Interproximal gingivitis and plaque reduction by four interdental products.

OBJECTIVE: The study was conducted to compare the performance of three interdental products to dental floss in the control and removal of plaque, and in the reduction of gingivitis. METHODOLOGY: One-hundred and twenty subjects were screened for the presence of interproximal sites of a size suitable for a GUMO Go-Betweens cleaner, and for being in compliance with inclusion and exclusion criteria. They were then assessed with the Plaque, Gingivitis, and Eastman Interdental Bleeding Indices (EIBI) at baseline, given a prophylaxis, randomly assigned to one of four products (Glide dental floss, Butler flossers, GUM Go-Betweens cleaners, and GUM Soft-Picks cleaners), and given product use instructions. Subjects returned at three weeks for a compliance review and at six weeks for a final visit. Plaque was assessed at the final visit before and after using the assigned products. Plaque, gingivitis, and bleeding scores were evaluated by analysis of covariance using the baseline measurements as the covariate. RESULTS: All four interdental products significantly reduced interdental plaque from baseline to before-use at the final visit (after six weeks) employing baseline plaque as a covariate. Reductions were 16% to 24%. Similarly, use of the products at the final visit resulted in 26% to 31% reductions in plaque with the before-use plaque as a covariate. Interdental gingivitis scores showed a reduction both lingually and buccally, with reductions ranging from 27% to 36% for the former and 34% to 53% for the latter (baseline was the covariate). No statistical differences were found between the products on the lingual interdental sites. The Go-Betweens cleaners showed a statistically greater reduction in the Gingival Index score buccally than the other three products. No differences were noted among the products for the EIBI. CONCLUSION: In this study, dental floss, the recognized "gold standard" for gingivitis reduction, was matched in performance by flossers and an interdental cleaner with small elastomeric fingers, and surpassed by an interdental brush. All products performed comparably for plaque reduction and removal.

Clinical evaluation of a novel whitening gel, containing 6% hydrogen peroxide and a standard fluoride toothpaste.

OBJECTIVES: The aim of this study was to determine the effect on tooth colour (after 1 and 2 weeks use) of a self-applied tooth-whitening gel containing 6% hydrogen peroxide using a novel applicator, compared to a standard fluoride toothpaste. METHODS: A 2-week, examiner-blind, stratified, parallel design clinical trial was conducted. Efficacy was measured by comparing the Vita shade scores recorded at baseline and after 1 and 2 weeks of product application. To qualify for the study, subjects were required to have at least one upper incisor/canine tooth measuring Vita shade A3 or darker. All upper incisors/canines of qualifying subjects were evaluated for change in Vita shade irrespective of their level of whiteness at baseline, allowing for the whitening gel to be tested on the full range of Vita tooth shades. One hundred and seventeen subjects were divided into two groups, balanced according to their darkest tooth shade. One group followed a 2-week, twice-daily regimen of brushing with toothpaste followed by the application of the hydrogen peroxide whitening gel. The other group brushed twice daily with toothpaste for 2 weeks. RESULTS: Subjects using the whitening gel showed a statistically significant improvement, (p<0.05) in mean tooth shade score of 0.75 and 1.02 units after 1 and 2 weeks, compared to baseline. These improvements from baseline were significantly greater than those observed for the toothpaste only group (0.14 and 0.35 units change after 1 and 2 weeks). CONCLUSIONS: The self-applied tooth-whitening gel containing 6% hydrogen peroxide has been shown to significantly improve the whiteness of teeth after 1 and 2 weeks of product use, compared to the baseline and the toothpaste only group.

An investigation into the effect of three months' clinical wear on toothbrush efficacy: results from two independent studies.

OBJECTIVE: Limited evidence has suggested that a worn toothbrush may be significantly less effective than a new brush with respect to plaque removal. Two independent studies, one with a manual toothbrush and one with a powered toothbrush, were undertaken to compared the ability of these toothbrushes as new and after three months' use to remove plaque. METHODOLOGY: Subjects from a general population were given either an Oral-B CrossAction manual toothbrush (Study 1) or a Braun Oral-B Battery (D4) toothbrush (Study 2). They were instructed to use their respective toothbrushes twice per day for a period of three months. After this time, those subjects meeting the studies' respective inclusion criteria entered the single-use, cross-over phase of the two studies. Both studies involved disclosing the teeth prior to measuring plaque. In Study 1, plaque was recorded using the Proximal Marginal Plaque Index and subjects brushed for one minute, by random assignment, with either a new or a worn toothbrush. In Study 2, plaque was measured using the Modified Quigley-Hein Plaque Index and subjects brushed for two minutes with either new or used brush heads, by random assignment. After a period of approximately one week, subjects returned to the test facilities and brushed with the alternate brush. RESULTS: Study 1 showed that both the new and the worn CrossAction toothbrushes significantly reduced plaque scores (p < 0.0001). A comparison of the two toothbrushes revealed no significant difference for whole-mouth plaque scores; however, at approximal sites the new toothbrush was significantly more effective than the worn brush (p = 0.033). In Study 2, as in Study 1, brushing with either a new or a worn brush head significantly reduced plaque scores (p < 0.0001). A comparison of the efficacies of the new and worn D4 toothbrushes revealed a non-significant tendency for the new brush head to remove more plaque than the worn brush head. However, when plaque removal was assessed for subjects using brush heads with the most extreme wear, i.e., scores of 3 or 4 (n = 15), a significant difference (p < 0.05) between new and worn brush heads was observed for the whole-mouth and approximal surfaces. CONCLUSION: The results from these two studies provide further data in support of the hypothesis that a worn toothbrush is less efficient with respect to plaque removal than a new brush. Patients should therefore be encouraged to replace their toothbrush regularly before bristle wear becomes excessive.