Efficacy of straight versus angled interdental brushes on interproximal tooth cleaning: a randomized controlled trial.

BACKGROUND: To investigate interproximal biofilm reduction with an angled interdental brush as compared to a straight interdental brush (standard control) in a clinical, single-centre, single-blind, controlled, parallel-group trial. METHODS: Recruitment and examinations of the subjects were performed at the Witten/Herdecke University School of Dental Medicine. 128 volunteers, aged 20-65 years, were recruited and stratified according to sex and age. Two groups with 64 subjects each used either straight (standard control) or angled (test group) handgripped interdental toothbrushes of the same bristle stiffness. After a 12-day home-care habituation period, participants received a professional tooth cleaning followed by a 48-h plaque regrowth period. At the intervention appointment, plaque was recorded with a fluorescent revelator and soft tissue damage was noted (T0 ). Interdental brushing was performed by the participant for 2 min, and clinical parameters were recorded again (T1 ). The primary efficacy end point was the difference in modified Proximal Plaque Index (mPPI) after brushing compared to baseline. Secondary efficacy end points were mPPI differences in subgroups (anterior vs. posterior teeth; vestibular vs. oral tooth surfaces). Safety end point was the Danser gingival abrasion index (DI). RESULTS: mPPI showed lower scores after brushing within all (sub)groups (P < 0.01). mPPI brushing efficacy (ΔT0  - T1 ) in subjects using straight interdental brushes was significantly higher as compared to angled interdental brushes (P < 0.0001). Straight interdental brushes were significantly more effective in posterior teeth, when used from vestibular and from oral tooth surfaces (P < 0.0001, P < 0.01 and P < 0.0001, respectively). No significant differences were found between the groups in anterior teeth and concerning soft tissue damage. CONCLUSIONS: Straight interdental brushes may better remove plaque interproximally when compared to angled interdental brushes.

Pilot pathfinder survey of oral hygiene and periodontal conditions in the rural population of The Gambia (West Africa).

OBJECTIVE: To document oral hygiene and periodontal conditions in the rural population of The Gambia. BASIC RESEARCH DESIGN: Cross-sectional study according to the recommendations of the WHO for oral health surveys. CLINICAL SETTING: Examination by two calibrated investigators in the health centres of rural communities after a public radio call. Patients were randomly allocated to the investigators. PARTICIPANTS: 162 patients (20-54 years old; 52.5% female, 47.5% male). INTERVENTIONS: Patients were interviewed for personal information and examined in a full-mouth recording. MAIN OUTCOME MEASURES: Oral Hygiene Index (OHI), Gingival Index (GI), Community Periodontal Index (CPI), and the Gingivitis-Periodontitis-Missing/Teeth Index (GPM/T). Statistical analysis was performed using the Wilcoxon-rank-sum test and Kruskal-Wallis test with statistical significance at P < 0.05. RESULTS: OHI increased by age from 6.9 to 9.2 (P < 0.05) and showed in tendency higher levels in men (P = 0.07), while the GI remained stable at 1.2. Community Periodontal Index codes increased by age (P < 0.05) and showed a fourfold higher prevalence for severe periodontitis in males (P < 0.05). Likewise, an age-related increase in GPM/T was evident (20.5 versus 25.4), significantly in the number of moderate periodontitis and missing teeth (P < 0.05). In GPM/T, males again demonstrated significantly more teeth affected by periodontitis than women. No statistical associations were found between ethnic groups or for different oral hygiene methods concerning CPI or GPM/T. CONCLUSIONS: Prevalence of predominantly mild to moderate periodontal disease indicates treatment needs that should be considered when developing a national oral health care plan in The Gambia (West Africa).