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Periodontology II Assignment

Dental hygieneAbstract

Objective: This study was conducted in order to compare the performance of three interdental products in the control of plaque.

Methodology: One hundred and forty subjects were screened after which they were instructed to return to Periodontal department after a period of three weeks. This period was considered appropriate since the subjects had been directed on the medical attentions to adhered to. Later, the subjects were evaluated to approve for compliance and this was bases on the baseline; before and after using the assigned products.

Results: All the four groups showed some improvements and this was in accordance to the anticipation by out dental specialists. The products entitled for the subjects proved to be effective to some degree though to others were less celebrated. The use of the product marked an improvement ranging between 19 -27%. However, there were no much statistical differences in the manner of reduction on lingual interdental sites on based gingivitis index.

Conclusion: In the study, oral irrigation proved to be superior in controlling dental gingivitis than when sticking to manual brushing or flossing alone.

Introduction

Intensive research carried out over the last decades indicates that the periodontal disease is an infection by the bacteria leading to the inflammation of the gum. There have been several attempts applied in the control of gingivitis and periodontal with some proving to be effective whereas other showing no impacts (Kinane 122). Interference with the dental plaque has been an option to many victims though it is not the definite means of controlling this abhorrent condition (William 172). Medical experts recommends oral hygiene device known as the oral irrigator in suppressing this disease. Studies shows that this device reduces dental bleeding, clogging by the pathogens, gingivitis and the general gum inflammation; effective if only the victim develops a habit of using it on daily basis.

Despite the praise crowned to this device, there has been criticism revolving in its effectiveness with some of the dentists limiting prescription to their patients. Research by various professionals have generated few inconsistences and thus raising doubt about this deviation. The emergence of traditional plaque of indices has provided a cutline for outdoing oral irrigator in evaluating the quantitative changes from suffering to recovering stage of this ailment. Still, this is not enough to ascertain of the actual cure of the condition as the fears and uncertainties are prevalent.

Research indicates that the dental biofilm is rather complicated menace than how it appeared to be. Home irrigation has been tested of its effectiveness, showing some bit of assurance in altering the composition of the biofilm. It is believed that the oral irrigation wrecks the bacterial cells and sets un-conducive environment for their multiplication. The irrigated teeth bear a membrane of damaged pathogens cell wall and thus become too difficult for their development. Subsequently, endotoxins are released as a response to the immunity and therefore facilitating more protection.

Latest research by Fleming’s proved irrigation to be more beneficial in reducing gingivitis and bleeding. In fact, the study indicated that it is 50% more effective than going for the oral hygiene means. There is this traditional view that manual and flossing are considered as effective in the reduction of gingivitis (Dumitrescu 144). The disadvantage with this illusion is that there is no consistency in the whole procedure. Going by these perspectives, the objective of this study is to evaluate how effective it would be in incorporating oral irrigation to manual and power tooth brushing methods.

Materials and Methods

Adults between the ages of 18 t0 72 years were selected for this study without considering ethnic origin or race. The quorum that responded to our emails advertisement were informed about the study during recruitment and also at screening with objectives of the study properly highlighted to all. All the subjects were requested to bear their medical history certificates in order to create room for partiality. Still, those who were under orthodontic treatment were included as this would allow the team to gauge on the effective of the health measure they were instructed upon. However, some of the other criteria that subjects were supposed to fulfill include: not be having a long term medication, not tested with AIDS, absence of pregnancy of any stage, and no cases of suffering from cirrhosis, diabetes or cancer. One hundred and forty subjects met the criteria hence enrolled into the study. The assessment of the subjects took place at the Periodontology Department in Amsterdam.

Four different dental products were grouped into this study with 35 subjects participating in each group. The subjects in all groups received standard tooth brush and a fluoride dentifrice. Still, the subjects were taken through a process of interdental cleaning in three different groups as shown below.

Group 1: oral tooth brush, dental floss, (OIP).

Group 2: water flossier, (Oral-B 38, USA, Fort Collins).

Group 3: water jet (WB-60P, CO, BOSTON), Sonic toothbrush.

Group 4: flossier, (MP-54B, USA).

The toothbrushes used by subjects in group 1 and 3 were a standard bristle brushes, having uniform setting of the rows and fine bristles. The wax applied was maintained to be unflavored and un-waxed. The water jet and flossier used by group 3 and 2 had an electronic feed mechanism that enabled automatic brushing with optimal speed. Our examiners in the Periodontal Department were highly qualified in this field and this created high degree of generating genuine report: (a brush and an oral irrigator)

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Data was recorded during this screening and at the same time the subjects were guided on the best manner of maintaining their hygiene. Irrigating instruction and the best ways of flossing were recommended verbally to the subjects. Demonstrations were still included using the required standard of the tooth brushes and as well as correct techniques of coordinating the middle, index and the thumb fingers.

Subjects were prescribed to certain products just after the baseline assessment and they were supposed to adhere to the manufacturers specifications. All subjects were guided to brush thrice in a day; at the morning, at noon and at evening. Still, subjects were supposed to refrain from using other available oral hygienic instruments such as the toothpicks and mouth-rinse. (The table below illustrates reaction from using recommended products)

Plaque index

Evaluation no. Mean SD percentage change

Baseline2.67-

FlosserBefore use1.8922%

After use1.2430%

Glide floss Baseline 2.54 –

Before use1.8427%

After use1.3032%

Soft brush Baseline2.14-

Before use1.7824%

After use1.4528%

Results

At the end of the study, the number of the subjects in each group had reduced uniformly by 5. This emerged as some of the subjects suffered from ailment that required use of high antibiotics and consequently that would accelerate manipulated result thus demanding their dismissal. The plaque index figures reduced systematically with usage of different products. Even with these significant changes, at no one time did the mean percentage recorded went to zero. As indicated in the above table, the mean improvement ranged between 19-23% whereby this figure was quite encouraging.

Discussion

It merged that though it is universally believed that proximal dental cleaning is the most acceptable, most people have challenges in adopting this system due to the deep-rooted manner of applying the ancient dental floss. That is, most people go for alternative means of controlling bleeding.

Our study revealed that incorporation of the oral irrigator to manual tooth brushing helps in reducing gingivitis and bleeding. Furthermore, it was evidenced that those who adhered to both methods had significantly improved as compared to those who craved to one method of dental hygiene.

However, another study conducted at Harvard School of Dental Studies revealed that the capacity of irrigation in reducing gingivitis and suppressing pathogens was still questionable as the anticipated achievements didn’t come out clearly. It managed to control subgingival pathogen only by 0.02% hence the change was not too much significant. Interestingly, the reduction didn’t match with the known history of floss and manual brushing in reducing bleeding.

Conclusion

From that study, the following emerged:

Pairing of oral irrigation with manual toothbrush proved to be more effective than when using manual brushing alone.

Notably, oral irrigation proved to be more superior in controlling bleeding and gingivitis than sticking to either flossing or manual brushing.

Oral irrigation was noted to bear great significance on facial surfaces than when sticking to flossing and manual brushing on plaques and lingual surfaces.

References

Williams, David M. Pathology of Periodontal Disease. Oxford: Oxford University Press, 1992. Print.

Dumitrescu, Alexandrina L, and Junya Kobayashi. Genetic Variants in Periodontal Health and Disease. Dordrecht: Springer, 2010. Print

Kinane, Denis F, and Andrea Mombelli. Periodontal Disease. Basel: Karger, 2012. Print