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Altalhi AM, Alqahtani NS, Alareefi JA, Alamri SS, Almutairi KS, Bin Dous RA, Albaqami IA. A Comparative Review of Water Flossers in Periodontal Therapy. Cureus 2023; 15:e50162. [PMID: 38186424 PMCID: PMC10771714 DOI: 10.7759/cureus.50162] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/08/2023] [Indexed: 01/09/2024] Open
Abstract
This study investigated the efficacy of water flossers (WFs), devices used to irrigate the interdental and subgingival areas, compared to other interdental care methods, in the management of periodontal disease. A computerized PubMed search was conducted by the author, encompassing the years 1962 to 2023. The year 1962 was selected due to it being the introduction of the first WF. Keywords included "oral irrigator", "efficacy," and "water flossers." The review provided a broad comparative assessment of WFs, rather than an exhaustive detailed article review. We discussed the history and evolution of commercially available WFs and introduced a novel classification system. The research also evaluated the performance of WFs in comparison to traditional and novel interdental care methods, focusing on crucial clinical parameters such as plaque removal efficiency and reduction in gingival inflammation. The results of the study reveal that WFs appear to be superior in the management of periodontal disease and have demonstrated effectiveness in a variety of indices. However, it's worth noting that the author did not statistically analyze any of the data. We identified gaps in the literature and found opportunities for further clinical studies. These findings hold implications for optimal periodontal disease prevention and management, addressing the evolving landscape of oral care practices.
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Avenetti DM, Martin MA, Gansky SA, Ramos-Gomez FJ, Hyde S, Van Horn R, Jue B, Rosales GF, Cheng NF, Shiboski CH. Calibration and reliability testing of a novel asynchronous photographic plaque scoring system in young children. J Public Health Dent 2023; 83:108-115. [PMID: 36781405 PMCID: PMC10329468 DOI: 10.1111/jphd.12557] [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: 03/11/2022] [Revised: 11/17/2022] [Accepted: 12/02/2022] [Indexed: 02/15/2023]
Abstract
OBJECTIVES The Simplified Oral Hygiene Index for Maxillary Incisors (OHI-MIS) is a novel plaque scoring system adapted for young children. This study describes calibration training and testing used to establish the inter- and intra-rater reliability for OHI-MIS measured from clinical photographs. METHODS Two raters from the Coordinated Oral Health Promotion Chicago (CO-OP) and one from the Behavioral EConomics for Oral health iNnovation (BEECON) randomized controlled trials (RCTs) underwent calibration with gold standard raters, followed by annual re-calibration. Raters from CO-OP also completed inter-rater reliability testing; all three raters completed intra-rater reliability testing rounds. Photographs were obtained from children aged 9-39 months. RESULTS All three raters achieved greater than 0.77 Lin's Concordance Correlation (LCC) versus gold standard consensus during calibration. All three raters had LCC ≥0.83 at recalibration 1 year later. CO-OP trial raters scored 604 photos (151 sets of 4 photographs); mostly both raters were somewhat/very confident in their scoring (≥89%), describing the most photos as "clear" (90% and 81%). The CO-OP inter-rater LCC for total OHI-MIS score was 0.86, changing little when low quality or confidence photos were removed. All three raters demonstrated high intra-rater reliability (≥0.83). CONCLUSIONS The OHI-MIS plaque scoring system on photos had good reliability within and between trials following protocol training and calibration. OHI-MIS provides a novel asynchronous plaque scoring system for use in young children. Non-clinicians in field or clinical settings can obtain photographs, offering new opportunities for research and clinical care.
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Affiliation(s)
- David M. Avenetti
- Department of Pediatric Dentistry, UIC College of Dentistry, University of Illinois Chicago, Chicago, Illinois, USA
| | - Molly A. Martin
- Department of Pediatrics, UIC College of Medicine, University of Illinois Chicago, Chicago, Illinois, USA
- Institute for Health Research and Policy, University of Illinois at Chicago, Chicago, Illinois, USA
| | - Stuart A. Gansky
- Department Preventive and Restorative Dental Sciences, UCSF School of Dentistry, University of California, San Francisco, California, USA
| | - Francisco J. Ramos-Gomez
- Division of Preventative and Restorative Sciences, Section of Pediatric Dentistry, UCLA School of Dentistry, University of California, Los Angeles, California, USA
| | - Susan Hyde
- Department Preventive and Restorative Dental Sciences, UCSF School of Dentistry, University of California, San Francisco, California, USA
| | - Rebecca Van Horn
- Department of Pediatric Dentistry, UIC College of Dentistry, University of Illinois Chicago, Chicago, Illinois, USA
| | - Bonnie Jue
- Department Preventive and Restorative Dental Sciences, UCSF School of Dentistry, University of California, San Francisco, California, USA
| | - Genesis F. Rosales
- Institute for Health Research and Policy, University of Illinois at Chicago, Chicago, Illinois, USA
| | - Nancy F. Cheng
- Department Preventive and Restorative Dental Sciences, UCSF School of Dentistry, University of California, San Francisco, California, USA
| | - Caroline H. Shiboski
- Department of Orofacial Sciences, UCSF School of Dentistry, University of California, San Francisco, California, USA
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Deepika V, Chandrasekhar R, Uloopi KS, Ratnaditya A, Vinay C, RojaRamya KS. A Randomized Controlled Trial for Evaluation of the Effectiveness of Oral Irrigator and Interdental Floss for Plaque Control in Children with Visual Impairment. Int J Clin Pediatr Dent 2022; 15:389-393. [PMID: 36875980 PMCID: PMC9983593 DOI: 10.5005/jp-journals-10005-2404] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
Aim To evaluate the effectiveness of oral irrigator and interdental floss as adjuncts to manual tooth brushing in 8-16 years old children with visual impairment. Materials and methods A three-arm, parallel-group randomized controlled trial with blinded outcome assessment was carried out with the inclusion of 90 institutionalized children with visual impairment of age 8-16 years. They were equally allocated to three groups: group I: tooth brushing along with interdental flossing, group II: brushing along with a powered oral irrigator, and group III: brushing alone (control). Baseline oral hygiene index-simplified (OHI-S), gingival index (GI), and plaque index (PI) scores were recorded for all the samples and compared with post-intervention scores at 14 and 28 days intervals. Repeated measures of analysis of variance (ANOVA), one-way ANOVA, and post hoc Tukey tests were used for statistical analysis. Results At 28 days interval, children in group II showed a highly statistically significant reduction in OHI-S (0.46; p = 0.0001), PI (0.16; p = 0.0001), and GI (0.24; p = 0.0001) scores compared to control group. They also showed a significant reduction in OHI-S (0.25; p = 0.018), PI (0.15; p = 0.011), and GI (0.15; p = 0.0001) scores compared to group I. There is no significant reduction in the scores of children of group I compared to control group except for the GI score (0.08; p = 0.02). Conclusion Oral hygiene maintenance using oral irrigator along with brushing was found to be more effective in visually challenged children. Interdental flossing, along with brushing and brushing alone was found to be less effective. Clinical significance This study underlines the fact that comprehensive oral hygiene care should include interdental cleaning aids for effective plaque control to prevent dental diseases in children with visual impairment. Since these children have less manual dexterity to perform good oral hygiene practices, electrically driven interdental cleaning aids like oral irrigator may help them to overcome the problem. How to cite this article Deepika V, Chandrasekhar R, Uloopi KS, et al. A Randomized Controlled Trial for Evaluation of the Effectiveness of Oral Irrigator and Interdental Floss for Plaque Control in Children with Visual Impairment. Int J Clin Pediatr Dent 2022;15(4):389-393.
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Affiliation(s)
- Vajrala Deepika
- Department of Pedodontics and Preventive Dentistry, Vishnu Dental College, Bhimavaram, Andhra Pradesh, India
| | - Rayala Chandrasekhar
- Department of Pedodontics and Preventive Dentistry, Vishnu Dental College, Bhimavaram, Andhra Pradesh, India
| | - KS Uloopi
- Department of Pedodontics and Preventive Dentistry, Vishnu Dental College, Bhimavaram, Andhra Pradesh, India
| | - A Ratnaditya
- Department of Pedodontics and Preventive Dentistry, Vishnu Dental College, Bhimavaram, Andhra Pradesh, India
| | - C Vinay
- Department of Pedodontics and Preventive Dentistry, Vishnu Dental College, Bhimavaram, Andhra Pradesh, India
| | - Kakarla Sri RojaRamya
- Department of Pedodontics and Preventive Dentistry, Vishnu Dental College, Bhimavaram, Andhra Pradesh, India
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Which determinants should be considered to reduce social inequalities in paediatric dental care access? A cross-sectional study in France. PLoS One 2021; 16:e0255360. [PMID: 34347827 PMCID: PMC8336796 DOI: 10.1371/journal.pone.0255360] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2021] [Accepted: 07/14/2021] [Indexed: 12/03/2022] Open
Abstract
Better access to dental care through systemic and educational strategies is needed to lessen the burden of disease due to severe early caries. Our study aims to describe family characteristics associated with severe early caries: parental knowledge, attitudes, practices in oral health and socio-demographic factors. For this cross-sectional study, 102 parents of children aged under 6 years with severe early caries and attending paediatric dentistry service in France completed a questionnaire during face-to-face interviews. Caries were diagnosed clinically by calibrated investigators, using the American Academy of Paediatric Dentistry criteria, and dental status was recorded using the decayed, missing, and filled teeth index. The majority of children were from underprivileged backgrounds and had poor oral health status, with a median dmft index of 10. Parents highlighted the difficulty of finding suitable dental care in private practices. Parents appeared to have good oral health knowledge and engaged in adapted behaviours but showed a low sense of self-efficacy. They perceived the severity of early caries as important but the susceptibility of their child as moderate. The study affirmed the importance of improving the accessibility of paediatric dental care and developing educational strategies to enhance the knowledge, skills, and oral health practices of families.
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Ng E, Lim LP. An Overview of Different Interdental Cleaning Aids and Their Effectiveness. Dent J (Basel) 2019; 7:dj7020056. [PMID: 31159354 PMCID: PMC6630384 DOI: 10.3390/dj7020056] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2019] [Revised: 04/22/2019] [Accepted: 05/05/2019] [Indexed: 11/24/2022] Open
Abstract
Optimisation of plaque control is essential for the success of non-surgical and surgical periodontal therapy. This cannot be achieved with brushing alone; hence, there is a need for adjunctive interdental cleaning aids. The aim of this paper is to provide an overview of different interdental cleaning aids and review the literature for consensus on their effectiveness. A literature search of articles in English, up to December 2018, was conducted in Pubmed. High-quality flossing is difficult to achieve, and ineffective routine use of floss may not confer significant benefits over brushing alone. Interdental brushes are more effective than brushing as a monotherapy. They are at least as good if not superior to floss in reducing plaque and gingivitis. Although they are effective for patients regardless of their periodontal status (healthy or active), they are especially indicated in periodontal patients where widened embrasures are common. Added benefits include ease of use, patient acceptance, and recontouring of interdental tissues. Rubberpiks do not demonstrate inferiority to conventional interdental brushes. Wooden interdental aids appear to offer no significant advantage over brushing with respect to plaque removal; they may, however, reduce gingival bleeding. Oral irrigators are a promising tool for reducing gingival inflammation, despite minimal changes to plaque levels. For cleaning around dental implants, oral irrigators and interdental brushes are preferred over floss.
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Affiliation(s)
- Ethan Ng
- Discipline of Periodontics, Faculty of Dentistry, National University of Singapore, 11 Lower Kent Ridge Road, Singapore 119083, Singapore.
- Department of Restorative Dentistry, National Dental Centre Singapore, 5 Second Hospital Avenue, Singapore 168938, Singapore.
| | - Lum Peng Lim
- Discipline of Periodontics, Faculty of Dentistry, National University of Singapore, 11 Lower Kent Ridge Road, Singapore 119083, Singapore.
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Lin YC, Chang CS, Ho PS, Lee CH, Chen JH, Huang HL. Immigrant⁻Native Differences in Sugar-Sweetened Beverage and Snack Consumption and Preventive Behaviors Associated with Severe Early Childhood Caries: A Large-Scale Survey in Taiwan. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16061047. [PMID: 30909520 PMCID: PMC6466279 DOI: 10.3390/ijerph16061047] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/13/2019] [Revised: 03/11/2019] [Accepted: 03/20/2019] [Indexed: 12/04/2022]
Abstract
This study assessed the differences between immigrants and natives in terms of combined effects of sugar-sweetened beverage (SSB) or snack consumption and preventive behaviors for severe early childhood caries (SECC) through a large-scale survey of 31,565 native and 1046 immigrant child–parent pairs in Taiwan. Children aged 3–5 years underwent dental examinations, and parents completed structured questionnaires. Immigrants had a significantly higher SECC prevalence than native children (32.3% vs. 19.4%). A combined effect of SECC was observed in native children who did not receive assistance when brushing teeth at night before sleep and those who consumed SSBs more than four times weekly (adjusted odds ratio (aOR) = 4.8). Moreover, native children who did not use dental floss and who consumed snacks more than four times weekly had an aOR of 4.1 for SECC. The combined effects of children with immigrant parents who did not receive assistance when brushing their teeth at night before sleep and those who consumed snacks more than four times weekly had an aOR of 8.2 for SECC. The results suggest the necessity of cross-cultural caries prevention programs for immigrants. Parents must limit children’s SSB and snack intake, and implement preventive measures to reduce SECC development.
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Affiliation(s)
- Ying-Chun Lin
- Department of Oral Hygiene, College of Dental Medicine, Kaohsiung Medical University, Kaohsiung 807, Taiwan.
| | - Chin-Shun Chang
- Taiwan Society of Oral Health, Keelung 201, Taiwan.
- School of Oral Hygiene, College of Oral Medicine, Taipei Medical University, Taipei 110, Taiwan.
| | - Pei-Shan Ho
- Department of Oral Hygiene, College of Dental Medicine, Kaohsiung Medical University, Kaohsiung 807, Taiwan.
- Division of Medical Statistics and Bioinformatics, Department of Medical Research, Kaohsiung Medical University Hospital, Kaohsiung 807, Taiwan.
| | - Chien-Hung Lee
- Division of Medical Statistics and Bioinformatics, Department of Medical Research, Kaohsiung Medical University Hospital, Kaohsiung 807, Taiwan.
- Department of Public Health and Research Center for Environmental Medicine, Kaohsiung Medical University, Kaohsiung 807, Taiwan.
| | - Jen-Hao Chen
- School of Dentistry, College of Dental Medicine, Kaohsiung Medical University, Kaohsiung 807, Taiwan.
- Department of Prosthodontics, Kaohsiung Medical University Hospital, Kaohsiung 807, Taiwan.
| | - Hsiao-Ling Huang
- Department of Oral Hygiene, College of Dental Medicine, Kaohsiung Medical University, Kaohsiung 807, Taiwan.
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Homecare protective and risk factors for early childhood caries in Japan. Environ Health Prev Med 2018; 23:57. [PMID: 30400771 PMCID: PMC6220465 DOI: 10.1186/s12199-018-0746-8] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2018] [Accepted: 10/19/2018] [Indexed: 11/10/2022] Open
Abstract
Background Early childhood caries (ECC) affects children across Japan and throughout the world. Thus, it is important to identify dietary and dental care habits that either promote oral health or cause ECC. The objective of this study was to identify protective and risk factors associated with ECC in Japan. Methods In a typical rural Japanese community, we selected children born between 2004 and 2008 who had received checkups at their community health center including oral examinations conducted by dentists. We obtained data from children’s records and from a questionnaire filled out by parents. We enrolled only children who at their checkup for 18-month-olds had no caries, and we obtained data about them at their checkup for 3-year-olds. We classified children as either having caries (treated or untreated) or being caries-free. We conducted bivariate analyses using data on child/family demographic characteristics, child’s dietary habits, and child/parental oral health habits. We also conducted logistic regression analysis to control for variables and identify predictors of the presence/absence of caries. Results Five hundred sixty six children (278 boys, 288 girls) were enrolled and followed. After 2 years, 173 children (30.6%) presented with caries. Logistic regression analysis predicting caries at follow-up identified the interaction term “bottlefed overnight and brushed irregularly” at 18 months of age as a highly significant predictor of developing caries—adjusted odds ratio (AOR) of 14.27, 95% confidence interval (CI) 1.02–199.71. Two variables measured at follow-up were also significant predictors: having low levels of dental plaque (AOR 2.41, 95% CI 1.34–4.35) and having a mother who had untreated caries (AOR 1.84, 95% CI 1.09–3.12). Conclusion Public health efforts should encourage parents to eliminate bottle feeding overnight and promote brushing twice daily as children’s teeth begin to erupt. Greater efforts should be made to teach parents and daytime caregivers how to brush effectively to remove all plaque. Health professionals should pay close attention to mothers’ oral health status. Mothers with caries should receive prompt treatment and be assisted in developing better dietary and oral health habits that will benefit themselves and their children. Policies and programs should focus more on family oral health rather than just child oral health.
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