclosing agents. The maximum accuracy attained in the plaque indexing through DeepPlaq was 0.84 (probability that DeepPlaq scored identical to experts), and the smallest average scoring error was less than 0.25 on a 0 to 5 scale for scoring. A three-stage approach demonstrated excellent performance in detecting and segmenting target teeth, and DeepPlaq model also showed strong performance in assessing dental plaque indices. Application of artificial intelligence to the evaluation of dental plaque distribution could enhance diagnostic accuracy and treatment efficiency and accuracy.

Halitosis in young patients with chronic kidney disease: findings from a randomized controlled trial

BackgroundChronic kidney disease (CKD) directly affects oral health. Yet data about halitosis in young CKD patients and the impact of dental prophylaxis is limited. Therefore, as part of this randomized clinical trial, halitosis in young CKD patients undergoing intensive or standard oral preventive procedures was to be explored.MethodsThree volatile sulfur compounds (hydrogen sulfide, methyl mercaptan and dimethyl sulfide) were measured in 30 young patients with CKD (mean age 14.2 years; 16 males, 14 females). Breath samples were taken after 3 and 6 months and analyzed with selective gas chromatography (OralChroma). Tongue coating (Winkel Index) and clinical indices to determine local inflammation or oral hygiene (Papillary Bleeding Index and Quigley-Hein Index) were assessed. Within an extended anamnesis, patients and their mothers and nurses were questioned about the perceived halitosis. Corresponding quotes were noted verbatim. Patients were randomized to either intensive need-related oral health care measures (oral preventative program, OPP) or a one-stage standard prevention (treatment as usual, TAU).ResultsWhile there were no differences in volatile sulfur compound levels between TAU and OPP at the three time points of measurements (p > 0.05), there was a tendency towards a reduction in dimethyl sulfide and hydrogen sulfide of affected patients within the OPP group over time. Looking at potential differences between both groups with regard to tongue coating, significant differences were observed between baseline and 3 months after study start in the OPP group, and between baseline and 6 months after study start in the TAU group (p < 0.05). The burden of halitosis was frequently reported by patients’ mothers and nurses.ConclusionsYoung CKD patients regularly suffered from halitosis and dimethyl sulfide was its main source. Preventive measures mainly resulted in a reduction of tongue coating. Trial registration: The German Clinical Trial Register (# DRKS00010580).

Self-determined use of provided powered oral hygiene devices leads to improved gingival health after 1 year: a longitudinal clinical trial

PurposeOur study aimed to evaluate the long-term concordance and acceptance when using powered devices for everyday oral hygiene routine and gingival health in patients showing papillary bleeding.Patients and methodsThirty-one participants were recruited at the dental clinic of the University Hospital of Cologne, Germany, over a 6-week duration. At baseline, a standard dental check-up was performed, including oral hygiene indices and documentation of oral hygiene devices used. The study consisted of two consecutive phases: the first (motivational trial) was designed to prove the effectiveness and safety of a microdroplet device and a powered toothbrush compared to dental floss and a manual toothbrush over a period of 4 weeks. The second (observational) phase began with all participants receiving the powered oral homecare devices. Participants were able to use their oral hygiene measures of choice over an unsupervised period of 1 year. All participants were then rescheduled for a routine dental check-up, where oral hygiene indices and oral hygiene devices used were reevaluated.ResultsAfter 1 year, 93.3% of participants stated they performed interdental cleaning on a regular basis (baseline 60.0%). The percentage using a powered toothbrush increased from 41.9% (baseline) to 90.0% after 1 year. Oral hygiene parameters had improved after both the motivational trial and observational phases compared to baseline (papillary bleeding index p = .000; Rustogi Modified Navy Plaque Index p < .05; Quigley-Hein Index p = .000).ConclusionIn the long term, participants preferred using powered oral hygiene devices over the gold standard dental floss and manual toothbrush. Improved oral hygiene parameters after 1 year may indicate implementation of newly acquired oral-hygiene skills during the 4-week instruction phase.

Çiğnenebilir, elektrikli ve manuel diş fırçalarının plak uzaklaştırma etkinliklerinin karşılaştırılması: Randomize klinik çalışma

Objective: A comparative evaluation of the plaque removal efficacy of manual, electric, and chewable toothbrushes. Material-Method: Our randomized and examiner-blinded clinical study involved 90 dental students. The students were divided into three groups: manual, electric, and chewable toothbrush users. The plaque removal efficiency of the brushes was evaluated using the Turesky modification of the Quigley–Hein Index (TMQHI). Results: Ninety participants, consisting of 32 males and 58 females, aged between 21 and 23 years (average age 220.47) were included in the study. The mean TMQHI score before brushing was 2.4±0.49 in the manual brushing group, 1.81±0.61 in the electric toothbrush group, and 1.93±0.6 in the chewable brush group. The mean for the manual brushing group was thus higher than that of the other two groups (p&amp;lt;0.001). The mean TMQHI score after brushing was 1.37±0.43 in the manual brushing group, 0.91±0.52 in the electric toothbrush group, and 1.31±0.67 in the chewable brush group. The effectiveness of the chewable brush in plaque removal in all regions of the mouth was lower than that of the other two (p&amp;lt;0.001). There was no statistical difference between the manual and electric toothbrushes. Conclusion: The plaque removal efficiency of the chewable toothbrush was found to be lower than that of the electric and manual toothbrushes.

Evaluation of the cleaning efficacy of a normal toothbrush and a manual U shaped toothbrush in children aged 8–10 years: A randomized crossover trial

ABSTRACT Background: Plaque removal rates are influenced by toothbrush design as well as brushing methods. Aim: The study aimed to determine the efficacy of a manual U-shaped toothbrush when compared to a regular toothbrush in removing dental plaque from teeth in children aged 8–10 years. Materials and Methods: Our research included 40, 8–10-year-old children. Stage I included days 0–7, while Stage II covered days 8–15. A disclosing agent was used to identify and score the dental plaque. During Stage I of the study, Group I was given a regular toothbrush, and Group II was given a U-shaped toothbrush. During Stage II of the study, the cross-over of interventions was carried out. Loe-Silness gingival index and Turesky modification of the Quigley-Hein index were measured on the 8th and 16th day. Unpaired t-test/independent samples t-test were performed for comparison between the groups. Results: The intergroup evaluation of plaque scores on various surfaces between the two groups revealed statistically significant differences (P = 0.05) between the mean plaque scores at stage I on the labial surface (P = 0.001) and the lingual surface (P = 0.002) between the two groups. Comparing gingival health scores of various surfaces between the two groups, mesial, labial, distal, and lingual surfaces revealed statistically significant differences (P = 0.05) at stage II and lingual surfaces at stage I and stage II, respectively. Conclusion: The experimental U-shape toothbrush significantly reduced the extent of plaque on the lingual surfaces and improved the gingival index scores, which helped improve gingival health and oral hygiene.

Association between child's behaviour during first dental appointment and effectiveness of dental plaque removal by caregivers.

To evaluate the association between the behaviour of children aged 1 to 4 years during their dental appointment and the effectiveness of dental plaque removal by caregivers. This longitudinal study with intervention had the participation of 146 children (mean age=34.89months), 75 of whom (51.4%) showed positive behaviour (+ and ++) and 71 (48.6%), negative behaviour (- and - -). The children were evaluated at the first dental appointment, according to the Frankl scale. They were subjected to an assessment of oral conditions, and their plaque level was recorded (Quigley-Hein Index modified by Turesky) using the Evince® device. Caregivers received oral hygiene guidance. The dental plaque assessment was performed before giving the oral hygiene guidance and 14 days later. The statistical analysis included a descriptive assessment and the Wilcoxon test (p < 0.05). Mean dental plaque levels dropped significantly from the first to the second assessment (p < 0.001). The sample was divided according to the child's behaviour, observing that only the group of children with positive behaviour showed significantly less dental plaque in the second assessment (p < 0.001). The positive behaviour of children aged 1 to 4 years during the first dental appointments is associated with more effective dental plaque removal by caregivers.

Association of children's toothbrushing and fine motor skills: a cross-sectional study.

Fine motor skills (FMS) allow for the control and coordination of the distal musculature of hands and fingers, a skill required to brush teeth. The objective of this study was to investigate the association between FMS and toothbrushing efficacy. This cross-sectional study included 42 low-income Latino children aged 5 to 9 years from Pasto, Colombia. Toothbrushing efficacy was determined by the children's dental plaque Quigley-Hein Index (QH-I) mean-score difference from before and after toothbrushing. FMS were evaluated using the 5-15R parent evaluation, the spiral drawing Archimedes test, and a neurodevelopmental assessment of movements and prehension patterns during toothbrushing. A descriptive analysis was performed to assess the characteristics of FMS and children's toothbrushing, and a generalized linear model was used to determine associations between these skills and toothbrushing efficacy. Eighty-six percent of the children had at least one difficulty with FMS, and in 7%, they interfered with daily activities. Fourteen percent presented a moderate pattern in the Archimedes test, and 43% had inefficient prehension patterns. Toothbrushing reduced the QH-I by a mean of 1.45 (SD = 0.78-2.12) (p < 0.001). Toothbrushing efficacy was only significantly associated with age (mean-difference = -0.315, 95%CI: -0.481 to -0.148, p < 0.001). FMS and toothbrushing efficacy were not significantly associated. Other components of fine motor control should be analyzed to understand the kinetics of toothbrushing.

A randomized controlled trial on the plaque-removing efficacy of a low-abrasive air-polishing system to improve oral health care.

While air polishing with abrasive powders has been proved efficient for sub- and supragingival application, only few studies concerning the quality of supragingival biofilm removal using the low-abrasive erythritol powder (EP) exist. The aim of the present randomized controlled trial was to clinically compare the efficacy of supragingival air polishing using EP in comparison with the rubber cup method, and to juxtapose the corresponding biofilm regrowth rates. Thirty-two young adults, suspending oral hygiene for 48 hours, were enrolled in the present double-blind short-term investigation. Using a split-mouth design, tooth polishing was conducted by means of either air polishing or rubber cups with prophylaxis paste (control). While 16 participants received air polishing in the second and fourth quadrants (and rubber cup prophylaxis in the first and third ones), the reverse sequence was applied with the remaining 16 subjects. Biofilms were assessed using the modified Quigley-Hein index (QHI), and QHI sum scores achieved both prior to and immediately after the polishing procedure, as well as 24 hours later, were assessed using a two-way analysis of variance (ANOVA), followed by Tukey's HSD to test multiple pairwise comparisons. Both methods revealed a significant reduction of QHI scores (P < .001). Compared to the rubber cup method, air polishing resulted in significantly lower scores, both after tooth cleaning and after 24 hours (P < .001). Supragingival biofilm removal by means of air polishing combined with low-abrasive erythritol seems to be more efficacious than the traditional polishing method, and should improve oral health care.

A tailored tooth brushing program to control plaque accumulation and gingivitis among orphan children: A randomized trial

Objectives: Poor oral hygiene among children is major cause of gingivitis, caries, and especially orphans constitute socially disadvantaged group. The objective of the study was to assess the efficacy of a tailored tooth brushing program to improve supragingival plaque control and gingival health among 13–17-year-old orphan children in Chennai city over a period of 21 days. Materials and Methods: A double-blind parallel, controlled clinical trial was conducted among 60 orphan children (28 males and 32 females) with mean age of 15.24 years. Dental plaque was assessed using the Turesky modification of Quigley-Hein index; gingival inflammation was assessed using gingival index at initial visit and after 14 and 21 days. Subjects were randomly allocated into one of two groups (study – audiovisual and individual demonstration of brushing technique with reinforcement at 14 days follow-up/control – only individual demonstration) and instructed to brush twice daily using modified bass technique with the toothbrush and paste provided throughout the trial. Results: The children who had audiovisual, individual demonstrations of brushing technique exhibited significantly superior total oral plaque control and significant reduction in the gingival inflammation at the end of 21 days trial (P &lt; 0.05). The study group participants reported improved compliance and motivation to practice modified bass technique because of the reinforcement. Conclusion: The children who had both audiovisual and individual demonstration exhibited superior total plaque control and gingival health compared to control group and continued to demonstrate modified bass technique without any reinforcement at the end of 21 days trial.

Objective masticatory efficiency and subjective quality of masticatory function among patients with periodontal disease.

To examine patient-centred clinical outcomes for objective masticatory efficiency (OME) and subjective quality of masticatory function (QMF) among periodontitis patients using test methods easily applicable in daily practice. Cross-sectional investigation of patients undergoing supportive periodontal therapy (n=224). Outcomes included OME and QMF related to periodontitis characteristics. OME and QMF were associated (x2 =0.252, p=0.037) and showed highest values in stage 4 according to the new classification of periodontal disease. There were correlations particularly in stage 2 between OME and number of teeth (x2 =-0.317, p<0.001), Quigley-Hein Index (x2 =0.152, p=0.031), attachment level (x2 =0.268, p<0.001), probing depths (x2 =0.185, p=0.006), tooth mobility (x2 =0.147, p=0.031) and functional occlusal units (x2 =-0.423, p<0.001) but not bleeding on probing. A trend existed between QMF and number of teeth (x2 =-0.237, p=0.050) and functional occlusal units (x2 =0.238, p=0.058), but not other periodontal findings. OME and QMF values represent each other and are highest in stage 4. Periodontitis findings influence masticatory efficiency particularly in stage 2, but gingival inflammation does not. Number of teeth and functional occlusal units are associated with QMF, while periodontitis findings have less impact. An assessment of mastication should be routinely included in the diagnosis of periodontitis patients in all stages.

Testing the ability for autonomous oral hygiene in hospitalized geriatric patients\u2014clinical validation study

ObjectivesThis study aimed to evaluate if the Timed Test for Money Counting (TTMC) complemented with testing the range of shoulder motion by griping the backside of the neck (NG) predicts the ability of geriatric inpatients to perform effective plaque reduction by autonomously conducted oral hygiene.Material and methodsThis clinical validation study involved 74 hospitalized geriatric inpatients, 48 (64.9%) females, aged between 66 and 98 years (mean age 84.1 years). Oral health status was examined. Dental plaque was assessed with the Turesky modified Quigley-Hein Index (TI) on teeth and the Denture Hygiene Index (DHI) on removable dentures. The performance and duration of TTMC and NG were recorded. After autonomous tooth brushing and denture cleaning by the patient, dental plaque was scored again with the TI and DHI. Geriatric assessment data were collected from medical records.ResultsForty-nine (66.2%) geriatric inpatients completed the TTMC&NG successfully. Passing the TTMC&NG was significantly associated with better plaque removal on teeth and dentures by autonomously conducted oral hygiene. The sensitivity of the TTMC&NG for above average plaque reduction was 86.4% on teeth and 77.8% on dentures. The test revealed a negative predictive value of 75.0% to detect below average plaque reduction on teeth and 72.7% on dentures.ConclusionsThe TTMC&NG served as a suitable predictor for the ability of geriatric inpatients to perform autonomously effective tooth brushing and denture cleaning.Clinical relevanceThis simple and short test might help the medical staff to identify geriatric inpatients unable to perform effective oral hygiene by themselves.

Effects of Toothpaste Containing Granular Calcium Carbonate on Oral Health

Aims and Objectives: To investigate the oral health effects of using toothpaste containing granular calcium carbonate (CaG). Materials and Methods: The subjects were adult volunteers. Two kinds of toothpaste, Paste P and Q were used. Paste P contained 13% CaG, which had a mean diameter of 250 µm and a breaking strength of 20 gf. Paste Q had the same formulation without CaG. Study 1 was to evaluate the ability to remove dental plaque by toothpaste with a single use, and it was a crossover study. The subjects were 50 adults. Plaque levels were assessed using the Quigley–Hein Index (QHI). Study 2 was to investigate the effects of CaG in toothpaste on gingival health. The subjects were 60 adults. The subjects used Paste P for 3 days before the baseline assessment. On the baseline assessment, the subjects whose gingival sulci were found to contain CaG were asked to continue using the Paste P for 6 months. The pocket depth, the gingival index (GI), the QHI, and the presence of CaG in the gingival sulci at 1, 3, and 6 months from the baseline were examined. Results: In study 1, the CaG-containing toothpaste produced a significantly lower mean QHI than the control. In study 2, the QHI and GI of the gingival sulci in which CaG was detected were significantly lower than those of the gingival sulci in which CaG was not detected. Conclusion: Toothpaste containing CaG removed greater amounts of plaque and did not have adverse effects on periodontal tissue.

Comparative Evaluation of Plaque Removal Effectiveness of Manual and Chewable Toothbrushes in Children: A Randomized Clinical Trial.

ABSTRACTObjectiveIn children, manual dexterity poses a problem with the use of manual tooth brushes (MB), resulting in inefficient plaque removal. Recently, novel chewable brushes (CB) have been introduced which could overcome this problem but are less researched in children. The objective of this study is to assess and compare the plaque removal effectiveness of CB with that of MB.Materials and methodsA total of 60 patients aged 8 to 10 years were enrolled in a single-blinded randomized clinical trial. At baseline, disclosing solution was applied and the Turesky modification of the Quigley–Hein index (TQHI) plaque index and Loe and Silness gingival index were recorded. The subjects were randomly divided into two groups as group I (MB) and group II (CB) and they were instructed to use their respective brushes for a period of 1 week. For statistical comparison, the difference (prebrushing minus postbrushing) in average scores was calculated. Data were evaluated by the independent t test and paired t test, with p < 0.05.ResultsThe overall plaque scores reduced from 1.71 ± 0.4 to 0.79 ± 0.24 when using CB and from 1.64 ± 0.64 to 1.13 ± 0.47 when using MBs. On lingual tooth surfaces, CB showed a plaque reduction of 38.70 ± 11.04 to 12.60 ± 4.79 compared to less reduction from 37.43 ± 14.26 to 28.73 ± 11.37 for MB. The overall gingival scores were also reduced from 0.33 ± 0.51 to 0.09 ± 0.07 when using CB and from 0.30 ± 0.33 to 0.19 ± 0.23 when using MB. Differences in scores between the two brushes were statistically significant (p = 0.0001).ConclusionIt was concluded that the experimental CB was able to remove a significant amount of plaque, particularly on the lingual surfaces, and reduced gingival index scores, thereby improving oral hygiene and gingival health status.How to cite this articleKayalvizhi G, Radha S, et al. Comparative Evaluation of Plaque Removal Effectiveness of Manual and Chewable Toothbrushes in Children: A Randomized Clinical Trial. Int J Clin Pediatr Dent 2019;12(2):107–110.

Effectiveness of plaque removal withan experimental chewable brush in children between age 9 and 13years.

To evaluate the effectiveness of plaque removal of an experimental chewable brush in comparison with a manual brush in children between age 9 and 13years. This single blinded randomised controlled study included a total of 60 healthy children between age 9 and 13years that fulfilled the selection criteria. Selected children were randomly assigned to manual toothbrush group (MT) and chewable toothbrush group (CT). Children were instructed to use the respective toothbrushes under supervision. Effectiveness of plaque removal was evaluated by recording Turesky's modification of Quigley-Hein index scores (TMQHI) before and after brushing on single use. Difference in the pre-brushing and post-brushing plaque scores between the groups were statistically compared by using Mann-Whitney U test. TMQHI plaque scores of selected children for the MT and CT groups was found to be statistically similar before using the toothbrush (p = 0.072). Difference between overall plaque reduction scores were found to be 1.0 for MT and 1.13 for CT, which did not reveal statistical significance (p = 0.308). In order to evaluate efficiency of chewable toothbrush, TMQHI scores for buccal and lingual scores were analysed separately, and found no statistical significance in plaque removal on either surfaces (p = 0.944 for buccal, p = 0.080 for lingual). Chewable toothbrush was found to be as effective in total plaque removal as manual tooth brushing in the children between age 9 and 13years. The chewable brush may be an appropriate oral hygiene adjunct for school children spending a considerable amount of time out of home.

Effect of essential oil mouthwashes on plaque and gingivitis.

Data sourcesMedline, Embase, LILACS and Scopus database.Study selectionStudies were screened independently by three reviewers. Randomised controlled trials with a minimum of six months follow-up of daily use of essential oils-containing (EO) mouthwashes compared with placebo, flossing or cetylpyridinium chloride (CPC) as adjuncts to mechanical plaque control were considered.Data extraction and synthesisData were abstracted by two reviewers and study quality assessed using the Cochrane risk of bias tool. Dental plaque was summarised using the Turesky modification of the Quigley-Hein Index (QHI), gingivitis using three indices; the Gingival Index (GI) by Loe and Silness, the Modified Gingival Index (MGI) and bleeding upon probing. Mean and standard deviations were reported and meta-analysis conducted. Sources of effect modification were investigated using meta-regression.ResultsSixteen trials were included involving 4016 patients in total. Study quality was considered to be moderate to low. Compared with placebo meta-analysis of 14 studies showed statistically significant differences in favour of EO mouthwashes for plaque and gingival indices. Meta-analysis of four studies also demonstrated statistically lower levels of plaque and gingivitis for EO mouthwashes compared with cetylpyridium chloride (CPC). Meta-regression indicated that heterogeneity observed in plaque scores was mainly explained by the percentage of males in a trial and supervision of the mouthwash use.ConclusionsIn patients with gingivitis, EO-containing mouthwashes are more efficacious for the reduction of plaque and gingival inflammation than mechanical plaque control either alone (placebo) or in combination with mouthwashes with CPC. The expected benefits may be clinically relevant and may be also observed in the interproximal area.

The effect of a triclosan/copolymer/fluoride toothpaste on plaque formation, gingivitis, and dentin hypersensitivity: A single-blinded randomized clinical study.

The daily removal of supragingival dental plaque is a key factor in the prevention of gingivitis. The aim of the study was to compare the gingival health benefits of a triclosan/copolymer/fluoride toothpaste (Colgate Total, a fluoride toothpaste containing an antiseptic) to a commercially available toothpaste containing 0.243% sodium fluoride in a silica base (Colgate Herbal, a conventional fluoride toothpaste with herbal extracts). A total of 50 patients with gingivitis and at least one sensitive tooth were included. The subjects were randomly stratified into two groups: Colgate Total toothpaste, and Colgate Herbal toothpaste. After a 4-week pre-experimental phase, baseline Plaque Index (Quigley-Hein Index) (PI), Gingival Index (GI), Gingival Bleeding Index (GBI), and Visual Analog Scale (VAS) were assessed. The PI, GI, GBI, and VAS were reexamined at weeks 4, 12, and 24 after the baseline. Fifty subjects complied with the protocol and completed the study. The conventional fluoride toothpaste with herbal extracts group and the fluoride toothpaste containing an antiseptic group exhibited significant reductions in PI, GI, GBI, and VAS over time. The amount of reduction after 6 months of the treatment was higher in the Total group compared to Herbal group (1.82 vs 1.39, P = .015 for PI; 0.67 vs 0.37, P < .005 for GI; and 56.64% vs 34.26%, P < .005 for GBI). No significant difference was seen for VAS. Twice daily brushing with a toothpaste containing 0.3% triclosan and polyvinyl methyl ether and maleic acid copolymer provides a more effective level of plaque control and gingival health with no effect on decreasing dentin hypersensitivity compared to conventional fluoride toothpaste. Toothpastes containing triclosan/copolymer, in addition to fluoride, result in a higher reduction in plaque, gingival inflammation, and gingival bleeding when compared with fluoride toothpastes without triclosan/copolymer.

Dental and microbiological risk factors for hospital-acquired pneumonia in non-ventilated older patients.

Hospital acquired pneumonia (HAP) is often fatal in older patients. The mouth is the main reservoir of infection and studies have suggested that oral hygiene interventions may prevent HAP. The aim of this study was to investigate associations between HAP and preceding a) heavy dental plaque and b) oral carriage of potential respiratory pathogens in older patients with lower limb fracture to determine the target for intervention studies.MethodsWe obtained a time series of tongue/throat swabs from 90 patients with lower limb fracture, aged 65-101 in a general hospital in the North East of England between April 2009-July 2010. We used novel real-time multiplex PCR assays to detect S. aureus, MRSA, E. coli, P. aeruginosa, S. pneumoniae, H. influenza and Acinetobacter spp. We collected data on dental/denture plaque (modified Quigley-Hein index) and outcomes of clinician-diagnosed HAP.ResultsThe crude incidence of HAP was 10% (n = 90), with mortality of 80% at 90 days post discharge. 50% of cases occurred within the first 25 days. HAP was not associated with being dentate, tooth number, or heavy dental/denture plaque. HAP was associated with prior oral carriage with E. coli/S. aureus/P.aeruginosa/MRSA (p = 0.002, OR 9.48 95% CI 2.28-38.78). The incidence of HAP in those with carriage was 35% (4% without), with relative risk 6.44 (95% CI 2.04-20.34, p = 0.002). HAP was associated with increased length of stay (Fishers exact test, p=0.01), with mean 30 excess days (range -11.5-115). Target organisms were first detected within 72 hours of admission in 90% participants, but HAP was significantly associated with S. aureus/MRSA/P. aeruginosa/E. coli being detected at days 5 (OR 4.39, 95%CI1.73-11.16) or 14 (OR 6.69, 95%CI 2.40-18.60).ConclusionsPatients with lower limb fracture who were colonised orally with E. coli/ S. aureus/MRSA/P. aeruginosa after 5 days in hospital were at significantly greater risk of HAP (p = 0.002).

How effective is a chewable brush in removing plaque in children? A pilot study

The aim of this pilot study was to evaluate the plaque removal efficiency of a chewable toothbrush (CB) in children. A total of 20 patients aged 10-12 years who attended to the Department of Pediatric Dentistry were enrolled in the study. This was a single-blinded crossover study which examined plaque removal efficiency of a CB compared to a manual toothbrush (MB) following a consecutive use. After professional prophylaxis had been given, participants refrained from brushing and chewing for 48 h. Supragingival plaque was examined using the Turesky modification of the Quigley-Hein Index (TQHI) and the simplified oral hygiene index (OHI-S). For statistical comparison, the difference (prebrushing minus postbrushing) in average scores was calculated. Data were evaluated by Mann-Whitney U-test, with a P 0.05). Within the limits of this study, the experimental chewable brush was found to be as effective as a manual brush in removing plaque. The chewable brush may be an appropriate oral hygiene adjunct for school children, including children with disabilities.

Clinical and Microbiologic Effects of Commercially Available Dentifrice Containing Aloe Vera: A Randomized Controlled Clinical Trial

Certain plants used in folk medicine serve as a source of therapeutic agents that have antimicrobial and other multipotential effects. This prospective, randomized, placebo, and positively controlled clinical trial was designed to evaluate the clinical and microbiologic effects of a commercially available dentifrice containing aloe vera on the reduction of plaque and gingival inflammation in patients with gingivitis. Ninety patients diagnosed with chronic generalized gingivitis were selected and randomly divided into three groups: group 1, placebo toothpaste; group 2, toothpaste containing aloe vera; and group 3, toothpaste with polymer and fluoride containing triclosan. Clinical evaluation was undertaken using a gingival index, plaque was assessed using a modification of the Quigley-Hein index, and microbiologic counts were assessed at baseline, 6 weeks, 12 weeks, and 24 weeks. A subjective evaluation was also undertaken by questionnaire. Toothpaste containing aloe vera showed significant improvement in gingival and plaque index scores as well as microbiologic counts compared with placebo dentifrice. These improvements were comparable to those achieved with toothpaste containing triclosan. Toothpaste containing aloe vera may be a useful herbal formulation for chemical plaque control agents and improvement in plaque and gingival status.