The provision of oral hygiene instructions and patient motivation in a dental care system without dental hygienists.

INTRODUCTION: Oral hygiene instructions (OHI) and patient motivation (PM), often provided by dental hygienists, are essential attributes to establishing good oral health in patients. The purpose of this study was to investigate the provision of OHI and PM by dental professionals in a dental care system without dental hygienists. METHODS AND MATERIALS: A questionnaire, including 22 items (demographics, OHI and PM), was presented to 1037 dental professionals (=21.6% Flemish population). Descriptive statistics were used to analyse the provision of OHI and PM. Additionally, the Fisher-Freeman-Halton exact test was used to investigate the influence of qualification (general practitioner/specialist), work experience (< or ≥ 25 years), workload (< or ≥ 30 h), location of practice (rural/urban) and chair-side assistance (with/without). RESULTS: Response rate was 75%. Participants reported a single strategy for preventive care and felt their efforts were not in harmony with the results. Lack of time, remuneration and patient interest were reported as complicating factors and participants agreed on allowing assistants to provide preventive care. Significant variance was found based on qualification (12/17 items), work experience (7/17 items), workload (1/17 items), location of practice (2/17 items) and chair-side assistance (15/17 items). CONCLUSION: In a context without dental hygienists, OHI and PM appeared non-compliant with current international guidelines. Although dental professionals were concerned with preventive dentistry, they reported barriers including lack of time, remuneration and patient compliance. Almost all participants expressed the need for delegation of in-mouth OHI, suggesting a need for dental hygienists.

Plaque removing effect of a convex-shaped brush compared with a conventional flat brush.

The plaque-removing effect of a convex-shaped multitufted brush was compared with that of a conventional flat multitufted brush. Two group (five and seven dental students, respectively), well instructed in the modified Bass technique, participated in a blind, splitmouth, crossover study during two consecutive experimental periods of 96 hours of undisturbed plaque growth. After each of these periods, a supervised brushing session was performed, followed by toothpick utilization. Plaque removal was evaluated using the modified Navy Plaque Index (MNPI) and planimetry. A 4% erythrosin solution was used as a disclosing agent. Planimetrically, the flat Oral B brush appeared significantly more effective than the convex shaped Ph brush (P less than 0.001). This superiority was even enhanced after the use of toothpicks (P less than 0.0005). The differences between the brushes, however, were too small to be detected by the less discriminating MNPI. Although it has been claimed that the convex brush could assure approximal plaque control, the results indicate that for the convex-shaped, as well as for the flat brush, an approximal aid is essential for good plaque control. The hypothesis that the design of the convex-shaped brush could facilitate the modified Bass technique for the average patient could not be proven in this study.

Double-blind comparison of the analgesic potency of ciramadol, codeine and placebo against postsurgical pain in ambulant patients.

The efficacy and safety of ciramadol (Cir) as an analgesic in relieving moderate to severe pain after oral surgery has been studied in 79 patients randomly assigned to receive single oral doses of Cir 15, 30 or 60 mg, codeine 60 mg or placebo. During the 6-hour observation period, the three ciramadol-treated groups indicated greater pain relief than the codeine 60 mg or placebo groups. In general, Cir 60 mg was significantly more effective than codeine 60 mg, and all doses of Cir were superior to placebo. The proportion of patients in each Cir group reporting adverse experiences was significantly higher than in either the placebo or codeine groups. The experimental system proved very effective in demonstrating analgesic potency of Cir. The very high incidence of side-effects in the three ciramadol-treated groups makes it unfit for further clinical use in ambulant patients.