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1.
Br Dent J ; 2019 Feb 01.
Article in English | MEDLINE | ID: mdl-30705443

ABSTRACT

The science and practice of dentistry are underpinned by research and clinical developments that have been evaluated rigorously before being presented to the profession in peer-reviewed journals or at national and international meetings. The online platform that supports open access journals has been corrupted by the emergence of so-called 'predatory journals', which accept papers on payment of a significant publication fee. This practice has now extended to dental conferences and this article describes the author's personal views of predatory conferences.

2.
Br Dent J ; 219(4): 159-63, 2015 Aug 28.
Article in English | MEDLINE | ID: mdl-26315174

ABSTRACT

Many commissioning bodies for research expect that researchers will actively involve the public and patients in their projects. The National Institute for Health Research (NIHR), for example, involves members of the public in reviewing funding applications and making recommendations about research funding. The NIHR's portfolio is currently operating in 97% of NHS Trusts and this now includes research sited in primary dental care. This paper presents some case studies of these and other projects which are designed specifically for patient benefit in dental services in the community. This means there is no necessity to translate the outcomes of such research from a university or hospital base to the general population as the projects are undertaken in dental practices that provide primary dental care to (predominantly) NHS patients. The relevance of the outcomes to dental care is, therefore, likely to be of direct interest and importance to commissioners of healthcare funding in the UK who have a duty to use evidence bases for commissioning decisions.


Subject(s)
Biomedical Research , Dental Care , Primary Health Care , Biomedical Research/ethics , Biomedical Research/legislation & jurisprudence , Biomedical Research/standards , Dental Care/legislation & jurisprudence , Dental Care/standards , Ethics, Research , Humans , Primary Health Care/legislation & jurisprudence , Primary Health Care/standards , Quality of Health Care , United Kingdom
3.
Br Dent J ; 219(1): 29-33, 2015 Jul 10.
Article in English | MEDLINE | ID: mdl-26159982

ABSTRACT

INTRODUCTION: In 1980 the British Society of Periodontology published a series of educational goals which have guided periodontal curricula at UK dental schools. Further, a survey of UK dental schools evaluated aspects of teaching and learning in periodontology. The aims of this project were to identify teaching practices and assessments in periodontology and best practice which may be developed in the future. MATERIALS AND METHODS: A questionnaire was sent to dental schools who had participated in the previous survey. The questionnaire sought information on aspects of teaching and learning in periodontology: teaching manpower, curriculum structure, assessment, research opportunities for students and whether implantology is delivered in the undergraduate curriculum. RESULTS: There is consistency between the education providers with respect to teaching and learning in periodontology. Most are developing integrated learning between dental undergraduates and members of the dental team although there are opportunities for further development. Students are expected to have knowledge of complex treatments but are not expected to be competent at undertaking periodontal surgery nor placing and restoring implants. CONCLUSION: The findings confirm that there is considerable consistency between the education providers with respect to aspects of teaching and learning in periodontology.


Subject(s)
Curriculum , Education, Dental/organization & administration , Education, Medical, Undergraduate/organization & administration , Schools, Dental , Humans , Surveys and Questionnaires , United Kingdom
4.
Br Dent J ; 217(8): 411-9, 2014 Oct.
Article in English | MEDLINE | ID: mdl-25342347

ABSTRACT

This paper reviews the effects that drugs may have on the gingival and periodontal tissues. Drug-induced gingival overgrowth has been recognised for over 70 years but is becoming a more prevalent occurrence with wider use of antihypertensive and immunosuppressant drugs. The anti-inflammatory steroids, non-steroidal drugs and anti-TNF-α agents might all be expected to exert a dampening effect on chronic periodontitis although the evidence is somewhat equivocal and none of these drugs has emerged as potentially valuable adjuncts to treat periodontal disease. Desquamative gingivitis is a clinical appearance of aggressive gingival inflammation with which a number of drugs have been associated and the oral contraceptives have also been implicated in the development of gingival inflammation. Patients who are prescribed bisphosphonates and anti-platelet drugs are at risk of serious side effects following more invasive dental procedures including extractions and surgical treatments although timely, conventional management of periodontal disease may be undertaken to reduce periodontal inflammation, prevent disease progression and ultimately the need for extractions.


Subject(s)
Gingiva/growth & development , Periodontal Diseases/drug therapy , Chronic Disease , Humans , United Kingdom
5.
Br Dent J ; 216(11): E23, 2014 Jun 13.
Article in English | MEDLINE | ID: mdl-24923961

ABSTRACT

OBJECTIVES: To explore general dental practitioners' opinions about continuing professional development (CPD) and potential barriers to translating research findings into clinical dental practice. DESIGN: Qualitative focus group and interviews. SUBJECTS, SETTING AND METHODS: Four semi-structured interviews and a single focus group were conducted with 11 general dental practitioners in North East England. OUTCOME MEASURE: Transcripts were analysed using the constant comparative method to identify emergent themes. RESULTS: The key theme for practitioners was a need to interact with colleagues in order to make informed decisions on a range of clinical issues. For some forms of continuing professional development the value for money and subsequent impact upon clinical practice was limited. There were significant practice pressures that constrained the ability of practitioners to participate in certain educational activities. The relevance of some research findings and the formats used for their dissemination were often identified as barriers to their implementation in general dental practice. CONCLUSIONS: There are a number of potential barriers that exist in general dental practice to the uptake and implementation of translational research. CPD plays a pivotal role in this process and if new methods of CPD are to be developed consideration should be given to include elements of structured content and peer review that engages practitioners in a way that promotes implementation of contemporary research findings.


Subject(s)
Dentists/psychology , Education, Dental, Continuing/organization & administration , General Practice, Dental/organization & administration , Attitude of Health Personnel , Dental Research , England , Focus Groups , Humans
6.
Br Dent J ; 216(6): 275-9, 2014 Mar.
Article in English | MEDLINE | ID: mdl-24651332

ABSTRACT

This paper reviews the classification of periodontal-endodontic lesions and considers the pathways through which inflammatory lesions or bacteria may communicate between the pulp and the periodontium. Such communications have previously underpinned the classification of periodontal-endodontic lesions but a more up-to-date approach is to focus specifically on those lesions that originate concurrently as pulpal infection (and necrosis) and periodontal disease on the affected teeth. In doing so, both conventional periodontal and endodontic treatments are indicated for the affected teeth, although more complex management strategies may occasionally be indicated.


Subject(s)
Dental Pulp Diseases/classification , Dental Pulp Diseases/complications , Periodontal Diseases/classification , Periodontal Diseases/complications , Dental Pulp Diseases/diagnosis , Dental Pulp Diseases/therapy , Humans , Periodontal Diseases/diagnosis , Periodontal Diseases/therapy , Prognosis
7.
Int J Dent Hyg ; 11(4): 273-9, 2013 Nov.
Article in English | MEDLINE | ID: mdl-23683080

ABSTRACT

OBJECTIVES: To investigate the site- and patient-level factors that impact on the response to non-surgical periodontal therapy in patients with chronic periodontitis. METHODS: A retrospective evaluation of clinical outcomes following non-surgical periodontal therapy delivered by dental hygienists in training was undertaken. Case notes from 195 patients with chronic periodontitis were reviewed and clinical data pre- and post-treatment abstracted. Patients were categorized as 'responders' or 'non-responders' according to defined outcome criteria, and the relationship between clinical and demographic variables and treatment outcomes was assessed. RESULTS: Overall, there was a good response to the periodontal treatment. At deep sites (those with pretreatment probing depth ≥5 mm), the mean probing depth reduction was 1.6 ± 0.9 mm. Seventy-one (36%) patients were classified as non-responders (indicating that at least 30% of their deep sites did not improve by at least 2 mm following treatment). The non-responding group contained a significantly greater proportion of smokers (28%) than the responding group (16%). Plaque scores did not differ significantly between responders or non-responders either pre- or post-treatment. Regression analyses indicated that smoking status (odds ratio, OR: 2.04), mean pretreatment probing depth (OR: 1.49) and percentage of deep sites ≥5 mm at pretreatment (OR: 1.02) were significantly associated with response to treatment. CONCLUSION: This study supports the benefits of non-surgical therapy in the treatment of chronic periodontitis by dental hygienists in training. Better responses to treatment tend to be observed in non-smokers and in those with less advanced periodontitis at baseline.


Subject(s)
Chronic Periodontitis/therapy , Dental Hygienists/education , Periodontal Debridement/methods , Chronic Periodontitis/classification , Cohort Studies , Dental Plaque/therapy , Dental Plaque Index , Dental Scaling/methods , Female , Follow-Up Studies , Gingival Hemorrhage/therapy , Humans , Male , Middle Aged , Motivation , Oral Hygiene/education , Periodontal Index , Periodontal Pocket/classification , Periodontal Pocket/therapy , Retrospective Studies , Root Planing/methods , Smoking , Treatment Outcome
8.
J Dent Res ; 88(6): 524-8, 2009 Jun.
Article in English | MEDLINE | ID: mdl-19587156

ABSTRACT

Smoking cessation improves the clinical manifestations of periodontitis; however, its effect on the subgingival biofilm, the primary etiological agent of periodontitis, is unclear. The purpose of this study was to investigate, longitudinally, if smoking cessation altered the composition of the subgingival microbial community, by means of a quantitative, cultivation-independent assay for bacterial profiling. Subgingival plaque was collected at baseline, and 3, 6, and 12 months post-treatment from smokers who received root planing and smoking cessation counseling. The plaque was analyzed by terminal restriction fragment length polymorphism (t-RFLP). Microbial profiles differed significantly between smokers and quitters at 6 and 12 months following smoking cessation. The microbial community in smokers was similar to baseline, while quitters demonstrated significantly divergent profiles. Changes in bacterial levels contributed to this shift. These findings reveal a critical role for smoking cessation in altering the subgingival biofilm and suggest a mechanism for improved periodontal health associated with smoking cessation.


Subject(s)
Dental Plaque/microbiology , Smoking Cessation , Chronic Periodontitis/microbiology , Chronic Periodontitis/therapy , DNA, Bacterial/analysis , Dental Scaling , Host-Pathogen Interactions , Humans , Longitudinal Studies , Polymorphism, Restriction Fragment Length , Smoking
9.
Br Dent J ; 201(2): 109-13; discussion 99, 2006 Jul 22.
Article in English | MEDLINE | ID: mdl-16841084

ABSTRACT

OBJECTIVE: To undertake a questionnaire-based survey to determine the attitudes and activities of dental professionals in primary care in the Northern Deanery of the UK in relation to providing smoking cessation advice. METHODS: Questionnaires for dentists, hygienists and dental nurses were sent to hygienists to distribute to other members of the team. The information collected included: smoking status of the professionals and the practice; roles of the dental team in giving smoking cessation advice; levels of training received; and potential barriers to giving this brief intervention. RESULTS: Over 90% of practices were smoke-free environments and significantly more dental nurses (23%) were smokers compared to dentists (10%) and hygienists (7%) (p<0.01). The majority of dentists and hygienists enquired about smoking status of their patients and all three groups believed that hygienists and dentists should offer brief smoking cessation advice. Potential barriers to delivering smoking cessation advice were identified: lack of remuneration; lack of time; and lack of training. CONCLUSION: Dental teams in primary care are aware of the importance of offering smoking cessation advice and, with further training and appropriate remuneration, could guide many of their patients who smoke to successful quit attempts.


Subject(s)
Attitude of Health Personnel , Dental Staff/psychology , Smoking Cessation , Analysis of Variance , Chi-Square Distribution , Counseling , Dentist-Patient Relations , Education, Dental, Continuing , Fees, Dental , Humans , Practice Patterns, Dentists'/statistics & numerical data , Professional Role , Surveys and Questionnaires , Time Management
10.
Br Dent J ; 200(5): 272-5; discussion 265, 2006 Mar 11.
Article in English | MEDLINE | ID: mdl-16528334

ABSTRACT

BACKGROUND: There are limited data on the utility of dental professionals in providing smoking cessation counselling in the UK. OBJECTIVES: The purpose of this study was to determine quit rates for smokers with chronic periodontitis who were referred to a dental hospital for treatment. MATERIALS AND METHODS: Forty-nine subjects with chronic periodontitis who smoked cigarettes were recruited. All subjects received periodontal treatment and smoking cessation advice as part of an individual, patient-based programme provided by dental hygienists trained in smoking cessation counselling. Smoking cessation interventions included counselling (all patients), and some patients also received nicotine replacement therapy (NRT) and/or Zyban medication. Smoking cessation advice was given at each visit at which periodontal treatment was undertaken (typically four to six visits) over a period of 10-12 weeks. Smoking cessation advice was also given monthly during the programme of supportive periodontal care over the following nine months. Smoking status was recorded at three, six and 12 months and was confirmed with carbon monoxide (CO) monitors and salivary cotinine assays. RESULTS: Forty-one per cent, 33%, 29% and 25% of patients had stopped smoking at week four, months three, six and 12, respectively. Gender, age, the presence of another smoker in the household, and baseline smoking status (determined using subject-reported pack years of smoking) were not significant predictors of quit success (P < 0.05). Baseline CO levels were significantly associated with quit success, however, and were significantly higher in those subjects who continued to smoke compared to those subjects who were quitters at week four, month three and month six (P < 0.05). CONCLUSION: Success rates in quitting smoking following smoking cessation advice given as part of a periodontal treatment compared very favourably to national quit rates achieved in specialist smoking cessation clinics. The dental profession has a crucial role to play in smoking cessation counselling, particularly for patients with chronic periodontitis.


Subject(s)
Counseling , Periodontitis/complications , Smoking Cessation , Adult , Breath Tests , Bupropion/therapeutic use , Carbon Monoxide/analysis , Central Nervous System Stimulants/therapeutic use , Chronic Disease , Cohort Studies , Cotinine/analysis , Dental Hygienists , Dopamine Uptake Inhibitors/therapeutic use , Female , Follow-Up Studies , Humans , Longitudinal Studies , Male , Nicotine , Patient Education as Topic , Periodontitis/therapy , Professional-Patient Relations , Saliva/chemistry , Smoking/adverse effects , Treatment Outcome
11.
J Clin Periodontol ; 33(4): 241-53, 2006 Apr.
Article in English | MEDLINE | ID: mdl-16553633

ABSTRACT

BACKGROUND: Smoking has been identified as a significant risk factor for periodontal diseases and is regarded as being responsible for incomplete or delayed healing in patients following treatment. AIM AND METHOD: The aim of this conventional review was to review, collate and tabulate the relative effectiveness of treatments of chronic periodontitis in smokers, non-smokers and ex-smokers. OBSERVATIONS: The majority of clinical trials show significantly greater reductions in probing depths and bleeding on probing, and significantly greater gain of clinical attachment following non-surgical and surgical treatments in non-smokers compared with smokers. This benefit is also seen at class I and II furcation sites and in patients prescribed systemic or local antimicrobial treatments. CONCLUSIONS: Data from epidemiological, cross-sectional and case-control studies strongly suggest that quitting smoking is beneficial to patients following periodontal treatments. The periodontal status of ex-smokers following treatment suggests that quitting the habit is beneficial although there are only limited data from long-term longitudinal clinical trials to demonstrate unequivocally the periodontal benefit of quitting smoking.


Subject(s)
Periodontal Diseases/therapy , Smoking/adverse effects , Chronic Disease , Humans , Periodontitis/therapy , Risk Factors , Smoking Cessation
12.
J Clin Periodontol ; 33(3): 172-6, 2006 Mar.
Article in English | MEDLINE | ID: mdl-16489942

ABSTRACT

AIM: To explore the possibility of using plaque weight rather than plaque index as a more objective, clinical outcome measure in periodontal clinical trials. MATERIALS AND METHODS: The study initially recruited 12 healthy volunteers who abstained from tooth cleaning for 24 h on each of the three occasions and then for 48 h on each of a further three occasions to accumulate plaque. On a further three visits, the subjects abstained from tooth cleaning for 24 h and then brushed with a powered toothbrush for 2 min. A split-mouth design with target teeth was adopted and plaque was first scored separately on each side of the mouth using the Turesky modification of the Quigley and Hein plaque index. Post-brushing residual plaque was also scored after tooth cleaning. Inter-proximal plaque was dried, removed, pooled and weighed: on one side of the mouth from the entire inter-proximal surfaces; and from beneath the contact points on the contra-lateral side. RESULTS: Discriminant validity showed the index to have an advantage over weight in discerning between 24- and 48-h plaque deposits, and between 24-h plaque and post-brushing plaque. Test-retest validity confirmed that for repeated plaque growth, variability within subjects was greater than the variability between subjects. There was an association between plaque weight and plaque index although the regression lines were non-linear. CONCLUSION: There appears to be no significant advantage in using plaque weight in periodontal clinical trials.


Subject(s)
Dental Plaque Index , Dental Plaque/pathology , Adolescent , Adult , Bicuspid/pathology , Calibration , Cohort Studies , Coloring Agents , Dental Plaque/classification , Dental Plaque/therapy , Humans , Molar/pathology , Observer Variation , Pilot Projects , Reproducibility of Results , Time Factors , Toothbrushing/instrumentation
13.
J Clin Periodontol ; 32(11): 1157-62, 2005 Nov.
Article in English | MEDLINE | ID: mdl-16212577

ABSTRACT

OBJECTIVES: To evaluate the crossover clinical trial design to assess plaque removal efficacy of the Sonicare Elite. MATERIAL AND METHODS: A single-cohort, 12-week, two-treatment, single-blind, crossover clinical trial recruited 45 subjects. Plaque was recorded using the modified Quigley and Hein index plaque index (PI). After screening, subjects used the toothbrush for 2 weeks and were reminded to abstain from tooth cleaning 12-18 h prior to appointments. At visit two, subjects were randomized to 2 or 2(1/2) min. brushing time. PIs was recorded pre- and post-brushing. Subjects brushed for the allocated time for a further 2 weeks. At visit 3, PIs were recorded pre- and post-brushing. Two weeks later, at visit 4, the subjects crossed over and the protocol was repeated. RESULTS: There was no evidence of a learning effect within each arm of the crossover. A significant period effect was detected; however, no significant treatment by period effect was found. 2(1/2) min. brushing removed more plaque at full mouth (p=0.037), smooth (p=0.012) and lingual (p=0.002) sites compared with 2 min. CONCLUSION: The crossover design is a valid model for assessing plaque removal efficacy in tooth-brushing studies where no carry-over effect is clinically plausible.


Subject(s)
Dental Plaque/therapy , Toothbrushing/methods , Adolescent , Adult , Aged , Analysis of Variance , Cross-Over Studies , Dental Plaque Index , Humans , Middle Aged , Single-Blind Method , Time Factors
14.
J Clin Periodontol ; 32(8): 869-79, 2005 Aug.
Article in English | MEDLINE | ID: mdl-15998271

ABSTRACT

OBJECTIVES: To evaluate longitudinally the effect of smoking cessation on clinical and radiographic outcomes following non-surgical treatment in smokers with chronic periodontitis. MATERIAL AND METHODS: Forty-nine smokers with chronic periodontitis who wished to quit smoking were recruited. Full-mouth probing depths, bleeding and plaque data were recorded at baseline, 3, 6 and 12 months. Clinical attachment levels were recorded at target sites and subtraction radiography was used to assess bone density changes. Patients received non-surgical periodontal therapy during the first 3 months and supportive periodontal care over the remainder of the study. Smoking cessation counselling was provided according to individual need. RESULTS: After 12 months, of patients with complete data, 10 had continuously quit smoking (20% of the original population), 10 continued smoking and six were oscillators (those patients who quit and then relapsed). There were no differences between the groups following treatment with respect to mean clinical or radiographic parameters. Analysis of probing depth reductions between baseline and month 12, however, and comparing quitters with the other two groups combined, demonstrated a significant difference in favour of quitters (p<0.05). Furthermore, quitters were significantly more likely to demonstrate probing depth reductions > or =2 and > or =3 mm than non-quitters and oscillators (p<0.05). CONCLUSION: Quitting smoking has an additional beneficial effect in reducing probing depths following non-surgical treatment over a 12-month period.


Subject(s)
Dental Scaling , Periodontitis/therapy , Smoking Cessation , Adult , Analysis of Variance , Chronic Disease , Dental Plaque Index , Female , Humans , Longitudinal Studies , Male , Middle Aged , Periodontal Index , Periodontal Pocket/pathology , Radiography, Bitewing , Statistics, Nonparametric
15.
J Clin Periodontol ; 31(11): 1007-11, 2004 Nov.
Article in English | MEDLINE | ID: mdl-15491318

ABSTRACT

OBJECTIVE: To compare the Sonicare Elite with the Sonicare Advance in terms of the reduction in supragingival plaque in the posterior, hard-to-reach areas of the mouth. METHOD: This was a single-cohort, 6-week, two-treatment, single-blind, cross-over clinical trial that recruited 45 subjects. Plaque scores were recorded throughout the study using a modification of the Quigley and Hein plaque index (PI). All subjects had a minimum pre-brushing PI of 1.8 at screening following 24 h abstention from tooth cleaning. Subjects then used a Sonicare Advance powered toothbrush at home for 4 weeks for familiarisation purposes. At the next visit (2), subjects were given either the Sonicare Elite or the Sonicare Advance powered toothbrush for a further 2 weeks of home use. Twenty-four hours prior to visit 3, subjects abstained again from tooth cleaning. At visit 3, the PI was recorded pre- and post-tooth brushing and then all remaining "mature" plaque was removed professionally with a dental prophylaxis. After a further period of 24 h (to accumulate new plaque) without tooth brushing the subjects returned for visit 4 at which PIs were again recorded pre- and post-tooth brushing. The subjects were then given the second toothbrush in the cross-over sequence and attended for visits 5 and 6 at which the protocol for visits 3 and 4 was repeated. RESULTS: The Sonicare Elite powered toothbrush was more effective than the Sonicare Advance model in removing both mature and newly formed plaque. The magnitude of the differences between the toothbrushes for all posterior sites, interproximal and smooth surfaces, respectively, was 0.35 U (p<0.001), 0.39 U (p<0.001) and 0.32 U (p<0.001) of the modified Quigley and Hein PI. There was no evidence of a significant period effect comparing data from visits 5 and 6 against those from visits 3 and 4. There was, however, a significant visit effect with full-mouth (p<0.01), interproximal (p<0.001) and smooth surface (p<0.01) post-brushing plaque scores being significantly lower at visits 4 and 6 than at visits 3 and 5. CONCLUSION: The data support the observation that the Sonicare Elite toothbrush is more effective than the Sonicare Advance model in removing both newly formed and mature plaque from all posterior, interproximal and smooth tooth surfaces.


Subject(s)
Dental Devices, Home Care , Dental Plaque/therapy , Toothbrushing/instrumentation , Adolescent , Adult , Aged , Cohort Studies , Cross-Over Studies , Dental Plaque Index , Electricity , Equipment Safety , Humans , Middle Aged , Single-Blind Method
16.
J Clin Periodontol ; 31(9): 805-12, 2004 Sep.
Article in English | MEDLINE | ID: mdl-15312105

ABSTRACT

PRIMARY OBJECTIVE: To compare the relative efficacy of an oscillating/rotating powered toothbrush to that of a conventional manual toothbrush in a group of periodontal patients over a 16-month period with respect to plaque control. SECONDARY OBJECTIVE: To compare differences in pocket depth (PD) and bleeding index (BI) between the two groups over a 16-month period. MATERIAL AND METHODS: Forty patients were recruited to a 16-month, single-blind, two-group, randomised, parallel group clinical trial to compare the effects of manual and oscillating/rotating powered toothbrushes in a cohort of patients with chronic periodontitis. None of the patients had previous experience of using an oscillating/rotating brush and had a mean plaque index (PI) of > 2.0 (modified Quigley and Hein index) at baseline. Patients were stratified by gender, age and smoking status then randomised to using a manual or an oscillating/rotating brush for the duration of the study. Conventional non-surgical periodontal therapy was undertaken within the first month after baseline. PI was the primary outcome measure with PDs and BI also recorded at baseline and months 3, 6, 10 and 16. RESULTS: Mean full-mouth (FM) scores at baseline for oscillating/rotating brushing and manual brushing groups were as follows: PI, 3.4 and 3.5; BI, 1.7 and 1.5; and PD, 3.4 and 3.3. The mean reduction in FM scores from baseline to 16 months were: PI, 0.72 and 0.75; PD, 0.43 and 0.57; and BI, 0.74 and 0.83, respectively. Repeated measures ANOVA were used to compare differences between groups (adjusted for baseline levels) at months 3, 6, 10 and 16 and showed no statistically significant difference between groups for PI and PD (p > 0.05). A difference of 0.2 BI units was detected in favour of the manual brushing group (p = 0.04). CONCLUSION: Over a 16-month period, there were no differences in PI reduction or PD reduction between patients who underwent non-surgical management of chronic periodontal disease and used either an oscillating/rotating powered toothbrush or a conventional manual toothbrush. A difference in gingival bleeding reduction was detected in favour of the patients allocated the manual brush.


Subject(s)
Dental Devices, Home Care , Dental Plaque/prevention & control , Periodontitis/therapy , Toothbrushing/instrumentation , Adult , Aged , Analysis of Variance , Chronic Disease , Dental Plaque Index , Electricity , Equipment Design , Female , Humans , Male , Middle Aged , Periodontal Index , Single-Blind Method
17.
J Clin Periodontol ; 30(5): 409-13, 2003 May.
Article in English | MEDLINE | ID: mdl-12716332

ABSTRACT

OBJECTIVES: Primary objective - To determine the effect of varying brushing forces and brushing times upon the plaque-removing efficacy of a powered toothbrush. Secondary objective - to determine the optimum combination of brushing force and time for plaque removal. MATERIAL AND METHODS: This randomised, single-blind, 16-cell, cross-over trial compared the efficacy of plaque removal of a powered toothbrush (PTB) used with four brushing forces (75, 150, 225 and 300 g) and over four brushing times (30, 60, 120 and 180 s). Twelve volunteers (18-30 years) were recruited and trained to use the Philips/Jordan Sensiflex 2000 PTB, which was modified so that specified forces and times could be recorded. Each subject was asked to abstain from all oral hygiene procedures for 24 hs prior to each brushing event, to allow plaque accumulation. Plaque was recorded using a modified Quigley & Hein index (PI) at six points per tooth before and after each episode of brushing, and the differences in the means (pre- to postbrushing) were compared. Three-way anova was undertaken to compare differences between plaque-removing efficacy for the 16 combinations of force and time. Subjects, brushing time and brushing force were used as fixed effects within the analysis. RESULTS: All 12 subjects participating completed the 16 combinations of force and time over which plaque removal was assessed. Statistically significant differences in PI reductions were found between different brushing times and forces over all tooth surfaces (p<0.001). The interaction of varying brushing force and brushing time was significant for full mouth (FM) and interproximal (IP) sites (p<0.03). No statistical significance was demonstrated for smooth surface (SS) sites, nor was it detected for the interaction of subjects with brushing force or subjects with brushing time (p>0.05). CONCLUSION: We conclude that brushing time and brushing force have significant effects upon the level of plaque removal by a PTB, and at 120 s brushing time the improvement in plaque removal with forces in excess of 150 g was negligible.


Subject(s)
Dental Plaque/therapy , Toothbrushing/methods , Adult , Analysis of Variance , Cross-Over Studies , Dental Plaque/pathology , Dental Plaque Index , Electric Power Supplies , Equipment Design , Humans , Single-Blind Method , Stress, Mechanical , Time Factors , Tooth/pathology , Toothbrushing/instrumentation , Treatment Outcome
18.
J Clin Periodontol ; 29(9): 838-43, 2002 Sep.
Article in English | MEDLINE | ID: mdl-12423297

ABSTRACT

OBJECTIVES: The primary objective of this study was to evaluate the viability of an electronic data logger to record the brushing episodes of patients receiving standardised oral hygiene instructions. The secondary objective was to estimate the compliance of a group of patients diagnosed with chronic periodontal disease with brushing time instructions for the daily use of a powered toothbrush over a 2-month period. MATERIAL AND METHODS: 17 modified Philips Jordan Sensiflex 2000 powered toothbrushes (PTBs) were provided to patients (32-67 years) attending for non-surgical management of chronic periodontal disease. The PTBs incorporated an electronic data logger which recorded, for each individual brushing event: the length of time the brush was used (identifying the brushing speed setting); the maximum, minimum and average current during operation; and the time spent charging in between two consecutive brushing events. The patients were given detailed instructions with the PTB and were told to use it for 2 min each morning and 2 min in the evening. The patients returned for non-surgical management over two visits prior to reinforcement of the oral hygiene instructions 1 month after PTB allocation. Subjects were asked to complete a simple brushing diary to record their use of the toothbrush on a daily basis. After 2 months of using the PTBs at home, the brushes and diaries were collected and the data downloaded from the data loggers. RESULTS: Of the 17 data loggers allocated, two recorded no information and two subjects did not return for the follow-up appointments. The data from the remaining 13 data loggers were evaluated for level of compliance. An event of brushing between 120 and 130 s was considered to be compliant, one of between 90 and 120 or 130-150 s was partially compliant and brushing for < 90 s or > 150 s was recorded as non-compliant. Percentage compliance for all the events (2087 recordings) was 34%, partial- and non-compliance were calculated as: 18%; 48% of events, respectively. CONCLUSION: This data logger has provided previously unrecorded data on the brushing times for a group of patients using a powered toothbrush at home during non-surgical management of chronic periodontal disease. The data suggested that almost half (48%) of the brushing events recorded by the data loggers were greater than 30 s above or below the instructed brushing time.


Subject(s)
Data Collection/instrumentation , Patient Compliance , Periodontitis/therapy , Toothbrushing/instrumentation , Adult , Aged , Humans , Middle Aged , Records
19.
J Clin Periodontol ; 29(10): 889-95, 2002 Oct.
Article in English | MEDLINE | ID: mdl-12445220

ABSTRACT

PRIMARY OBJECTIVE: To evaluate a multicentre clinical trial design for testing powered toothbrushes. SECONDARY OBJECTIVE: To compare the efficacy of a prototype brush head (N2.3) for the Philips Jordan Sensiflex 2000 powered toothbrush (PTB) to that of Braun Oral-B D15 PTB in removing dental plaque MATERIAL AND METHODS: 137 volunteers (ages 18-25 years) were recruited to this 3-centre, 2-week, 2-group, 2-treatment, single-blind trial. Plaque was recorded at screening and again 14 days later at baseline. Stratification of subjects, for gender and screening PI, occurred at baseline. Subjects were then asked to abstain from all oral hygiene measures for 48 h followed by a supervised episode of brushing for 3 min with the allocated PTB. The allocated PTB was used at home for the next 12 days before a second abstinence from all oral hygiene measures for the 48 h prior to a second supervised brushing episode. Plaque levels were scored using a modification of the Quigley & Hein plaque index (PI) at full mouth (FM), interproximal (IP) and smooth surfaces (SS). To enable the means of the within subject differences (pre to postbrushing) to be compared between groups PIs were recorded before and after the supervised brushing episodes, differences between centres, groups and visits were examined. RESULTS: No significant differences in PI between groups at screening, baseline or prior to the supervised brushings were detected (P > 0.05 anova). The results of the analysis of variance showed there to be a highly significant difference (P < 0.001) between brushing groups, but, significant differences between centres (P < 0.001) and a significant interaction effect between centre and brushing group (P < 0.001) was also detected. Therefore the difference between groups was not present at all three centres. Further examination of the single centre data showed there to be greater levels of plaque removed by the N2.3 compared to the D15 (FM reduction in PI 1.95 vs. 1.13, respectively) at centre 3 in contrast to the other two centres where no difference was detected. The precise reason for these differences could not be established. CONCLUSIONS: A multicentre study design is applicable for evaluating PTBs but a minimum of 3 centres should be included so that differences between centres can be identified. The prototype brush head N2.3 for the Philips Jordan Sensiflex 2000 PTB has comparable plaque removal efficacy to the Braun Oral-B D15 PTB at FM, IP and SS sites.


Subject(s)
Dental Plaque/therapy , Toothbrushing/instrumentation , Adolescent , Adult , Analysis of Variance , Dental Plaque Index , Electricity , Equipment Safety , Female , Humans , Male , Multicenter Studies as Topic , Observer Variation , Reproducibility of Results , Sample Size , Single-Blind Method
20.
Adv Dent Res ; 16(1): 9-15, 2002 May.
Article in English | MEDLINE | ID: mdl-12161388

ABSTRACT

Powered toothbrushes are becoming increasingly popular among the general population, and there are many models on the market from which to choose. The design of these toothbrushes is changing constantly, as one would expect with a developing and expanding market, and from the dental professional's standpoint, it is difficult to evaluate products from the literature simply because the designs of clinical trials for powered toothbrushes are so varied. For example, the cohort recruited for testing the products is seldom the same from one study to the next. The aim of this paper is to provide a brief overview of the findings from some of the more contemporary trials of powered toothbrushes and to examine some of the factors that might have an effect on the observations and outcomes.


Subject(s)
Dental Devices, Home Care , Toothbrushing/instrumentation , Clinical Trials as Topic , Dental Plaque/prevention & control , Electricity , Equipment Design , Equipment Safety , Humans , Research Design
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