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.     

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%.     

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.     

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.     

Effectiveness on oral health of a long-term health education programme for mothers with young children

AIM: To determine the effect of dental health education (DHE) on caries incidence in infants, through regular home visits by trained DH Educators over a period of 3 years. METHOD: A randomly selected cohort of 228 children born between 1st January and 30th September 1995, in a low socioeconomic/high caries suburb of Leeds (UK) were divided into the following groups: A) DHE focused on diet; B) DHE focused on oral hygiene instruction (OHI) using fluoride toothpaste; and C) DHE by a combined diet and OHI message. DHE was given using an interview and counselling for at least 15 minutes at home every 3 months for the first 2 years and twice a year in the third year of the study. A fourth group D was given diet and OHI, at home, once a year only. All children and mothers were examined for caries and oral hygiene. A fifth group E (control) received no DHE and were never visited but examined at 3 years of age only. RESULTS: In the groups of children visited regularly only two developed caries and three had gingivitis (all in group A). In group E, however, 33% of children had caries and nine (16%) had gingivitis. The differences in caries levels and caries risk factors between study and control groups were statistically significant (P < 0.001). Mothers of the study groups also showed an improvement in their own levels of gingivitis, debris and calculus scores by the second and third examinations (P < 0.001). CONCLUSION: Regular home visits to mothers with infants, commencing at or soon after the time of the eruption of the first deciduous teeth, was shown to be effective in preventing the occurrence of nursing caries.     

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.     

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.     

Intraindividual effect of daily supervised flossing on caries in schoolchildren.

The aim was to study the effect of flossing on proximal caries in children grouped according to different combinations of dietary and oral hygiene habits. 140 12--13-year-old children flossed the right or the left lateral region of the mouth once every school-day for 2 years by pulling a waxed floss once up and down through the proximal contacts. Proximal caries was recorded on bitewing films, taken at the baseline and at the 2-year registration. Diet history was obtained four times during the period. Oral hygiene was classified according to the number of bleeding points registered with a feather-loaded probe at the final examination. Caries increments on the control side during the experimental period were calculated for groups with the same habits. A logical border with respect to the amount of new caries was then established between suitable and unsuitable dietary habits as well as between sufficient and insufficient oral hygiene. No statistically significant difference was found between the control and experimental subgroups in the different combinations of dietary and oral hygiene habits, neither with respect to the whole material nor comparable contralateral surfaces. The numerical differences were so small that the technique of flossing studied here cannot be recommended.     

The effect of a preventive programme on dental plaque, gingivitis and caries in schoolchildren. Results after one and two years

Abstract The effect on plaque, gingivitis and dental caries of regularly repeated professional mechanical tooth cleaning combined with topical application of monofluoro-phosphate was tested in a group of 192 schoolchildren, 7–14 years of age, during a 2-year trial. They were divided into test and control groups. A baseline examination revealed that the test and control groups had a very similar oral hygiene status, degree of gingival inflammation and caries experience. Once every second week during the 2-year period the children of the test groups were given professional oral prophylaxis including careful tooth cleaning and topical application of 5 % sodium mono-fluorophosphate. Once every month, the children of the control groups brushed their teeth at school, under supervision, using a 0.2 % sodium fluoride solution. The results after 1 and 2 years of experiment indicate that the test group children had low Plaque Index scores (～ 0.3), only negligible signs of gingivitis (～ 0.25) and very low caries increment (0.1 new carious surface per year). The control group children had higher Plaque Index scores (～ 1.0), showed signs of gingivitis (～ 0.75), and developed on an average 3.1 new carious surfaces per year. It is suggested that the efficacy of public health programmes, based on professional tooth cleaning and topical fluoride administration, should be tested in larger groups of children and adults.     

Effect of controlled oral hygiene procedures on caries and periodontal disease in adults

Abstract The present investigation was carried out to determine if the occurrence of caries and the progression of periodontitis can be prevented in adults, and maintained at a high level of oral hygiene by regularly repeated oral hygiene instructions and prophylaxis. An attempt was also made to study the progression of dental diseases in individuals who received no special oral hygiene instruction but regularly received dental care of a traditional type. Two groups of individuals from one geographic site were recruited in 1971-72 for the trial; 375 were assigned to a test and 180 to a control group. A baseline examination revealed that the socio-economic status, the oral hygiene status, the incidence of gingivitis and the caries experience were similar among the test and control participants prior to the start of the study. During the subsequent 3-year period, the control patients were seen regularly once a year and given traditional dental care. The test group participants, on the other hand, were seen once every 2 months during the first 2 years and once every 3 months during the third year. On an individual basis they were instructed in a proper oral hygiene technique and given a careful dental prophylaxis including scaling and root planing. Each prophylactic session was handled by a dental hygienist. A re-examination was carried out towards the end of the third treatment year. The results of the trial clearly showed that it is possible, by regularly repeated tooth cleaning instruction and prophylaxis, to stimulate adults to adopt proper oral hygiene habits. The findings also demonstrated that persons who utilized proper oral hygiene techniques during a 3-year period had negligible signs of gingivitis, suffered no loss of periodontal tissue attachment, and developed practically no new carious lesions. The control patients, who during the same period received merely symptomatic treatment, suffered from gingivitis, lost periodontal tisssue support and developed several new as well as recurrent, carious lesions. These results indicate that dental treatment is a highly ineffective means of curing caries and periodontal disease.     

Effect of controlled oral hygiene procedures on caries and periodontal disease in adults

Abstract The present report describes the result of a clinical trial in which a group of adults have been maintained on a proper oral hygiene standard over a 6-year period. In 1971–72, 375 individuals were recruited to a test group and 180 to a control group. During the 6 years of trial, 65 persons from the test group and 34 controls were lost. The patients were divided into three age groups; I <35 years, II 36–50 years, III >50 years. The members of the test and control groups were first subjected to a Baseline examination which included assessments of oral hygiene, gingivitis, periodontal disease and caries. Following this examination all caries lesions were treated and ill-fitting dental restorations adjusted. Each patient was also given a detailed case presentation and a dental prophylaxis. The control group patients were not involved in any further dental health programs during the subsequent 6-year period. Once a year, however, they were recalled to a public dental health clinic for examination and received symptomatic dental treatment. The test group participants, on the other hand, were given a preventive treatment, repeated once every 2–3 months which included (1) instruction and practice in oral hygiene techniques and (2) meticulous prophylaxis. The patients were re-examined 3 and 6 years after the baseline examination. At the Follow-up examinations the parameters studied at the Baseline examination were recorded again. The findings demonstrated that a preventive program which stimulates individuals to adopt proper oral hygiene habits may resolve gingivitis and prevent progression of periodontal disease and caries. Traditional dental care, on the other hand, did not prevent the progression of caries and periodontitis in adults.     

Plaque and gingivitis in the elderly: a randomized, single-blind clinical trial on the outcome of intensified mechanical or antibacterial oral hygiene measures

OBJECTIVES: To study the outcome of intensified mechanical oral hygiene compared with the effect of an adjunctive antibacterial mouth rinse on plaque and gingivitis in elderly people. MATERIAL AND METHODS: In a randomized, single-blind, 6-month controlled clinical study, 106 subjects, 55 years or older, were divided into four groups: (I) Participants were instructed on improved mechanical oral hygiene, including interdental hygiene; (II) subjects used an antibacterial mouth rinse containing amine and stannous fluoride in addition to their usual oral hygiene practices; (III) both intensive mechanical and antibacterial measures were combined; and (IV) a control group with no specific regimen. Gingivitis and plaque were examined. RESULTS: After 6 months, both plaque and gingivitis scores were significantly lower than at baseline in all groups. Reductions in gingivitis differed significantly between the control group and all other groups but not between the three intervention groups. Only groups with improved mechanical oral hygiene showed significant improvements in plaque scores compared with control. CONCLUSIONS: Intensive mechanical oral hygiene resulted in greater plaque reduction than the combination of an antibacterial rinse and usual oral hygiene procedures. Gingivitis was reduced by both intensive oral hygiene and use of the amine/stannous fluoride rinse. Combining intensive mechanical oral hygiene with the antibacterial rinse did not result in further gingivitis reduction.     

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.     

Effect of fluoride containing dentifrice, mouthrinsing, and varnish on approximal dental caries in a 3-year clinical trial

The purpose of this study was to evaluate the separate effect of fluoride dentifrice, fluoride mouthrinsing and fluoride varnish on approximal dental caries. All 252 13-14-yr-old children at an elementary school were selected at random and divided among four groups for a 3-yr longitudinal study. Group 1 received a fluoride dentifrice for home care and a fluoride mouthrinse once a week. Group 2 received a fluoride dentifrice for home care and a placebo mouthrinse once a week. Group 3 received a fluoride dentifrice for home care and a fluoride varnish once every 3 months. Group 4 received a placebo dentifrice for home care and a fluoride rinse once a week. Fluoride rinsing did not give any additional effect compared with placebo-rinsing when a fluoride dentifrice was used for home care. Fluoride varnish gave a significant caries reduction compared with fluoride rinsing.     

Three-year study of the effect of fluoride varnish (Duraphat) on proximal caries progression in teenagers

Abstract – The effect of sodium fluoride varnish (Duraphat) applications on proximal caries progression was studied during a 3-yr period in 87 teenagers and compared to a control group (n= 107). In the fluoride varnish group the children were treated with fluoride varnish every third month during the experimental period. Caries lesions on the mesial surfaces of first premolars to the mesial surfaces of second molars were recorded annually on radiographs and an individual progression value was calculated. The study showed that topical application of fluoride varnish every third month significantly (p<0.05) reduced the progression of proximal caries lesions in premolars and molars. The most obvious reduction of caries progression was observed among children who developed between two and eight new proximal lesions during the test period. In the children with the highest caries activity (> nine new proximal lesions) Duraphat treatments did not significantly reduce proximal caries progression in premolars and molars.     

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.     

Report on caries reduction in French schoolchildren 3 years after the introduction of a preventive program

Abstract— A combination of preventive methods have been used to reduce dental caries in children aged 7–8 at baseline, living in a non-fluoridated area in the West of France. The preventive program involved a daily supervised toothbrushing at school with 180 mg of fluoridated toothpaste, professional prophylaxis every 2 months with topical application of fluoride gel and reinforced motivation. The oral hygiene level was measured using the Silness-Löe plaque index and caries were recorded using the def and DMF surface indices, including incipient lesions. The 3-yr results showed a signiflcant 52% plaque reduction in the test group compared with the control group. Caries reduction was signiflcant at the 0.01% level: 44% for primary teeth and 60% for permanent teeth.     

On the prevention of caries and periodontal disease

In 1971-72, a total of 375 adult subjects were recruited for a clinical trial aimed at assessing the effect of a preventive program, based on plaque control and topical application of fluoride, on the incidence of caries and periodontal disease. After a baseline examination, the volunteers were subjected to scaling, root planning and conventional caries therapy. During the course of the subsequent 6 years, they were recalled for preventive measures once every 2-3 months. After the 6-year follow-up examination, however, it was decided to extend the interval between the preventive sessions. Thus, during the next 9-year period, about 95% of the participants returned for preventive measures only 1 to 2 times per year. A small subgroup of about 15 subjects, who, during the initial 6 years had developed new caries lesions or had exhibited additional periodontal attachment loss, however, were also during the following 9 years recalled 3-6 times per year for oral hygiene control and preventive therapy. The re-examination performed in 1987 disclosed that the 317 subjects, who participated during the entire 15-year period, had a low incidence of caries and almost no further loss of periodontal tissue support. It was suggested that improved self performed oral hygiene, daily use of fluoridated dentifrice and regularly repeated professional tooth cleaning effectively prevented recurrence of dental disease.     

Prevalence of dental caries, gingivitis, and oral hygiene in hospitalized AIDS cases in Kinshasa, Zaire

The prevalence of dental caries and periodontal disease in African HIV-infected patients has not previously been assessed, in spite of the high prevalence of HIV-infection in some countries and the fact that atypical gingivitis may represent an early sign of HIV infection. In the present study 83 AIDS patients hospitalized in Kinshasa, Zaire, were assessed for dental caries, gingivitis and oral hygiene status. The prevalence of dental caries was lower among AIDS patients than among healthy controls previously examined in the same area. The prevalence of gingivitis was higher in AIDS than in controls in spite of good oral hygiene observed among AIDS patients.