A randomized trial of the effectiveness of an ultrasonic denture hygiene intervention program among community dwelling elders.

Purpose: This study aimed to assess the effectiveness of ultrasonic denture hygiene interventions in improving denture cleanliness among elderly individuals. Materials and methods: Sixty-six participants who had received upper metal framework removable partial dentures within the past 5 years were randomly allocated into three denture hygiene intervention groups: group 1 (mechanical cleaning with a toothbrush and ultrasonic cleaning with cetylpyridinium chloride), group 2 (mechanical cleaning with a toothbrush and ultrasonic cleaning with distilled water), and control (mechanical cleaning with a toothbrush only). Denture cleanliness was assessed at baseline and 1-month using: i) Denture Cleanliness Index (DCI) scores; ii) plaque coverage percentage; and (iii) microbiological samples for bacterial and yeast detection. Differences between groups were assessed with one-way analysis of variance and Chi-squared tests. Results: Mean DCI scores and mean percentages of plaque coverage area were significantly reduced in group 1 and group 2, compared to the control group for both cobalt chromium (CoCr) and acrylic fitting surfaces (p<0.001). No significant differences were found between groups 1 and 2 with regard to the prevalence and viable counts of yeasts or total microbial viable counts. No significant differences in the investigated clinical and microbiological parameters were observed between CoCr and acrylic surfaces following the intervention period. Conclusion: The ultrasonic cleaner was significantly more effective than mechanical cleaning in the reduction of biofilm coverage on metal framework removable partial dentures over a 1-month intervention period. Nevertheless, the adjunctive use of cetylpyridinium chloride with ultrasonic cleaning did not yield additional benefits.

A randomised clinical trial on the effect of oral antimicrobial sprays in institutionalised elders.

OBJECTIVE: To compare the effectiveness of chlorine dioxide, chlorhexidine and placebo sprays in improving oral hygiene among institutionalised elders. BACKGROUND: Available evidence suggests that oral sprays may be an effective alternative delivery method for plaque control; however, few studies have evaluated antimicrobial agents other than chlorhexidine. MATERIALS AND METHODS: A total of 228 elders across 11 nursing homes in Hong Kong were recruited into the clinical trial. Participants were randomly allocated into one of the following groups: 0.1% pH-balanced chlorine dioxide spray, 0.2% chlorhexidine spray or sterile water spray (placebo control), once daily. Dental plaque, gingival bleeding and other clinical oral health outcomes were assessed at baseline, 3 and 6 months. Participant acceptability of the interventions was assessed at the end of the clinical trial. RESULTS: Review assessments were conducted for 135 elders at 6 months. Significantly greater reductions in plaque index scores were observed with the chlorhexidine spray (0.4) and chlorine dioxide spray (0.3) than the placebo spray (0.1). While significant reductions in gingival bleeding scores were observed within the chlorhexidine (7.4), chlorine dioxide (7.5) and placebo (5.3) sprays after 6 months, change scores were not significantly different between groups. Significantly greater increases in the levels of staining were observed in the chlorhexidine spray group (-0.1) than the chlorine dioxide (0.0) and placebo spray (0.0) groups. CONCLUSION: Antimicrobial sprays were shown to be effective among institutionalised elders. Chlorine dioxide spray showed equivalent effects on dental plaque and gingival bleeding relative to the chlorhexidine spray over a 6-month period.

Effectiveness of computer-aided learning in oral health among patients and caregivers: a systematic review.

Computer-aided learning (CAL) offers enormous potential in disseminating oral health care information to patients and caregivers. The effectiveness of CAL, however, remains unclear. OBJECTIVES: The purpose of this study was to systematically review published evidence on the effectiveness of CAL in disseminating oral health care information to patients and caregivers. MATERIALS AND METHODS: A structured comprehensive search was undertaken among 7 electronic databases (PUBMED, CINAHL Plus, EMBASE, SCOPUS, WEB of SCIENCE, the Cochrane Library, and PsycINFO) to identify relevant studies. Randomized controlled trials (RCTs) and observational studies were included in this review. Papers were screened by 2 independent reviewers, and studies that met the inclusion criteria were selected for further assessment. RESULTS: A total of 2915 papers were screened, and full texts of 53 potentially relevant papers (κ = 0.885) were retrieved. A total of 5 studies that met the inclusion criteria (1 RCT, 1 quasi-experimental study, and 3 post-intervention studies) were identified. Outcome measures included knowledge, attitude, behavior, and oral health. Significant improvements in clinical oral health parameters (P < .05) and knowledge/attitudes (P < .001) were reported in 2 of the studies. The 3 remaining studies reported improved oral health behaviors and confidence. CONCLUSION: There is a limited number of studies which have examined the effectiveness of CAL interventions for oral health care among patients and caregivers. Synthesis of the data suggests that CAL has positive impacts on knowledge, attitude, behavior, and oral health. Further high- quality studies on the effectiveness of CAL in promoting oral health are warranted.