In a review of evidence for dental hygiene techniques, only a few were able to provide additional protection against gingivitis and periodontitis beyond brushing one’s teeth with a basic toothbrush.
The paper was published in the Journal of the International Academy of Periodontology and examines the effectiveness of various oral hygiene devices.
At the moment, all other oral hygiene interventions are only supported by insufficient evidence, said principal investigator Frank Scannapieco, DMD, PhD, professor of oral biology in the UB School of Dental Medicine. The findings, he said, will help identify best practices for preventing gum disease.
“Patients can be confident that the oral care tools and practices supported by research, as described in the paper, will prevent the initiation and progression of periodontal disease, if they are performed regularly and properly,” said Prof Scannapieco.
The list of proven techniques includes: basic toothbrush; interdental brush; water pick; chlorhexidine gluconate (CHX), cetylpyridinium chloride (CPC) and essential oil (Listerine) mouth rinses.
Tooth brushing is the cornerstone of daily oral hygiene and is a reliable way to control dental plaque, said Scannapieco. Interdental brushes and water picks also performed better than other interdental oral hygiene devices at reducing gingivitis, and both should be used in combination with daily tooth brushing to prevent gum disease.
Mouth rinses based on CHX, CPC, and essential oils (such as Listerine) were proven to be effective at significantly reducing plaque and gingivitis.
While not effective at fighting gingivitis, toothpicks were useful for monitoring gum health, said Prof Scannapieco. By gently prodding the gums with a toothpick and monitoring for bleeding, patients could detect signs of gum disease.
While triclosan toothpastes and mouth rinses significantly reduced plaque and gingivitis, the compound is linked to cancer development and reproductive defects, and has been removed from most toothpastes in the US.
Unfortunately for those who invested in one, electric-powered toothbrushes are no more effective at reducing plaque and gingivitis than a basic toothbrush, the researchers found. And little evidence has been published in support of dental floss – the mainstay of interdental cleaning – to reduce plaque and gingivitis. However, Prof Scannapieco said that flossing is still necessary:
“While there are few studies available that specifically examined toothbrushes or floss alone, both are still essential. Floss is especially useful to remove interdental plaque for people who have tight space between their teeth. Floss also likely reduces the risk for cavities that from between the teeth.”
Evidence was lacking for mouthwashes based on tea tree oil, green tea, anti-inflammatory agents, hydrogen peroxide, sodium benzoate, stannous fluoride, hexetidine or delmopinol reduced gingivitis.
Though promising as a preventive strategy against gum disease, the effectiveness of probiotics was unproven. There was also little evidence for dietary supplements improving gum health. The investigators also found insufficient evidence that professional plaque removal (known as scaling, the process of removing plaque with a scraper) prevents gum disease.
Source: University at Buffalo
