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Deinzer R, Weik U, Eidenhardt Z, Leufkens D, Sälzer S. Manual toothbrushing techniques for plaque removal and the prevention of gingivitis-A systematic review with network meta-analysis. PLoS One 2024; 19:e0306302. [PMID: 38968165 PMCID: PMC11226064 DOI: 10.1371/journal.pone.0306302] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2024] [Accepted: 06/15/2024] [Indexed: 07/07/2024] Open
Abstract
BACKGROUND The meaning of the toothbrushing technique for the effectivity of toothbrushing in terms of plaque removal and parameters of gingivitis is unknown. This systematic review and network meta-analysis (NMA) aimed to synthesize evidence from randomized controlled trials (RCTs). METHODS We searched MEDLINE (PubMed), the Cochrane Central Register of Controlled Trials, and the Web of Science for RCTs that compared any self-applied manual toothbrushing technique to any other technique or control and assessed plaque after toothbrushing and gingivitis. Where intervention effects were recorded repeatedly, the last post-intervention assessment was treated as the primary outcome date (POD), and the assessment closest to the intervention as the secondary outcome date (SOD). Age restrictions were not imposed. Participants with fixed orthodontic appliances were excluded. The evidence was evaluated using the Confidence in Network Meta-Analyses (CINeMA) approach, which is based on the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach. RESULTS Thirteen publications, including 15 studies, were identified. Ten studies assessing the Fones, Bass, and Scrub techniques provided data eligible for the NMA. The confidence rating of the evidence varied from very low to high in the case of plaque, and from very low to low in the case of gingivitis. Regarding PODs, Fones probably reduces plaque slightly compared with no training; the evidence is very uncertain that Fones may have little to no effect on gingivitis. Bass may result in little to no difference in plaque; the evidence that Bass may result in a slight increase in gingivitis is very uncertain. The evidence is very uncertain that Scrub may result in little to no difference in plaque at the SOD (no POD-data available) and that it may result in a slight increase in gingivitis. CONCLUSION There is limited evidence regarding the effects of toothbrushing techniques on plaque after brushing or gingivitis.
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Affiliation(s)
- Renate Deinzer
- Department of Medicine, Institute of Medical Psychology, Justus Liebig University of Giessen, Giessen, Germany
| | - Ulrike Weik
- Department of Medicine, Institute of Medical Psychology, Justus Liebig University of Giessen, Giessen, Germany
| | - Zdenka Eidenhardt
- Department of Medicine, Institute of Medical Psychology, Justus Liebig University of Giessen, Giessen, Germany
| | - Daniel Leufkens
- Department of Medicine, Institute of Medical Informatics, Justus Liebig University of Giessen, Giessen, Germany
| | - Sonja Sälzer
- Clinic for Conservative Dentistry and Periodontology, School for Dental Medicine, Christian-Albrechts-University of Kiel, Kiel, Germany
- Privat Practice in Hamburg, Hamburg, Germany
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Deinzer R, Eidenhardt Z, Sohrabi K, Stenger M, Kraft D, Sick B, Götz-Hahn F, Bottenbruch C, Berneburg N, Weik U. It is the habit not the handle that affects tooth brushing - a randomised counterbalanced cross over study with young and healthy adults. BMC Oral Health 2024; 24:757. [PMID: 38956565 PMCID: PMC11218271 DOI: 10.1186/s12903-024-04538-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2023] [Accepted: 06/27/2024] [Indexed: 07/04/2024] Open
Abstract
OBJECTIVE To assess the effect of the toothbrush handle on video-observed toothbrushing behaviour and toothbrushing effectiveness. METHODS This is a randomized counterbalanced cross-over study. N = 50 university students and employees brushed their teeth at two occasions, one week apart, using either a commercial ergonomically designed manual toothbrush (MT) or Brushalyze V1 (BV1), a manual toothbrush with a thick cylindrical handle without any specific ergonomic features. Brushing behaviour was video-analysed. Plaque was assessed at the second occasion immediately after brushing. Participants also rated their self-perceived oral cleanliness and directly compared the two brushes regarding their handling and compared them to the brushed they used at home. RESULTS The study participants found the BV1 significantly more cumbersome than the M1 or their brush at home. (p < 0.05). However, correlation analyses revealed a strong consistency of brushing behavior with the two brushes (0.71 < r < 0.91). Means differed only slightly (all d < 0.36). These differences became statistically significant only for the brushing time at inner surfaces (d = 0.31 p = 0.03) and horizontal movements at inner surfaces (d = 0.35, p = 0.02). Plaque levels at the gingival margins did not differ while slightly more plaque persisted at the more coronal aspects of the crown after brushing with BV1 (d = 0.592; p 0.042). DISCUSSION The results of the study indicate that the brushing handle does not play a major role in brushing behavior or brushing effectiveness.
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Affiliation(s)
- Renate Deinzer
- Department of Medicine, Justus-Liebig-University Giessen, Klinikstr. 29, Giessen, 35392, Germany.
| | - Zdenka Eidenhardt
- Department of Medicine, Justus-Liebig-University Giessen, Klinikstr. 29, Giessen, 35392, Germany
| | - Keywan Sohrabi
- Faculty of Health Sciences, University of Applied Sciences Giessen, Ostanlage 45, Giessen, 35390, Germany
| | - Manuel Stenger
- Department of Medicine, Justus-Liebig-University Giessen, Klinikstr. 29, Giessen, 35392, Germany
| | - Dominik Kraft
- Faculty of Health Sciences, University of Applied Sciences Giessen, Ostanlage 45, Giessen, 35390, Germany
| | - Bernhard Sick
- Intelligent Embedded Systems, University of Kassel, Wilhelmshöher Allee 73, Kassel, 34121, Germany
| | - Franz Götz-Hahn
- Intelligent Embedded Systems, University of Kassel, Wilhelmshöher Allee 73, Kassel, 34121, Germany
| | - Carlotta Bottenbruch
- Department of Medicine, Justus-Liebig-University Giessen, Klinikstr. 29, Giessen, 35392, Germany
| | - Nils Berneburg
- Department of Medicine, Justus-Liebig-University Giessen, Klinikstr. 29, Giessen, 35392, Germany
| | - Ulrike Weik
- Department of Medicine, Justus-Liebig-University Giessen, Klinikstr. 29, Giessen, 35392, Germany
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Kanzow P, Witt C, Lechte C, Barke S, Rohland B, Schmidt A, Wiegand A. Effect of different brushing parameters on erosive tooth wear in primary bovine enamel and dentin. PLoS One 2024; 19:e0302261. [PMID: 38626124 PMCID: PMC11020396 DOI: 10.1371/journal.pone.0302261] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2024] [Accepted: 03/31/2024] [Indexed: 04/18/2024] Open
Abstract
This in-vitro study aimed to analyse the effect of brushing and different brushing parameters (kind of toothpaste, kind of toothbrush, brushing force) on erosive tooth wear of primary bovine enamel and dentin. Specimens were prepared from primary bovine enamel or dentin (each group n = 12) and cyclically eroded (6 × 60 s/d, citric acid, pH 2.4) and brushed with children's toothbrushes (2 × 15 s/d) over 5 days. The brushing parameters under investigation were: toothpaste (fluoridated, fluoride-free), toothbrush (manual; rotating-oscillating and sonic, each at two different activation modes) and brushing force (1 N, 2 N). Specimens that were only eroded and not brushed served as controls. Enamel and dentin wear was quantified using widefield confocal microscopy. Statistical analysis was performed using three- and one-way ANOVAs followed by Scheffe's (enamel) or Tamhane's (dentin) post-hoc tests (p < 0.05). Brushing with the fluoridated toothpaste was able to significantly reduce erosive wear in enamel (by 15 to 37%, 6 of 10 groups) and in dentin (by 58 to 72%, all groups), while brushing with the fluoride-free toothpaste was not different from the controls. Considering the kind of toothpaste and brushing force, slight differences between the toothbrushes were observed in enamel, but not in dentin. Within the same toothbrush and activation mode, almost no differences between 1 and 2 N brushing force were detected. In conclusion, erosive tooth wear on primary bovine dental hard tissue mainly depends on the kind of toothpaste, rather than on the kind of toothbrush and the brushing force.
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Affiliation(s)
- Philipp Kanzow
- Department of Preventive Dentistry, Periodontology and Cariology, University Medical Center Göttingen, Göttingen, Germany
| | - Corinna Witt
- Department of Preventive Dentistry, Periodontology and Cariology, University Medical Center Göttingen, Göttingen, Germany
| | - Clemens Lechte
- Department of Preventive Dentistry, Periodontology and Cariology, University Medical Center Göttingen, Göttingen, Germany
| | - Sarah Barke
- Department of Preventive Dentistry, Periodontology and Cariology, University Medical Center Göttingen, Göttingen, Germany
| | - Bianca Rohland
- Department of Preventive Dentistry, Periodontology and Cariology, University Medical Center Göttingen, Göttingen, Germany
| | - Alexandra Schmidt
- Department of Preventive Dentistry, Periodontology and Cariology, University Medical Center Göttingen, Göttingen, Germany
| | - Annette Wiegand
- Department of Preventive Dentistry, Periodontology and Cariology, University Medical Center Göttingen, Göttingen, Germany
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4
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Deinzer R, Jordan AR. Periodontal health literacy in Germany-Results of a telephone survey. Int J Dent Hyg 2024. [PMID: 38575852 DOI: 10.1111/idh.12803] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2023] [Revised: 03/15/2024] [Accepted: 03/21/2024] [Indexed: 04/06/2024]
Abstract
OBJECTIVE Assess the periodontal health literacy of German adolescents, adults and senior residents. BACKGROUND The prevalence of periodontitis is high. One explanation for this may be that people lack periodontal health literacy (PHL). METHODS This was a cross-sectional descriptive study. Former participants of the 5th German Oral Health Study (n = 333 16-year-olds, n = 307 39-48-year-olds, n = 332 69-78-year-olds) participated in a computer-assisted telephone interview. Open-ended questions (OEQs) were used to assess the participants' current knowledge. Corresponding single- and multiple-choice questions (SCQs and MCQs) supplemented the OEQs to allow detailed analyses of the nature of the knowledge gaps. RESULTS Less than 10% of the participants in the three age groups could explain the term 'periodontitis' or select the correct answer in an SCQ. Responding to the OEQs, 89% of 16-year olds, 64% of 39-48-year-olds, and 59% of 69-78-year-olds, could not name any consequence of periodontitis, and 83%, 51%, and 60%, respectively, could not name any risk factors. The OEQs regarding proper oral hygiene behaviour revealed that participants lacked awareness regarding important aspects of oral hygiene (e.g., systematics) or areas to which they should pay attention to (e.g., interdental spaces and gingival margins). CONCLUSIONS The survey revealed PHL deficits in German adolescents, adults, and seniors and a need for community-based measures to improve PHL in all age groups. Dental teams should be aware that their patients might lack the PHL necessary for understanding and adherence to professional dental advice, and that they might even lack PHL regarding the proper use of oral hygiene devices.
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Affiliation(s)
- Renate Deinzer
- Department of Medicine, Institute of Medical Psychology, Justus-Liebig-University Giessen, Giessen, Germany
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Zaborskis A, Kavaliauskienė A, Levi S, Tesler R, Dimitrova E. Adolescent Toothbrushing and Its Association with Sociodemographic Factors-Time Trends from 1994 to 2018 in Twenty Countries. Healthcare (Basel) 2023; 11:3148. [PMID: 38132038 PMCID: PMC10742657 DOI: 10.3390/healthcare11243148] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2023] [Revised: 12/08/2023] [Accepted: 12/09/2023] [Indexed: 12/23/2023] Open
Abstract
Regular toothbrushing is the primary self-care method to prevent the most common dental diseases and is considered an important public health indicator. This retrospective observational study aimed to examine cross-national time trends in adolescent toothbrushing behaviour and its association with sociodemographic factors between 1994 and 2018. We studied data from 20 countries that conducted seven surveys of the Health Behaviour in School-aged Children (HBSC) study. Adolescents aged 11, 13 and 15 years responded to questions on their toothbrushing frequency, family affluence and structure. Altogether, reports of 691,559 students were analysed using descriptive statistics and binominal logistic regression. The findings showed an overall positive trend in the prevalence of more-than-once-a-day toothbrushing frequency during the entire study period mainly due to a noticeable increase from 1994 to 2010 (except Denmark and Sweden); this trend continued significantly thereafter in 12 of 20 countries. Across all countries, girls and adolescents from more affluent families were more likely to brush their teeth regularly. These relationships remained unchanged throughout the study period, whereas the age-related difference in toothbrushing prevalence decreased noticeably, and the negative relationship between toothbrushing and living in a non-intact family became evident. While the prevalence of regular toothbrushing among adolescents has increased in recent decades, it is still far behind the recommended level of twice-daily brushing for everyone across all countries. The promotion of toothbrushing needs to start at an early age, with a special focus on boys and adolescents from low-affluence and non-intact families.
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Affiliation(s)
- Apolinaras Zaborskis
- Faculty of Public Health, Medical Academy, Lithuanian University of Health Sciences, LT-44307 Kaunas, Lithuania
| | - Aistė Kavaliauskienė
- Faculty of Odontology, Medical Academy, Lithuanian University of Health Sciences, LT-44307 Kaunas, Lithuania;
| | - Sharon Levi
- Department of Health Systems Management, School of Health Sciences, Ariel University, Ariel 4077625, Israel; (S.L.); (R.T.)
- Department of Health Systems Management, The Max Stern Yezreel Valley College, Yezreel Valley, Afula 1930600, Israel
| | - Riki Tesler
- Department of Health Systems Management, School of Health Sciences, Ariel University, Ariel 4077625, Israel; (S.L.); (R.T.)
| | - Elitsa Dimitrova
- Institute for Population and Human Studies, Bulgarian Academy of Sciences & Plovdiv University Paisii Hilendarski, 1000 Sofia, Bulgaria;
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Weik U, Shankar-Subramanian S, Sämann T, Wöstmann B, Margraf-Stiksrud J, Deinzer R. "You should brush your teeth better": a randomized controlled trial comparing best-possible versus as-usual toothbrushing. BMC Oral Health 2023; 23:456. [PMID: 37415160 PMCID: PMC10327354 DOI: 10.1186/s12903-023-03127-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2022] [Accepted: 06/11/2023] [Indexed: 07/08/2023] Open
Abstract
BACKGROUND Most people's tooth brushing performance is deficient, even when they are encouraged to brush to the best of their abilities. The aim of the present study was to explore the nature of this deficit by comparing best-possible vs. as-usual brushing. METHODS University students (N = 111) were randomly assigned to receive one of two instructions: "brush your teeth as usual" (AU-instruction) or "brush your teeth to the best of your abilities" (BP-instruction). Video analyses assessed brushing performance. The marginal plaque index (MPI) assessed after brushing was used as an indicator of brushing effectiveness. A questionnaire assessed subjectively perceived oral cleanliness (SPOC). RESULTS Participants in the BP group brushed their teeth longer (p = 0.008, d = 0.57) and used interdental devices more often (p < 0.001). No group differences emerged in the distribution of brushing time among surfaces, the percentage of brushing techniques used beyond horizontal scrubbing, or the appropriate use of interdental devices (all p > 0.16, all d < 0.30). Plaque persisted at the majority of the sections of the gingival margins, and the groups did not differ in this respect (p = 0.15; d = 0.22). SPOC values in the BP group were higher than those in the AU group (p = 0.006; d = 0.54). Both groups overestimated their actual oral cleanliness by approximately twofold. CONCLUSIONS Compared to their usual brushing effort, study participants increased their effort when asked to brush their teeth in the best possible manner. However, that increase in effort was ineffective in terms of oral cleanliness. The results indicate that people's concept of optimized brushing refers to quantitative aspects (e.g., longer duration, more interdental hygiene) rather than qualitative aspects (e.g., considering inner surfaces and gingival margins, appropriate use of dental floss). TRIAL REGISTRATION The study was registered in the appropriate national register ( www.drks.de ; ID: DRKS00017812; date of registration: 27/08/2019 - retrospectively registered).
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Affiliation(s)
- Ulrike Weik
- Institute of Medical Psychology, Justus-Liebig-University Giessen, Klinikstr. 29, Giessen, D-35392 Germany
| | - Sadhvi Shankar-Subramanian
- Institute of Medical Psychology, Justus-Liebig-University Giessen, Klinikstr. 29, Giessen, D-35392 Germany
| | - Thorben Sämann
- Institute of Medical Psychology, Justus-Liebig-University Giessen, Klinikstr. 29, Giessen, D-35392 Germany
| | - Bernd Wöstmann
- Dental Clinic - Department of Prosthodontics, Justus-Liebig-University Giessen, Giessen, Germany
| | | | - Renate Deinzer
- Institute of Medical Psychology, Justus-Liebig-University Giessen, Klinikstr. 29, Giessen, D-35392 Germany
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Chalkidis J, Barke S, Rohland B, Schmidt A, Kanzow P, Wiegand A. In vitro study on the preventive effect of children's toothpastes on erosive tooth wear of primary bovine enamel and dentin. Sci Rep 2023; 13:10884. [PMID: 37407760 DOI: 10.1038/s41598-023-38043-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2023] [Accepted: 07/01/2023] [Indexed: 07/07/2023] Open
Abstract
This in vitro study aimed to analyse the effect of various children's toothpastes on erosive tooth wear of primary bovine enamel and dentin. Enamel and dentin specimens (n = 12) were cyclically eroded (6 × 60 s/d, citric acid, pH 2.4) and brushed (2 × 15 s/d, 2 N) over 5 days. Nine fluoride toothpastes (500 to 1450 ppm) and eight toothpastes containing no fluoride or other active ingredients (hydroxyapatite and/or xylitol) were tested. Unbrushed specimens served as control. Tissue loss was quantified using widefield confocal microscopy and statistically analysed using two-way and one-way ANOVAs followed by Scheffe's (enamel) or Tamhane's (dentin) post-hoc tests (p < 0.05). Only one fluoride toothpaste (1400 ppm) was able to reduce erosive wear of enamel significantly by 15% compared to the control (padj. = 0.002). All fluoridated toothpastes reduced dentin surface loss significantly by 32 to 69% compared to the control (padj. ≤ 0.001), while fluoride-free toothpastes were unable to reduce dentin loss significantly (padj. ≥ 0.971). Most fluoridated toothpastes caused less erosive wear compared to fluoride-free toothpastes. Children toothpastes containing fluoride were more effective in reducing erosive wear compared to toothpastes containing no fluoride or other active ingredients.
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Affiliation(s)
- Jennifer Chalkidis
- Department of Preventive Dentistry, Periodontology and Cariology, University Medical Center Göttingen, Robert-Koch-Str. 40, 37075, Göttingen, Germany
| | - Sarah Barke
- Department of Preventive Dentistry, Periodontology and Cariology, University Medical Center Göttingen, Robert-Koch-Str. 40, 37075, Göttingen, Germany
| | - Bianca Rohland
- Department of Preventive Dentistry, Periodontology and Cariology, University Medical Center Göttingen, Robert-Koch-Str. 40, 37075, Göttingen, Germany
| | - Alexandra Schmidt
- Department of Preventive Dentistry, Periodontology and Cariology, University Medical Center Göttingen, Robert-Koch-Str. 40, 37075, Göttingen, Germany
| | - Philipp Kanzow
- Department of Preventive Dentistry, Periodontology and Cariology, University Medical Center Göttingen, Robert-Koch-Str. 40, 37075, Göttingen, Germany
| | - Annette Wiegand
- Department of Preventive Dentistry, Periodontology and Cariology, University Medical Center Göttingen, Robert-Koch-Str. 40, 37075, Göttingen, Germany.
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Eidenhardt Z, Busse S, Margraf-Stiksrud J, Deinzer R. Patients' awareness regarding the quality of their oral hygiene: development and validation of a new measurement instrument. BMC Oral Health 2022; 22:629. [PMID: 36550463 PMCID: PMC9773685 DOI: 10.1186/s12903-022-02659-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2022] [Accepted: 12/09/2022] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND The present research aimed to develop and validate a standardised survey instrument for the assessment of patients' awareness of the quality of their oral hygiene performance. METHODS A digital questionnaire was developed that assesses both patients' naïve self-perceptions of oral cleanliness (SPOCn) after tooth brushing and patients' perceptions after being informed how oral cleanliness may be captured in dentistry (SPOCd). Three studies (N = 56 adults, N = 66 adolescents and one of their parents, N = 24 university students) assessed the instrument's feasibility (patient reports), reliability (internal consistency), validity (correlation with other constructs; sensitivity to manipulation of actual tooth brushing), and the correlation with actual oral cleanliness after tooth brushing. RESULTS All study groups accepted the questionnaire well; average answering times were less than 5 min. Cronbach's α exceeds 0.90; correlational analyses support the discriminant validity regarding oral hygiene related self-efficacy expectations and stages of change; manipulation of oral hygiene behaviour results in the expected changes of SPOC scores. Patients' SPOC correlate only moderately with actual oral cleanliness. The comparison between SPOCd scores and actual oral cleanliness indicate that they considerably overestimate their oral hygiene performance. CONCLUSIONS The SPOC questionnaire is an easy-to-use, well-accepted, reliable and valid instrument for the assessment of patients' awareness of the quality of their oral hygiene for research and clinical purposes. The results of the questionnaire may help to reveal unrealistic self-perceptions of patients regarding their oral hygiene. It can raise their awareness of the need to improve their skills and/or efforts in this regard. Trial registration The third study was an interventional study and was registered in the appropriate national register ( www.drks.de ; ID: DRKS00018781; date of registration: 12/09/2019).
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Affiliation(s)
- Zdenka Eidenhardt
- Department of Medicine, Institute of Medical Psychology, Justus-Liebig-University Giessen, Klinikstr. 29, 35392 Giessen, Germany
| | - Sebastian Busse
- Department of Medicine, Institute of Medical Psychology, Justus-Liebig-University Giessen, Klinikstr. 29, 35392 Giessen, Germany
| | | | - Renate Deinzer
- Department of Medicine, Institute of Medical Psychology, Justus-Liebig-University Giessen, Klinikstr. 29, 35392 Giessen, Germany
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Kanoute A, Carrouel F, Gare J, Dieng SN, Dieng A, Diop M, Faye D, Fraticelli L, Bourgeois D. Evaluation of Oral Hygiene-Related Mobile Apps for Children in Sub-Saharan Africa. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:12565. [PMID: 36231862 PMCID: PMC9565087 DOI: 10.3390/ijerph191912565] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/12/2022] [Revised: 09/24/2022] [Accepted: 09/27/2022] [Indexed: 06/16/2023]
Abstract
In sub-Saharan Africa, oral health is a real epidemiological challenge. Mobile applications represent a hope for the learning of oral hygiene in children and the fight against oral diseases. This study overviews and assesses the quality of mobile applications linked to oral hygiene for children currently featured on the iOS and Android stores in sub-Saharan Africa. Ten oral health professionals (OHP) used the French Mobile App Rating Scale (MARS-F) to rate 15 selected applications. The highest MARS-F scores for overall quality were reported for Bonne nuit Caillou (3.89 ± 0.74), Mon Raccoon (3.63 ± 0.95), and Chomper Chums (3.54 ± 0.54) while the lowest MARS-F scores for overall quality were achieved by Brushing time (2.31 ± 0.61), De belles dents (2.55 ± 0.55) and Brushing Hero (2.77 ± 0.53). The subjective quality scores ranged from 1.50 ± 0.68 for Brushing time to 3.25 ± 0.97 for Bonne nuit Caillou. Specificity scores ranged from 1.95 ± 0.88 (Brushing time) to 3.75 ± 0.84 (Bonne nuit Caillou). Thus, OHP rated positively the quality of the majority of mobile applications linked to oral hygiene for children, their effect on users' knowledge, attitudes, and intentions to change, and the probability of effective oral hygiene behavior modification. They stated that they would recommend their use to their patients who need them. However, studies analyzing the change in oral hygiene behavior of children using these apps need to be conducted.
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Affiliation(s)
- Aida Kanoute
- Public Health Service, Department of Dentistry, Cheikh Anta Diop University, Dakar 10700, Senegal
| | - Florence Carrouel
- Health, Systemic, Process (P2S), UR 4129 Research Unit, University Claude Bernard Lyon 1, University of Lyon, 69008 Lyon, France
| | - Jocelyne Gare
- Health, Systemic, Process (P2S), UR 4129 Research Unit, University Claude Bernard Lyon 1, University of Lyon, 69008 Lyon, France
- Public Health Laboratory (LASAP), ED2S Doctoral School of Sciences and Health, University Joseph Ki Zerbo, Ouagadougou 7021, Burkina Faso
| | - Serigne Ndame Dieng
- Public Health Service, Department of Dentistry, Cheikh Anta Diop University, Dakar 10700, Senegal
| | - Amadou Dieng
- Public Health Service, Department of Dentistry, Cheikh Anta Diop University, Dakar 10700, Senegal
| | - Mbathio Diop
- Public Health Service, Department of Dentistry, Cheikh Anta Diop University, Dakar 10700, Senegal
| | - Daouda Faye
- Public Health Service, Department of Dentistry, Cheikh Anta Diop University, Dakar 10700, Senegal
| | - Laurie Fraticelli
- Health, Systemic, Process (P2S), UR 4129 Research Unit, University Claude Bernard Lyon 1, University of Lyon, 69008 Lyon, France
| | - Denis Bourgeois
- Health, Systemic, Process (P2S), UR 4129 Research Unit, University Claude Bernard Lyon 1, University of Lyon, 69008 Lyon, France
- Hospices Civils de Lyon (HCL), 69002 Lyon, France
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10
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The Effect of Changing the Toothbrush on the Marginal Gingiva Microcirculation in the Adolescent Population—A Laser Doppler Flowmetry Assessment. Diagnostics (Basel) 2022; 12:diagnostics12081830. [PMID: 36010181 PMCID: PMC9406728 DOI: 10.3390/diagnostics12081830] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2022] [Revised: 07/16/2022] [Accepted: 07/27/2022] [Indexed: 12/22/2022] Open
Abstract
It is well-known that proper tooth brushing has the effect of stimulating microcirculation in a healthy gingiva. The aim of this study was to evaluate the microcirculation dynamics at the level of healthy marginal gingiva in adolescents after changing their toothbrush. Three evaluation instruments were employed to assess and quantify the effects on the marginal gingiva: the periodontal probing depth (PD), gingival index (GI) and laser Doppler flowmetry (LDF). A total of 12 adolescents, aged between 15 and 20, were enrolled in the study, resulting in a total of 72 frontal upper teeth for PD and GI and 48 gingival interdental sites for LDF assessment. For each measurement, the pulp blood flow signal was recorded for 1 min and represented as a pulsatory signal. Data were collected in four moments: before the toothbrush changed and 24 h, 7 days and 14 days after. For the statistical analysis, the nonparametric Friedman test was applied for comparisons between more than two pair numeric series and for comparisons between two sets of pair values without Gaussian distribution, the Wilcoxon signed-rank test was applied. The paired t test was used for two sets of normally distributed paired values. The results showed that using a new toothbrush in the adolescent population with healthy gingiva can induce statistically significant increases in gingival blood flow, which remain at a high level even at two weeks. The GI also increases significantly at 7 days and 14 days, while the periodontal PD does not change significantly.
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Carrouel F, Bourgeois D, Clément C, Tardivo D, Martinon P, Guiral S, Lan R, Viennot S, Dussart C, Fraticelli L. Oral-Hygiene-Related Mobile Apps in the French App Stores: Assessment of Functionality and Quality. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:7293. [PMID: 35742541 PMCID: PMC9223428 DOI: 10.3390/ijerph19127293] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/12/2022] [Revised: 06/10/2022] [Accepted: 06/11/2022] [Indexed: 02/07/2023]
Abstract
Mobile health apps can contribute to increased quality of individual oral hygiene behaviors. This study provides an overview and an evaluation of quality of oral-hygiene-related mobile apps currently available in Google Play Store and the French Apple App. A shortlist of nine apps was assessed by 10 oral health professionals using the Mobile App Rating Scale. Intraclass correlation was used to evaluate interrater agreement. Best quality scores were obtained by Oral-B (3.4 ± 0.97), Colgate Connect (3.20 ± 0.63), and Preventeeth (3.10 ± 1.1) and worst ones by Mimizaur se brosse les dents (1.80 ± 0.79) and Kolibree (2.30 ± 0.82). The subjective quality scores ranged from 2.62 ± 0.61 (Oral-B) to 1.5 ± 0.61 (MSD). Specificity of the content ranged from 3.46 ± 0.84 (Preventeeth) to 1.78 ± 0.47 (Mimizaur se brosse les dents). Thus, even if oral health professionals positively evaluated the quality of oral-hygiene-related mobile apps, they are less assertive concerning their impact on the user's knowledge, attitudes, and intentions to change, as well as the likelihood of actual change in the oral hygiene behavior. Further investigations are needed to assess whether information from these apps is consistent with oral hygiene recommendations and to determine the long-term impacts of these apps.
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Affiliation(s)
- Florence Carrouel
- Health, Systemic, Process, UR 4129 Research Unit, University Claude Bernard Lyon 1, University of Lyon, 69008 Lyon, France; (D.B.); (C.C.); (P.M.); (S.V.); (C.D.); (L.F.)
| | - Denis Bourgeois
- Health, Systemic, Process, UR 4129 Research Unit, University Claude Bernard Lyon 1, University of Lyon, 69008 Lyon, France; (D.B.); (C.C.); (P.M.); (S.V.); (C.D.); (L.F.)
| | - Céline Clément
- Health, Systemic, Process, UR 4129 Research Unit, University Claude Bernard Lyon 1, University of Lyon, 69008 Lyon, France; (D.B.); (C.C.); (P.M.); (S.V.); (C.D.); (L.F.)
- Prisme Team, Interpsy Laboratory, EA 4432, University of Lorraine, CEDEX, 54015 Nancy, France
| | - Delphine Tardivo
- Laboratory Anthropology, Health Law, and Medical Ethics, UMR 7268, Aix-Marseille University 2, 13344 Marseille, France; (D.T.); (R.L.)
| | - Prescilla Martinon
- Health, Systemic, Process, UR 4129 Research Unit, University Claude Bernard Lyon 1, University of Lyon, 69008 Lyon, France; (D.B.); (C.C.); (P.M.); (S.V.); (C.D.); (L.F.)
| | - Sébastien Guiral
- Laboratory Molecular Microbiology and Structural Biochemistry (MMSB), UMR 5086 CNRS/University of Lyon, 69367 Lyon, France;
| | - Romain Lan
- Laboratory Anthropology, Health Law, and Medical Ethics, UMR 7268, Aix-Marseille University 2, 13344 Marseille, France; (D.T.); (R.L.)
| | - Stéphane Viennot
- Health, Systemic, Process, UR 4129 Research Unit, University Claude Bernard Lyon 1, University of Lyon, 69008 Lyon, France; (D.B.); (C.C.); (P.M.); (S.V.); (C.D.); (L.F.)
| | - Claude Dussart
- Health, Systemic, Process, UR 4129 Research Unit, University Claude Bernard Lyon 1, University of Lyon, 69008 Lyon, France; (D.B.); (C.C.); (P.M.); (S.V.); (C.D.); (L.F.)
| | - Laurie Fraticelli
- Health, Systemic, Process, UR 4129 Research Unit, University Claude Bernard Lyon 1, University of Lyon, 69008 Lyon, France; (D.B.); (C.C.); (P.M.); (S.V.); (C.D.); (L.F.)
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Supportive Home Remedies for Orofacial Pain during the Coronavirus Disease 2019 Pandemic: Their Value and Limitations. Int J Dent 2022; 2022:2005935. [PMID: 35069740 PMCID: PMC8771145 DOI: 10.1155/2022/2005935] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2021] [Accepted: 01/06/2022] [Indexed: 12/03/2022] Open
Abstract
Background The coronavirus disease 2019 (COVID-19) pandemic has impeded access to timely dental care, and there is an urgent need for adjuvant therapies that can reduce orofacial pain in emergencies. Aims To provide information on the benefits and limitations of eight representative home remedies as palliative care for orofacial pain during the coronavirus disease 2019 (COVID-19) pandemic. Methods PubMed and Medline were electronically searched for eight home remedies for orofacial pain that can be used in COVID-19. Papers published in English in the past 30 years were considered. Among the published studies suitable for the research purpose, those in which the abstract and body text were confirmed were targeted, and duplicate studies were excluded. Finally, 86 studies were included. Results There is extensive and high-level scientific evidence for the application of tooth brushing and flossing, mouth rinsing with chlorhexidine, use of over-the-counter pain medication, and application of cryotherapy in emergencies. Gargling with salt water, brushing with bamboo salt, gargling with garlic juice, and oil pulling are traditional methods used for centuries. The use of natural products for orofacial pain has a significant empirical effect but has weak scientific evidence. Conclusions Knowing the correct application method, effects, and side effects is desirable to use these methods appropriately in emergencies. However, scientific evidence is unclear and generally lacking for home remedies to be the main treatment strategy, and there are clear limitations to their use as a single main treatment.
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Deinzer R, Shankar-Subramanian S, Ritsert A, Ebel S, Wöstmann B, Margraf-Stiksrud J, Eidenhardt Z. Good role models? Tooth brushing capabilities of parents: a video observation study. BMC Oral Health 2021; 21:469. [PMID: 34560851 PMCID: PMC8461594 DOI: 10.1186/s12903-021-01823-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2021] [Accepted: 09/08/2021] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND Research in adolescents reveals that they are not capable to remove dental plaque effectively. Inconsistent application of brushing techniques and neglect of certain areas while brushing are very common. As parents play a major role in the oral health education, the present study aimed to examine and describe the tooth brushing performance of the parents of adolescents. METHODS Parents of adolescents (N = 66) were asked to perform oral hygiene to the best of their capabilities in front of a video camera and dental plaque was recorded before and afterwards. Papillary bleeding was also assessed. RESULTS The tooth contact time (i.e. net brushing duration) averaged 155 s ± 58 s. Gingival margins showed persistent plaque at 68% ± 14% of the sections assessed. Papillary bleeding was found at 52% ± 18% of the papillae. Parents brushed inner surfaces lesser than the outer surfaces (41 s ± 24 s vs. 73 s ± 33 s) and 29% of the parents completely missed the inner surfaces of at least one sextant. On the outer surfaces parents predominantly applied circular movements (66% ± 25% of brushing time). Vertical brushing prevailed on the inner surfaces (52% ± 30%). However, horizontal scrubbing was also very common (46% ± 31%). CONCLUSIONS Parents' tooth brushing performance was neither effective in terms of plaque removal nor did they fully comply with tooth brushing recommendations such as considering all inner surfaces when brushing or application of other than horizontal movements to lateral surfaces. Regarding oral hygiene, parents should not only be a good role model in terms of timing, frequency and duration of tooth brushing but should also be able to demonstrate how to brush teeth completely and effectively. The current research indicates that they might lack the latter skill.
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Affiliation(s)
- Renate Deinzer
- Department of Medicine, Justus-Liebig-University Giessen, Klinikstr. 29, 35392 Giessen, Germany
- Department of Medicine, Institute of Medical Psychology, Justus-Liebig-University Giessen, Klinikstr. 29, 35392 Giessen, Germany
| | | | - Alexander Ritsert
- Department of Medicine, Justus-Liebig-University Giessen, Klinikstr. 29, 35392 Giessen, Germany
| | - Stefanie Ebel
- Department of Medicine, Justus-Liebig-University Giessen, Klinikstr. 29, 35392 Giessen, Germany
| | - Bernd Wöstmann
- Department of Medicine, Justus-Liebig-University Giessen, Schlangenzahl 14, 35392 Giessen, Germany
| | | | - Zdenka Eidenhardt
- Department of Medicine, Justus-Liebig-University Giessen, Klinikstr. 29, 35392 Giessen, Germany
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