Psychological interventions for improving adherence to oral hygiene instructions in adults with periodontal diseases

Background: Adherence to oral hygiene is an important aspect of the treatment of periodontal disease. Traditional educational interventions have been shown to be of little value in achieving long term behaviour change. Objectives: The aim of this review was to determine the impact of interventions aimed to increase adherence to oral hygiene instructions in adult periodontal patients based on psychological models and theoretical frameworks. This review considered the following outcomes:Observational measures of oral health related behaviourSelf reported oral health related behaviours, beliefs and attitudes towards oral health related behaviourClinical markers of periodontal disease. Search methods: The Cochrane Oral Health Group's Trials Register (2005), CENTRAL (The Cochrane Library 2004, Issue 4), MEDLINE (from 1966 to December 2004), EMBASE (from 1980 to December 2004), PsycINFO (from 1966 to December 2004), Ingenta (from 1998 to December 2004) and CINAHL (from 1966 to December 2004). Reference lists from relevant articles were searched and the authors of eligible trials were contacted to identify trials and obtain additional information. No language restriction was applied. Selection criteria: Randomised controlled trials testing the effectiveness of interventions based on psychological models compared with educational, attention or no active intervention controls to improve adherence to oral hygiene in adults with either gingivitis or periodontitis. Data collection and analysis: Titles and abstracts of studies that were potentially relevant to the review were independently screened by two review authors. Those that were clearly ineligible were rejected. For the remaining studies, the full paper was reviewed by two review authors and where necessary further information was sought from the author to verify eligibility. Included studies were assessed on their quality using standard criteria. Main results: The review identified four studies (including 344 participants) in which a psychological model or theory had been explicitly used as the basis for the design of the intervention. The overall quality of trials was low. Due to the heterogeneity between studies, both in terms of outcome measures and psychological models adopted, a meta-analysis was not possible. The four studies adopted four different theoretical frameworks, though there was some overlap in that three of the studies incorporated elements of Operant and Classical Conditioning. Psychological interventions resulted in improved plaque scores in comparison to no intervention groups, and in one study in comparison to an attention control group. One study found decreased gingival bleeding in the active intervention group but no change in pocket depth or attachment loss after 4 months. Psychological interventions were associated with improved self reported brushing and flossing in both studies which assessed these behaviours. Only one study explored the impact of psychological interventions on beliefs and attitudes, the psychological intervention, in comparison to educational and no intervention controls, showed improved self efficacy beliefs in relation to flossing, but no effect on dental knowledge or self efficacy beliefs in relation to tooth brushing. Authors' conclusions: There is tentative evidence from low quality studies that psychological approaches to behaviour management can improve oral hygiene related behaviours. However, the overall quality of the included trials was low. Furthermore, the design of the interventions was weak and limited, ignoring key aspects of the theories. Thus, there is a need for greater methodological rigour in the design of trials in this area

The problems of implementation and using of e-learning in high educational establishments

Розглянуто стан впровадження електронного навчання у вищих навчальних закладах України та за кордоном. Проаналізовано результати експериментального дослідження щодо ставлення викладачів до впровадження та реалізації електронного навчання на прикладі педагогічного університету. Встановлено, що однією з причин гальмування реалізації електронного навчання в Україні є проблема нормативно-правового забезпечення електронного навчання.Рассмотрено состояние внедрения электронного обучения в высших учебных заведениях Украины и за рубежом. Проанализированы результаты экспериментального исследования в отношении преподавателей к внедрению и реализации электронного обучения на примере педагогического университета. Установлено, что одной из причин торможения реализации электронного обучения в Украине есть проблема нормативно-правового обеспечения электронного обученияThe state of implementation of e-learning in high educational establishments in Ukraine and abroad is reviewed in the article. The experimental research results of teachers’ attitude to the implementation and realization of e-learning on the example of Pedagogical University was analyzed in the article. One of the reasons of slowing down the realization of e-learning in Ukraine is a legal problem

Bacterial morphotype grading for periodontal disease assessment

BACKGROUND: Listgarten and Hellden (1978) used darkfield microscopy of wet mounts to differentiate between healthy and periodontally diseased sites in the mouth by expressing the different bacterial morphotypes observed as a percentage of the total number of bacteria counted. This method of periodontal disease assessment gained favour as a diagnostic tool but presented with the limitation of immediate examination to determine the number of motile rods present and an inability to distinguish between gingivitis and periodontitis. Grading of bacterial morphotypes into several distinct categories of health or disease (Ison and Hay, 2002), simplified the scoring system of Gram-stained smears for the diagnosis of bacterial vaginosis (Nugent et al. 1991). The application of a similar grading system using stained smears rather than wet mounts could be advantageous to the diagnosis of periodontal disease. OBJECTIVES/AIMS: This study tested the hypothesis that stained smears of dental plaque collected from the gingival crevice of individuals with varying probing pocket depths (PD) may provide a grading system for periodontal disease assessment. MATERIALS AND METHODS: Subgingival plaque samples were collected from 49 patients, stained with a silver stain and the proportions of each bacterial morphotype graded relative to their respective PD measurements. RESULTS: This technique allowed for a grading system of I–IV, with grade I indicating health and grade IV indicating severe periodontal disease. DISCUSSION: Stained smear examination eliminates the time restriction for motile rod enumeration and allows for storage of smears for future reference. CONCLUSION: Standardization of the microscopic areas to be evaluated or examined will facilitate the agreement of cut-off values for the diagnosis of periodontal disease.This material is based on work partially supported financially by the National Research Foundation (NRF) of South Africa

The effects of subgingival application of ozonated olive oil gel in patient with localized aggressive periodontitis. A clinical and bacteriological study

AbstractThis study evaluates the effect of subgingival application of ozonated olive oil gel as an adjunct to scaling and root planing (SRP) in aggressive periodontitis.Material & methodsThirty patients were randomly selected and equally divided into: Group I received SRP only, group II received SRP and ozonated olive oil gel (Oxactiv). Subgingival application of ozone gel was performed following initial SRP and at 7, 14 and 21 days. Clinical measurements included pocket depth (PD), plaque index (PI), gingival index (GI), bleeding on probing (BOP) and clinical attachment level (CAL). Real time PCR was carried out to determine the effect of the treatment on both Aggregatibacter actinomycetemcomitans (Aa) and Porphyromonas gingivalis (Pg). Clinical measurements and Plaque samples for PCR were recorded at baseline, one, three and six months after treatment.ResultsThe results showed improvement in all clinical parameters in (group II) which was maintained up to six months (P < 0.05). However, this improvement was best following one month but gradually decrease at 3 and 6 months. Whereas SRP alone resulted in a significant improvement only up to one month for BOP, PPD and CAL parameters and up to three months for the PI and GI scores as compared to baseline values.Microbiological resultsRevealed significant reduction of the mean Pg and Aa DNA copies at 1 and 3 months for (groupII), whereas group I resulted in slight reduction up to 1 month only followed by gradual increase reaching baseline values. There was no significant difference between groups at three and six months regarding Pg DNA copies. There was a significant difference between groups at the one and three months periods in term of number of Aa copies (P < 0.001, P < 0.05 respectively).ConclusionThe study concluded that (Oxactiv) gel could be a promising adjunct to SRP in the treatment of aggressive periodontitis

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

Principles of Periodontology

Periodontal diseases are among the most common diseases affecting humans. Dental biofilm is a contributor to the etiology of most periodontal diseases. It is also widely accepted that immunological and inflammatory responses to biofilm components are manifested by signs and symptoms of periodontal disease. The outcome of such interaction is modulated by risk factors (modifiers), either inherent (genetic) or acquired (environmental), significantly affecting the initiation and progression of different periodontal disease phenotypes. While definitive genetic determinants responsible for either susceptibility or resistance to periodontal disease have yet to be identified, many factors affecting the pathogenesis have been described, including smoking, diabetes, obesity, medications, and nutrition. Currently, periodontal diseases are classified based upon clinical disease traits using radiographs and clinical examination. Advances in genomics, molecular biology, and personalized medicine may result in new guidelines for unambiguous disease definition and diagnosis in the future. Recent studies have implied relationships between periodontal diseases and systemic conditions. Answering critical questions regarding host‐parasite interactions in periodontal diseases may provide new insight in the pathogenesis of other biomedical disorders. Therapeutic efforts have focused on the microbial nature of the infection, as active treatment centers on biofilm disruption by non‐surgical mechanical debridement with antimicrobial and sometimes anti‐inflammatory adjuncts. The surgical treatment aims at gaining access to periodontal lesions and correcting unfavorable gingival/osseous contours to achieve a periodontal architecture that will provide for more effective oral hygiene and periodontal maintenance. In addition, advances in tissue engineering have provided innovative means to regenerate/repair periodontal defects, based upon principles of guided tissue regeneration and utilization of growth factors/biologic mediators. To maintain periodontal stability, these treatments need to be supplemented with long‐term maintenance (supportive periodontal therapy) programs

A COMPARISON OF THE EFFECTIVENESS OF THE “TOOTHKEEPER’ AND A TRADITIONAL DENTAL HEALTH EDUCATION PROGRAM

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/66303/1/j.1752-7325.1975.tb04031.x.pd

The impact of dental restorations' quality on caries risk

publishersversionPeer reviewe