The effect of controlled oral hygiene and topical fluoride application on caries and gingivitis in Swedish schoolchildren

ABSTRACT An attempt was made to assess the effect of regularly repeated professional mechanical tooth cleaning on caries development and gingivitis in schoolchildren. A total of 209 children from the first (7–8 years old), fourth (10–11 years), and seventh (13–14 years) classes of an elementary school in Sweden participated. Children from each age group were assigned to one test and one control group. At a baseline examination the state of the gingiva, the oral hygiene and the number of decayed and filled tooth surfaces were determined. Once every second week after the baseline examination the members of the test groups were given careful oral prophylaxis including topical application of monofluoro-phosphate. Once a month the members of the control group brushed their teeth under the supervision of a dental nurse. Twelve months after the initial examination the test and control groups were re-examined. The results show that children given frequent oral prophylaxis combined with topical fluoride applications had clean teeth, only negligible signs of gingivitis, and practically no caries.     

The effect of various plaque control measures on gingivitis and caries in schoolchildren

The aims of the present study were (1) to analyze the separate effects on plaque, caries, and gingivitis of several measures (oral hygiene instruction, professional tooth cleaning with mechanical instruments, topical application of sodium monofluorophosphate - MFP) which have been incorporated in a prophylactic treatment program, described by AXELSSON & LINDHE1, and (2) to prevent caries and gingivitis by applying the combined treatment but replacing the professional mechanical tooth cleaning with chemical cleaning using a chlorhexidine-containing gel. 164 children, 13-14 years old, divided into four groups, participated in a 2-year trial. All participants were recalled once every 2nd week for preventive treatment provided by dental nurses. During the 1st year Group 3 and 4 received prophylactic treatment identical to that described by AXELSSON & LINDHE1. During the 2nd year the professional tooth cleaning was omitted but oral hygiene instruction was given every 2nd week. During the 1st year Groups 1 and 2 were treated with 0.5% chlorhexidine but during the 2nd year they were subjected to professional tooth cleaning with mechanical instruments. Throughout the trial Groups 1 and 3 rinsed once every 2nd week with a 2% MFP solution. The results showed that by oral hygiene instruction and frequently repeated professional tooth cleanings it was possible to substantially reduce the frequency of gingivitis and prevent caries. When this treatment was used, mouthrinsings with 2% MFP had no additional effect on caries. The substitution of the mechanical cleaning procedure with topical application of a 0.5% chlorhexidine gel failed to (1) remove supragingival plaque accumulations, (2) reduce the frequency of gingivitis, and (3) retard the rate of caries development. The data also revealed that interdental cleaning with mechanical instruments was of decisive importance in the prevention of approximal surface caries.     

Effect of fluoride on gingivitis and dental caries in a preventive program based on plaque control

ABSTRACT The purpose of the investigation was to estimate the relative effect of fluoride on caries in a preventive program based on meticulous plaque control. The material consisted of 82 children; 41 in the test and 41 in the control group. At the start of the study the children were 13–14 years of age. In August 1973 an examination was performed to obtain baseline data for the trial. Prophylactic treatment was given to the children once every second week. A total of 18 treatments were given during a 10-month period. In the control group an abrasive paste was used containing 5 % sodium monofluorophosphate (Jodka Fluor Polerpasta®). In the test group an abrasive paste was used which was identical with the control paste except that it did not contain any fluoride components. Twelve months after the baseline examination the test and control groups were reexamined. The trial demonstrated that, in children, fortnightly professional cleaning of the teeth combined with meticulous toothbrushing instructions result in (1) a high standard of oral hygiene and (2) only very few new carious surfaces. Though the control group children received fortnightly topical application of F^? during the prophylactic sessions and used a fluoridated dentifrice, there was no significant difference between the two groups regarding number of new carious tooth surfaces per child per year.     

Four years of monthly professional toothcleaning and topical fluoride application in Brazilian schoolchildren.

The effect on gingivitis of monthly professional toothcleaning, without oral hygiene instruction, was evaluated in 103, 7- to 11-year-old Brazilian children. Plaque and gingivitis (PlI and GI) were recorded initially and after 1, 2, 3 and 4 years. The baseline examination showed a similar high level of plaque (PlI approximately 1.55) and low level of gingivitis (GI approximately 0.32) around permanent teeth of both test and control groups. The test children were given monthly professional toothcleaning followed by topical application of fluoride gel (APF), totaling 32 sessions. At all annual follow-up examinations, the mean PlI in the test group was significantly lower than in the control group. However, even in the test group, at least 80% of the tooth surfaces harbored plaque. In spite of this, no child in the test group showed overt gingivitis (mean individual GI greater than or equal to 1.0) and the distribution of "GI score = 2" was very low. In the control group the percentage of children with overt gingivitis increased from 3% at the baseline to 20% at the final examination and areas scoring GI = 2 doubled in number. It is suggested that for young children, monthly thorough removal of plaque is sufficient to prevent the development of gingivitis.     

Effectiveness of silver diamine fluoride and sodium fluoride varnish in arresting dentin caries in Chinese pre-school children

Untreated dental caries in Chinese pre-school children is common. This prospective controlled clinical trial investigated the effectiveness of topical fluoride applications in arresting dentin caries. Three hundred seventy-five children, aged 3-5 years, with carious upper anterior teeth were divided into five groups. Children in the first and second groups received annual applications of silver diamine fluoride solution (44,800 ppm F). Sodium fluoride varnish (22,600 ppm F) was applied every three months to the lesions of children in the third and fourth groups. For children in the first and third groups, soft carious tissues were removed prior to fluoride application. The fifth group was the control. Three hundred eight children were followed for 30 months. The respective mean numbers of arrested carious tooth surfaces in the five groups were 2.5, 2.8, 1.5, 1.5, and 1.3 (p < 0.001). Silver diamine fluoride was found to be effective in arresting dentin caries in primary anterior teeth in pre-school children.     

Effect of proper oral hygiene on gingivitis and dental caries in Swedish schoolchildren

ABSTRACT The present paper reports the effect of a 3-year study of regularly repeated professional toothcleaning on oral hygiene status, gingivitis, and dental caries. At the initiation of the study in 1971, the children were 7–8 years old (Group 1), 10–11 (Group 2) or 13–14 (Group 3). The children were divided into test and control groups. Before the study all the children were examined regarding oral hygiene, state of the gingiva and dental caries. Throughout the 3-year period the controls brushed their teeth with a 0.2 % sodium fluoride solution once a month under supervision. During the first 2 years of the trial all the children of the test groups were given professional oral prophylaxis once every second week during the school terms. During the third year the interval between consecutive prophylactic sessions was prolonged to 4 weeks in Groups 1 and 2 and to 8 weeks in Group 3. The results demonstrated that regularly repeated professional cleaning of the teeth combined with fluoride applications and toothbrushing instructions, over a 3-year period in schoolchildren resulted in the establishment and maintenance of excellent oral hygiene standards. Inflammation of the marginal gingiva almost entirely disappeared, and practically no new carious lesions developed.     

Effect of a preventive program based on professional toothcleaning and fluoride application on caries and gingivitis

The effect of a preventive program was studied in 12-14-yr-old children. 104 children (test group) participated in this program. After four visits in the first 6 wk, the children visited the oral hygienist five times a year to receive professional oral prophylactic treatment and instructions. Additionally a fluoride application (Duraphat) was given two times a year. Children of a control group (n = 117) received no prophylactic treatment. Diet was not controlled in either test or control group. After 2 yr mean caries increment amounted to 2.7 +/- 2.8 new DFS in the test group and 5.0 +/- 4.2 new DFS in the control group, respectively. The most pronounced differences between the two groups could be found on the proximal surfaces. In all, caries was reduced by 46% during the 2-yr period. Plaque accumulation and frequency of gingivitis were significantly reduced only in the test group (67% and 55%, resp.). The data revealed that the program reduced both caries and gingivitis to a remarkable extent.     

Dental prophylaxis for youths in their late teens I. Clinical effect of different preventive regimes on oral hygiene, gingivitis and dental caries

Abstract The effect of a dental prophylactic program based on systematic plaque control has been tested during a 3-year period on youths aged 16–19 years. During their last year at comprehensive school they received professional tooth cleaning every third week by specially trained dental hygiene nurses. At the end of this first experimental year the subjects were offered continued prophylaxis of the same type against caries and gingivitis during 2 more years. Interested subjects were divided equally at random into test groups A and B. In the second year group A received professional tooth cleaning once a month and in the third year once each 6 months. Group B was offered, both in the second and third years, only two prophylactic sessions each year according to this model. Test group C comprised the subjects who expressed no interest in continued professional tooth cleaning. A control group, group D, consisted of pupils of the same ages from a neighboring school area. These received in the first experimental year a prophylactic program based on mouthrinsing each second week with 0.2% sodium fluoride solution. After this first year neither test group C nor the control group D participated in any organized dental health care program. After the first year there were significant differences among the groups, the plaque and gingival indices in the control group D being significantly higher than in test groups A, B and C. At the end of the third year significant improvements in these indices had taken place in groups A and B. The corresponding values in groups C and D did not differ significantly at the three recordings. Significant correlations existed between the plaque and gingivitis scores at the end of the experimental period within the respective groups. Significantly more dental caries (new DPS) developed in the control group D than in test groups A and B during the period of the experiment: on average 3.3 versus 1.0 and 1.2 new DFS, respectively. The figure for caries increment in group C was 2.0. Regardless of grouping, individuals with caries increment during the experimental period had a significantly higher number of risk factors, here defined as the total of upper or lower quartile values for lactobacillus counts, secretion rate and buffering capacity of the saliva, than individuals without caries increment.     

Two-year study on the effect of professional toothcleaning on schoolchildren in Oppegård, Norway

A longitudinal study on the effect of a preventive program based on bimonthly professional toothcleaning and hygiene instruction was carried out on 293 schoolchildren from the 1st, 4th and 7th grades. The prophylactic paste used contained 0.8%sodium monofluorophosphate. The control groups brushed with a 0.2% sodium fluoride solution four to five times during each school year. After 2 years the Visible Plaque Index and the Gingival Bleeding Index were significantly reduced for all grades in the test groups as compared to the controls. The percentage of children without new caries lesions increased significantly from an average of 50 % in the control to 71% in (he lest group. The mean caries increments during the 2 years, excluding occlusal surfaces, were 0.22, 0.28 and 1.20 in the three test groups. This represents an average caries reduction of 65%, compared to the control group. The increment reductions reached borderline significance, using the chi-square test.     

A community-based caries control program for pre-school children using topical fluorides: 18-month results.

Dental caries in Chinese pre-school children is common, and restorative treatment is not readily available. This prospective controlled clinical trial investigated the effectiveness of topical fluoride applications in arresting dentin caries. We divided 375 children (aged 3-5 yrs) with carious upper anterior teeth into five groups. Children in the first and second groups received annual applications of silver diamine fluoride solution (44,800 ppm F). NaF varnish (22,600 ppm F) was applied every three months onto the lesions of children in the third and fourth groups. For children in the first and third groups, soft carious tissues were removed prior to fluoride application. The fifth group was the control. We followed 341 children for 18 months. The mean numbers of new caries surfaces in the five groups were 0.4, 0.4, 0.8, 0.6, and 1.2, respectively (p = 0.001). The respective mean numbers of arrested carious tooth surfaces were 2.8, 3.0, 1.7, 1.5, and 1.0 (p < 0.001).     

Anti-gingivitis efficacy of a stabilized 0.454% stannous fluoride/sodium hexametaphosphate dentifrice

OBJECTIVE: Stannous fluoride is a broad-spectrum anti-microbial agent that has been used in dentistry as a chemical adjunct to prevent dental caries and gingivitis. The objective of this study was to assess the anti-gingivitis efficacy of a stabilized 0.454% stannous fluoride/sodium hexametaphosphate dentifrice relative to a negative control. METHODS: This was a randomized, 6-month, double-blind, parallel-group gingivitis study conducted according to the guidelines for evaluating chemotherapeutic products for the control of gingivitis outlined by the American Dental Association. A stabilized 0.454% stannous fluoride/sodium hexametaphosphate dentifrice was tested against a commercially available negative control dentifrice. Following baseline measurements, subjects received a dental prophylaxis. Subjects were then instructed to brush twice daily for 60 s using their assigned product. Oral soft-hard-tissue examinations and clinical examinations using the Modified Gingival Index, Gingival Bleeding Index, and the Turesky modification of the Quigley-Hein Plaque Index were performed at baseline, 3 and 6 months post-treatment. RESULTS: A total of 143 subjects were enrolled and 130 of them completed the 6-month study. After 6 months of product usage, the experimental group had 21.7% less gingivitis (p<0.001), 57.1% less bleeding (p<0.001), and 6.9% less plaque (p=0.01) on average compared with the negative control group. No adverse oral soft-hard-tissue effects or extrinsic tooth staining was observed in the study. CONCLUSION: The results demonstrate that use of the stabilized 0.454% stannous fluoride/sodium hexametaphosphate dentifrice over a 6-month period provided statistically significant reductions in gingivitis, gingival bleeding, and plaque when compared with a negative control dentifrice.     

Effect of monthly prophylaxis on caries and gingivitis in schoolchildren

ABSTRACT The effect of professional prophylaxis given each month to individual children was investigated. A total of 225 schoolchildren, 10–12 years of age, participated during the experimental year. Each prophylactic session required about 15 min, and included tooth-brushing instructions, professional tooth cleansings and fluoride rinses. Significantly fewer new interproximal carious lesions were obtained in the experimental group compared with the control group. No differences were observed for occlusal, buccal or lingual surfaces. The frequency of gingivitis was significantly reduced during the year of trial in the experimental group. The efficacy of the preventive treatment was most noticeable in children with high caries experience. For clinical practice monthly prophylaxes could be recommended to the most susceptible individuals.     

Effect of flouride varnish (Duraphat) treatment every six months compared with weekly mouthrinses with 0.2 per cent NaF solution on dental caries.

Recent studies have shown a high fluorine uptake in the enamel and a considerable caries reduction following the application of varnished containing fluoride. As the application is easy to carry out it may in certain situations serve as an alternative to other topical fluoride school programmes. The aim of the present study, therefore, was to compare the caries increment in schoolchildren exposed to a fluoride varnish (Duraphat) every six months and in children receiving the conventional weekly fluoride mouthrinsing programme with 0.2 per cent sodium fluoride over a two-year period. Two hundred 14-year-old children, divided into one test and one control group took part in the study. They were clinically and radiographically examined every year. Preexperimental data revealed no differences between the groups. During the experimental period the children in the fluoride varnish group developed a statistically significant lower number of new carious lesions compared with those in the mouthrinsing group. The difference in caries increment was about 30 per cent. Further clinical studies to compare the effects of various topical fluoride programmes are recommended.     

The effect of a dentifrice containing zinc citrate and Triclosan on developing gingivitis

A partial mouth experimental gingivitis model was employed to establish the potential efficacy of a dentifrice containing a zinc salt and the antimicrobial agent Triclosan to prevent or delay the development of gingivitis over a period of 28 days. Initially, gingival health was established in 34 subjects following a 6-week period of professional tooth cleaning and oral hygiene instruction. A toothshield was constructed to fit 4 posterior mandibular teeth. Undiluted test or placebo dentifrice was applied to the experimental teeth via the toothshield, which also prevented plaque removal from these teeth during habitual brushing of the remainder of the dentition. The presence of plaque, bleeding after probing and visual signs of inflammation were independently assessed. Plaque accumulated rapidly and gingivitis developed in both groups. At the 2-wk assessments, lower mean plaque scores were recorded for the group using the test dentifrice. At the 4-wk assessment a significantly lower level of gingivitis was recorded for the test group. It is concluded that (a) the model can be used to establish the potential efficacy of a dentifrice to maintain gingival health, (b) the dentifrice containing zinc citrate and Triclosan was efficacious and (c) the Gingival Index possibly overestimates the proportion of healthy gingival sites.     

Dental prophylaxis for youths in their late teens. II. Knowledge about dental health and diseases and the relation to dental health behavior

A study of the knowledge about dental health and diseases of youths in their late teens has been conducted. A 10-class questionnaire relating to dental caries and gingivitis/periodontitis was answered by three test groups (A, B, C) totalling seventy-eight 19-year-olds who, during a 3-year period, had undergone professional prophylaxis at different intervals. Nineteen young people of the same age without organized preventive measures since their last attendance at the public dental service constituted a control group (D). The test groups were found to have a significantly better knowledge of factors relating to gingivitis/periodontitis than the control group. In questions relating to caries there were no differences among the groups. Higher points were scored in knowledge of therapy and prevention than of the causes and symptoms of the dental diseases. Several regularly repeated sessions for professional prophylaxis did not lead to better knowledge than only a few. No consistent correlation was found for any of the groups between knowledge and both quantitative tooth cleaning, i.e. type and frequency of use of oral hygiene aids, and qualitative tooth cleaning, expressed as the occurrence of plaque and gingivitis. Nor were significant differences found in these respects between individuals with and without a caries increment during the observation period regardless of grouping.     

Effect of a field program based on systematic plaque control on caries and gingivitis in schoolchildren after 3 years

The effect of a field program, based on systematic plaque control, on caries and gingivitis was tested during a 3-year period on 1,100 schoolchildren. Once every 3rd week the children were given oral hygiene instructions, professional toothcleaning and fluorides topically delivered by specially trained dental nurses. The children of a control group of approximately the same number of pupils, participated in a preventive program consisting of mouthrinsings once every 2nd week with a 0.2% sodium fluoride solution. The children of the third and fourth grades were, at the start of the experiment, selected as reference groups and then continuously examined once every year. At the end of the trial the mean reduction of surfaces haboring plaque and units with gingival inflammation was 59% and 73%, respectively. The reduction in caries increment was 51%.     

学龄前儿童乳牙局部加氟抑龋研究

目的 :利用局部加氟方法抑制乳上前牙龋病进展。方法 :选用同一生活区内有上前牙乳牙龋的 779名 3～6岁学龄前儿童 ,经基线检查、记录结束后 ,分成实验组和对照组。第一、二组每日氟水含漱 (0 .0 5 %) ,第三、四组每3个月一次含氟涂料涂布 ,其中第二、四组处理前去除软龋 ,1年后复查抑龋效果。结果 :各组抑龋牙面龋为 0 .91±1.88、1.0 2± 2 .11、2 .47± 1.90、2 .75± 1.90、0 .75± 2 .34。结论 :局部加氟抑龋效果确定 ,实施前是否去除龋坏组织对抑龋效果无明显影响。     

Effect on caries and gingivitis of a preventive program based on oral hygiene measures and fluoride application

Abstract The present investigation was performed to estimate the effect on caries and gingivitis of a plaque control program delivered at different intervals and supplemented with different fluoride compounds. The study ran for 2 years and was completed by 260 children who were 13–14 years old at the beginning. Professional toothcleaning in combination with detailed oral hygiene instructions repeated once a month or every 3 months significantly improved their oral hygiene status and reduced clinical signs of gingivitis. The addition of fluoride (NaF or MFP) in mouthrinses and toothpastes significantly reduced the number of new carious lesions. No significant differences were observed in gingival health and caries activity between the programs delivered once a month and every 3 months.     

Effect of oral hygiene instruction and professional toothcleaning on caries and gingivitis in schoolchildren

Abstract The present study was performed lo assess the effect on caries and gingivitis of plaque control measures such as oral hygiene instruction, toothcleaning practice and professional toothcleaning. 104 children, 13-14 years old, participated in the trial. Prior to the start of the preventive treatment all children were examined regarding oral hygiene, gingivitis and caries. The caries examination was limited to the proximal surfaces of molars and premolars. Following this baseline examination the children were randomly divided into two treatment groups, A and B. Both groups of children were recalled for professional toothcleaning once every 2 weeks during an 18-month period. In each child the professional toothcleaning was restricted to either the right or the left jaws by random selection. In addition, the children of Group A at each recall appointment received careful oral hygiene instruction and practice in proper toothcleaning methods. In conjunction with the professional toothcleaning an abrasive paste was used including fluoride. The children were re-examined 18 months after the baseline examination. The result of the present investigation demonstrated that professional toothcleaning repeated every second week is a prophylactic measure which in children substantially improves the oral hygiene status, and effectively reduces clinical signs of gingivitis and caries. It was also observed that while oral hygiene instruction and practice in proper toothcleaning techniques reduced plaque and gingivitis, no such effect could be detected regarding the development of caries.     

氟化氨银和氟化钠涂料对乳牙龋治疗作用

目的 :观察 3 8mL/L氟化氨银液和 50mg/L氟化钠涂料对乳前牙龋的治疗作用。 方法 :来自 8所幼儿园的 3 75名 3～ 5岁患有上颌前牙龋的儿童参加了该项研究 ,他们被随机分配到 5个组。各组处理分别为去腐和每年涂布 1次氟化氨银 ;每年涂布 1次氟化氨银 ;去腐和每 3个月涂布 1次氟化钠 ;每 3个月涂布 1次氟化钠 ;涂布水。结果 :2 4个月后各组儿童上颌前牙平均静止龋牙面数分别为 3 .52、3 .54、1.93、1.95和1.67(P <0 .0 0 1)。结论 :1年 1次涂布 3 8mL/L氟化氨银对乳前牙龋有治疗作用 ,涂氟前是否去腐对治疗效果无影响