Effects of two essential oil mouthrinses on 4-day supragingival plaque regrowth: a randomized cross-over study.

PURPOSE: To investigate the plaque inhibiting effects of two commercially available mouthrinses containing essential oils (EO). Both products contained the same concentration of EO, but one of them did not contain ethanol. METHODS: The study was an observer-masked, randomized, 4 x 4 Latin square cross-over design, balanced for carryover effects, involving 12 participants in a 4-day plaque regrowth model. A 0.12% chlorhexidine (CHX) rinse and a saline solution served as positive and negative controls, respectively. On Day 1, subjects received professional prophylaxis, suspended oral hygiene measures, and commenced rinsing with their allocated rinses. On Day 5, subjects were scored for disclosed plaque. RESULTS: Differences among treatments were highly significant (P < 0.0001), with greater plaque inhibition by CHX compared to EO rinse containing ethanol (P = 0.012), which, in turn, was significantly more effective than the rinse without ethanol and the saline (P < 0.001). The reduction in plaque regrowth seen with the EO rinse without ethanol was quite similar to that elicited by saline (P > 0.05).

Effect of hormone replacement therapy (HRT) on periodontal status of postmenopausal women.

BACKGROUND: The risks/benefits balance of hormone replacement therapy (HRT) is controversial. The aim of this study was to assess the periodontal status of a postmenopausal women group receiving HRT and to determine the effects of HRT on clinical measures of periodontal disease. MATERIAL/METHODS: Ninety-one postmenopausal women, 52 taking HRT (HRT+) and 39 not taking HRT (HRT-), completed the study. Clinical parameters measured included visible supragingival plaque, probing pocket depth (PD) and clinical attachment level (CAL). Gingival status was recorded as gingival bleeding on probing (BOP). Previous oral contraceptive use and current and past smoking status were also assessed. RESULTS: Data indicated that PD and CAL were not significantly different between HRT+ patients and HRT- patients (P=0.8067 and P=0.1627, respectively). The HRT+ group exhibited significantly lower visible plaque levels compared to the control group (P<0.0001). The percentage of gingival sites with positive BOP was significantly lower in the HRT+ group compared to the HRT- group (34.85% vs. 65.15%; P=0.0007). Plaque accumulation was also tested in ANCOVA as a possible explanatory variable for the differences observed in gingival bleeding. The ANCOVA showed no significant differences in gingival bleeding between HRT+ and HRT- women (P=0.4677). No significant differences in past smoking status and oral contraceptive use were detected between HRT+ and HRT- women (P=0.9999 and P=0.0845, respectively). CONCLUSIONS: These findings indicated that long-term HRT was not associated with relevant effects on periodontal status and clinical measures of periodontal disease, thus suggesting that HRT may not confer protection against periodontitis in postmenopausal women.

Prevalence and socio-behavioral determinants of dental caries in Sicilian schoolchildren.

BACKGROUND: Epidemiological data revealed a marked decline in dental caries prevalence in schoolchildren of Western industrialized countries. In Italy this decline is not well documented, particularly for schoolchildren living in southern Italy. This study investigated the prevalence of caries in schoolchildren in the city of Palermo, Sicily, and assessed the relationship between socio-behavioral determinants and caries. MATERIAL/METHODS: A sample of 511 schoolchildren, 153 aged 5 (29.94%) and 358 aged 12 (70.06%), was selected using the cluster sampling technique from a stratified population. The World Health Organization caries diagnostic criteria for Decayed, Missing and Filled Teeth and Surfaces for both permanent (DMFT/DMFS) and primary (dmft/dmfs) dentition was used. A questionnaire to assess oral health behaviors and socio-economic factors was completed by the parents. A logistic regression model was estimated, with DMFT/dmft index properly dichotomized as the dependent variable, and oral hygiene, dietary habits, dentist visit attendance, mother's employment status and level of education as explanatory variables. Two separate analyses were made for 5- and 12-year-old subjects. RESULTS: The overall prevalence of dental caries was 38.56% in 5-year-olds and 44.97% in 12-year-olds. In the case of the 5-year-olds, maternal educational level was a protective factor for caries, while in the case of the subjects aged 12, frequent snack consumption was significantly associated with caries. CONCLUSIONS: The prevalence of caries in Sicilian schoolchildren was quite high and appears to be related to socio-behavioral determinants (socio-economic background of mothers and frequency of cariogenic snack consumption).

Plaque removal efficacy of power and manual toothbrushes: a comparative study.

The aim of this study was to compare the plaque removal efficacy of a new oscillating/rotating/pulsating toothbrush [Oral-B Professional Care 8500 (PC 8500)] with two manual toothbrushes [Oral-B CrossAction Vitalizer (CAV) and Oral-B Indicator (IND), respectively]. The safety of the PC 8500 was also assessed. The study was a single-use, observer-masked, randomised 3 x 3 Latin square crossover design balanced for carryover effects. The enrolled subjects (n = 66) refrained from brushing for 23-25 h before each clinical examination. Plaque scores were recorded before and after brushing with the allocated toothbrush using the Turesky et al. modification of the Quigley and Hein plaque index. The safety was assessed evaluating the soft tissue conditions present after 30 days of the use of the PC 8500. The PC 8500 toothbrush was better in plaque removal efficacy compared with the CAV and IND brushes for full mouth and approximal surfaces (P < 0.01). When marginal surfaces were considered, the PC 8500 was significantly more effective than the IND (P < 0.01). No significant differences were found between PC 8500 and CAV (P > 0.05). The latter was shown to be significantly more effective than the IND at all tooth surfaces (P < 0.01). Safety examinations revealed the onset of only two small gingival abrasions after the 30-day use of the PC 8500. The PC 8500 toothbrush demonstrated to be more effective in plaque control than the CAV and IND in the full mouth and approximal surfaces and similar to the CAV in the marginal surfaces. The PC 8500 was safe to oral tissues in long-term use.

Genetic disorders and periodontal health: a literature review.

Periodontal diseases include a group of inflammatory diseases characterized by progressive destruction of the periodontium. Dental plaque is the initiator of periodontal disease, but disease severity and response to treatment are determined predominantly by host-based risk factors. Genetic disorders can modify the host defense mechanisms or influence the homeostasis of the periodontium during childhood, thus increasing patients' susceptibility to periodontal disease. The periodontal manifestations of these disorders may persist into adulthood. When dealing with periodontal problems, particularly in children and adolescents, it is advisable to establish a differential diagnosis of periodontal disease due to systemic conditions. This paper reviews the current literature concerning the effect on periodontal health of genetic disorders such as connective tissue metabolism disorders, metabolic disorders, skin disorders, leukocyte defects, and chromosome abnormalities. Treatment strategies of patients with genetic disorders affected by periodontal diseases are also suggested according to the evidence available. In patients affected by genetic disorders, the response to treatment is not always as expected, and sometimes the progression of periodontal disease is inevitable despite adequate maintenance treatment.

The effects of an essential oil and an amine fluoride/stannous fluoride mouthrinse on supragingival plaque regrowth.

BACKGROUND: The side effects of chlorhexidine (CHX) have stimulated the search for alternative antiplaque agents such as amine fluoride/stannous fluoride (ASF) and essential oils (EO). The aim of the study was to investigate the plaque-inhibiting effects of two commercially available mouthrinses containing ASF and EO, respectively. METHODS: The study was an observer-masked, randomized, 5 x 5 Latin square cross-over design, balanced for carryover effects, involving 15 volunteers in a 4-day plaque regrowth model. A 0.12% CHX rinse and a saline solution served as positive and negative controls, respectively. On day 1, subjects received professional prophylaxis, suspended oral hygiene measures, and commenced rinsing with their allocated rinses. On day 5, subjects were scored for disclosed plaque. The ASF rinse was tested at two dosages: 10 and 20 ml (ASF-10 and ASF-20, respectively). RESULTS: The ASF and EO rinses showed a significant inhibition of plaque regrowth compared to saline (P <0.0001), but the lowest plaque indices were obtained with the CHX product (P <0.01). There were no significant differences among products containing ASF-10, ASF-20, and EO (P >0.05). There was no correlation between the occurrence of side effects and the use of a particular rinse product (P >0.2). CONCLUSIONS: ASF and EO mouthrinses exerted effective and similar plaque inhibition. The two dosages tested for ASF did not differ in plaque reduction. These findings, together with those from long-term trials, suggest that ASF and EO rinses may represent effective alternatives to CHX rinse as adjuncts to oral hygiene.

The effects of sugar-free chewing gums on dental plaque regrowth: a comparative study.

UNLABELLED: Sugar-free chewing gum has been claimed to be a useful means of reducing dental plaque accumulation. The incorporation of additives, such as enzymes, abrasives and divalent metal ions, into gum formulations might improve their antiplaque activity, particularly at the buccal and lingual surfaces of the teeth. OBJECTIVES: The aim of this study was to investigate the plaque inhibitory effects of three sugar-free chewing gums each containing lactoperoxidase (LP), micro granules of silicon dioxide (SD), and zinc gluconate (ZG). METHODS: The study was an observer-masked, randomized cross-over design balanced for carryover effects, involving 12 healthy volunteers in a 4-day plaque regrowth model. An additive-free (AF) gum served as positive/negative control for occlusal and smooth surfaces, respectively. On day 1, subjects received professional prophylaxis, suspended oral hygiene measures, and commenced chewing their allocated product. Gum chewing was one piece chewed for 30min 4 times a day. On day 5, subjects were scored for disclosed plaque. RESULTS: There were no significant differences in antiplaque activity of the gums tested, neither for the smooth nor for the occlusal surfaces (P=0.447 and P=0.418, respectively). Similar results were obtained for the anterior and posterior sites of smooth surfaces (P>0.05), and for the lower and upper sites of occlusal surfaces (P=0.451 and P=0.53, respectively). CONCLUSIONS: These findings suggest that the chewing gums containing LP, SD and ZG would provide no plaque inhibitory effects on smooth surfaces. The gums containing these additives, therefore, should not be recommended as adjuncts to mechanical oral hygiene.

The effects of antimicrobial sprays and mouthrinses on supragingival plaque regrowth: a comparative study.

BACKGROUND: Due to the side effects of chlorhexidine digluconate (CHX) mouthrinsing, a spray has been proposed as an alternative method of CHX delivery to the oral cavity. The aim of this study was to investigate the plaque inhibitory effects of CHX, cetylpyridinium chloride (CPC), and triclosan (TRN) delivered by sprays and mouthrinses. METHODS: The study was an observer-masked, randomized cross-over design balanced for carryover effects, involving 15 healthy volunteers in a 4-day plaque regrowth model. Products being tested (0.2% CHX, 0.12% CHX, 0.05% CPC, and 0.03% TRN) were used both as sprays and mouthrinses. A saline solution served as a negative control. On day 1, subjects received professional prophylaxis, suspended oral hygiene measures, and commenced using their allocated products. On day 5, subjects were scored for disclosed plaque. RESULTS: CHX sprays (P<0.01) were the most effective sprays in preventing plaque regrowth, without significant differences between the two concentrations tested (P>0.05). TRN spray showed a significant inhibition of plaque regrowth in comparison to the negative control (P<0.05). CPC spray did not differ from saline spray (P>0.05). A similar trend of efficacy was detected for rinses. Although the effect on plaque regrowth observed with CHX rinses was superior to that of CHX sprays (P<0.0003), the latter did not cause side effects (P>0.2). CONCLUSIONS: These findings, together with those from clinical trials, suggest that the CHX-containing sprays may represent an effective alternative to CHX rinses when mechanical oral hygiene has to be avoided in restricted areas. On the contrary, the TRN and CPC sprays showed little or no plaque inhibitory effects.

Community water fluoridation and caries prevention: a critical review.

The aim of this paper was to critically review the current role of community water fluoridation in preventing dental caries. Original articles and reviews published in English language from January 2001 to June 2006 were selected through MEDLINE database. Other sources were taken from the references of the selected papers. For the past 50 years community water fluoridation has been considered the milestone of caries prevention and as one of the major public health measures of the 20th century. However, it is now accepted that the primary cariostatic action of fluoride occurs after tooth eruption. Moreover, the caries reduction directly attributable to water fluoridation have declined in the last decades as the use of topical fluoride had become more widespread, whereas enamel fluorosis has been reported as an emerging problem in fluoridated areas. Several studies conducted in fluoridated and nonfluoridated communities suggested that this method of delivering fluoride may be unnecessary for caries prevention, particularly in the industrialized countries where the caries level has became low. Although water fluoridation may still be a relevant public health measure in poor and disadvantaged populations, the use of topical fluoride offers an optimal opportunity to prevent caries among people living in both industrialized and developing countries.