The efficacy of a rubber bristles interdental cleaner on parameters of oral soft tissue health-a systematic review

New design of interdental rubber picks - does the archimedean screw design bring an improvement for experimental cleaning efficacy and force?

BACKGROUND

Up to date, interdental brushes (IDB) are the first choice for interdental cleaning because of their cleaning efficacy. Cylindrical ones must be selected individually according to the size/morphology of the interdental area (IDR), whereas conical ones cover a larger variability of IDR. However, there is a trend on the part of patients towards interdental rubber picks (IRP) which are in general conically shaped, and which seem to be linked with lower cleaning efficacy. A new IRP with an Archimedes´ screw design was developed to overcome this limitation. Therefore, the in vitro study aimed to measure the experimental cleaning efficacy (ECE) and force (ECF) during interdental use of IDBs versus the new IRP type.

METHODS

Three IRPs with different tapers (PHB angled: 0.039, PHB straight S: 0.027, Vitis straight M: 0.045; all Flexipicks, Dentaid, Cerdanyola del Vallès, Spain) were compared to one IDB (Interprox micro PHD 0.9, Dentaid, Cerdanyola del Vallès, Spain). IDR were reproduced by a 3D-printer (Form2, Formlabs Sommerville, MA, USA) according to human teeth and matched to equivalent pairs (isosceles triangle, concave, convex) in three different diameters (1.0 mm,1.1 mm,1.3 mm). Covered with simulated biofilm, pre-/ post-brushing situations of IDR (standardized, computer-aided ten cycles) were photographed and quantified by digital image subtraction to calculate ECE [%]. ECF were registered with a load cell [N]. Statistically significant differences were detected using the Mann-Whitney-U-test and the Kruskal-Wallis-test with Bonferroni correction for multiple testing.

RESULTS

Overall, the ECE (mean ± SD) was higher for IDB micro 0.9 (45.95 ± 11.34%, p < 0.001) compared to all IRPs (PHB angled: 25.37 ± 15.29%; PHB straight: 22.28 ± 16.75%; Vitis straight: 25.24 ± 12.21%; p ≤ 0.001), whereat best ECE was achieved in isosceles triangle IDR of 1.0-1.1 mm (IDB micro 0.9: 70.7 ± 7.7%; PHB angled S: 57.30 ± 4.43%; p < 0.001). The highest ECF occurred for Vitis straight M with 2.11 ± 0.46 N, while IDB micro 0.9 showed lowest ECF values (0.64 ± 0.14 N; p < 0.001).

CONCLUSIONS

IRP with an Archimedes´ screw design and a higher taper were associated with advanced ECE but also higher ECF, nevertheless, ECE didn't reach the cleaning efficacy of conventional IDBs.

Mechanical plaque removal in step-1 of care

Maintaining a regular oral hygiene routine is essential for taking care of our mouths, ensuring healthy teeth, and achieving fresh breath. Patient education on oral hygiene is an important component of their overall treatment. Firstly, patients should be informed about the direct connection between bacteria in dental plaque and oral diseases. It is important for patients to understand that these conditions can be treated, but the success of treatment greatly depends on their level of oral hygiene. This journey begins by selecting the appropriate toothbrush and mastering the correct brushing technique to effectively remove dental plaque while avoiding any potential damage to the gums. In addition to toothbrushes, there are other devices available for comprehensive dental cleaning, such as floss, interdental sticks, interdental brushes, and oral irrigators. These aids are particularly beneficial for eliminating dental plaque from hard-to-reach areas. Moreover, tongue brushing or tongue scraping can effectively reduce breath odor and tongue coating. Currently, self-care recommendations for dental implants are primarily based on existing knowledge regarding natural teeth cleaning. Evidence-based recommendations are derived from comprehensive systematic evaluation of various oral hygiene aids.

Patient-reported understanding and dentist-reported management of periodontal diseases - a survey: do you know what gum disease is?

Introduction Mild-to-moderate gingivitis is treatable by effective toothbrushing with appropriate over-the-counter oral health care products; however, rates remain high.Aim To determine patient knowledge of gingivitis and dentists' views on management.Methods Surveys were completed by dentists and dental hospital patients.Results In total, 224 patients and 50 dentists participated. Clinical health, gingivitis, or periodontitis was detected in 2%, 33% and 56% of patients, respectively; 32% reported never suffering gingival bleeding. Moreover, 74% of patients reported gingival health as very important but only 53.7% with gingivitis occasionally/often were moderately-extremely worried about their symptoms. More than 50% of patients knew gingivitis causes poor oral health but <20% knew it elevated risks of other systemic conditions. Patients thought education on risks associated with poor oral health and product recommendations were most likely, and daily reminders least likely, to improve compliance with oral health advice (OHA). Also, 40% of dentists thought their patients were relatively unaware of the importance of gingival health, 76.9% of their patient-base had gingivitis, and 96% give OHA to these patients but only 30% thought this effected improvement. The most useful tools for improving oral health were better patient knowledge of the consequences and one-to-one instruction.Conclusion Patients struggle to attain oral health following OHA. Education about gingivitis-associated risks might improve OHA compliance.

Health action process approach in oral health behaviour: Target interventions, constructs and groups-A systematic review

OBJECTIVE

The aim of this study was to systematically map the Health Action Process Approach (HAPA)-based interventions in dentistry in relation to the type of intervention, the target groups and the constructs of the HAPA model that are used in the study and to assess the clinical relevance of the studies.

METHODS

A search in the databases of the National Library of Medicine (MEDLINE-PubMed), PsychINFO and Cochrane-CENTRAL was conducted. A quality assessment to estimate the risk of bias and a qualitative descriptive analysis were performed. The overall gathered evidence was graded.

RESULTS

Ten randomized controlled trials and three observational studies thus in total 13 studies were included. Flossing was the targeted behaviour in ten studies. The target groups consisted of students, adolescents and dental patients. Overall, all nine HAPA constructs were used, but only one study used all HAPA constructs. Six studies presented the used behavioural change techniques according to the BCT taxonomy. Based on the number of the used constructs, only two studies were classified as HAPA intervention studies. The most frequently used constructs were action control as an intervention and behaviour as an outcome measure. The overall evidence was graded with moderate certainty.

CONCLUSION

In the majority of the studies, the targeted intervention was flossing and the population consisted of students, adolescents and dental patients. All studies used only a selection of the HAPA constructs. Therefore, only a minority of the studies can be considered real HAPA intervention studies.