Assessment of chewing sugar-free gums for oral debris reduction: a randomized controlled crossover clinical trial.

PURPOSE: To assess the oral debris removal efficacy of two commercial sugar-free chewing gums, based on a newly developed oral debris scoring system. METHODS: A randomized, examiner-blinded, three-arm crossover study was conducted, with a 1-week washout period between the crossover phases. 42 healthy adults were randomly assigned to sugar-free stick gum (Wrigley's Extra Freshmint), sugar-free pellet gum (Wrigley's Extra Fruit) or no-gum chewing groups. Subjects consumed a single chocolate cookie, and were examined at baseline, and at 2-, 5-, and 10-minute time points with or without gum-chewing treatment. Primary outcome measures were oral debris scores on the occlusal surface, interproximal and gingival margin areas. The entire test procedure was repeated on two subsequent visits. RESULTS: The baseline conditions in the three groups did not differ significantly. Chewing either stick gum or pellet gum resulted in significantly lower oral debris scores (P < 0.0001) compared to the control (no-gum) treatment for all intraoral sites, while no significant difference was observed between the two chewing gum groups. Intra-examiner repeatability of the new scoring criteria was high throughout the study (Kappa > 0.90).

Oral hygiene status in relation to sociodemographic factors of children and adults who are hearing impaired, attending a special school.

This study examined the oral hygiene levels and periodontal status in a group of children and adults with hearing impairment attending a special school in Udaipur, India. Oral hygiene status was assessed by the Simplified Oral Hygiene Index (OHI-S) of Greene and Vermillion and periodontal status by the Community Periodontal Index. An analysis using a bivariate analysis revealed that all the oral hygiene variables varied significantly with age, economic status, and education of the parents. A multiple regression analysis showed that the education of the mother was the single best predictor for oral hygiene status and explained 92% of the variance. These findings show that children with hearing impairment have poor oral hygiene and high levels of periodontal disease. This may be due to a lack of communication; hence, appropriate oral health education should be tailored to the needs of these students with the support of their teachers and their parents.

Effects of 11-month interventions on oral cleanliness among the long-term hospitalised elderly.

OBJECTIVES: This trial studied the effects of interventions on the oral cleanliness of the long-term hospitalised elderly. BACKGROUND: Oral cleanliness is mostly poor in long-term facilities. While many agree on the importance of oral hygiene education for nursing personnel, little information and agreement exists on how to organise this education in geriatric institutions. MATERIALS AND METHODS: This is a longitudinal study with interventions. After a baseline clinical examination, the patient wards were divided into three groups (A, B and C) and the type of intervention was randomly assigned. In group A, dental hygienists provided oral hygiene measures for the subjects once every 3 weeks. In group B, the nursing staff first received hands-on instructions after which they assumed responsibility for the subjects' daily oral hygiene. Group C served as a control. Denture hygiene and dental hygiene were recorded at baseline and in the end of the 11-month study period. In total, 130 subjects completed the interventions; their mean age was 82.9 years. RESULTS: The best outcome in both denture and dental hygiene occurred when nursing staff at the wards took care of hygiene (group B). The increase in the proportion of those with good denture hygiene was the most prominent in group B (from 11% to 56%). The proportion of subjects with poor overall dental hygiene decreased from 61% at baseline to 57% in the end, for group B from 80% to 48%. CONCLUSIONS: Organised oral health education of the nursing staff should receive more attention.

Investigation of the cleanliness of dentures in a university hospital.

PURPOSE: The purpose of this study was to determine denture cleanliness of a population sample, as well as to investigate denture cleaning habits and attitudes. MATERIALS AND METHODS: Two hundred thirty-four denture-wearing patients were surveyed via a questionnaire to identify types and frequency of use of denture cleaning methods. Patients were also clinically examined to determine denture cleanliness. Dentures were classified as clean, dirty, or extremely dirty based on the level of debris and stain present. The oral mucosa was also examined and rated. RESULTS: The most common regimen employed was brushing with toothpaste (40.59% of patients), while only 1 patient reported soaking the denture in mouthwash. Results showed that 38.9% of patients were not satisfied with their cleansing methods, and 82.9% of patients claimed their dentists did not inform them how to clean their dentures. Only 11.9% of patients had clean dentures. Older dentures tended to be dirtier than newer ones (P = .0001) and had a higher incidence rate of accompanying denture stomatitis (P= .0001). CONCLUSION: In this population sample, most denture wearers did not clean their dentures satisfactorily.

Caries experience in existing and new nursing home residents in Adelaide, Australia.

OBJECTIVES: The Adelaide Dental Study of Nursing Homes was instigated to provide comprehensive information concerning oral disease experience, incidence and increments in a random sample of those older South Australians residing in Adelaide nursing homes. METHODS: This paper presents caries experience results for existing and new nursing home residents, and caries incidence and increments for existing residents, from dental inspections conducted at the baseline and one-year data collections. RESULTS: The residents in this study were very functionally dependent, medically compromised, cognitively impaired and behaviourally difficult older adults, the great majority of whom had moderate to severe cognitive impairment. Residents gave their carers many complex and challenging behavioural problems during oral hygiene care provision. Existing and new residents had similar dental history, oral hygiene, and sociodemographic characteristics, and similar cognitive, medical, functional, and nutritional status. Oral disease experience was high in both existing and new residents. There were no significant differences between existing and new residents for their dentate status, tooth status, coronal caries experience, or root caries experience, with the exceptions that new residents had significantly greater mean number of teeth, more filled coronal and root surfaces, and also new residents had significantly fewer decayed retained roots. Large numbers of tooth surfaces were covered in plaque and debris that negated more precise assessment of caries. The existing residents had caries increments on both coronal (2.5 surfaces) and root surfaces (1.0 surfaces) over the one-year period. Coronal caries incidence was 64% and root caries incidence was 49% of existing residents. CONCLUSIONS: Oral disease experience was high in both existing and new residents. There were few significant differences between existing and new residents' oral health status. New residents were being admitted to nursing homes with a compromised oral health status. Coronal and root caries increments and incidence were high for existing residents over the one-year period.

A study of oral health condition in individuals with no oral hygiene and its association with plaque acidogenesis.

OBJECTIVE: To study the association of long-term deposited plaque, due to lack of oral hygiene, with acidogenesis of the plaque bacteria. METHODS: Seventy-seven subjects with poor oral hygiene were selected. Debris index (DI) and calculus index (CI) were recorded. Among them, 16 were DMFS > 8, and comprised the caries active (CA) group; 27 were caries free, and comprised the caries free (CF) group. Plaque fluids in both groups were analyzed for organic acids, phosphate, and inorganic cations by use of capillary electrophoresis, while pH was measured by microelectrodes. RESULTS: No differences were found on debris index (CF group measured 2.07-0.47, CA group measured 2.01-0.53) or calculus index (CF group measured 2.47-0.50, CA group measured 2.48-0.53) relative to carious status, although there was a positive relationship between DI and CI (r = 0.52, P < 0.001). The main finding in this study was that the quantity of lactic acid produced by sucrose exposure in these individuals with poor oral hygiene was much less (increased no more than 2 times, compared with content at rest) than in a previous report (increased 3 to 5 times, compared with content at rest) on subjects with good oral hygiene habits. CONCLUSIONS: Long-term deposited plaque due to lack of oral hygiene may have less cariogenic capability, although patients' susceptibility to periodontal disease would increase.

Effect of two common Nigerian chewing sticks on gingival health and oral hygiene.

This study was conducted with the objective of assessing the effect on gingival health and oral hygiene of two chewing sticks, commonly used in a Yoruba community in Nigeria. Sixty, 12-year old primary school pupils participated in the study. After baseline data were collected on the status of oral hygiene and gingival health, complete prophylaxis was carried out on all the children. They were then divided into three groups to which toothbrushes, Pako Ijebu (Massularia acuminata) and Orin Ayan (Distemonanthus benthamianus) were assigned. They received instructions and supervision appropriate to the implement they were provided with. At the expiration of the six weeks intervention period, post-intervention readings were taken. There was no significant difference in the oral hygiene status between those using the toothbrush and those using the chewing sticks. Slight improvements were detected in the gingival status of those using the chewing sticks relative to those in the group using toothbrush. The best score was recorded among those using the Orin Ayan (D. Benthamianus). These differences were however not statistically significant. Even though an association between gingival health and use of these chewing sticks could not be drawn, it is suggested that further studies be conducted in this area.

Oral hygiene status of mentally handicapped school children in Ibadan, Nigeria.

This paper gives the state of oral hygiene in mentally handicapped school children aged 6-15 years in a Nigerian population. Oral hygiene was found to be poorer than in normal population. Institutional status, age and sex were found to be important determinants in oral hygiene status of this student group. Ways of improving the oral hygiene were highlighted.