Improving Oral Hygiene Skills by Computer-Based Training: A Randomized Controlled Comparison of the Modified Bass and the Fones Techniques

Background: Gingivitis and other plaque-associated diseases have a high prevalence in western communities even though the majority of adults report daily oral hygiene. This indicates a lack of oral hygiene skills. Currently, there is no clear evidence as to which brushing technique would bring about the best oral hygiene skills. While the modified Bass technique is often recommended by dentists and in textbooks, the Fones technique is often recommended in patient brochures. Still, standardized comparisons of the effectiveness of teaching these techniques are lacking. Methodology/Principal Findings: In a final sample of n=56 students, this multidisciplinary, randomized, examiner-blinded, controlled study compared the effects of parallel and standardized interactive computer presentations teaching either the Fones or the modified Bass technique. A control group was taught the basics of tooth brushing alone. Oral hygiene skills (remaining plaque after thorough oral hygiene) and gingivitis were assessed at baseline and 6, 12, and 28 weeks after the intervention. We found a significant group×time interaction for gingivitis (F(4/102)=3.267; p=0.016; e=0.957; ?2=0.114) and a significant main effect of group for oral hygiene skills (F(2/51)=7.088; p=0.002; ?2=0.218). Fones was superior to Bass; Bass did not differ from the control group. Group differences were most prominent after 6 and 12 weeks. Conclusions/Significance: The present trial indicates an advantage of teaching the Fones as compared to the modified Bass technique with respect to oral hygiene skills and gingivitis. Future studies are needed to analyze whether the disadvantage of teaching the Bass technique observed here is restricted to the teaching method employed. Trial Registration: German Clinical Trials Register http://www.drks.de/DRKS0000348

The effects on chronic periodontitis of a subgingivally-placed redox agent in a slow release device

Adjunctive chemical agents can reduce the need for meticulous plaque control. The aim of this investigation was to evaluate the periodontal treatment potential of subgingival application of the redox agent methylene blue in a slow release device. This randomized, single-blind, split-mouth study included 18 patients aged 35- 57 years, with chronic adult periodontitis, pocketing of at least 5mm and radiographic evidence of regular bone loss. All experimental sites received subgingival debridement at day 0. Test sites received 32% w/w methylene blue in the slow release device at days 0 and 28. Clinical examination and microbiological sampling were performed at days 0, 7, 28, 56 and 84. Clinical improvements were seen in both groups, but test sites showed consistently greater improvements, some of which were statistically significant (as determined by between-group comparisons utilising SNDs). Significant between-group differences in relation to baseline levels were seen in bleeding index at days 7 and 56, in probable pocket depth at day 56 and for the Perioscan BANA test at day 7. This pilot study thus showed that adjunctive methylene blue in a slow-release device can produce greater clinical and microbiological improvements than subgingival debridement alone.peer-reviewe

Wirkung einer Mundspülung mit Teebaumöl auf Plaque und Entzündung

English: The tea tree oil (melaleuca alternifolia) has antiseptic, fungicide and bactericide effects. The efficiency against oral bacteria was also evident. Xylitol is known for counterattacking the cariogenic effect caused by the streptococcus mutans. Less plaque was developed during the time of the study. Deutsch: Teebaumöl (Melaleuca alternifolia)verfügt über antiseptische, fungizide und bakterizide Wirkungen, welche auch gegen orale Keime nachgewiesen wurden. Xylitol ist bekannt als Zuckerersatzstoff und erwies sich als wirksam gegen Streptococci mutans und Plaquebildung. In der vorliegenden Studie wurde die Effizienz einer Testmundspülung, enthaltend 1,5% Teebaumöl und 10% Xylitol (Tebodont®), bezüglich Plaquebildung und Entzündung im Vergleich zu einer Placebospülung untersucht. Die Testmundspülung reduzierte die Entzündung von Anfang bis nach 3 Monaten Anwendung signifikant (26–32%). Die Reduktion erfolgte deutlicher an allen der Zahnbürste nicht so gut zugänglichen Stellen. Die Zahnbeläge haben bei der Testmundspülung abgenommen, während die Plaque an allen Flächen bei der Placebomundspülung zunahm. Der Unterschied betrug zwischen 10–21%, war aber statistisch nicht signifikant. Für die Testmundspülung kann demnach sowohl für die Entzündung als auch für den Plaquebefall von einer positiven Wirkung gesprochen werden. Die Tendenz ist eindeutig. Bei so kleinen Fallzahlen (13 Probanden/Gruppe) ist jedoch eine statistische Signifikanz zwischen den beiden Gruppen kaum zu erreichen oder höchstens mit ausserordentlich stark wirkenden Mundspülungen. Beide Mundspülungen haben in der Mundhöhle keine unerwünschten Veränderungen hervorgerufen. Der Geschmack der Testmundspülung wurde nach 3 Wochen als verbesserungswürdig beurteilt, wobei nach 3 Monaten bereits eine deutliche Anpassung stattgefunden hatte, indem deutlich weniger Bemerkungen registriert wurden