The effect of different plaque reduction methods

This is a report from the 11th European Workshop in Periodontology on primary prevention of periodontitis. The working group has focused on four different approaches: mechanical self-administrated plaque control regimes, self-administered interdental mechanical plaque control, adjunctive chemical plaque control and anti-inflammatory approaches.

Dental professionals
PR Collection 1064

A number of conclusions are drawn in this report. It is implied that professional oral hygiene instruction contributes to plaque and gingivitis reduction, and that reinforcement of the instruction may lead to enhanced results.

Furthermore, a single exercise of manual toothbrushing leads to an approximate 42% reduction of plaque scores compared with pre-brushing scores. The corresponding figure for power brushing is 46%. Meta-analyses have not shown any differences in plaque reduction between different bristle designs in manual toothbrushes. Regarding reduction of gingival inflammation, it is not reported in any meta-analysis. Greater plaque reduction is reported for re-chargeable and oscillating-rotating powered toothbrushes, compared to brushes with replaceable batteries and brushes with side-to-side movements.

Concerning interdental brushes, they have shown the highest efficacy in plaque removal and are also shown to be the most accepted interdental cleaning devices among patients. Regarding the use of floss, most studies cannot show a general effectiveness in plaque removal or reduction of gingival inflammation. According to the working group, interdental brushes are the preferable choice for interdental cleaning. Floss can be an alternative only when sites are too narrow for the interdental brush and show gingival and periodontal health. It is stressed that any method chosen for interproximal cleaning should be preceded by professional instruction.

For managing gingival inflammation and preventing accumulation of plaque, chemical anti-plaque agents have a significant impact. As to the effect of anti-inflammatory agents in managing gingivitis, they lack sufficient scientific support.

The report ends with general health recommendations: Daily toothbrushing for at least two minutes in combination with fluoridated dentifrice, and daily interdental cleaning to reduce plaque and gingival inflammation. In cases of gingivitis, adjunctive use of chemical agents can be recommended.

A summary of a scientific article

This summary of a scientific study by Chapple IL et al. is presented by Anna Nilvéus Olofsson, DDS, Manager Odontology and Scientific Affairs. Click here for more information.