Reduction In Plaque Index Research Articles

The effect of chlorhexidine on plaque index and mutans streptococci in orthodontic patients: A pilot study

Aim: The purpose of this study was to assess chlorhexidine effects on plaque index and salivary levels of mutans streptococci (MS) when used as the immersion solution for removable orthodontic appliances and added to their acrylic resin composition. Methods: Forty-five patients (6 to 12 years old) were randomly assigned into three groups with 15 patients each. Group I (control)—without orthodontic appliances disinfection; Group II—removable orthodontic appliances which had been immersed in 0.12% chlorhexidine digluconate overnight (8 hours), and Group III—orthodontic appliances in which 0.12% chlorhexidine digluconate solution had been incorporated into their resin composition. Saliva was collected for quantification of MS and evaluation of plaque index was performed before and after installation of orthodontic appliance at 0, 2, 4, 6, 8, and 10 weeks. Data were analyzed by using analysis of variance. Results: Number of MS colonies in saliva and plaque index showed no statistically differences among groups at the different periods (p > 0.05). Conclusions: It could be concluded that chlorhexidine incorporation into the acrylic resin of removable orthodontic appliances at 0.12% concentration and immersion of the appliance into 0.12% chlorhexidine solution were not effective in reducing plaque index and the number of MS in saliva.

The effectiveness of a musical toothbrush for dental plaque removal: A comparative study

the purpose of this study was to clinically evaluate and compare the efficacy of "Brush Buddies" musical tooth brush and Colgate Smile tooth brush in the reduction of established plaque and gingivitis. for this study, 120 healthy kids (73 boys and 47 Girls) were selected. The subjects were randomly assigned into two groups by a second examiner; one group used Colgate Smile brush and the other group used "Brush Buddies" musical tooth brush. Plaque index (Quigley and Hein), Modified Gingival Index (Lobene and Associates) and Gingival Bleeding Index (Ainamo and Bay) were assessed at baseline, 30th day, 60th day, and 90th day. all the baseline indices appeared to be well balanced. At the end of the study, reduction in plaque index, modified gingival index and gingival bleeding index were statistically highly significant during each interval for both the toothbrushes. For "Brush Buddies" musical tooth brush, the reduction in all clinical parameters were statistically significant for 30 days and 60 days interval, while nonsignificant at 90 days interval. both the tooth brushes used in this study were clinically effective in removing plaque, improving gingival health. Musical tooth brush is more effective initially but as the time period increases both tooth brushes give almost similar results.

The effect of green tea mouthwash (<i>Camellia sinensis</i>) on wound healing following periodontal crown lengthening surgery; a double blind randomized controlled trial

Green tea has been used as a traditional medicine since 2700 BC and several studies have shown that green tea polyphenols inhibit the growth of oral and periodontal pathogenic bacteria and can improve oral and gingival health. In this clinical study we investigated the effect of green tea mouthwash on microbial dental plaque and gingival inflammation following periodontal surgery. A total of 34 crown lengthening surgeries were included in this study. After removing periodontal dressing, green tea mouthwash for the test group and placebo for the patients in the control group were prescribed, and periodontal parameters were assessed at base line and after 2 weeks. Analysis of the data revealed the significant effect of green tea mouthwash on reducing Plaque index (PI), Gingival Index (GI) and Bleeding on probing (BOP). Therefore it would be recommended as a safe, anti-inflammatory and anti-microbial mouthwash for treating gingival inflammation and maintaining oral and gingival health.

Use of Strips Containing Tetracycline Hydrochloride or Metronidazole for the Treatment of Advanced Periodontal Disease

Strips containing tetracycline hydrochloride or metronidazole 25% in polyhydroxybutyric acid as a biodegradable polymer matrix, showed sustained release in simulated gingival fluid pH 6.6 at 37 degrees C. When evaluated in patients suffering from advanced periodontal disease, the greatest response to therapy was observed with tetracycline hydrochloride strips inserted into periodontal pockets at four-day intervals for 16 days, compared with an untreated control group. A reduction in plaque index, gingival index and pocket depth was observed. A favourable alteration occurred in the microbial flora of treated pockets with an increase in the proportion of cocci and decrease in gram-negative rods, fusiforms and spirochetes. Metronidazole strips or root-planning tended not to be as effective. The clinical improvement produced by each treatment was not maintained when treatment was terminated.

A 6-month comparison of toothbrushing efficacy between the horizontal Scrub and modified Bass methods in visually impaired students

The aim of this study was to compare the efficacy of the horizontal Scrub and modified Bass methods of toothbrushing in visually impaired students for 6 months. Sixty visually impaired students, aged 10-12 years, were recruited to a randomized controlled clinical trial. At baseline, plaque index (PI) and gingival index (GI) were assessed, and then subjects were randomly divided into the horizontal Scrub and modified Bass groups. Subjects received verbal and tactile toothbrushing instruction and used their assigned methods twice daily. They were recalled at 1 and 6 months for clinical measurement and reinforce of instruction. Significance of PI and GI over time was compared using the paired t-test and between brushing group at each time point using the t-test. Over the 6-month period, there were significant reduction from baseline for the mean PI and GI in both groups (P < 0.001). There were no significant differences between two methods at each time point (P > 0.05), however. Both the horizontal Scrub and modified Bass methods can be effectively reduced plaque index and gingival index in visually impaired students. The efficacy of both methods was not different, however.

A clinical evaluation of the effect of 0.2% chlorhexidine gluconate as a mouthrinse on gingival inflammation in pregnant and non-pregnant women with and without undergoing scaling and root planing procedures

There is a high incidence of gingivitis in pregnant women due to combined effect of local and systemic factors. Chlorhexidine is an effective chemical plaque control agent by virtue of its property substantivity. Aim and Objective: In the present work we propose to study the effect of 0.2% chlorhexidine gluconate solution as a mouth rinse on gingival inflammation in pregnant women in comparison with non-pregnant women, before and after scaling and polishing procedures. Materials and Methods: A total number of seventy six healthy pregnant and non pregnant females in the age group of 20 to 30 years were included for the study. All the subjects used 0.2% chlorhexidine gluconate mouthrinse twice a day for 3 weeks. Weekly observations were made in both subgroups. Results: There was no significant reduction in plaque index, papilla,marginal gingiva and attached gingiva index and gingival bleeding index when 0.2% chlorhexidine gluconate mouth rinse was used alone without scaling and polishing procedures. When 0.2% chlorhexidine gluconate mouthrinse was used after scaling and polishing procedures at the end of 3 weeks, there was highly significant reduction in PMA index and gingival bleeding index in nonpregnant women group, whereas in pregnant women group there was only a significant reduction in the gingival bleeding index. Conclusion: 0.2% chlorhexidine gluconate used as mouth rinse twice a day for three weeks reduces gingival inflammation and gingival bleeding in both pregnant and non pregnant women, but significantly more in non pregnant women.

Clinical evaluation of a novel herbal dental cream in plaque formation: a double-blind, randomized, controlled clinical trial.

The aim of this study was to evaluate the efficacy and safety of herbal dental cream in comparison to fluoride dental cream. Clinical evaluation of a novel herbal dental cream in plaque formation: a double-blind, randomized, controlled clinical trial. One hundred and two patients with established dental plaque were randomly assigned to either herbal dental group or fluoride dental group for six weeks in a double-blind design. Improvement in plaque index, oral hygiene status, bleeding index, and gingival index was evaluated in these patients along with microbiological study. Results indicated a significant reduction in plaque index, gingival index, oral hygiene index, and microbial growth in both groups. Difference between the groups was not significant. There was no significant change in bleeding index. No adverse events were reported and both the dental creams were well tolerated. The finding of this preliminary study indicates that herbal dental cream is as safe and effective as fluoride dental cream, but not superior to it.

Efficacy of an electrically active sonic toothbrush and an oscillating/rotating powered toothbrush in the reduction of plaque and gingivitis: A comparative clinical trial

Objectives: The purpose of the present study was to clinically evaluate and compare the efficacy of an electrically active sonic toothbrush and an oscillating/rotating powered toothbrush in the reduction of plaque and gingivitis. Material and Methods: For this study, 40 healthy student volunteers (20 males, 20 females) were selected. The subjects were randomly assigned into two groups by a second examiner; one group used a current producing sonic toothbrush and the other group used a battery powered toothbrush. Plaque Index, Modified Gingival Index and Gingival Bleeding Index were assessed at baseline, 15 th day, 30 th day, 45 th day and 60 th day. Results: All the baseline indices appeared to be well balanced. At the end of the study, reduction in plaque index, modified gingival index and gingival bleeding index were statistically highly significant during each interval for both the toothbrushes. The difference in reduction of clinical parameters between the two toothbrushes was statistically non significant. Conclusion: Both the toothbrushes used in this study were clinically effective in removing plaque and improving gingival health.

What's New in Dentistry

What's New in Dentistry

Comparative effect of an essential oil mouthrinse on plaque, gingivitis and salivary Streptococcus mutans levels: a double blind randomized study

An open, randomized, controlled study with two parallel treatment groups was done to evaluate the efficacy of a Lippia sidoides essential oil (EO) 1% mouthrinse compared with chlorhexidine 0.12% mouthrinse, applied two times daily for 1 week, in the treatment of dental plaque and gingivitis. Fifty-five patients were included in the study. The efficacy variables were the colony count of Streptococcus mutans from the stimulated saliva and periodontal indices on days 0, 7 and 30 after commencement of therapy. Twenty eight patients received chlorhexidine mouthrinse (Periogard((R))) and 27 Lippia sidoides essential oil mouthrinse (Cepakill((R))). The clinical and microbiological parameters were significantly reduced by both mouthrinses. No significant difference was seen between the two groups (p > 0.05). There was a significant reduction in the colony count of S. mutans in both groups (p < 0.05). Chlorhexidine treatment reduced more efficiently than L. sidoides, however, no statistical difference was seen, the efficacy of both groups was similar (p = 0.3). The results indicate that Chlorhexidine mouthrinse reduced plaque index, gingival bleeding and the number of CFU (colonies forming units) more efficiently than L. sidoides but did not reach statistical significance. This study demonstrated that Lippia sidoides EO mouthrinse is effective in reducing microbial plaque and gingival inflammation.

Evaluation of a New Furcation Stent as a Fixed Reference Point for Class II Furcation Measurements

To date probing of the furcation using sounding has been one of the reliable methods to assess horizontal component of furcation in multirooted teeth. A more precise and reliable measurement of this horizontal component of furcation involves using a fixed reference point providing stability and reproducibility of measurements. A custom stent is used to provide a fixed reference point and can be used pre- and post-surgically without re-entry. Therefore, the purposes of this study were to (1) assess the reliability of furcation measurements by direct probing (without stent) and with the use of a newly designed furcation stent and (2) to assess the furcation measurements in relation to gingival margin position pre- and post-operatively. Forty-three chronic periodontitis patients with buccal grade II furcation involvement in maxillary or mandibular molars were included. The furcation involvement was measured by direct probing using a UNC-15 calibrated probe with and without using a custom stent. The furcation involvement and gingival margin position were measured pre- and post-surgically. There was a significant reduction in plaque (PI) and gingival inflammation (GI) during the study period. The reduction in plaque index and gingival index was observed from 1.75 +/- 0.35 to 0.92 +/- 0.30, 1.88 +/- 0.35 to 0.98 +/- 0.29, respectively. Complete agreement was found between the first and the second measurement for about 74% of sites without the custom stent, whereas 86% of the sites measured using the stent had complete agreement. The differences never exceeded 1 mm for any of the sites. There was significant (t = 2.49; p<0.05) difference observed at complete agreement level ('0' difference). It may be concluded the clinical attachment level-H of the furcation involvement using a PCP UNC-15 probe and a custom designed stent provides reproducible information about the furcation depth in multirooted teeth. Use of a simple modified furcation stent has shown greater reproducibility of furcal depth measurements than direct probing without the stent. The furcation stent definitely addresses the problems of existing methods of horizontal furcal depth measurements reported in the literature. The major advantages of the newly designed stent are the simple construction and non-invasive application which translates to wide practical applications.

Effect of Curcuma Xanthorrhiza containing gum on reduction of the plaque and the gingivitis

The purpose of the present study was to determine the effect of a chewing gum containing 70% xylitol and 0.23% Curcuma xanthorrhiza extract to remove dental plaque and reduce gingivitis when used as a supplement to daily toothbrushing for 3 weeks. The study group consisted of 75 adults with moderate gingvitis. Participants were divided into 3 groups(contol 1 group - Gum base, contol 2 group - 70% Xylitol, experiment group - 70% xylitol and 0.23% xanthorrhizol) and instructed to chew the study gum for 3 times daily for 3 weeks in addition to regular daily toothbrushing. Chewing xylitol/xanthorrhizol gum significantly reduced plaque index with significant difference by week 3(p&lt;0.01). Gingival index and bleeding on probing were decreased in xy/ Curcuma xanthorrhiza extract group by 35.9% and 31.65% each in the same period. No adverse effects on the oral tissues were observed in any of the participants for the duration of the study. In conclusion, regular use of a chewing gum containing 70% xylitol and 0.23% Curcuma xanthorrhiza extract appears safe and effective for the removal of dental plaque and reduction of gingivitis when used in conjunction with daily toothbrushing.

The comparison of 0.05% sodium fluoride and 0.2% chlorhexidine usage and aquadest to the plaque index on fixed orthodontic patients

The fixed orthodontic appliance will cause changes in microbial flora the oral cavity and food debris accumulation and will be formed especially around the gingival sulcus. Plaque control using chemical means can be done by using mouth rinse. This research compared the influence of 0.05% sodium fluoride mouth rinse with aquadest and 0.2% chlorhexidine to the plaque index in fixed orthodontic patients. A double-blind and cross over clinical assessment were applied using a sample size of 16 male fixed orthodontic patients with the age above 21 years. 0.05% sodium fluoride, 0.2% chlorhexidine mouth rinse was given to all patients as a positive control and aquadest as a negative control. Plaque index was then measured after 24 hours without tooth brushing, after using the mouth rinse and a week after using the mouth rinse with tooth brushing. The results showed that the use of 0.05% sodium fluoride mouth rinse reduced plaque index more significantly compared to 0.2% chlorhexidine. The mechanical plaque control by tooth brushing is still the most influential mean to reduce plaque index in fixed orthodontic patients. Mouth rinse is just an additional mean to reduce plaque.

Effect of Weissella cibaria Isolates on the Formation of Streptococcus mutans Biofilm

The objective of this study was to isolate and identify lactic acid bacteria able to inhibit the in vitro formation of Streptococcus mutans biofilm as well as the in vivo formation of oral biofilm. Two strains, CMS1 and CMS3, exhibiting profound inhibitory effects on the formation of S. mutans biofilm and the proliferation of S. mutans, were isolated from children’s saliva and identified as Weissella cibaria by 16S rDNA sequencing. The water-soluble polymers produced from sucrose by the W. cibaria isolates also inhibited the formation of S. mutans biofilm. According to the results of thin-layer chromatographic analysis, the hydrolysates of water-soluble polymers produced by the isolates were identical to those of dextran, forming mostly α-(1–6) glucose linkages. In the clinical study, the subjects mouthrinsed with a solution containing W. cibaria CMS1 evidenced plaque index reduction of approximately 20.7% (p < 0.001). These results indicate that the W. cibaria isolates possess the ability to inhibit biofilm formation, both in vitro and in vivo.

Compliance as a Prognostic Indicator: Retrospective Study of 505 Patients Treated and Maintained for 15 Years

The relationship of patient compliance to overall tooth prognosis remains controversial. There are little data, often conflicting, that pertain to tooth loss as a function of patient compliance. This retrospective study evaluates the impact of compliance (complete versus erratic) on common periodontal clinical variables, such as probing depth, bleeding index, plaque index, and tooth loss for 505 patients in a long-term period of observation (15 to 23 years) and maintenance therapy (at least 10 years). Compliance was defined in two ways for all analyses. Under the definition for compliance 1, patients who missed <30% of all prescribed maintenance visits were classified as complete compliers. Under the definition for compliance 2, patients who never went 2 years without a maintenance visit were classified as complete compliers. Change in clinical variables was dichotomized into reduction in plaque index versus no reduction, reduction in bleeding on probing versus no reduction, reduction in the percentage of periodontal pockets>3 mm versus no reduction, no increase in decayed, missing, or filled teeth (DMFT) versus increase, and no tooth loss versus tooth loss. The effects of both definitions of compliance were then evaluated in a series of multiple logistic regression models with adjustment for potential confounders. The analysis of the dichotomous change in clinical parameters over time revealed that complete compliers tended to show reduction in bleeding on probing and reduction in plaque index compared to erratic compliers for both definitions of compliance. In contrast, complete compliers under compliance 2 were less likely to have a reduction in the percentage of periodontal pockets >3 mm compared to erratic compliers, whereas complete compliers under compliance 1 had about the same likelihood of demonstrating a reduction in periodontal pockets compared to erratic compliers under this classification scheme. Under both definitions for compliance, complete compliers were more likely to exhibit tooth loss than erratic compliers, with the greatest tooth loss exhibited by complete compliers under the definition for compliance 1. Based on these results, complete compliers under both definitions tended to show a reduction in plaque and bleeding on probing over time. However, change in periodontal pockets and DMFT over time varied according to the definition of compliance that was used. In addition, the results seem to indicate that the decision for tooth extraction made by dental health professionals at maintenance visits may result in greater tooth loss.

THE COMPARISON OF REDUCING PLAQUE INDEX BEFORE AND AFTER USING CHEWING GUM AND TOOTH BRUSHING IN PERTIWI JUNIOR HIGH SCHOOL STUDENTS

Up to present, plaque control is the most effective method to maintain oral hygiene. Using chewing gum after eating food and snacks can stimulate saliva, promote remineralization and reduce potential dental plaque. To know whether using chewing gum can reduce plaque index as good as toothbrushing, thus an experimental study was performed. Sample was the first grade of junior high school students. After selection according to the requirements, the sample size was 35 students. Each sample got two different treatments, In the first day, they used chewing gum and the next day they were instructed to brush their teeth. Before and after using chewing gum and toothbrushing their dental plaque was scored. The mean of plaque score before using chewing gum was 2.24 and after using chewing gum was 1.28, statistically there was a significant difference (t = 33: df – 34; p<0,001). The mean of plaque score before toothbrushing was 2.26 and after toothbrushing 1.10, statistically there was a significant difference. Using chewing gum and toothbrushing can reduce plaque score, though the reduction of plaque score by toothbrushing was greater compared with using chewing gum.

Comparison of video and written instructions for plaque removal by an oscillating/rotating/reciprocating electric toothbrush

A previous crossover study showed that a watch-and-follow instructional video improved plaque removal by an electric toothbrush compared to the use of the instructional leaflet. This study employed a parallel design to assess the value of an instructional video for plaque removal by a new model oscillating/rotating/reciprocating electric toothbrush. 2 groups of 26 dentate subjects with average oral hygiene, who had never used an electric toothbrush, participated in this single blind, randomised parallel group designed study. On day 1 of the study, subjects received a professional prophylaxis to remove all plaque. Oral hygiene measures were then suspended and subjects returned on day 3 when a prebrushing plaque score was recorded by plaque index and area. Subjects withdrew and either read the manufacturers instructional leaflet (group L) or observed the instructional video (group V). Groups L and V then performed toothbrushing with toothpaste for 2 minutes and with group V brushing in time with the instructional video. Post-brushing plaque indices and areas were then recorded. Whole mouth, lingual, upper, lower, anterior and posterior but not buccal % reductions in plaque index and area were significantly greater in group V compared to group L. % plaque removal was also significantly greater by area at mid and distal sites but not mesial sites. Whole-mouth plaque reductions were 10% greater in group V but reached >15% at lingual surfaces. Within group differences in plaque removal at paired sites e.g., buccal/lingual, remained similar, suggesting that further improvement could be achieved by modifying the video to devote more time to the difficult-to-clean areas. In conclusion, in the early period of learning the use of an electric toothbrush, plaque removal can be improved by using an instructional video. Such watch-and-follow video routines could be extended to other areas of oral hygiene practices.

Is dental health education effective? A systematic review of current evidence.

In order that health service resources are allocated in the way which most benefits the population, systematic review of the available evidence regarding the effectiveness of programmes and interventions are required. This study examined papers relating to dental health education interventions, which were published between 1982 and 1994 (n = 143). Each was scored by two independent researchers according to twenty predetermined validity criteria. For each paper which achieved a validity score of more than 12 (n = 37), data concerning the objectives of the intervention, the types and numbers of participants, and the outcomes, were extracted from the article. Where sufficient data were provided in a paper which met more than 15 of the validity criteria quantitative meta-analysis was carried out i.e. the results of the studies were pooled in order to calculate an overall intervention effect with confidence intervals. This combination of qualitative and quantitative review techniques showed that dental health interventions have: a small positive, but temporary effect on plaque accumulation (reduction in plaque index = 0.37 95% CI -0.29-0.59); no discernible effect on caries increment and a consistent positive effect on knowledge levels. The results of this analysis suggest that further efforts to synthesise current information about dental health education, in a systematic way, are required, along with maintenance of rigorous scientific standards in evaluation research.

Efficacy of a 2‐Phase Oil:Water Mouthrinse in Controlling Oral Malodor, Gingivitis, and Plaque

The purpose of the study was to examine the anti-malodor, anti-gingivitis, and plaque reducing properties of a 2 phase oil:water mouthrinse compared with a control mouthrinse. Fifty subjects rinsed with one of the two rinses for 30 seconds twice a day over 6 weeks, while continuing their normal oral hygiene habits. Measurements were made at time zero (prior to beginning the rinsing regimen), and > or = 9 hours following rinsing, at intervals of 1, 3, and 6 weeks. Malodor of whole mouth, as well as tongue dorsum anterior and posterior, was assessed on a 0 to 5 semi-integer scale by two odor judges. Volatile sulphide compounds (VSC) were determined using a sulphide monitor. Gingival, plaque, and bleeding indices were recorded for Ramfjord teeth. Oral microbial levels were assessed using the oratest. Salivary levels of diamines (putrescine and cadaverine) were analyzed by HPLC. Results were analyzed by 2-tailed covariant ANOVA, with the time zero value as covariant. Dramatic improvements were observed in parameters associated with malodor, periodontal health, plaque accumulation, and microbial levels in both groups. As compared to time zero scores, whole mouth odor, tongue dorsum anterior and posterior odors decreased continuously over time, attaining 80%, 79% and 70%, reductions, respectively following 6 weeks, in the 2-phase mouthrinse group, versus 70%, 77% and 59% for the control group. For whole mouth and tongue dorsum posterior, the reductions observed in the 2-phase mouthrinse group were significantly greater than those obtained with the control mouthrinse (P = 0.026 and P = 0.025, respectively), suggesting that the 2-phase mouthrinse is superior to the control mouthrinse in long-term reduction of oral malodor. For bleeding index, gingival index, oral microbial levels, and VSC, differences between the groups were not significant. Diamine levels were not significantly reduced in either group. The control mouthrinse reduced plaque index more significantly than the 2-phase mouthrinse (P < 0.005). The results of this randomized clinical trial suggest that the 2-phase oil:water mouthrinse formulation is superior to the control mouthrinse in long-term reduction of oral malodor.

The effect of porcelain laminate veneers on gingival health and bacterial plaque characteristics.

The aim of this study was to evaluate the response of microbial plaque and gingival inflammation to the placement of porcelain laminate veneers on anterior teeth. 9 patients, 7 female and 2 male (mean age of 30 years), with a total of 35 veneers were examined. The volume of gingival crevicular fluid (GCF), level of neutral proteolytic enzyme activity, gingival index (GI), plaque index (PlI) and plaque bacteria vitality were measured at baseline and after the placement of veneers. The volume of GCF increased after the placement of veneers (p = 0.03). No statistically significant differences were found in proteolytic enzyme activity or GI (p > 0.05). There were statistically significant reductions in PlI (p = 0.000) and plaque bacteria vitality (p = 0.018). Further research is required to assess the long-term influence of porcelain laminate veneers on gingival health and microbial plaque characteristics.