Comparison of gingivitis and plaque efficacy of a battery-powered toothbrush and an ADA-provided manual toothbrush.

This examiner-blind clinical study evaluated the efficacy of a new battery-powered toothbrush with oscillating head (Colgate Actibrush) on established gingivitis and plaque at 15 days and again at 30 days, as compared to a control manual toothbrush (American Dental Association [ADA]-provided toothbrush, full head, soft bristles). A total of 63 participants completed the study. They were stratified into two balanced groups according to their mean baseline prebrushing plaque scores and were randomly assigned to use the battery-powered test toothbrush or the manual control toothbrush. Participants were instructed to brush their teeth twice daily (mornings and evenings) for 1 minute with their assigned toothbrush for the 30-day duration of the study. Gingivitis and plaque (pre- and postbrushing) examinations were conducted by the same dental examiner at baseline, after 15 days, and again after 30 days. The Colgate Actibrush demonstrated a significantly greater reduction of plaque (46.53%) and gingivitis (18.57%) when compared to the ADA-provided toothbrush after 30 days of use. Additionally, a comparison of the plaque scores for the battery-powered toothbrush at 15 and 30 days shows a continued reduction in plaque of more than 25% for a cumulative difference from baseline of 73%. These results support the conclusion that the new battery-powered toothbrush is clinically superior in plaque removal efficacy and gingivitis efficacy to the manual toothbrush, and continues to significantly improve plaque scores even up to 30 days of use.

The relative anticaries effectiveness of sodium monofluorophosphate and sodium fluoride as contained in currently available dentifrice formulations.

A 36-month double-blind clinical caries study was conducted to determine the comparative anticaries efficacy of sodium monofluorophosphate (MFP) and sodium fluoride (NaF) as incorporated in dentifrice formulations. The test dentifrices which were utilized are commercially available in the United States and all have been granted the American Dental Association Seal of Acceptance for anticaries efficacy. The study was conducted in accordance with the 1988 Guidelines of the American Dental Association Council on Dental Therapeutics. The two formulations used in the NaF versus MFP comparison were Colgate Winterfresh Gel with 0.76% sodium monofluorophosphate in a silica base and Crest Regular Flavor Toothpaste with 0.24% sodium fluoride in a silica base. A third commercially-available NaF dentifrice, Colgate Junior Toothpaste with 0.243% sodium fluoride in a silica base, was included in the study for further comparison. Schoolchildren residing in Maine, U.S.A. received a baseline caries clinical examination and then were randomly assigned to the twice-daily use of one of the three dentifrices which were purchased in the marketplace and repackaged in plain white tubes. Caries clinical examinations were subsequently conducted after 2 and 3 years' use of the dentifrices. A total of 2,222 children participated in both the 2 and 3-year caries clinical examinations. The 36-month DFS (decayed and filled surfaces) and the DFT (decayed and filled teeth) mean caries increments for the three dentifrice groups were virtually identical. The children using the MFP formulation experienced a DFS of 1.50 and a DFT of 1.08; those using the Crest NaF formulation experienced a DFS of 1.48 and a DFT of 1.07; subjects in the third group (Colgate Junior Toothpaste, 0.243% NaF) had a DFS of 1.49 and DFT of 1.06. The statistical evaluation of the data consisted of the calculation of 90% confidence bounds for the ratio of (true) mean increments, in accordance with the 1988 American Dental Association Guidelines. Expressed in the language of the Guidelines, the analyses indicated that, (1) the anticaries efficacy provided by the MFP formulation, (Colgate Winterfresh Gel with 0.76% MFP) is "as good as" that provided by the NaF formulation, (Crest Regular Flavor Toothpaste, with 0.243% NaF), and (2) the anticaries efficacy provided by the one NaF formulation (Colgate Junior Toothpaste, with 0.243% NaF) is "as good as" that provided by the other, (Crest Regular Flavor Toothpaste, with 0.243% NaF).

The efficacy of a novel toothbrush design.

The single-blind study compared a novel toothbrush design (Aquafresh Flex soft, medium, and firm bristle versions) to a widely-available, standard brush with soft bristles. Subjects (n = 32-35/group, mean age = 46 yrs) were randomly assigned to the four groups and instructed to maintain their normal oral hygiene routine. Safety, as well as plaque (Turesky et al. index as modified by Soparkar) and gingivitis (Loe-Silness index as modified by Lobene) were evaluated for the Ramfjord teeth at baseline, two weeks, and six weeks. At termination, all brands were considered to be safe. After two weeks, the mean plaque scores for each of the four groups were reduced significantly, although a difference between the control group and the test groups could not be demonstrated. Between two and six weeks, the mean plaque scores for the test brushes leveled off while the corresponding score for the control brush increased significantly (p = 0.02). The gingivitis scores showed a similar pattern. This pattern suggests more favorable user acceptance for the test brushes, which is consistent with information provided by the subjects on a post-study questionnaire. Presumably, this phenomenon is associated with the unique design of the test brushes.

Association of the microbial flora of dental plaque and saliva with human root-surface caries.

Dental plaque was obtained from one or two sound root surfaces of subjects with different degrees of root-surface caries experience. From subjects with root-surface caries, plaque samples were also obtained from either one incipient or one more advanced lesion. Proportions of the total flora were determined for total streptococci and different streptococcal species, total and different Actinomyces species, and lactobacilli. A sample of saliva was obtained from about one-third of the subjects for determination of the concentrations of mutans streptococci and lactobacilli. The main observations were: (1) Subjects without root-surface caries or restorations (group I), as compared with subjects with root-surface caries with or without restorations (group II), were characterized by having a lower prevalence and proportion of mutans streptococci and a higher prevalence and proportion of A. naeslundii in plaque on sound root surfaces; (2) subjects in group I also tended to have a lower salivary concentration of mutans streptococci and lactobacilli than subjects in group II; (3) dental plaque on sound surfaces in group II subjects contained a lower proportion of mutans streptococci than plaque associated with incipient or advanced lesions; and (4) the prevalence and proportion of lactobacilli in plaque associated with sound as well as carious root surfaces were very low. The data reinforce findings from other studies and indicate that, as for coronal caries, the plaque and saliva populations of mutans streptococci specifically are correlated positively with the presence of root-surface caries.

Long-term evaluation of a prebrushing dental rinse for the control of dental plaque and gingivitis.

One hundred and three adults completed a double-blind, 6-month controlled study to assess the effects of rinsing with Plax (Oral Care Division of Pfizer Inc., New York, NY) before brushing on plaque, gingivitis and calculus. All the parameters were evaluated at baseline and after three and six months of home use of either Plax or placebo rinse. Microbiological components of plaque were monitored. Following prolonged use as a prebrushing rinse, Plax was no more effective than placebo in reducing plaque, gingivitis and calculus.

Methodological issues relative to the quantification of root surface caries.

The purpose of this study was to assess the effect upon the quantification of root surface caries (RSC) of (1) the separation of the disease into its discrete clinical phases, (2) the confounding caused by the presence of restored abraded surfaces, and (3) the decision rule formulated for dealing with lesions and restorations which involve both crown and root. It was found that the apparent prevalence of RSC varied widely depending upon arbitrary decisions as to what stages of the disease were included in the measurement scheme. The addition of restorations (confined to the root) greatly enlarged the various disease measures, but probably also introduced some degree of error since there are several indications from the data and the clinical patterns of affected surfaces which suggest that some of the restored surfaces were formerly abraded rather than carious. The inclusion of lesions and restorations involving both root and crown produced another conspicuous increment in all disease measures, which is a cause for concern given that these components are included in some studies and ignored in others. These findings serve as the basis for several recommendations for future prevalence and incidence studies of RSC.

Clinical profiles of individuals with and without root surface caries.

As part of a collaborative multidisciplinary investigation of root surface caries (RSC), 273 subjects (median age = 57) were clinically evaluated for coronal caries, debris, calculus, gingivitis, periodontal pocketing, recession, abrasion, as well as RSC. The entire study group was divided into three subgroups: (1) subjects whose exposed root surface were without lesions or restorations (non-diseased individuals, n = 43); (2) subjects whose exposed root surfaces had one or more lesions and may or may not have had restorations (diseased individuals, n = 110); (3) subjects with one or more restorations but no lesions, since it was not known whether these restorations were preceded by RSC or abrasion the disease status of these individuals was unclear (n = 120). A comparison of Subgroup 1 (unequivocally non-diseased) and Subgroup 2 (unequivocally diseased) revealed that subjects without RSC had more teeth, less coronal caries, less recession, less debris, less calculus, less gingivitis, and more abrasion. We infer that the common factor underlying most if not all of the subgroup differences is oral hygiene which must therefore be a major disease determinant.

Reduced formation of supragingival calculus with use of fluoride-zinc chloride dentifrice.

Results of this comparative, double-blind, clinical study show that fluoride dentifrice with 2.0% zinc chloride is effective in reducing calculus accumulation after a dental prophylaxis. The data also confirm earlier observations on calculus formation in that accumulation was not constant during the two 3-month study phases.