Biomedical subjects

P A Heasman

Publications and source records attributed to P A Heasman.

At least 19 recordsLinked to original sources

PubMed2006

Smoking cessation as a dental intervention--views of the profession.

OBJECTIVE: To undertake a questionnaire-based survey to determine the attitudes and activities of dental professionals in primary care in the Northern Deanery of the UK in relation to providing smoking cessation advice. METHODS: Questionnaires for dentists, hygienists and dental nurses were sent to hygienists to distribute to other members of the team. The information collected included: smoking status of the professionals and the practice; roles of the dental team in giving smoking cessation advice; levels of training received; and potential barriers to giving this brief intervention. RESULTS: Over 90% of practices were smoke-free environments and significantly more dental nurses (23%) were smokers compared to dentists (10%) and hygienists (7%) (p<0.01). The majority of dentists and hygienists enquired about smoking status of their patients and all three groups believed that hygienists and dentists should offer brief smoking cessation advice. Potential barriers to delivering smoking cessation advice were identified: lack of remuneration; lack of time; and lack of training. CONCLUSION: Dental teams in primary care are aware of the importance of offering smoking cessation advice and, with further training and appropriate remuneration, could guide many of their patients who smoke to successful quit attempts.

Analysis of Variance↗

PubMed2006

Smoking cessation advice for patients with chronic periodontitis.

BACKGROUND: There are limited data on the utility of dental professionals in providing smoking cessation counselling in the UK. OBJECTIVES: The purpose of this study was to determine quit rates for smokers with chronic periodontitis who were referred to a dental hospital for treatment. MATERIALS AND METHODS: Forty-nine subjects with chronic periodontitis who smoked cigarettes were recruited. All subjects received periodontal treatment and smoking cessation advice as part of an individual, patient-based programme provided by dental hygienists trained in smoking cessation counselling. Smoking cessation interventions included counselling (all patients), and some patients also received nicotine replacement therapy (NRT) and/or Zyban medication. Smoking cessation advice was given at each visit at which periodontal treatment was undertaken (typically four to six visits) over a period of 10-12 weeks. Smoking cessation advice was also given monthly during the programme of supportive periodontal care over the following nine months. Smoking status was recorded at three, six and 12 months and was confirmed with carbon monoxide (CO) monitors and salivary cotinine assays. RESULTS: Forty-one per cent, 33%, 29% and 25% of patients had stopped smoking at week four, months three, six and 12, respectively. Gender, age, the presence of another smoker in the household, and baseline smoking status (determined using subject-reported pack years of smoking) were not significant predictors of quit success (P < 0.05). Baseline CO levels were significantly associated with quit success, however, and were significantly higher in those subjects who continued to smoke compared to those subjects who were quitters at week four, month three and month six (P < 0.05). CONCLUSION: Success rates in quitting smoking following smoking cessation advice given as part of a periodontal treatment compared very favourably to national quit rates achieved in specialist smoking cessation clinics. The dental profession has a crucial role to play in smoking cessation counselling, particularly for patients with chronic periodontitis.

Adult↗

PubMed2006

Measuring plaque in clinical trials: index or weight?

AIM: To explore the possibility of using plaque weight rather than plaque index as a more objective, clinical outcome measure in periodontal clinical trials. MATERIALS AND METHODS: The study initially recruited 12 healthy volunteers who abstained from tooth cleaning for 24 h on each of the three occasions and then for 48 h on each of a further three occasions to accumulate plaque. On a further three visits, the subjects abstained from tooth cleaning for 24 h and then brushed with a powered toothbrush for 2 min. A split-mouth design with target teeth was adopted and plaque was first scored separately on each side of the mouth using the Turesky modification of the Quigley and Hein plaque index. Post-brushing residual plaque was also scored after tooth cleaning. Inter-proximal plaque was dried, removed, pooled and weighed: on one side of the mouth from the entire inter-proximal surfaces; and from beneath the contact points on the contra-lateral side. RESULTS: Discriminant validity showed the index to have an advantage over weight in discerning between 24- and 48-h plaque deposits, and between 24-h plaque and post-brushing plaque. Test-retest validity confirmed that for repeated plaque growth, variability within subjects was greater than the variability between subjects. There was an association between plaque weight and plaque index although the regression lines were non-linear. CONCLUSION: There appears to be no significant advantage in using plaque weight in periodontal clinical trials.

Adolescent↗

PubMed2006

The effect of smoking on periodontal treatment response: a review of clinical evidence.

BACKGROUND: Smoking has been identified as a significant risk factor for periodontal diseases and is regarded as being responsible for incomplete or delayed healing in patients following treatment. AIM AND METHOD: The aim of this conventional review was to review, collate and tabulate the relative effectiveness of treatments of chronic periodontitis in smokers, non-smokers and ex-smokers. OBSERVATIONS: The majority of clinical trials show significantly greater reductions in probing depths and bleeding on probing, and significantly greater gain of clinical attachment following non-surgical and surgical treatments in non-smokers compared with smokers. This benefit is also seen at class I and II furcation sites and in patients prescribed systemic or local antimicrobial treatments. CONCLUSIONS: Data from epidemiological, cross-sectional and case-control studies strongly suggest that quitting smoking is beneficial to patients following periodontal treatments. The periodontal status of ex-smokers following treatment suggests that quitting the habit is beneficial although there are only limited data from long-term longitudinal clinical trials to demonstrate unequivocally the periodontal benefit of quitting smoking.

Chronic Disease↗

PubMed2005

The effect of quitting smoking on chronic periodontitis.

OBJECTIVES: To evaluate longitudinally the effect of smoking cessation on clinical and radiographic outcomes following non-surgical treatment in smokers with chronic periodontitis. MATERIAL AND METHODS: Forty-nine smokers with chronic periodontitis who wished to quit smoking were recruited. Full-mouth probing depths, bleeding and plaque data were recorded at baseline, 3, 6 and 12 months. Clinical attachment levels were recorded at target sites and subtraction radiography was used to assess bone density changes. Patients received non-surgical periodontal therapy during the first 3 months and supportive periodontal care over the remainder of the study. Smoking cessation counselling was provided according to individual need. RESULTS: After 12 months, of patients with complete data, 10 had continuously quit smoking (20% of the original population), 10 continued smoking and six were oscillators (those patients who quit and then relapsed). There were no differences between the groups following treatment with respect to mean clinical or radiographic parameters. Analysis of probing depth reductions between baseline and month 12, however, and comparing quitters with the other two groups combined, demonstrated a significant difference in favour of quitters (p<0.05). Furthermore, quitters were significantly more likely to demonstrate probing depth reductions > or =2 and > or =3 mm than non-quitters and oscillators (p<0.05). CONCLUSION: Quitting smoking has an additional beneficial effect in reducing probing depths following non-surgical treatment over a 12-month period.

Adult↗

PubMed2005

The crossover design to evaluate the efficacy of plaque removal in tooth-brushing studies.

OBJECTIVES: To evaluate the crossover clinical trial design to assess plaque removal efficacy of the Sonicare Elite. MATERIAL AND METHODS: A single-cohort, 12-week, two-treatment, single-blind, crossover clinical trial recruited 45 subjects. Plaque was recorded using the modified Quigley and Hein index plaque index (PI). After screening, subjects used the toothbrush for 2 weeks and were reminded to abstain from tooth cleaning 12-18 h prior to appointments. At visit two, subjects were randomized to 2 or 2(1/2) min. brushing time. PIs was recorded pre- and post-brushing. Subjects brushed for the allocated time for a further 2 weeks. At visit 3, PIs were recorded pre- and post-brushing. Two weeks later, at visit 4, the subjects crossed over and the protocol was repeated. RESULTS: There was no evidence of a learning effect within each arm of the crossover. A significant period effect was detected; however, no significant treatment by period effect was found. 2(1/2) min. brushing removed more plaque at full mouth (p=0.037), smooth (p=0.012) and lingual (p=0.002) sites compared with 2 min. CONCLUSION: The crossover design is a valid model for assessing plaque removal efficacy in tooth-brushing studies where no carry-over effect is clinically plausible.

Adolescent↗

PubMed2004

A clinical comparison of an oscillating/rotating powered toothbrush and a manual toothbrush in patients with chronic periodontitis.

OBJECTIVES PRIMARY OBJECTIVE: To compare the relative efficacy of an oscillating/rotating powered toothbrush to that of a conventional manual toothbrush in a group of periodontal patients over a 16-month period with respect to plaque control. SECONDARY OBJECTIVE: To compare differences in pocket depth (PD) and bleeding index (BI) between the two groups over a 16-month period. MATERIAL AND METHODS: Forty patients were recruited to a 16-month, single-blind, two-group, randomised, parallel group clinical trial to compare the effects of manual and oscillating/rotating powered toothbrushes in a cohort of patients with chronic periodontitis. None of the patients had previous experience of using an oscillating/rotating brush and had a mean plaque index (PI) of > 2.0 (modified Quigley and Hein index) at baseline. Patients were stratified by gender, age and smoking status then randomised to using a manual or an oscillating/rotating brush for the duration of the study. Conventional non-surgical periodontal therapy was undertaken within the first month after baseline. PI was the primary outcome measure with PDs and BI also recorded at baseline and months 3, 6, 10 and 16. RESULTS: Mean full-mouth (FM) scores at baseline for oscillating/rotating brushing and manual brushing groups were as follows: PI, 3.4 and 3.5; BI, 1.7 and 1.5; and PD, 3.4 and 3.3. The mean reduction in FM scores from baseline to 16 months were: PI, 0.72 and 0.75; PD, 0.43 and 0.57; and BI, 0.74 and 0.83, respectively. Repeated measures ANOVA were used to compare differences between groups (adjusted for baseline levels) at months 3, 6, 10 and 16 and showed no statistically significant difference between groups for PI and PD (p > 0.05). A difference of 0.2 BI units was detected in favour of the manual brushing group (p = 0.04). CONCLUSION: Over a 16-month period, there were no differences in PI reduction or PD reduction between patients who underwent non-surgical management of chronic periodontal disease and used either an oscillating/rotating powered toothbrush or a conventional manual toothbrush. A difference in gingival bleeding reduction was detected in favour of the patients allocated the manual brush.

Adult↗

PubMed2004

Efficacy of plaque removal of the Sonicare Elite versus the Sonicare Advance from hard-to-reach sites.

OBJECTIVE: To compare the Sonicare Elite with the Sonicare Advance in terms of the reduction in supragingival plaque in the posterior, hard-to-reach areas of the mouth. METHOD: This was a single-cohort, 6-week, two-treatment, single-blind, cross-over clinical trial that recruited 45 subjects. Plaque scores were recorded throughout the study using a modification of the Quigley and Hein plaque index (PI). All subjects had a minimum pre-brushing PI of 1.8 at screening following 24 h abstention from tooth cleaning. Subjects then used a Sonicare Advance powered toothbrush at home for 4 weeks for familiarisation purposes. At the next visit (2), subjects were given either the Sonicare Elite or the Sonicare Advance powered toothbrush for a further 2 weeks of home use. Twenty-four hours prior to visit 3, subjects abstained again from tooth cleaning. At visit 3, the PI was recorded pre- and post-tooth brushing and then all remaining "mature" plaque was removed professionally with a dental prophylaxis. After a further period of 24 h (to accumulate new plaque) without tooth brushing the subjects returned for visit 4 at which PIs were again recorded pre- and post-tooth brushing. The subjects were then given the second toothbrush in the cross-over sequence and attended for visits 5 and 6 at which the protocol for visits 3 and 4 was repeated. RESULTS: The Sonicare Elite powered toothbrush was more effective than the Sonicare Advance model in removing both mature and newly formed plaque. The magnitude of the differences between the toothbrushes for all posterior sites, interproximal and smooth surfaces, respectively, was 0.35 U (p<0.001), 0.39 U (p<0.001) and 0.32 U (p<0.001) of the modified Quigley and Hein PI. There was no evidence of a significant period effect comparing data from visits 5 and 6 against those from visits 3 and 4. There was, however, a significant visit effect with full-mouth (p<0.01), interproximal (p<0.001) and smooth surface (p<0.01) post-brushing plaque scores being significantly lower at visits 4 and 6 than at visits 3 and 5. CONCLUSION: The data support the observation that the Sonicare Elite toothbrush is more effective than the Sonicare Advance model in removing both newly formed and mature plaque from all posterior, interproximal and smooth tooth surfaces.

Adolescent↗

PubMed2003

Effect of brushing force and time on plaque removal using a powered toothbrush.

OBJECTIVES: Primary objective - To determine the effect of varying brushing forces and brushing times upon the plaque-removing efficacy of a powered toothbrush. Secondary objective - to determine the optimum combination of brushing force and time for plaque removal. MATERIAL AND METHODS: This randomised, single-blind, 16-cell, cross-over trial compared the efficacy of plaque removal of a powered toothbrush (PTB) used with four brushing forces (75, 150, 225 and 300 g) and over four brushing times (30, 60, 120 and 180 s). Twelve volunteers (18-30 years) were recruited and trained to use the Philips/Jordan Sensiflex 2000 PTB, which was modified so that specified forces and times could be recorded. Each subject was asked to abstain from all oral hygiene procedures for 24 hs prior to each brushing event, to allow plaque accumulation. Plaque was recorded using a modified Quigley & Hein index (PI) at six points per tooth before and after each episode of brushing, and the differences in the means (pre- to postbrushing) were compared. Three-way anova was undertaken to compare differences between plaque-removing efficacy for the 16 combinations of force and time. Subjects, brushing time and brushing force were used as fixed effects within the analysis. RESULTS: All 12 subjects participating completed the 16 combinations of force and time over which plaque removal was assessed. Statistically significant differences in PI reductions were found between different brushing times and forces over all tooth surfaces (p<0.001). The interaction of varying brushing force and brushing time was significant for full mouth (FM) and interproximal (IP) sites (p<0.03). No statistical significance was demonstrated for smooth surface (SS) sites, nor was it detected for the interaction of subjects with brushing force or subjects with brushing time (p>0.05). CONCLUSION: We conclude that brushing time and brushing force have significant effects upon the level of plaque removal by a PTB, and at 120 s brushing time the improvement in plaque removal with forces in excess of 150 g was negligible.

Adult↗

PubMed2002

Testing the efficacy of 2 prototype brush heads for a powered toothbrush: refining the model.

OBJECTIVES: To compare 2 prototype powered toothbrush (PTB) heads (A, B) to a marketed head (Sensiflex 2000) for plaque removing efficacy on the Philips/Jordan HX2550 PTB. MATERIALS AND METHODS: A 2-week, 3-group, single-blind trial recruited 78 volunteers (18-25). Plaque indices (PIs) were recorded at screening and 14 days later at baseline. Subjects were stratified (gender and PI) and then asked to abstain from oral hygiene measures for 48 h. A supervised episode of brushing with the allocated PTB head followed. Subjects then used the PTBs at home for the next 12 days before being asked to abstain from all oral hygiene measures for another 48 h prior to a second supervised brushing episode. Plaque was scored using a new modification of the Quigley & Hein Index (PI) at full mouth (FM), interproximal (IP) and smooth surfaces (SS). PIs were recorded before and after the supervised brushing episodes to enable the means of the within subject differences (pre- to post-brushing) to be compared between groups (ANOVA/t-tests). RESULTS: There were no significant differences in PI between groups at baseline or prior to the supervised brushings (p>0.05). Highly significant, mean reductions in PIs (approximately 1/2 of one PI unit) were observed for design B compared with the Sensiflex 2000 at FM and IP sites (p<0.0001) for both supervised brushing episodes. A significant reduction in PI at SS was seen only after the first brushing episode (p=0.0004). For design A, PI reductions were consistently greater than those for the Sensiflex 2000 but differences were only significant at the p<0.05 level. CONCLUSION: It is concluded that this model of clinical trial has sufficient power to demonstrate clinical superiority with respect to plaque removal for PTBs and can be used for testing one or more prototype designs of brush heads.

Adolescent↗

PubMed2002

A clinical evaluation of a novel data logger to determine compliance with the use of powered toothbrushes.

OBJECTIVES: The primary objective of this study was to evaluate the viability of an electronic data logger to record the brushing episodes of patients receiving standardised oral hygiene instructions. The secondary objective was to estimate the compliance of a group of patients diagnosed with chronic periodontal disease with brushing time instructions for the daily use of a powered toothbrush over a 2-month period. MATERIAL AND METHODS: 17 modified Philips Jordan Sensiflex 2000 powered toothbrushes (PTBs) were provided to patients (32-67 years) attending for non-surgical management of chronic periodontal disease. The PTBs incorporated an electronic data logger which recorded, for each individual brushing event: the length of time the brush was used (identifying the brushing speed setting); the maximum, minimum and average current during operation; and the time spent charging in between two consecutive brushing events. The patients were given detailed instructions with the PTB and were told to use it for 2 min each morning and 2 min in the evening. The patients returned for non-surgical management over two visits prior to reinforcement of the oral hygiene instructions 1 month after PTB allocation. Subjects were asked to complete a simple brushing diary to record their use of the toothbrush on a daily basis. After 2 months of using the PTBs at home, the brushes and diaries were collected and the data downloaded from the data loggers. RESULTS: Of the 17 data loggers allocated, two recorded no information and two subjects did not return for the follow-up appointments. The data from the remaining 13 data loggers were evaluated for level of compliance. An event of brushing between 120 and 130 s was considered to be compliant, one of between 90 and 120 or 130-150 s was partially compliant and brushing for < 90 s or > 150 s was recorded as non-compliant. Percentage compliance for all the events (2087 recordings) was 34%, partial- and non-compliance were calculated as: 18%; 48% of events, respectively. CONCLUSION: This data logger has provided previously unrecorded data on the brushing times for a group of patients using a powered toothbrush at home during non-surgical management of chronic periodontal disease. The data suggested that almost half (48%) of the brushing events recorded by the data loggers were greater than 30 s above or below the instructed brushing time.

Adult↗

PubMed2002

Efficacy of a prototype brush head for a powered toothbrush. A multicentre study.

PRIMARY OBJECTIVE: To evaluate a multicentre clinical trial design for testing powered toothbrushes. SECONDARY OBJECTIVE: To compare the efficacy of a prototype brush head (N2.3) for the Philips Jordan Sensiflex 2000 powered toothbrush (PTB) to that of Braun Oral-B D15 PTB in removing dental plaque MATERIAL AND METHODS: 137 volunteers (ages 18-25 years) were recruited to this 3-centre, 2-week, 2-group, 2-treatment, single-blind trial. Plaque was recorded at screening and again 14 days later at baseline. Stratification of subjects, for gender and screening PI, occurred at baseline. Subjects were then asked to abstain from all oral hygiene measures for 48 h followed by a supervised episode of brushing for 3 min with the allocated PTB. The allocated PTB was used at home for the next 12 days before a second abstinence from all oral hygiene measures for the 48 h prior to a second supervised brushing episode. Plaque levels were scored using a modification of the Quigley & Hein plaque index (PI) at full mouth (FM), interproximal (IP) and smooth surfaces (SS). To enable the means of the within subject differences (pre to postbrushing) to be compared between groups PIs were recorded before and after the supervised brushing episodes, differences between centres, groups and visits were examined. RESULTS: No significant differences in PI between groups at screening, baseline or prior to the supervised brushings were detected (P > 0.05 anova). The results of the analysis of variance showed there to be a highly significant difference (P < 0.001) between brushing groups, but, significant differences between centres (P < 0.001) and a significant interaction effect between centre and brushing group (P < 0.001) was also detected. Therefore the difference between groups was not present at all three centres. Further examination of the single centre data showed there to be greater levels of plaque removed by the N2.3 compared to the D15 (FM reduction in PI 1.95 vs. 1.13, respectively) at centre 3 in contrast to the other two centres where no difference was detected. The precise reason for these differences could not be established. CONCLUSIONS: A multicentre study design is applicable for evaluating PTBs but a minimum of 3 centres should be included so that differences between centres can be identified. The prototype brush head N2.3 for the Philips Jordan Sensiflex 2000 PTB has comparable plaque removal efficacy to the Braun Oral-B D15 PTB at FM, IP and SS sites.

Adolescent↗

PubMed2002

Clinical evidence for the efficacy and safety of powered toothbrushes.

Powered toothbrushes are becoming increasingly popular among the general population, and there are many models on the market from which to choose. The design of these toothbrushes is changing constantly, as one would expect with a developing and expanding market, and from the dental professional's standpoint, it is difficult to evaluate products from the literature simply because the designs of clinical trials for powered toothbrushes are so varied. For example, the cohort recruited for testing the products is seldom the same from one study to the next. The aim of this paper is to provide a brief overview of the findings from some of the more contemporary trials of powered toothbrushes and to examine some of the factors that might have an effect on the observations and outcomes.

Clinical Trials as Topic↗

PubMed2001

Local delivery of chlorhexidine gluconate (PerioChip) in periodontal maintenance patients.

AIM: The aim of this randomised, split-mouth, single-blind study was to determine the efficacy of controlled-release delivery of chlorhexidine gluconate 2.5 mg (PerioChip) in patients with residual bleeding pockets (>5 mm) at least 3 months following oral hygiene and root debridement phase therapy. MATERIAL AND METHODS: 26 patients (non-smokers) were screened and potential study sites identified. Clinical parameters recorded at baseline and all subsequent visits were plaque index (PI), pocket probing depth (PPD), bleeding index (BI) and clinical attachment level (CAL). All study sites were debrided using ultrasonic instrumentation. PerioChips (PC) were placed in the selected sites of two quadrants (left or right) whilst identified sites in the remaining quadrants were left without adjunctive antimicrobial treatment. Clinical measurements were made at follow-up visits after 1, 3 and 6 months. Mean changes from baseline in PPD, BI and CAL were calculated with the patient as the experimental unit and comparability between the treatments was determined using t-tests. RESULTS: At baseline there were no significant differences between PC and control sites for mean PI, PD, BI or CAL. The mean (SE) reductions in PPD for PC and control treatments were: 0.47 (0.1), 0.46 (0.1); 0.76 (0.1), 0.55 (0.1); 0.78 (0.1), 0.45 (0.1) for months 1, 3 and 6 respectively. Only at month 6 did the difference between treatments approach statistical significance (p=0.06). Mean (SE) reductions in CAL over the same periods were: 0.17 (0.1), 0.04 (0.08); 0.38 (0.1), 0.21 (0.1); 0.43 (0.1), 0.15 (0.09) p=0.048. Mean (SE) reduction in BI between PC and control treatments only reached statistical significance at 6 months: 1.08 (0.1), 0.59 (0.1) p=0.05. CONCLUSION: These data suggest that PerioChip is beneficial for patients on maintenance therapy although the benefit is not apparent until 6 months after placement.

Adult↗

PubMed2001

Influence of a controlled pressure system on toothbrushing behavior.

The use of excessive brushing force has been shown to be a major cause of gingival abrasion. To aid in preventing over-vigorous brushing, the Philips/Jordan electric toothbrush incorporates a Controlled Pressure system (CPS) that causes the brush head to flex back when a toothbrushing force (TBF) in excess of a pre-determined threshold is exerted against the teeth or soft tissues. Two studies (I/II) were conducted to determine whether this mechanical feedback system is sufficiently sensitive to enable users to control their brushing behavior. In Study I, the learning pattern of brushing behavior as a response to the feedback system was evaluated. Seventeen subjects were asked to brush their teeth under observation at least twice a day for a two-week period. During these observations, the number of clicks, as well as the time the brush was pushed "through the click" were recorded. Ten of seventeen volunteers demonstrated a clear learning behavior; the mean number of clicks/minute (for all subjects) was reduced from 10 to 4 after 10 sessions of brushing, and then to 2 or 3 clicks at the end of two weeks. In Study II, 46 subjects used the electric toothbrush with the CPS click force set at various levels between 150-420 g (at 30 g intervals). After a 4-week learning period, the mean TBF was determined in each subject. TBF was most strongly influenced at pre-set click forces between 180 and 270 g. The mean TBF was lowest (about 80 g) when the threshold was set at 210 or 240 g; it then increased (to about 130-140 g TBF) both for smaller and larger values of the threshold setting. Hence, both studies indicate that the Controlled Pressure system is a functional feature that can be used to control the habitual brushing force in a learning period of less than 2 weeks.

Adult↗

PubMed2001

A comparative study of two powered toothbrushes and one manual toothbrush in young adults.

The aim of this 3-group, 3-treatment, single-blind, parallel group study was to evaluate and compare the efficacies of the Philips/Jordan HP735 powered toothbrush, the Braun/Oral-B D7 powered toothbrush, and the Oral-B Advantage B35 manual toothbrush in young adults (18-25 years). Full mouth mean (SD) modified Turesky Plaque Index (PI) and the Löe & Silness Gingival Index (GI) were recorded at baseline. After 24 hours abstinence from oral hygiene, the PI was recorded and each subject was given one of the test brushes with detailed instructions for use. Each subject then brushed under supervision for 90 seconds, during which time mean (SD) toothbrushing forces (TBF) were recorded. PIs were recorded immediately after brushing, and the subjects were then discharged for 6 weeks to use the allocated toothbrush at home. After 6 weeks, PI, GI and TBF were again recorded. There were no significant differences (ANOVA) for PI and GI between groups at baseline, or for PI following brushing at 24 hours. After 6 weeks, the powered brushes produced lower mean PI (SD) scores than the manual brushes, but the differences were significant only at interproximal sites. Mean GI scores for the HP735 group were similar at baseline and at 6 weeks, although for the other brushes the GI scores actually increased over this period. Mean (SD) TBF (grams/force) at baseline and 6 weeks, respectively, for the brushes were; HP735 233 (205), D7 159 (58), B35 279 (122) (p = 0.026): HP735 194 (86), D7 141 (57), B35 297 (113) (p = 0.0001). The within-group variability for the HP735 TBF reduced considerably over 6 weeks, which is possibly because of the click-force threshold feature of this brush.

Adolescent↗

PubMed2000

Anticalculus agents.

Most dentifrices and some mouthrinses now contain 1 or more active anticalculus agents to achieve so-called tartar control. The aim of this article is to review the research associated with the development of anticalculus agents and to evaluate in some detail, the efficacy of those agents which are currently available in dentifrice products.

Dental Calculus↗

PubMed2000

Testing the efficacy of plaque removal of a prototype brush head for a powered toothbrush.

BACKGROUND/AIMS: The principal aim of the study was to compare the efficacy of a powered toothbrush (PTB) prototype (B) brush head in removing dental plaque to the relative efficacy of a marketed model (A). METHOD: A 12-week, 2-group, 2-treatment, double-blind trial of 2, two-brush heads (with the same power unit) recruited 62 volunteers (18-25 years) who were non-clinical university students. After a screening visit, 31 subjects were allocated to each of groups A and B at baseline with stratification according to gender and plaque index. After 48 h of plaque growth, subjects underwent a timed and supervised brushing episode with the allocated PTB (visit 1). Subjects then used the PTBs at home for 12 days before being recalled (visit 2) and asked again to abstain from all oral hygiene measures for 48 h. Supervised brushing was repeated (visit 3) before the subjects were dismissed for a further 10-week, unsupervised period of home use of the PTBs. The sequence of visits (2 and 3) was then repeated at visits 4 and 5. RESULTS: The sole outcome variable was plaque which was scored at all visits using the modified Quigley & Hein Index (PI) at full mouth (FM), interproximal (IP) and smooth surfaces (S). At visits 1, 3 and 5, the PI was recorded both before and after supervised brushing. There were no significant differences in PI between the brushing groups at baseline, visit 1, visit 2 or visit 5 (2 sided t-test). At visit 3, the prototype achieved significantly lower PIs than the marketed PTB brush head for IP (and FM) surfaces, this difference was most apparent on posterior tooth surfaces. For within-group changes, PIs at visit 2 were significantly lower than those at baseline (paired t-test), an observation which may be attributable to the improved cleaning and 'novelty effect' of a PTB. The PIs at visit 5 were significantly higher than the baseline values (paired t test) and this may be accountable to an element of Hawthorne effect and/or, a fall off in compliance over the entire 12 weeks. CONCLUSION: We conclude that this in vivo model is appropriate for testing the efficacy of PTB prototypes but only over a 2-week period, as the inter-group differences were not maintained over the full 12 weeks of the trial.

Adolescent↗