Effect of a multi-faceted intervention on gingival health among adults with systemic sclerosis.

OBJECTIVES: To evaluate the effect of adaptive oral hygiene devices and orofacial exercise to improve gingival health among adults with systemic sclerosis (SSc). METHODS: Forty-eight patients with SSc were assigned randomly to the multifaceted oral health intervention or usual dental care control group. Participants in the intervention group received a rechargeable, powered Oral-B® oscillating-rotating-pulsating toothbrush and a Reach® Access™ Flosser that has a toothbrush-like handle. For those with an oral aperture of less than 40 mm, orofacial exercises were taught. Participants in the control group were each given a manual toothbrush and dental floss. Participants in both groups received instructions and demonstration on the use of the devices, and were requested to perform the respective intervention twice a day for 6 months. Evaluations were at baseline, 3-, and 6-months. The main outcome was gingival index (GI), an indicator of gingival inflammation. RESULTS: Both groups showed significant reduction in GI scores at 6 months (ps<0.005). Reduction in GI scores of the intervention group at 6 months was 20.8% which is considered to be clinically significant. Compared to the control group, the intervention group showed a significant and larger reduction in GI score by 8% at 6 months (p=0.0007). CONCLUSIONS: Results support the use of adaptive devices and orofacial exercise to improve gingival health in adults with SSc when compared to use of manual toothbrushing and finger-held flossing. Recommending and educating patients with SSc to use adaptive devices to clean the tooth surfaces looks promising for long-term oral health improvement.

How effective are interdental cleaning aids in improving dental health?

UNLABELLED: This paper reviews recent systematic reviews of the evidence on the effectiveness of interdental cleaning aids in delivering oral health benefits. CLINICAL RELEVANCE: Dental professionals need to consider the evidence for the effectiveness of different interdental cleaning aids carefully when making recommendations to patients.

Effect of regulatory and professional guidelines on the development and marketing of a dental device: case history.

The FDA encourages organizations such as the ADA to develop voluntary standards for drugs and dental devices. The landmark process of gaining ADA approval of an oral irrigator as the first therapeutic device is described. The process was time consuming and expensive, and obligates the manufacturer to submit all future marketing and advertising claims for ADA review. The ADA should continue to ensure standardized guidelines for all product categories. Education of the dental profession and the consumer concerning the significance of the ADA seal of approval is encouraged.

Guidelines for the acceptance of peroxide-containing oral hygiene products. American Dental Association Council on Dental Therapeutics.

Safety and efficacy criteria are defined for oral products containing various forms of peroxides. The guidelines ask for safety and efficacy studies plus observation criteria that include long-term follow-up.

ADA supports vital tooth bleaching--but look for the seal.

The ADA has lent its support to tooth bleaching by providing procedural codes, educational materials and product evaluation procedures. The author describes the elements of the ADA product evaluation process and the role they should play in product development.

Impact of improved toothbrushes on dental diseases. II.

The new generation of manual and powered toothbrushes that have been tested in recent years exhibit better plaque removal than do older brushes. Differences are most significant when individuals have been instructed in proper brushing technique. Comparisons of powered and manual brushes show the clear superiority of newer powered brushes, but there is no such effect with older powered brushes, which stop when force is applied. Newer powered brushes reduce gingivitis and gingival abrasions. In a limited 18-month trial, a powered oscillating toothbrush improved existing periodontal conditions, thus effecting a considerable savings in treatment costs. At present, under optimal conditions, improved designs of both manual and powered toothbrushes, which do not stop or break down in use, produce more significant plaque removal in critical sites. Long-term trials are needed to confirm these results.

Comparing the Dr. SEDOC and ADA toothbrushes in three independent laboratory procedures.

OBJECTIVE: The purpose of this research was to compare the Dr. SEDOC toothbrush, tufted with super-tapered bristles, to the ADA standard toothbrush in three laboratory procedures designed to evaluate 1) the cleaning ability of toothbrush bristles at the gingival margin (GMC), 2) interproximal access efficacy (IAE) and plaque removal efficacy, or 3) subgingival access (SA) into, and removal of artificial plaque deposits from under the gingival margin. METHODOLOGY: Efficacy was tested using three published laboratory methods, with pressure-sensitive paper placed around simulated teeth, at a brushing pressure of 250 or 500 g, with horizontal or vertical brushing motions. Twenty-four tests on each toothbrush design were conducted, and results were statistically analyzed using ANOVA. RESULTS: In all three assays, the Dr. SEDOC toothbrush had a significantly superior (p < 0.001) efficacy mean value compared to the ADA toothbrush. CONCLUSION: The Dr. SEDOC toothbrush, with super-tapered bristles, offers the potential for improved cleaning and plaque removal compared to the ADA standard control toothbrush.

[Microscopic studies of the structures of different dental floss types]. / Mikroskopische Untersuchungen zur Struktur verschiedener Zahnseidetypen.

26 different dental flosses, made from silk, polyamide (Nylon) or Teflon, were analyzed with respect to their surface structure and their cross-section. Principally, two different types of manufacturing could be distinguished. The dental flosses either consisted of a large number of individual fibers, or a single, falted membrane. Even flosses that were manufactured in the same manner revealed considerable differences. Apart from the chemical composition, the structure of dental flosses is decisive for their use and this is why an exact classification would be desirable. In this study the requirements for classifying dental flosses are provided.

[Prevention of caries in children]. / Cariëspreventie bij kinderen.

There is a stagnation in the previously ongoing improvement of the dental health of children. Therefore, an evaluation of the guidelines for dental care is necessary. Prevention should be based on an improvement of home care. It is advised to use a dentifrice with 500 to 750 ppm fluoride till the age of five. Professional applications in the dental office are most beneficial when early signs of decay are observed. Indications for professional applications are proposed.

[Certification of oral hygiene agents from a microbiological viewpoint]. / Sertifikatsiia sredtsv gigieny polosti rta s mikrobiologicheskikh pozitsii.

The authors validate the necessity of hygienic certification including microbiological control of perfumes and cosmetics, to which oral hygiene means belong. They consider that the absence of sanitary regulations for some goods, toothpastes included, is one of the causes, responsible for the absence of a proper sanitary control on the part of State Epidemiological Survey of the Russian Federation. In accordance with the resolution "On Certification of Perfumes and Cosmetics" issued in 1994, Central Research Institute of Stomatology is appointed the central institution responsible for certification of means of oral hygiene, and at present its main task is development of sanitary regulations, standards, methods of investigation, and training of personnel for institutions which are to carry out certification.