Home oral hygiene revisited. Options and evidence.
In regard to the limited literature on the subject, and the contradictions observed, we can not conclude that the types of manual brushes produce clinically important effects on the patients' gingival health, or that these effects can be detected consistently. However, the best results have been obtained with new brush designs, and future studies are necessary to clarify the existing contradictions. There is a clear need of long-term studies which comparatively evaluate the ability to reduce gingivitis and plaque with the newly designed brushes. On the other hand, there is evidence that supports the use of powered toothbrushes in the general population, especially those of the oscillating-rotating and counter-rotational type, as they have shown their ability to reduce gingival bleeding or inflammation, and dental plaque with greater efficacy than manual brushes. There is a clear need of long-term trials on the efficacy of powered brushes in orthodontic patients. With the existing studies we can conclude that there is limited evidence that orthodontic patients using a powered toothbrush show a slight, but significant, reduction of bleeding, compared with users of manual brushes. No conclusion can be made concerning the type of brush to be used. The techniques of interproximal oral hygiene, fundamentally the use of dental floss and interproximal brushes, appear to add additional benefits, in terms of plaque reduction, when they are associated with conventional manual brushes. Further long-term studies are necessary to confirm their efficacy in the reduction of gingival bleeding or inflammation. The choice of the type of technique must be made in relation to the characteristics of the patient: dental floss could be indicated in individuals with closed interdental spaces, and inter-proximal brushes in periodontal patients, or in those with open embrasures.
Sicilia
Alberto
A
Department of Periodontology, Faculty of Dentistry, University of Oviedo, Oviedo, Spain. asicilia@clinicasicilia.com
Arregui
Ignacio
I
Gallego
Montserrat
M
Cabezas
Blanca
B
Cuesta
Susana
S
D003742:Dental Devices, Home Care; D003773:Dental Plaque / Q000517:prevention & control*; D004867:Equipment Design; D005884:Gingival Hemorrhage / Q000517:prevention & control; D005891:Gingivitis / Q000517:prevention & control*; D006801:Humans; D009910:Oral Hygiene / Q000295:instrumentation / Q000379:methods*; D012648:Self Care; D014099:Toothbrushing / Q000295:instrumentation