The clinical effect of a prolonged oral hygiene phase prior to periodontal therapy in periodontitis patients. A randomized clinical study.

According to this article, there has been a shift in the approach to periodontal treatment planning. The planning used to include an initial oral hygiene phase consisting of oral hygiene instructions and motivation, which has instead become a less focused part of the actual causal therapy.

 

This study, conducted in Norway, included a study population diagnosed with severe periodontitis. Half of the group received, apart from baseline periodontal recordings, education on periodontitis: etiology, treatment and prevention. This test group also received individually tailored oral hygiene instructions based on their oral conditions. The instructions consisted of brushing with a manual toothbrush using the scrub method. For interdental cleaning, the patients were instructed to use interdental brushes of the correct size; when spaces were too narrow, picks or floss was recommended.

The oral hygiene instructions were thorough – the patients were asked to perform the oral hygiene recommendation under supervision to make sure that the patients had understood the information and instructions correctly. They were also instructed to rinse with 0.2% fluoride solution every evening to avoid pain from sensitivity and root caries on exposed root surfaces. The control group, on the other hand, just had baseline periodontal recordings.

After three months, there was a clear effect on plaque, bleeding and pocket depth in the intervention group. Sites with plaque showed a reduction of 36.6%, the corresponding figure for bleeding on probing was 30.7%, and mean probing pocket depth was reduced by 1.6mm. The control group, however, showed minimal changes.

To conclude, this study shows the great effect that one initial single session could have on periodontal parameters. The session included education, oral hygiene instruction and motivation, and was followed by three months of strict oral hygiene home care. All this could also have an impact on the therapy planning.