Screening for periodontal diseases by non-dental health professionals: a protocol for a systematic review and overview of reviews

Minimal changes in daily flossing behavior among US adults from 2009 through 2020

BACKGROUND

Flossing is considered to be an integral component of oral hygiene. The authors evaluated trends in daily flossing and their associations with sociodemographic variables.

METHODS

The authors used data from the 2009-2020 National Health and Nutrition Examination Surveys, accounting for survey weights in all analyses. Descriptive statistics were computed for all study variables. Pooled univariable and multivariable logistic regression were performed to evaluate which sociodemographic factors were associated with daily flossing and to assess potential interactions with survey periods. Multivariable logistic regression was performed and stratified according to survey period.

RESULTS

This study included 26,624 adults. Although the prevalence of daily flossing increased from 29.4% in 2009 through 2010 to 34.8% in 2017 through 2020, this increase was not significant after multivariable adjustment. Results of the pooled survey logistic regression also showed that participants who were older, female, Hispanic, and had a higher income to poverty ratio had higher odds of daily flossing. The interaction between education and survey period was significantly associated with daily flossing (P = .012). Logistic regression for each survey period corroborated the pooled model results.

CONCLUSIONS

Approximately 1 in 3 adults in the United States reported flossing daily (32.7%). Although the prevalence of daily flossing increased from 2009 through 2020, this change was not significant after controlling for sociodemographic variables.

PRACTICAL IMPLICATIONS

The nonsignificant changes in flossing behavior from 2009 through 2020 suggest that messaging to encourage adults to floss daily has had little effect. Although the authors did not elucidate the benefits of flossing, dental providers should continue to consider encouraging patients to floss until new evidence suggests otherwise.

Epidemiological methods used in the periodontal health research in military personnel: a systematic review

INTRODUCTION

Periodontal disease is a prevalent pathology in military personnel worldwide. The objective is to analyse the methodological features of periodontal health research performed in military personnel in their home countries.

METHODS

A PRISMA systematic review of literature was carried out in PubMed, EMBASE and Web of Science databases on military periodontal health studies. Study design type, language, publication date, year, country, size and sample selection, age, sex, military, diagnostic procedure, examiners, periodontal, gingival and oral hygiene index were extracted.

RESULTS

Eighty-eight out of 5355 studies found were selected, published between 1921 and 2020, with samples ranging from 52 to 16 869 individuals, generally not randomised, and consisting mainly of men with a mean age of 25 years. Predominant studies were cross-sectional descriptive studies, carried out in the Army, on American military personnel, and in the English language. Most of the studies used the WHO periodontal probe handled by two or more examiners. The Löe and Silness gingival index and the Silness and Löe plaque index were the most used indexes to assess gingival condition and oral hygiene, respectively. Community Periodontal Index of Treatment Needs was the most widely used periodontal index.

CONCLUSIONS

Research on periodontal health carried out in military populations from the 1920s to the present has been performed from an almost exclusively descriptive approach. Issues such as the characteristics and representativeness of the samples, the epidemiological design and the different gingival-periodontal indexes used may limit the comparability of the study results.

A two-week single-group longitudinal test of a new sonic-powered toothbrush simulating the 'bass brushing technique' with tapered bristles on the brush head for reduction of dental plaque and gingivitis

OBJECTIVE

To investigate the effect of a new powered toothbrush with tapered bristles on the brush head for the reduction of dental plaque and gingivitis.

METHODS

This was a single-centre, single-group, longitudinal clinical trial. Thirty-two participants who were typical manual toothbrush users were recruited and assigned the sonic-powered brush. Interviews were arranged on the 1^st , 4^th , and 15^th days which represented the baseline (T₁ ), middle (T₂ ) and final (T₃ ) time points, respectively. At each visit, the plaque index (PlI), gingival index (GI), bleeding on probing (BOP) and probing depth (PD) were recorded for the Ramfjord index teeth, gingival crevicular fluid(GCF) samples were collected and the proportions of eight periodontal pathogenic bacteria were analysed. Repeated-measures analysis of variance (ANOVA) was used for comparisons at different time points.

RESULTS

PlI was significantly reduced by 41.67% from T₁ to T₂ (p<0.001) and decreased by 18.57% from T₂ to T₃ (p=0.003). GI also varied significantly from T₁ to T₂ (p=0.018) and T₁ to T₃ (p=0.037). A 35.86% reduction in the BOP percentage occurred after using the sonic-powered toothbrush for 3 days (p=0.001). However, no significant difference was observed in the mean values of PD at different examination intervals (p=0.529). There was no significant difference in the proportions of bacteria between T₁ and T₃ (p>0.05).

CONCLUSION

This research demonstrated the efficacy of the sonic-powered brush handle together with tapered bristles on the brush in reducing plaque and gingivitis within a short time period.

Prevalence and severity of periodontal disease among Spanish military personnel

Introduction

Periodontal disease ranges from simple gums inflammation to major damage to the periodontal tissues, even losing teeth. Severe periodontitis has a world overall prevalence of 11.2%. These are evaluated with periodontal probes and oral epidemiological indices. Our aim is to estimate the prevalence and severity of periodontal disease of a Spanish military population according to the 2013 WHO criteria.

Methods

Observational study of prevalence carried out in a representative random sample of 221 military staff from the Spanish Army base ‘Conde de Gazola’. Prevalence was estimated by calculating the Community Periodontal Index modified, loss of attachment, Plaque Index and Gingival Bleeding Index measured with a third-generation electronic ‘Pa-on’ periodontal probe.

Results

Averages of probing depth, recession and clinical attachment level were 2.17, 0.19 and 2.36 mm. Plaque and gingival bleeding indices were 71% and 40.3%. All subjects bled in some tooth after probing. 3.6% of subjects had no periodontal pockets, 58.8% mild periodontal pockets and 37.1% severe periodontal pockets. All had some loss of attachment, 52% mild loss of attachment and 47.5% severe loss of attachment. Teeth present with and without bleeding were 24.4 (86.5%) and 3.6 (13.1%). 28% of teeth had periodontal pockets and 40.4% loss of attachment. Sextant averages with periodontal pockets and loss of attachment were 2.79 and 3.56.

Conclusions

Our plaque and gingival bleeding indices were high and we found a higher prevalence and severity of periodontal disease than other Spanish and foreign military populations. This could be related to differences in context, life habits and insufficient dental hygiene.