The anti-plaque effect of high concentration sodium bicarbonate dentifrice on plaque formation and gingival inflammation, irrespective to individual polishing technique and plaque quality

AIM

To assess the anti-plaque effect of a high concentration sodium bicarbonate dentifrice on plaque formation, and gingivitis, as compared to a control toothpaste, irrespective of individual brushing technique and plaque quality.

METHODS

The experimental gingivitis model, with a split-mouth design was used to assess the anti-plaque effect of a high concentration sodium bicarbonate dentifrice on plaque formation. By producing individual fitted trays, the toothpaste was applied in the test quadrant and a control dentifrice in the contralateral. The participants used the individual fitted trays for 1 min every morning and evening, for 21 days. In this period, the participants was only allowed to brush the teeth in the opposite jaw, as usual. Twenty healthy individuals successfully completed the study.

RESULTS

At 21 days, there was no statistically significant difference between test quadrant and control quadrant with regard to plaque indices, gingival index and number of bleeding sites.

CONCLUSION

This study demonstrated that the high concentration sodium bicarbonate dentifrice used did not produce statistically significant anti-plaque effect compared to the control dentifrice, in terms of Plaque- and Gingival Indices, number of bleeding sites or by Quigely and Hein, the Turesky modification Plaque Index, irrespective of brushing technique and individual plaque quality.

TRIAL REGISTRATION

Regional Committee for Medical Research and Ethics, South-East Norway in 2021 (REK.2021/370116).

CLINICAL TRIAL REGISTRATION

NCT05441371 (First registered 09/06/2022, First posted 01/07/2022) ( http://www.

CLINICALTRIALS

gov ). (Retrospectively registered).

Inter-rater agreement among multiple examiners for the assessment of plaque scores between quantitative light-induced fluorescence-digital and two-tone disclosing solution-stained digital images

BACKGROUND

To utilize plaque scoring indices as objective measures, a certain standard of intra-rater and inter-rater agreement must be met. Achievement of high consistency among several examiners in the assessment of images from Q-ray cam (for quantitative light-induced fluorescence-digital imaging) and digital single-lens reflex camera of stained tooth surfaces might enable more efficient undertaking of large epidemiological studies and oral tests.

METHODS

Second-year dental hygiene students and registered dental hygienists 40 examiners were randomly selected, all of whom provided informed consent. Multiple examiners assessed plaque scoring indices from the two types of images of the same 30 patients. The images were observed on a computer monitor, and the area with dental plaque was assessed using the Patient Hygiene Performance Index. The intra-class correlation coefficient was determined to evaluate the agreement among examiners and test methods for dental plaque Q-ray cam and digital single-lens reflex camera measurements were compared using a Bland-Altman plot. The intra-class correlation coefficient was analyzed using SPSS version 24 software (SPSS Inc., Chicago, IL, USA), and the exploratory graph was analyzed with MedCalc.

RESULTS

Agreement among 40 examiners was excellent with an intra-class correlation coefficient of 0.990 when the Q-ray cam was used. The intra-class correlation coefficient for the registered dental hygienists group was 0.987 and that for the dental hygiene students group was 0.980.

CONCLUSIONS

The study was high agreement in the assessment of Q-ray cam images and digital single-lens reflex camera images of stained dental plaque by multiple examiners, confirming that the two methods are validated both independently and with high mutual agreement.

Could a national oral health promotion program improve the oral hygiene of persons attending special care establishments in France? Evaluation of a pilot program

This study aimed to investigate the effectiveness of an oral health promotion intervention implemented in special care establishments by dentists trained online. Twenty-six dentists intervening in 27 French special care establishments undertook a standardised oral health promotion intervention, including a conference presentation for care staff and hands-on toothbrushing workshops. Oral hygiene status of the residents was performed at baseline and at 6 months, and were compared using the McNemar test. Mixed logistic regression was performed to identify the factors associated with an improvement of dental plaque removal. The oral health intervention was completed by 890 residents: 445 children, 373 adults and 72 elderly adults. At baseline, dental plaque was observed for 79.8% of the 797 dentate residents. Among the 691 dentate residents included in the final analysis, dental plaque removal was improved for 34%. Improvement in dental plaque removal was recorded more often for the group of 13 to 20-year-old residents (OR = 1.97; 95% CI = 1.15-3.38). The results indicate that this programme failed to significantly improve the dental plaque removal of the residents. More research is needed to understand the limiting factors of such interventions.

A novel approach for classifying protruding ears is easy to calculate and implement in daily clinical practice

AIM

Protruding ears are a prevalent deformity, with a reported incidence of 5% in the paediatric population, but it lacks a simple digital classification. The aim of this study was to find a parameter that would objectively allow the photographic classification of protrusion, by comparing frontal facial images of patients with protruding ears with aged-matched controls.

METHODS

This prospective cohort study compared the frontal facial images of 105 patients with protruding ears with 112 aged-matched controls without protruding ears. A rectangle was drawn on the image for each ear, encompassing its full visible anatomy. The width of each rectangle was divided by its height to create an index. The mean value of both ears was defined as the Frontal Aesthetics Translation Index for Measurement of Amplitude of the Ears (FATIMAE).

RESULTS

The calculated values for group with protruding ears were significantly higher than for the controls. No gender differences were found. However, the FATIMAE values decreased with age, establishing different classification criteria for separate age groups.

CONCLUSION

The FATIMAE is easy to calculate and implement in daily clinical practice and establishes a practical approach for classification of protrusion, as well as for referral criteria for a specialised surgical consultation.

Pilot testing of intervention protocols to prevent pneumonia in nursing home residents

OBJECTIVES

To test intervention protocols for feasibility, staff adherence, and effectiveness in reducing pneumonia risk factors (impaired oral hygiene, swallowing difficulty) in nursing home residents.

DESIGN

Prospective study.

SETTING

Two nursing homes.

PARTICIPANTS

Fifty-two nursing home residents.

INTERVENTION

Thirty residents with impaired oral hygiene were randomly assigned to manual oral brushing plus 0.12% chlorhexidine oral rinse at different frequencies daily. Twenty-two residents with swallowing difficulty were randomly assigned to upright feeding positioning, teaching swallowing techniques, or manual oral brushing. All protocols were administered over 3 months.

MEASUREMENTS

Feasibility was assessed monthly and defined as high if the protocol took less than 10 minutes to administer. Adherence was assessed weekly and defined as high if full staff adherence was demonstrated in more than 75% of assessments. Effectiveness for improved oral hygiene (reduction in oral plaque score) and swallowing (reduction in cough during swallowing) was compared at baseline and 3 months.

RESULTS

Daily manual oral brushing plus 0.12% chlorhexidine rinse demonstrated high feasibility, high staff adherence, and effectiveness in improving oral hygiene (P<.001 vs baseline); this combination administered twice per day showed the highest plaque score reduction. Daily manual oral brushing and upright feeding positioning demonstrated high feasibility, high staff adherence, and effectiveness in improving swallowing.

CONCLUSION

Manual oral brushing, 0.12% chlorhexidine oral rinse, and upright feeding positioning demonstrated high feasibility, high staff adherence, and effectiveness in pneumonia risk factor reduction. A protocol combining these components warrants testing for its ability to reduce pneumonia in nursing home residents.