Impact of oral hygiene instructions on plaque index in adolescents

The effect of audiovisual motivation and oral health education on oral health status and oral health-related quality of life among children at social homes: a randomised clinical trial

AIM

This study aimed to evaluate the effect of audiovisual motivation (AVM) and oral health education (OHE) on oral health (OH) and oral health-related quality of life (OHRQoL) among children at social homes.

METHODS

This was a double-blinded cluster-randomised clinical trial. Subjects (n = 225) aged 4-14 years were recruited from social homes and randomly divided into 2 groups: control group (n = 100) and study group (n = 115); each was further divided into sub-groups: 4-6, 7-12 and > 12 years. Both groups were interviewed and examined to record DMFT/dmft (baseline and 12 months), plaque index (PI) and gingival index (GI) (baseline, 3, 6 and 12 months). The study group had multiple AVM and OHE sessions; the control group had no intervention.

RESULTS

Mean sample age was 9.1 ± 2.7 years. At 12 months, 4-6-year-olds had a significant improvement in PI for study and control groups (P < 0.001, P = 0.008 respectively), and GI was significantly improved in study group (P < 0.001). In 7-12-year-olds, a significant improvement in the PI, GI and dmft was found in study group (P < 0.001 for all), with an increase in DMFT in the control group (P < 0.001). For > 12 years, there was a significant improvement in PI (P = 0.002), GI (P = 0.043). There was significant improvement in OHRQoL in the study group only in these domains: bleeding when brushing teeth (P = 0.04) and presence of bad breath in the morning (P < 0.001).

CONCLUSION

There was a favourable effect of AVM and OHE on OH and OHRQoL in children aged 4-14 years at social homes after 12 months.

Effectiveness of a school-based educational intervention on oral health knowledge, attitudes, practices, and self-efficacy among female secondary school students: a randomized controlled trial

INTRODUCTION

Oral health is crucial during adolescence, yet many young individuals engage in suboptimal oral hygiene behaviors, contributing to oral health issues. While genetics may have some influence, lifestyle factors such as diet, preventive care, and oral hygiene practices play a more critical role in the development of dental caries. The World Health Organization recognizes oral health as a lifelong cornerstone of overall well-being. This study aimed to evaluate the effectiveness of a school-based educational intervention for improving oral health knowledge, attitudes, practices, and self-efficacy among female secondary school students in Kashan, Iran.

METHODS

This randomized controlled trial was conducted in 2023 with 80 female students aged 12 years from two public schools at Kashan. The participants were selected via cluster sampling and randomly assigned to either the intervention group (n = 40) or the control group (n = 40). Data were collected at baseline, one month postintervention, and three months postintervention via a standardized questionnaire administered to both groups. The intervention consisted of four weekly 90-minute educational sessions led by a dentist and a health education specialist, with a focus on oral health knowledge, attitudes, practices, and self-efficacy. Additionally, the intervention group received a digital educational booklet, while parents were provided with a checklist to monitor their children's tooth brushing and flossing behaviors. The control group did not receive any educational intervention or a checklist for tracking oral hygiene behaviors during the study period. Dental plaque levels were assessed via plaque-disclosing tablets (PDTs) at baseline and three months postintervention. Data analysis was performed via SPSS version 24, which employs the chi-square test, Wilcoxon test, Mann‒Whitney test, and Friedman test.

RESULTS

There was a significant difference between the intervention and control groups in all the measured variables after the intervention (p < 0.001). Postintervention, the intervention group demonstrated significant increases in mean scores for oral health knowledge (from 5.4 to 9.3), attitudes (from 55.6 to 62.1), self-efficacy (from 53.5 to 62.7), and practices (from 28.0 to 33.4) (p < 0.05). No significant changes were observed in the control group (p > 0.05). There was a significant difference between the intervention and control groups in all the measured variables after the intervention (p < 0.001). The average score of dental plaque was significantly different between the two groups (p < 0.001). The Wilcoxon test revealed that after the intervention, the test group had improved indicators, and the control group had increased dental plaque scores.

CONCLUSION

The educational intervention effectively enhanced oral health knowledge, attitudes, self-efficacy, and practices among female students. The incorporation of such interventions into school health programs may promote long-term improvements in oral health behaviors among adolescents.

TRIAL REGISTRATION

Clinical Trial Registry (IRCT code: IRCT20180827040889N1), registered on 27/01/2024.

Evaluation of the Effectiveness of a Mouthwash Containing Spilanthol and Cannabidiol on Improving Oral Health in Patients with Gingivitis-Clinical Trial

Background/Objectives: Plaque-associated gingivitis is widely regarded as a local inflammatory condition initiated by the accumulation of a non-specific dental biofilm in the interaction with the host immune system. The initial symptom noticed by the patient is bleeding gums. The use of mouthwash can serve to supplement mechanotherapy. However, there is an increasing interest in mouthwashes comprising natural ingredients, including cannabidiol (CBD) and spilanthol. The objective of this study was to evaluate the effect of an oral rinse containing spilanthol and CBD oil compared to a rinse containing tea tree oil on the oral microbiota and the values of selected oral status indicators in patients with gingivitis. Methods: The study included 40 patients treated with a rinse containing tea tree oil (TTO)/TTO + spilanthol + CBD for a period of 42 days. Patients rinsed their mouth twice daily for 30 s. The patients' oral microbiome was assessed before and after treatment, and bleeding on probing (BOP) and approximal plaque index (API) were assessed. The study was double-blind. Results: API and BOP were reduced in all groups, both the test and control. The most significant decrease in baseline BOP-1 scores was observed in test groups A and D (p = 0.005062 and p = 0.005062, respectively). A significant difference in API improvement was observed between the initial and final visits in the test (A, D) and control (B, C) groups (p = 0.012516, p = 0.005062, p = 0.004028, p = 0.003172, respectively). Conclusions: Firstly, the use of a mouthwash containing cannabidiol (CBD) and spilanthol was demonstrated to be efficacious in the maintenance of oral microbiota homeostasis. Secondly, the combination of TTO with spilanthol and CBD in the rinse was shown to result in a more significant reduction in selected oral health parameters (BOP and API) and anti-inflammatory effects when compared to a rinse with TTO alone. It should be noted that this is a pilot study and will continue.

The role of psychology and communication skills in orthodontic practice: a systematic review

Effective communication and psychological strategies are integral to orthodontic practice, influencing patient satisfaction, adherence, and overall treatment outcomes. This systematic review, conducted in accordance with PRISMA guidelines and registered with PROSPERO (ID: CRD42024560432), examined the role of these strategies in orthodontic care and their integration into educational curricula. A comprehensive search identified studies focusing on communication and psychological interventions in orthodontics. The findings emphasize that patient-centered communication enhances understanding, adherence, and satisfaction. Structured approaches, such as personalized follow-up reminders and digital tools like social media, have shown significant improvements in patient engagement. Psychosocial factors, including anxiety and body image concerns, were identified as critical barriers to adherence, necessitating tailored psychological support and empathy-based communication. Additionally, gaps in orthodontic education were identified, with recommendations for integrating simulations, interprofessional education, and ongoing training into curricula to address these challenges. This review underscores the importance of addressing the psychological and communicative dimensions of orthodontic care, providing actionable recommendations for enhancing patient outcomes and optimizing educational practices. Future research should explore the long-term impact of these strategies and assess their effectiveness across diverse populations.

Possibilities of Application of Cold Atmospheric Pressure Plasmas in Dentistry—A Narrative Review

According to the World Human Organization (WHO), dental and periodontal diseases are common among the human population. Traditional dentistry offers a wide range of methods for treating oral diseases and performing esthetic procedures. In contrast, cold atmospheric pressure plasma (CAPP) has been found to be a promising technology in multiple fields, particularly in medical sciences such as dentistry. In this study, CAPP might be a promising adjunct to conventional dental treatments. A substantial number of studies have confirmed the effectiveness of both direct and indirect CAPP applications in dentistry. Because CAPP technology is fast, inexpensive, and noninvasive, we aim to review recent literature focused on the application of this methodology in dentistry.

Concordance and Clinical Outcomes Improvement Following Oral Hygiene Motivation: A Systematic Review and Report of the Workshop of the Italian Societies of Dental Hygiene

Aim: A workshop on concordance and oral hygiene was held in February 2024. To address the topic, a systematic review aimed at investigating the effectiveness of motivational interventions in improving oral hygiene and focusing on periodontal clinical indices outcomes was designed. Materials and Methods: A comprehensive literature search was conducted across PubMed and Scopus electronic databases to identify relevant articles published up to 2024. Inclusion criteria encompassed studies comparing motivational interventions targeting oral hygiene behaviours, with a focus on periodontal clinical indices. Twelve articles meeting the eligibility criteria were selected for analysis. Quality assessment and data extraction were performed systematically. Results: The synthesis of findings from the selected studies revealed a consistent positive effect of motivational interventions on periodontal clinical indices. These interventions encompassed various strategies, including educational sessions, personalized feedback and motivational interviewing. Improvement in indices such as plaque index (PI), gingival index (GI) and periodontal probing depth was observed following motivational interventions, despite the variety of motivational protocols employed. Conclusion: Motivational interventions are effective in enhancing oral hygiene practices and improving periodontal clinical indices. Tailored motivational approaches can serve as valuable tools in promoting oral health behaviours among individuals, potentially reducing the risk of periodontal diseases. Further research is warranted to explore the long-term sustainability and scalability of motivational interventions in diverse populations and settings.

Impact of sleeve gastrectomy on the periodontal status of patients with and without type 2 diabetes: a 1-year prospective real-world study

Background

Periodontitis is a chronic inflammatory disease potentially associated with obesity and type 2 diabetes (T2D). Sleeve gastrectomy (SG) has shown substantial effect on weight loss and treatment of T2D. However, there is no direct evidence comparing the impact of SG on the periodontal status of patients with and without T2D.

Objectives

To determine the impact of SG on the periodontal status of patients with and without T2D in a real-world setting.

Methods

In a prospective and two-armed cohort design, participants who were scheduled for SG at an affiliated hospital between April 2022 and December 2022 were approached for eligibility. After a clinical evaluation and oral examination, those with periodontitis were included and further divided into the DM group (diabetic) and the Control group (non-diabetic) with a 1-year follow-up after surgery. The primary outcome was the periodontal status of patients at 12 months after SG. The secondary outcomes included weight loss, diabetes remission, and alterations in inflammatory markers for up to 1 year after SG.

Results

Fifty-seven and 49 patients were included in the DM and the Control group, respectively. Before surgery, patients in the DM group had further worsened periodontal condition compared with those in the Control group. Accompanied by weight loss and glucose reduction, patients in both groups demonstrated significant decreases in plaque index (PLI) and bleeding index (BI) with no alterations in probing depth or clinical attachment loss for up to 1 year after SG. Even patients in the DM group achieved less TWL% (32.79 ± 6.20% vs. 37.95 ± 8.34, P<0.01), their periodontal condition had more substantial improvement with no significant difference in PLI and BI between groups at 1 year after SG. We also observed a significant reduction in the levels of high sensitive C-reactive protein and interleukin-6 in both groups at 1 year after SG.

Conclusion

Both patients with and without T2D demonstrated improved periodontal status for up to 1 year after SG. Patients with T2D achieved less weight loss but a more substantial improvement in periodontal condition. The significant reduction in inflammatory biomarkers contributed to the improvement of periodontal status after SG.

Oral Hygiene Instruction – How it Affects the Caries Experience, Oral Hygiene Status, and sCD14 Levels?

Background:

Caries experience, oral hygiene status, and salivary sCD14 level are three essential factors to analyse individual dental caries development risk. Therefore, regular and effective oral hygiene instruction (OHI) is essential for dental caries prevention.

Objective:

This study aims to analyse the differences in caries experience, oral hygiene status, and sCD14 levels before and after OHI.

Methods:

An observational study with intervention before and after oral hygiene instruction was conducted on 40 samples of each group taken with an accidental sampling method. The sample was calculated using the sample size formula to determine the difference between two paired means; confidence level 95%; power test 90%. The OHI materials include microbial aspects, plaque control methods and instruments, and directives for visiting the dentist. Caries' experience was obtained using DMF-T index; oral hygiene status using simplified oral hygiene instruction (OHI-S); sCD14 levels obtained from unstimulated saliva using an ELISA kit. Data analysis used the Kolmogorov-Smirnov normality test, paired t-test, and Wilcoxon signed-rank test.

Results:

Kolmogorov normality test showed that the caries experience data were normally distributed, while oral hygiene status and sCD14 were not. The paired-t difference test result for caries experience cannot be determined because the data showed a similar value. The Wilcoxon signed-rank test result for oral hygiene status showed no significant difference, while the sCD14 showed a significant difference.

Conclusion:

Oral hygiene instruction showed a similar value of caries experience before and after oral hygiene, and also no difference was found in oral hygiene status; however, the sCD14 levels showed a difference after oral hygiene instruction.

Influence of digital media in the oral health education of mother-child pairs: study protocol of a parallel double-blind randomized clinical trial

BACKGROUND

Dental caries is the most common non transmissible chronic disease in childhood and the control of dental biofilm in children is one of the greatest challenges in oral disease prevention. Digital media applications can help patients in improving their oral hygiene performance and reducing the number of appointments due to pain and discomfort reasons. This study aims to investigate the use of an smartphone application (WhatsApp) to deliver oral health education to mother-child pairs, with the ultimate goal of controlling dental biofilm and caries through digital activities focused on oral hygiene.

METHODS

This study was designed as a randomized, double-blind, parallel clinical trial involving 100 pairs of mothers and children (6-12 years old). The mothers and children will be randomly allocated to the control group (n = 50 pairs), who will receive a single visit conventional oral health education, or to the experimental group (n = 50 pairs), who will receive both a single visit conventional oral health education and educational videos through WhatsApp Messenger, twice a week. Before randomization of the groups and after the intervention, pairs will be evaluated regarding to plaque index (VPI), gingival bleeding index (GBI), and number of decayed, missing and filled permanent or primary teeth (DMF-T) modified by the inclusion of active non-cavitated carious lesions (Nyvad criteria). Socioeconomic data, dental history, and oral health literacy will obtained using questionnaires (Oral Health Literacy Assessment Task for Paediatric Dentistry; BOHLAT-P). Chi-square, Student's t-test, paired Student's t-test, Mann-Whitney, and Friedman tests will be used with a 5% significance level.

DISCUSSION

This intervention proposal is designed to motivate behavioral change in mother-child pairs. We hypothesize that adding digital media to traditional oral health programs will provoke improvements in oral hygiene behavior and health outcomes. To our knowledge, this is the first study evaluating the effect of educational videos communicated by digital media (WhatsApp) on the oral health of mother-child pairs evaluated by long-term dental examinations. In addition, we will assess the maternal level of comprehension of the provided information via a literacy assessment tool. The clinical trial is registered at the Brazilian Registry of Clinical Trials (No. RBR-7s8bw6m).