The Effect of the Bass Intrasulcular Toothbrushing Technique on the Reduction of Gingival Inflammation: A Randomized Clinical Trial.

OBJECTIVES: The primary objective of this randomized controlled clinical trial was to investigate the effect of the Bass Intrasulcular Technique (BIT) on reducing gingival inflammation at 4 and 12 weeks compared with the toothbrushing techniques commonly used. METHODS AND MATERIALS: After receiving ethical approval from the Tufts Health Sciences Institutional Review Board, 55 subjects were invited to participate in the study. Only the subjects who presented with bleeding on probing (BoP) were enrolled. The test group (BT) was instructed on how to use the BIT, and the control group (NI) received no brushing technique instructions. Clinical measurements (probing depth, plaque score, BoP) of each tooth were recorded at 4 and 12 weeks. The toothbrushes of all participants were photographed and assessed by two blinded examiners using the ImageJ software. The statistical significance between the cohorts' BoP and their plaque score results was assessed via hierarchical logistic regression. The analyses were performed using the SAS software (version 9.4; SAS Institute, Cary, NC). RESULTS: Forty-eight participants were eligible to participate and were randomly assigned to one of the two groups (N = 24). The BT group showed significantly smaller percentages of BoP than the NI group at 4 (BT = 12.4% and NI = 31.4%) and 12 (BT = 11.6% and NI = 43.8%) weeks. The difference in plaque scores at 12 weeks was statistically significant (P = .0003) between the two groups. At 12 weeks, the Mann-Whitney U Test indicated that the difference between the groups in terms of toothbrush area was statistically significant (P = .043). CONCLUSIONS: Within the limitations of this randomized controlled clinical trial, the BIT used by participants in the BT group was significantly more effective in reducing gingival inflammation as determined by BoP than the techniques used by participants who had no instructions on brushing techniques; at 12 weeks, the BT group experienced less toothbrush deformation than the control group. CLINICAL RELEVANCE: BIT should be recommended particularly to patients exhibiting BoP and periodontal diseases.

Should the U.S. Adopt a National Dental Clinical Licensure Examination? Two Viewpoints: Viewpoint 1: National Licensure Would Provide Multiple Advantages for Practitioners and the Profession and Viewpoint 2: Licensing Authority Should Remain Under State Dental Boards' Jurisdiction.

This Point/Counterpoint article examines the need for and potential impact of implementing a national clinical examination for initial licensure in dentistry. Viewpoint 1 supports a national licensure exam that meets the clinical exam's credentialing requirement for licensure in every state. According to this viewpoint, a national exam will reduce costs, enhance portability of graduates, simplify the transition from dental school to practice or specialty training programs, and standardize requirements for licensure between states. Viewpoint 2 opposes a national licensure exam. This viewpoint supports individual states' dental board decision making process, which is based on identifiable state-specific criteria. The ability to prioritize needs at the state level allows for higher exam standards, easier modifications, more focused requirements, and better calibration in specific exam areas. Viewpoint 2 argues that the delicate balance between licensure agencies and organized dentistry in each state, as well as the involvement of dental schools in the licensure process, must be preserved. This Point/Counterpoint concludes with a joint statement about the prospects for adoption of a national licensure exam.