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The Cochrane Database of Systematic... Dec 2020Ventilator-associated pneumonia (VAP) is defined as pneumonia developing in people who have received mechanical ventilation for at least 48 hours. VAP is a potentially... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Ventilator-associated pneumonia (VAP) is defined as pneumonia developing in people who have received mechanical ventilation for at least 48 hours. VAP is a potentially serious complication in these patients who are already critically ill. Oral hygiene care (OHC), using either a mouthrinse, gel, swab, toothbrush, or combination, together with suction of secretions, may reduce the risk of VAP in these patients.
OBJECTIVES
To assess the effects of oral hygiene care (OHC) on incidence of ventilator-associated pneumonia in critically ill patients receiving mechanical ventilation in hospital intensive care units (ICUs).
SEARCH METHODS
Cochrane Oral Health's Information Specialist searched the following databases: Cochrane Oral Health's Trials Register (to 25 February 2020), the Cochrane Central Register of Controlled Trials (CENTRAL) (the Cochrane Library, 2020, Issue 1), MEDLINE Ovid (1946 to 25 February 2020), Embase Ovid (1980 to 25 February 2020), LILACS BIREME Virtual Health Library (1982 to 25 February 2020) and CINAHL EBSCO (1937 to 25 February 2020). We also searched the VIP Database (January 2012 to 8 March 2020). The US National Institutes of Health Trials Registry (ClinicalTrials.gov) and the World Health Organization International Clinical Trials Registry Platform were searched for ongoing trials. No restrictions were placed on the language or date of publication when searching the electronic databases.
SELECTION CRITERIA
We included randomised controlled trials (RCTs) evaluating the effects of OHC (mouthrinse, gel, swab, toothbrush or combination) in critically ill patients receiving mechanical ventilation for at least 48 hours.
DATA COLLECTION AND ANALYSIS
At least two review authors independently assessed search results, extracted data and assessed risk of bias in included studies. We contacted study authors for additional information. We reported risk ratio (RR) for dichotomous outcomes and mean difference (MD) for continuous outcomes, using the random-effects model of meta-analysis when data from four or more trials were combined.
MAIN RESULTS
We included 40 RCTs (5675 participants), which were conducted in various countries including China, USA, Brazil and Iran. We categorised these RCTs into five main comparisons: chlorhexidine (CHX) mouthrinse or gel versus placebo/usual care; CHX mouthrinse versus other oral care agents; toothbrushing (± antiseptics) versus no toothbrushing (± antiseptics); powered versus manual toothbrushing; and comparisons of other oral care agents used in OHC (other oral care agents versus placebo/usual care, or head-to-head comparisons between other oral care agents). We assessed the overall risk of bias as high in 31 trials and low in two, with the rest being unclear. Moderate-certainty evidence from 13 RCTs (1206 participants, 92% adults) shows that CHX mouthrinse or gel, as part of OHC, probably reduces the incidence of VAP compared to placebo or usual care from 26% to about 18% (RR 0.67, 95% confidence intervals (CI) 0.47 to 0.97; P = 0.03; I = 66%). This is equivalent to a number needed to treat for an additional beneficial outcome (NNTB) of 12 (95% CI 7 to 128), i.e. providing OHC including CHX for 12 ventilated patients in intensive care would prevent one patient developing VAP. There was no evidence of a difference between interventions for the outcomes of mortality (RR 1.03, 95% CI 0.80 to 1.33; P = 0.86, I = 0%; 9 RCTs, 944 participants; moderate-certainty evidence), duration of mechanical ventilation (MD -1.10 days, 95% CI -3.20 to 1.00 days; P = 0.30, I = 74%; 4 RCTs, 594 participants; very low-certainty evidence) or duration of intensive care unit (ICU) stay (MD -0.89 days, 95% CI -3.59 to 1.82 days; P = 0.52, I = 69%; 5 RCTs, 627 participants; low-certainty evidence). Most studies did not mention adverse effects. One study reported adverse effects, which were mild, with similar frequency in CHX and control groups and one study reported there were no adverse effects. Toothbrushing (± antiseptics) may reduce the incidence of VAP (RR 0.61, 95% CI 0.41 to 0.91; P = 0.01, I = 40%; 5 RCTs, 910 participants; low-certainty evidence) compared to OHC without toothbrushing (± antiseptics). There is also some evidence that toothbrushing may reduce the duration of ICU stay (MD -1.89 days, 95% CI -3.52 to -0.27 days; P = 0.02, I = 0%; 3 RCTs, 749 participants), but this is very low certainty. Low-certainty evidence did not show a reduction in mortality (RR 0.84, 95% CI 0.67 to 1.05; P = 0.12, I = 0%; 5 RCTs, 910 participants) or duration of mechanical ventilation (MD -0.43, 95% CI -1.17 to 0.30; P = 0.25, I = 46%; 4 RCTs, 810 participants).
AUTHORS' CONCLUSIONS
Chlorhexidine mouthwash or gel, as part of OHC, probably reduces the incidence of developing ventilator-associated pneumonia (VAP) in critically ill patients from 26% to about 18%, when compared to placebo or usual care. We did not find a difference in mortality, duration of mechanical ventilation or duration of stay in the intensive care unit, although the evidence was low certainty. OHC including both antiseptics and toothbrushing may be more effective than OHC with antiseptics alone to reduce the incidence of VAP and the length of ICU stay, but, again, the evidence is low certainty. There is insufficient evidence to determine whether any of the interventions evaluated in the studies are associated with adverse effects.
Topics: Adult; Child; Chlorhexidine; Critical Illness; Humans; Incidence; Intensive Care Units; Length of Stay; Mouthwashes; Oral Hygiene; Pneumonia, Ventilator-Associated; Randomized Controlled Trials as Topic; Respiration, Artificial; Toothbrushing
PubMed: 33368159
DOI: 10.1002/14651858.CD008367.pub4 -
Journal of Clinical Periodontology Apr 2015Over the past decades, the placement of dental implants has become a routine procedure in the oral rehabilitation of fully and partially edentulous patients. However,...
AIMS
Over the past decades, the placement of dental implants has become a routine procedure in the oral rehabilitation of fully and partially edentulous patients. However, the number of patients/implants affected by peri-implant diseases is increasing. As there are--in contrast to periodontitis--at present no established and predictable concepts for the treatment of peri-implantitis, primary prevention is of key importance. The management of peri-implant mucositis is considered as a preventive measure for the onset of peri-implantitis. Therefore, the remit of this working group was to assess the prevalence of peri-implant diseases, as well as risks for peri-implant mucositis and to evaluate measures for the management of peri-implant mucositis.
METHODS
Discussions were informed by four systematic reviews on the current epidemiology of peri-implant diseases, on potential risks contributing to the development of peri-implant mucositis, and on the effect of patient and of professionally administered measures to manage peri-implant mucositis. This consensus report is based on the outcomes of these systematic reviews and on the expert opinion of the participants.
RESULTS
Key findings included: (i) meta-analysis estimated a weighted mean prevalence for peri-implant mucositis of 43% (CI: 32-54%) and for peri-implantitis of 22% (CI: 14-30%); (ii) bleeding on probing is considered as key clinical measure to distinguish between peri-implant health and disease; (iii) lack of regular supportive therapy in patients with peri-implant mucositis was associated with increased risk for onset of peri-implantitis; (iv) whereas plaque accumulation has been established as aetiological factor, smoking was identified as modifiable patient-related and excess cement as local risk indicator for the development of peri-implant mucositis; (v) patient-administered mechanical plaque control (with manual or powered toothbrushes) has been shown to be an effective preventive measure; (vi) professional intervention comprising oral hygiene instructions and mechanical debridement revealed a reduction in clinical signs of inflammation; (vii) adjunctive measures (antiseptics, local and systemic antibiotics, air-abrasive devices) were not found to improve the efficacy of professionally administered plaque removal in reducing clinical signs of inflammation.
CONCLUSIONS
Consensus was reached on recommendations for patients with dental implants and oral health care professionals with regard to the efficacy of measures to manage peri-implant mucositis. It was particularly emphasized that implant placement and prosthetic reconstructions need to allow proper personal cleaning, diagnosis by probing and professional plaque removal.
Topics: Dental Cements; Dental Implants; Dental Plaque; Humans; Oral Hygiene; Peri-Implantitis; Periodontal Debridement; Periodontal Index; Primary Prevention; Risk Factors; Smoking; Stomatitis; Toothbrushing
PubMed: 25626479
DOI: 10.1111/jcpe.12369 -
The Cochrane Database of Systematic... Jun 2014Removing dental plaque may play a key role maintaining oral health. There is conflicting evidence for the relative merits of manual and powered toothbrushing in... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Removing dental plaque may play a key role maintaining oral health. There is conflicting evidence for the relative merits of manual and powered toothbrushing in achieving this. This is an update of a Cochrane review first published in 2003, and previously updated in 2005.
OBJECTIVES
To compare manual and powered toothbrushes in everyday use, by people of any age, in relation to the removal of plaque, the health of the gingivae, staining and calculus, dependability, adverse effects and cost.
SEARCH METHODS
We searched the following electronic databases: the Cochrane Oral Health Group's Trials Register (to 23 January 2014), the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library 2014, Issue 1), MEDLINE via OVID (1946 to 23 January 2014), EMBASE via OVID (1980 to 23 January 2014) and CINAHL via EBSCO (1980 to 23 January 2014). We searched the US National Institutes of Health Trials Register and the WHO Clinical Trials Registry Platform for ongoing trials. No restrictions were placed on the language or date of publication when searching the electronic databases.
SELECTION CRITERIA
Randomised controlled trials of at least four weeks of unsupervised powered toothbrushing versus manual toothbrushing for oral health in children and adults.
DATA COLLECTION AND ANALYSIS
We used standard methodological procedures expected by The Cochrane Collaboration. Random-effects models were used provided there were four or more studies included in the meta-analysis, otherwise fixed-effect models were used. Data were classed as short term (one to three months) and long term (greater than three months).
MAIN RESULTS
Fifty-six trials met the inclusion criteria; 51 trials involving 4624 participants provided data for meta-analysis. Five trials were at low risk of bias, five at high and 46 at unclear risk of bias.There is moderate quality evidence that powered toothbrushes provide a statistically significant benefit compared with manual toothbrushes with regard to the reduction of plaque in both the short term (standardised mean difference (SMD) -0.50 (95% confidence interval (CI) -0.70 to -0.31); 40 trials, n = 2871) and long term (SMD -0.47 (95% CI -0.82 to -0.11; 14 trials, n = 978). These results correspond to an 11% reduction in plaque for the Quigley Hein index (Turesky) in the short term and 21% reduction long term. Both meta-analyses showed high levels of heterogeneity (I(2) = 83% and 86% respectively) that was not explained by the different powered toothbrush type subgroups.With regard to gingivitis, there is moderate quality evidence that powered toothbrushes again provide a statistically significant benefit when compared with manual toothbrushes both in the short term (SMD -0.43 (95% CI -0.60 to -0.25); 44 trials, n = 3345) and long term (SMD -0.21 (95% CI -0.31 to -0.12); 16 trials, n = 1645). This corresponds to a 6% and 11% reduction in gingivitis for the Löe and Silness index respectively. Both meta-analyses showed high levels of heterogeneity (I(2) = 82% and 51% respectively) that was not explained by the different powered toothbrush type subgroups.The number of trials for each type of powered toothbrush varied: side to side (10 trials), counter oscillation (five trials), rotation oscillation (27 trials), circular (two trials), ultrasonic (seven trials), ionic (four trials) and unknown (five trials). The greatest body of evidence was for rotation oscillation brushes which demonstrated a statistically significant reduction in plaque and gingivitis at both time points.
AUTHORS' CONCLUSIONS
Powered toothbrushes reduce plaque and gingivitis more than manual toothbrushing in the short and long term. The clinical importance of these findings remains unclear. Observation of methodological guidelines and greater standardisation of design would benefit both future trials and meta-analyses.Cost, reliability and side effects were inconsistently reported. Any reported side effects were localised and only temporary.
Topics: Dental Devices, Home Care; Dental Plaque; Gingival Diseases; Gingivitis; Humans; Oral Health; Periodontal Diseases; Randomized Controlled Trials as Topic; Toothbrushing
PubMed: 24934383
DOI: 10.1002/14651858.CD002281.pub3 -
International Journal of Dental Hygiene Feb 2022This systematic review and network meta-analysis synthesizes the available clinical evidence concerning efficacy with respect to plaque scores following a brushing... (Meta-Analysis)
Meta-Analysis Review
AIM
This systematic review and network meta-analysis synthesizes the available clinical evidence concerning efficacy with respect to plaque scores following a brushing action with oscillating-rotating (OR) or high-frequency sonic (HFS) powered toothbrushes (PTB) compared with a manual toothbrush (MTB) as control.
MATERIAL AND METHODS
Databases were searched up to 1 August 2021, for clinical trials that evaluated the efficacy of a PTB with OR or HFS technology compared with an MTB on plaque removal after a single-brushing action and conducted with healthy adult patients. Meta-analysis (MA) and a network meta-analysis (NMA) were performed.
RESULTS
Twenty-eight eligible publications, including 56 relevant comparisons, were retrieved. The overall NMA results for the mean post-brushing score showed a statistically significant difference for the comparison between an OR PTB and an MTB (SMD = -0.43; 95% CI [-0.696;-0.171]). The change in plaque score data showed a significant effect of a PTB over an MTB and OR over HFS. Based on ranking, the OR PTB was highest, followed by the HFS PTB and the MTB.
CONCLUSION
Within the limitations of the present study design, based on the outcome following a single-brushing action, it can be concluded that for dental plaque removal, there is a high certainty for a small effect of a PTB over an MTB. This supports the recommendation to use a powered toothbrush for daily plaque removal. There is moderate certainty for a very small benefit for the use of a powered toothbrush with an OR over an HFS mode of action.
Topics: Adult; Dental Plaque; Dental Plaque Index; Equipment Design; Humans; Network Meta-Analysis; Single-Blind Method; Toothbrushing
PubMed: 34877772
DOI: 10.1111/idh.12563 -
The Cochrane Database of Systematic... Oct 2016Ventilator-associated pneumonia (VAP) is defined as pneumonia developing in people who have received mechanical ventilation for at least 48 hours. VAP is a potentially... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Ventilator-associated pneumonia (VAP) is defined as pneumonia developing in people who have received mechanical ventilation for at least 48 hours. VAP is a potentially serious complication in these patients who are already critically ill. Oral hygiene care (OHC), using either a mouthrinse, gel, toothbrush, or combination, together with aspiration of secretions, may reduce the risk of VAP in these patients.
OBJECTIVES
To assess the effects of oral hygiene care on incidence of ventilator-associated pneumonia in critically ill patients receiving mechanical ventilation in hospital intensive care units (ICUs).
SEARCH METHODS
We searched the following electronic databases: Cochrane Oral Health's Trials Register (to 17 December 2015), the Cochrane Central Register of Controlled Trials (CENTRAL) (the Cochrane Library, 2015, Issue 11), MEDLINE Ovid (1946 to 17 December 2015), Embase Ovid (1980 to 17 December 2015), LILACS BIREME Virtual Health Library (1982 to 17 December 2015), CINAHL EBSCO (1937 to 17 December 2016), Chinese Biomedical Literature Database (1978 to 14 January 2013), China National Knowledge Infrastructure (1994 to 14 January 2013), Wan Fang Database (January 1984 to 14 January 2013) and VIP Database (January 2012 to 4 May 2016). We searched ClinicalTrials.gov and the World Health Organization International Clinical Trials Registry Platform for ongoing trials to 17 December 2015. We placed no restrictions on the language or date of publication when searching the electronic databases.
SELECTION CRITERIA
We included randomised controlled trials (RCTs) evaluating the effects of OHC (mouthrinse, swab, toothbrush or combination) in critically ill patients receiving mechanical ventilation for at least 48 hours.
DATA COLLECTION AND ANALYSIS
At least two review authors independently assessed search results, extracted data and assessed risk of bias in included studies. We contacted study authors for additional information. We pooled data from trials with similar interventions and outcomes. We reported risk ratio (RR) for dichotomous outcomes and mean difference (MD) for continuous outcomes, using random-effects models unless there were fewer than four studies.
MAIN RESULTS
We included 38 RCTs (6016 participants). There were four main comparisons: chlorhexidine (CHX) mouthrinse or gel versus placebo/usual care; toothbrushing versus no toothbrushing; powered versus manual toothbrushing; and comparisons of oral care solutions. We assessed the overall risk of bias as low in five trials (13%), high in 26 trials (68%), and unclear in seven trials (18%). We did not consider the risk of bias to be serious when assessing the quality of evidence (GRADE) for VAP incidence, but we downgraded other outcomes for risk of bias.High quality evidence from 18 RCTs (2451 participants, 86% adults) shows that CHX mouthrinse or gel, as part of OHC, reduces the risk of VAP compared to placebo or usual care from 25% to about 19% (RR 0.74, 95% confidence intervals (CI) 0.61 to 0.89, P = 0.002, I = 31%). This is equivalent to a number needed to treat for an additional beneficial outcome (NNTB) of 17 (95% CI 10 to 33), which indicates that for every 17 ventilated patients in intensive care receiving OHC including chlorhexidine, one outcome of VAP would be prevented. There is no evidence of a difference between CHX and placebo/usual care for the outcomes of mortality (RR 1.09, 95% CI 0.96 to 1.23, P = 0.18, I = 0%, 15 RCTs, 2163 participants, moderate quality evidence), duration of mechanical ventilation (MD -0.09 days, 95% CI -1.73 to 1.55 days, P = 0.91, I = 36%, five RCTs, 800 participants, low quality evidence), or duration of intensive care unit (ICU) stay (MD 0.21 days, 95% CI -1.48 to 1.89 days, P = 0.81, I = 9%, six RCTs, 833 participants, moderate quality evidence). There is insufficient evidence to determine the effect of CHX on duration of systemic antibiotics, oral health indices, caregivers' preferences or cost. Only two studies reported any adverse effects, and these were mild with similar frequency in CHX and control groups.We are uncertain as to the effects of toothbrushing (± antiseptics) on the outcomes of VAP (RR 0.69, 95% CI 0.44 to 1.09, P = 0.11, I = 64%, five RCTs, 889 participants, very low quality evidence) and mortality (RR 0.87, 95% CI 0.70 to 1.09, P = 0.24, I = 0%, five RCTs, 889 participants, low quality evidence) compared to OHC without toothbrushing (± antiseptics). There is insufficient evidence to determine whether toothbrushing affects duration of mechanical ventilation, duration of ICU stay, use of systemic antibiotics, oral health indices, adverse effects, caregivers' preferences or cost.Only one trial (78 participants) compared use of a powered toothbrush with a manual toothbrush, providing insufficient evidence to determine the effect on any of the outcomes of this review.Fifteen trials compared various other oral care solutions. There is very weak evidence that povidone iodine mouthrinse is more effective than saline/placebo (RR 0.69, 95% CI 0.50 to 0.95, P = 0.02, I = 74%, three studies, 356 participants, high risk of bias), and that saline rinse is more effective than saline swab (RR 0.47, 95% CI 0.37 to 0.62, P < 0.001, I = 84%, four studies, 488 participants, high risk of bias) in reducing VAP. Due to variation in comparisons and outcomes among trials, there is insufficient evidence concerning the effects of other oral care solutions.
AUTHORS' CONCLUSIONS
OHC including chlorhexidine mouthwash or gel reduces the risk of developing ventilator-associated pneumonia in critically ill patients from 25% to about 19%. However, there is no evidence of a difference in the outcomes of mortality, duration of mechanical ventilation or duration of ICU stay. There is no evidence that OHC including both antiseptics and toothbrushing is different from OHC with antiseptics alone, and some weak evidence to suggest that povidone iodine mouthrinse is more effective than saline/placebo, and saline rinse is more effective than saline swab in reducing VAP. There is insufficient evidence to determine whether powered toothbrushing or other oral care solutions are effective in reducing VAP. There is also insufficient evidence to determine whether any of the interventions evaluated in the studies are associated with adverse effects.
Topics: Adult; Child; Chlorhexidine; Critical Illness; Humans; Intensive Care Units; Mouthwashes; Oral Hygiene; Pneumonia, Ventilator-Associated; Randomized Controlled Trials as Topic; Respiration, Artificial; Toothbrushing
PubMed: 27778318
DOI: 10.1002/14651858.CD008367.pub3 -
Ciencia & Saude Coletiva 2019This study investigated the mediation of self-esteem in adolescents' oral health behaviors. The Rosenberg self-esteem scale was used to assess self-esteem, whereas data...
This study investigated the mediation of self-esteem in adolescents' oral health behaviors. The Rosenberg self-esteem scale was used to assess self-esteem, whereas data from socio-demographic and behavior characteristics were analyzed by questions validated in previous surveys. The teenagers had good oral health behavior, except unhealthy diet. The number of adolescents with high self-esteem was a lot smaller than those with low self-esteem. The use of dental services, even when associated with high self-esteem, lost significance after being adjusted by sex, age and tooth brushing frequency. Nevertheless, multiple logistic regression analysis, using unadjusted estimates and adjusted with their respective Confidence Intervals of 95%, showed a relationship of self-esteem with age (p-value=0.001) and tooth brushing frequency (p-value=0.019). Regardless of the sex, students over 16 years old with high self-esteem brush their teeth more often, having probably better oral health. These results confirm the modulation of self-esteem in oral health, and then it is necessary the analysis and the use of these psychosocial factors in the young oral health care.
Topics: Adolescent; Age Factors; Cross-Sectional Studies; Dental Care; Diet; Female; Health Behavior; Humans; Male; Oral Health; Self Concept; Students; Surveys and Questionnaires; Toothbrushing; Young Adult
PubMed: 31664381
DOI: 10.1590/1413-812320182411.02492018 -
Clinical Oral Investigations Apr 2013This study aimed to determine the brushing forces applied during in vivo toothbrushing with manual and sonic toothbrushes and to analyse the effect of these brushing...
OBJECTIVES
This study aimed to determine the brushing forces applied during in vivo toothbrushing with manual and sonic toothbrushes and to analyse the effect of these brushing forces on abrasion of sound and eroded enamel and dentin in vitro.
MATERIALS AND METHODS
Brushing forces of a manual and two sonic toothbrushes (low and high frequency mode) were measured in 27 adults before and after instruction of the respective brushing technique and statistically analysed by repeated measures analysis of variance (ANOVA). In the in vitro experiment, sound and eroded enamel and dentin specimens (each subgroup n = 12) were brushed in an automatic brushing machine with the respective brushing forces using a fluoridated toothpaste slurry. Abrasion was determined by profilometry and statistically analysed by one-way ANOVA.
RESULTS
Average brushing force of the manual toothbrush (1.6 ± 0.3 N) was significantly higher than for the sonic toothbrushes (0.9 ± 0.2 N), which were not significantly different from each other. Brushing force prior and after instruction of the brushing technique was not significantly different. The manual toothbrush caused highest abrasion of sound and eroded dentin, but lowest on sound enamel. No significant differences were detected on eroded enamel.
CONCLUSION
Brushing forces of manual and sonic toothbrushes are different and affect their abrasive capacity.
CLINICAL SIGNIFICANCE
Patients with severe tooth wear and exposed and/or eroded dentin surfaces should use sonic toothbrushes to reduce abrasion, while patients without tooth wear or with erosive lesions confining only to enamel do not benefit from sonic toothbrushes with regard to abrasion.
Topics: Adolescent; Adult; Analysis of Variance; Dental Enamel; Dental Stress Analysis; Dentin; Female; Humans; Male; Middle Aged; Statistics, Nonparametric; Tooth Abrasion; Tooth Erosion; Toothbrushing; Ultrasonics; Young Adult
PubMed: 22791283
DOI: 10.1007/s00784-012-0788-z -
Dental Materials Journal Oct 2022The relative dentin abrasivity-profilometry equivalent values were compared using non-contact profilometry with three subtypes of regular toothpaste and two subtypes of...
The relative dentin abrasivity-profilometry equivalent values were compared using non-contact profilometry with three subtypes of regular toothpaste and two subtypes of whitening toothpaste containing sodium bicarbonate and 35% hydrogen peroxide. Bovine dentin specimens were assigned to six groups: regular toothpaste (R): R1 (BAMBOO SALT GUM OINTMENT); R2 (MEDIAN TARTAR ORIGINAL); R3 (PERIOE Alpha), Reference slurry: RS (calcium pyrophosphate), whitening toothpaste (W): W1 (NET. WT); W2 (Vussen 28 WHITENING). Relative dentin abrasion-profilometry equivalent (RDA-PE) was determined by brushing 10,000 times (n=8). The pH of the toothpaste was measured (n=5) and the abrasive constituents of the toothpaste was analyzed by FE-SEM and EDS. The RDA-PE values ranged from 26 to 166, and the pH level ranges were 4.928-9.153. The RDA-PE value of the whitening toothpaste containing hydrogen peroxide was not high compared with that of the regular toothpaste. The RDA-PE values of whitening toothpaste could vary depending on the mechanism and ingredients of the whitening agents.
Topics: Animals; Bleaching Agents; Calcium Pyrophosphate; Cattle; Dentin; Hydrogen; Materials Testing; Ointments; Sodium Bicarbonate; Tooth Abrasion; Toothbrushing; Toothpastes
PubMed: 35793939
DOI: 10.4012/dmj.2021-303 -
Australian Dental Journal Dec 2019To identify and map existing evidence on the effectiveness of interdental cleaning devices in preventing dental caries and periodontal diseases, a scoping review was... (Review)
Review
To identify and map existing evidence on the effectiveness of interdental cleaning devices in preventing dental caries and periodontal diseases, a scoping review was carried out by electronically searching PubMed, Scopus and Embase. Studies on interdental cleaning devices, written in English, and published from January 2008 up to April 2019 were included in the review. Of 1860 studies identified, six systematic reviews (SR) were included in the review. One SR each was on flossing, interdental brushes, wood sticks and oral irrigation. Of two SR on multitude of interdental cleaning devices, one assessed comparative efficacy while the other both the individual and comparative efficacy. All reviews had assessed the heterogeneity and the methodological quality of studies included, and performed data extraction and meta-analysis where appropriate. Evidence ranged from weak to moderate with very low- to low-certainty for the adjunctive benefit of these devices to control plaque and gingivitis. It warrants long-term studies with sufficient power and those assessing the impact of interdental cleaning on interproximal caries to corroborate such evidence. Available evidence on the efficacy of interdental cleaning devices suggests that dental practitioners recommend patient-specific interdental cleaning devices that enable patients to achieve a safe and high standard of interdental cleaning.
Topics: Dental Caries; Dental Devices, Home Care; Dental Plaque; Gingivitis; Humans; Periodontal Diseases; Systematic Reviews as Topic; Toothbrushing
PubMed: 31556125
DOI: 10.1111/adj.12722 -
International Journal of Dental Hygiene Feb 2019To investigate to what extent the degree of toothbrush wear of 3-month-old manual toothbrushes influence plaque scores.
OBJECTIVE
To investigate to what extent the degree of toothbrush wear of 3-month-old manual toothbrushes influence plaque scores.
MATERIAL AND METHODS
During a recently published study with a follow-up of 1 year, all participants performed a similar basic home-based oral hygiene regimen. Hence, they were instructed to brush for 2 minutes twice daily according to the Bass method technique and using a standard dentifrice containing sodium fluoride. Toothbrushes were turned in every 3-month, and the degree of wear was scored. The mean plaque score data were additionally analysed and correlated with wear scores of the toothbrushes.
RESULTS
For analysis, for each of 172 individual participants, a set of three identical, 3-month-old used toothbrushes were available. Toothbrush wear varied widely between participants. However, per patient, the 3-month wear status of the three evaluated toothbrushes was strongly correlated (rho = 0.8, P < 0.0001). Participants who returned toothbrushes with extreme wear had significantly higher plaque scores than those who returned toothbrushes with no visible or light wear (P = 0.01).
CONCLUSION
Toothbrush wear per individual patient is fairly consistent. Toothbrushes with extreme wear were less effective than those with no or light wear. Therefore, bristle splaying appears to be a more appropriate measure of brush replacement time then the commonly used toothbrush age. Splaying of the outer tufts beyond the base of the toothbrush is a condition that indicates it is time to change the brush.
Topics: Adult; Dental Plaque Index; Equipment Failure; Female; Humans; Male; Toothbrushing; Young Adult
PubMed: 30326176
DOI: 10.1111/idh.12370