Biomedical subjects

Patricia A Walters

Publications and source records attributed to Patricia A Walters.

11 recordsLinked to original sources

PubMed2005

Dentinal hypersensitivity: a review.

Dentinal hypersensitivity is generally reported by the patient after experiencing a sharp pain caused by one of several different stimuli. The pain response varies substantially from one person to another. The condition generally involves the facial surfaces of teeth near the cervical aspect and is very common in premolars and canines. The most widely accepted theory of how the pain occurs is Brannstrom's hydrodynamic theory, fluid movement within the dentinal tubules. The dental professional, using a variety of diagnostic techniques, will discern the condition from other conditions that may cause sensitive teeth. Treatment of the condition can be invasive or non-invasive in nature. The most inexpensive and efficacious first line of treatment for most patients is a dentifrice containing a desensitizing active ingredient such as potassium nitrate and/or stannous fluoride. This review will address the prevalence, diagnosis, and treatment of dentinal hypersensitivity. In addition the home care recommendations will focus on desensitizing dentifrices.

Cold Temperature↗

PubMed2004

Benefits of sodium hexametaphosphate-containing chewing gum for extrinsic stain inhibition.

PURPOSE: This study was designed to examine the ability of sodium hexametaphosphate delivered from a chewing gum to prevent extrinsic tooth stain formation. METHODS: This study was a negative-controlled, randomized, two-period crossover design, with a 10-day washout period between treatments. The two treatments were a chewing gum containing 5.6% sodium hexametaphosphate and a negative control chewing gum. Eleven subjects who met study criteria were enrolled, and 10 completed the study over a two-week period. Each treatment period lasted approximately 48 hours and was separated by a washout period. After a dental prophylaxis, a digital image of the anterior teeth was taken to assess baseline stain. The three-day stain induction phase consisted of the patient using a 10 ml 0.2% chlorhexidine rinse for 60 seconds, followed by chewing two pellets/sticks of their assigned gum for five minutes and rinsing with 10 ml of cold tea solution for 60 seconds. No oral hygiene was permitted other than use of the test products. During both treatment periods, each subject followed the same regimen eight times, once per hour, throughout the day. RESULTS: On Days 2 and 3, the adjusted mean L* measurement was statistically significantly greater for the sodium hexametaphosphate gum than for the control gum. Moreover, nine of the 10 subjects had whiter teeth while on the experimental gum treatment at both Day 2 and Day 3. CONCLUSION: The results of this study support that sodium hexametaphosphate delivered from a chewing gum prevents dental stain formation and leads to a patient-desired whitening benefit.

Adult↗

PubMed2004

Short-term impact of a national dental education program on children's oral health and knowledge.

OBJECTIVE: The objective of this four-week, examiner-blind study was to determine the impact of an educational oral health program conducted within a Boys and Girls Club of America in Chicago, Illinois, USA. The educational program focused on the gingival health (gingivitis and plaque) of participating children who were between the ages of six and 15. METHODOLOGY: The multi-week program taught the participants the basics of oral biology and disease, as well as proper oral health prevention, including oral hygiene, dietary modification, and the importance of visiting the dentist. A calibrated examiner measured whole mouth Löe-Silness Gingival Index (GI) and Turesky Modification of Quigley-Hein Plaque Index (PI) at baseline (immediately prior to the initiation of the educational program) and four weeks later. The primary efficacy analysis was based on the change from baseline for 90 subjects who were enrolled at baseline, participated in the educational program, and were examined four weeks later. In addition, subjects completed five questions at baseline and at four weeks to assess their oral health knowledge before and after exposure. RESULTS: Mean baseline GI score was 0.184, while the four-week mean GI score was reduced to 0.140. This represents a 24% reduction in GI score, with p < 0.001. The mean baseline bleeding site score was 9.99, while the four-week mean bleeding score was reduced to 7.97. This represents a 20% reduction in bleeding sites, with p = 0.005. The mean baseline PI score was 3.06, while the four-week mean PI score was reduced to 2.97. This represents a 3% reduction in PI score with p = 0.044. The subject population was found to have statistically significantly (p < 0.001) greater knowledge following the program at week four, with 37% (33 of 90) and 69% (62 of 90) of subjects answering the questions correctly at baseline and week four, respectively. CONCLUSION: Collectively, these data support the role of an educational program in promoting improved oral health in these children over a four-week period.

Adolescent↗

PubMed2003

Initial impact of a national dental education program on the oral health and dental knowledge of children.

Oral health educational programs have been reported to have a variable impact on the oral health status of program participants. This paper reports the impact of an educational oral health program conducted within a single Boys & Girls Club of America. The objective of this 4-week examiner-blind study was to determine the impact of the educational program on the gingival health (gingivitis and plaque) of participating children who were between the ages of 5 and 15. The multi-week program taught the participants the basics of oral biology and disease, as well as proper oral health prevention including oral hygiene, dietary modification, and the importance of visiting the dentist. A calibrated examiner measured whole mouth Loe-Silness Gingival Index (GI) and Turesky Modification of Quigley-Hein Plaque index (PI) at baseline (immediately prior to the initiation of the educational program) and 4 weeks later. The primary efficacy analysis was based on change from baseline for 75 subjects who were enrolled at baseline, participated in the educational program, and were examined 4 weeks later. Mean baseline GI score was 0.37, while the 4 week mean GI score was reduced to 0.18. This represents a 51% reduction in GI score with p<0.001. Mean baseline PI score was 3.80, while the 4 week mean PI score was reduced to 2.68. This represents a 29% reduction in PI score with p<0.001. In addition, subjects completed a questionnaire (5 questions) at baseline and at 4 weeks to assess their oral health knowledge. The subject population was found to have statistically significantly (p<0.05) greater knowledge with respect to optimal brushing time and optimal frequency of dental recall visits following the program at week 4. Collectively, these data support the role of the educational program in promoting improved oral health in these children over a one month period.

Adolescent↗

PubMed2002

Dental plaque removal with two battery-powered toothbrushes.

PURPOSE: To compare the plaque removal efficacy of a positive control power toothbrush (Colgate Actibrush) to an experimental power toothbrush (Crest SpinBrush) following a single use. MATERIALS AND METHODS: This study was a randomized, controlled, examiner-blind, 4-period crossover design which examined plaque removal with the two toothbrushes following a single use in 39 completed subjects. Plaque was scored before and after brushing using the Turesky Modification of the Quigley-Hein Index. RESULTS: Baseline plaque scores averaged 2.18 and 2.16 for the experimental toothbrush and control toothbrush treatment groups, respectively. With respect to all surfaces examined, the experimental toothbrush delivered an adjusted (via analysis of covariance) mean difference between baseline and post-brushing plaque scores of 0.66 while the control toothbrush delivered an adjusted mean difference of 0.43. This represents an increase of 55% plaque removal relative to the control power toothbrush. The difference between brushes was statistically significant (P < 0.001). With respect to buccal and lingual surfaces, the experimental toothbrush delivered very consistent results relative to the control toothbrush. The differences between brushes were also statistically significant (P < 0.001).

Adolescent↗

PubMed2002

Plaque removal efficacy of a battery-operated power toothbrush compared to two control manual toothbrushes in single use studies.

PURPOSE: Recently, a power toothbrush (Crest SpinBrush) has been reported to remove plaque more effectively than a manual toothbrush (Colgate Navigator). The objective of these studies was to compare the plaque removal efficacy of two control manual toothbrushes (Colgate Wave and Colgate Plus) to an experimental power toothbrush (Crest SpinBrush). The Colgate Plus has an ordinary flat bristle trim design, while the Colgate Wave has an advanced design multilevel bristle trim for greater interproximal penetration. MATERIALS AND METHODS: Each of these two studies were randomized, controlled, examiner-blind, 4-period crossover designs which examined plaque removal with the experimental toothbrush relative to a control manual toothbrush following a single use in 37 and 35 subjects, respectively. Plaque was scored before and after brushing using the Turesky Modification of the Quigley-Hein Index. RESULTS: In the first study, average baseline plaque scores were 2.88 and 2.89 for the experimental toothbrush and advanced designed manual control toothbrush (Colgate Wave) treatment groups, respectively. With respect to all surfaces examined, the experimental toothbrush delivered an adjusted (via analysis of covariance) mean difference between baseline and post-brushing plaque scores of 0.70 while the control toothbrush delivered an adjusted mean difference of 0.59. The difference between the brushes was statistically significant (P < 0.001). The experimental toothbrush removed, on average, 19.9% more plaque than the control toothbrush. In the second study, baseline plaque scores averaged 3.07 and 3.04 for the experimental toothbrush and ordinary flat trim manual control toothbrush (Colgate Plus) treatment groups, respectively. With respect to all surfaces examined, the experimental toothbrush delivered an adjusted (via analysis of covariance) mean difference between baseline and post-brushing plaque scores of 0.87 while the control toothbrush delivered an adjusted mean difference of 0.62. The difference between brushes was statistically significant (P < 0.001). The experimental toothbrush removed, on average, 40.0% more plaque than the control toothbrush.

Adolescent↗

PubMed2002

Plaque removal efficacy of a new experimental battery-powered toothbrush relative to two advanced-design manual toothbrushes.

The current study was designed to assess the plaque removal efficacy of a novel experimental powered toothbrush (Crest SpinBrush Pro) compared to two leading manual toothbrushes, the Oral-B CrossAction and the Colgate Navigator. In addition, this paper reports the results of two additional studies examining the relative plaque removal efficacy of the two control manual toothbrushes and a number of other manual toothbrushes. The comparative study was a randomized, controlled, examiner-blind, nine-period crossover design, conducted among 127 adult subjects over a two-month period, that examined plaque removal with a new battery-powered toothbrush and two advanced-design manual toothbrushes. During the course of this study, subjects brushed three times with the experimental powered toothbrush and three times with each control manual toothbrush. Study participation was on a voluntary basis following written informed consent of the subjects. Plaque was scored before and after brushing using the Turesky, et al. Modification of the Quigley-Hein Index. Average baseline plaque scores were 2.68 to 2.69 for the three treatment groups. The experimental toothbrush delivered an adjusted (via analysis of covariance) mean difference between baseline and post-brushing plaque scores (i.e., a plaque removal score) of 0.69, while the control toothbrushes delivered adjusted mean differences of 0.46 (Colgate Navigator) and 0.54 (Oral-B CrossAction). All group differences were statistically significant (p < 0.001). The experimental powered toothbrush group had, on average, 49% and 28% greater plaque removal scores than the Colgate Navigator and Oral-B CrossAction groups, respectively. In addition, the Oral-B CrossAction group had, on average, a 16% greater plaque removal score than the Colgate Navigator group. This result was also statistically significant (p < 0.001). Results on buccal and lingual surfaces also demonstrated statistically significantly (p < 0.001) greater plaque removal for the experimental battery-powered toothbrush relative to the control manual toothbrushes.

Adolescent↗

PubMed2002

The relative effectiveness of six powered toothbrushes for dental plaque removal.

During the past three years, a number of new powered toothbrushes have been marketed in the United States. The objective of this study was to compare the single-use plaque removal efficacy of six powered toothbrushes: a new prototype (Crest SpinBrush Pro), Crest SpinBrush, Oral-B Battery, Colgate Motion, Oral-B 3-D Excel, and a Crest experimental toothbrush design. This study was a randomized, controlled, examiner-blind, six-period crossover design, which examined plaque removal with six powered toothbrushes following a single use in 26 subjects. Plaque was scored before and after brushing for one minute using the Turesky, et al. Modification of the Quigley-Hein Index. For statistical comparison, the plaque scores were averaged on a per-subject basis. Each subject had a single whole-mouth average score for baseline and for the exam following a one-minute brushing with their assigned toothbrush. The difference (baseline minus post-brushing) in average scores was calculated and analyzed using an analysis of covariance for a crossover design, with baseline whole-mouth average score as the covariate, and terms in the model for subjects, periods, and treatments. Mean baseline plaque scores ranged from 1.770-1.897 for the six toothbrush treatment groups and were not statistically significantly different. Using the analysis of covariance, with respect to all surfaces examined, the new prototype powered toothbrush (Crest SpinBrush Pro) delivered an adjusted mean difference between baseline and post-brushing plaque scores of 0.544, while the five remaining powered toothbrushes delivered an adjusted mean difference of 0.470-0.497. These results represent 10-16% greater plaque removal for the new prototype powered toothbrush. Overall, the six toothbrushes were not statistically significantly different (p = 0.199). However, results of unadjusted pair-wise comparisons conducted per the study protocol found that the new prototype powered toothbrush removed greater levels of plaque than the Oral-B 3-D Excel, Colgate Motion, and Crest experimental toothbrush (p = 0.028, p = 0.038, and p = 0.028, respectively). With respect to buccal and lingual surfaces, the new prototype powered toothbrush (Crest SpinBrush Pro) delivered very similar results relative to the control toothbrushes. Collectively, the results suggest that the new prototype powered toothbrush may offer enhanced plaque removal efficiency relative to the five other toothbrushes, and be at least as good as the five tested powered toothbrushes.

Adolescent↗

PubMed2002

A study to assess the safety and tolerability of three toothbrushes.

This study evaluated the oral soft tissue safety and tolerability of an experimental powered toothbrush (Crest SpinBrush Pro) compared to two leading manual toothbrushes: an advanced-design manual toothbrush (Oral-B CrossAction) and a flat-trimmed toothbrush (Oral-B 40 Indicator). Manual brushes are generally viewed as safe for use, and as such are appropriate controls. A total of 140 subjects was enrolled in this single-center, randomized, examiner-blind parallel study over a four-week test period. Subjects were instructed to brush in their normal manner, twice per day for 60 seconds per use. An oral soft tissue interview and examination were conducted by a trained dentist examiner at baseline, as well as three days and four weeks after baseline to assess clinical signs and symptoms of oral irritation associated with use of the toothbrushes. Overall, there were 19 adverse events reported for 18 subjects (13% of the population). The adverse events were distributed across test groups with five subjects in the experimental powered brush group, eight in the advanced design manual toothbrush group and five in the flat-trimmed toothbrush group experiencing at least one adverse event. The most frequently reported adverse event was localized irritation/inflammation of the gingiva. All adverse events were mild in severity except for one report of severe hyperesthesia (tooth sensitivity) in the advanced-design manual toothbrush group. There were no statistically significant differences between the groups for the proportion of subjects reporting adverse events at either three days or four weeks of product use. The results of this study indicate that daily use with the Crest SpinBrush Pro powered toothbrush is at least as safe as two leading manual toothbrushes.

Adult↗

PubMed2002

The reduction of gingivitis using battery-powered toothbrushes over a one-month period.

This study measured the ability of two powered toothbrushes (Crest SpinBrush and Crest SpinBrush Pro) to reduce gingivitis relative to baseline levels over a one-month period. This study made use of a randomized, controlled, examiner-blind, parallel design. Subjects were examined for Löe-Silness GI scores at baseline and at one month. The primary efficacy variable was GI score change at one month from the baseline GI score. Within-group comparisons to baseline were performed using paired t-tests. Secondarily, treatment group differences were examined using an analysis of covariance model, with baseline as the covariate. Separate analyses were performed for Löe-Silness GI scores and for the number of gingival bleeding sites. All comparisons were two-sided and used the 0.05 level of significance. A total of 87 subjects completed the study. Of these, there were 57 females and 30 males, ranging in age from 18 to 70 years with a mean age of 33.1 years. Baseline GI scores were 0.487 and 0.449 for the Crest SpinBrush and Crest SpinBrush Pro, respectively, and were not statistically significantly different. Both brushes demonstrated highly statistically significant reductions in GI vs. baseline (all p < 0.001), and delivered an approximately 60% reduction in GI. Baseline bleeding site scores were 37.6 and 34.4 for the Crest SpinBrush and Crest SpinBrush Pro, respectively, and were not statistically significantly different. Both brushes demonstrated highly statistically significant reductions in bleeding vs. baseline (all p < 0.001), and delivered an approximately 60% reduction in bleeding sites. None of the ANCOVA comparisons between brush groups were statistically significant (all p > or = 0.354). Both the Crest SpinBrush Pro and Crest SpinBrush powered toothbrushes were highly effective at reducing gingivitis when used per manufacturer's instructions.

Adolescent↗

PubMed2002

The effectiveness of two different battery-powered toothbrushes on whitening through removal of stain.

Whitening dentifrices have recently become popular, achieving a whitening benefit by surface chemical action and/or abrasion that serve to remove extrinsic stains and/or prevent extrinsic stain buildup. Some powered toothbrushes have also been demonstrated to have whitening/stain-removal efficacy when used with standard dentifrice products. The objective of this study was to evaluate the effectiveness of an experimental prototype powered toothbrush (Crest SpinBrush Pro) and a commercially available powered toothbrush (Crest SpinBrush) on dental whitening through the removal of extrinsic stain. This study was a randomized, controlled, examiner-blind, parallel-group design, which examined extrinsic stain removal over four weeks of brushing by 70 subjects. Following a three-week period of stain induction using rinses of chlorhexidine and tea, subjects were randomized to use one of the two toothbrushes. Tooth stain was scored using the Lobene stain index at baseline, and after two and four weeks of toothbrush use. Prior to statistical analysis, the stain scores were averaged on a per-subject basis. The stain reductions (baseline minus post-treatment) in average scores were calculated and analyzed using an analysis of covariance, with baseline average score as the covariate. The experimental prototype powered toothbrush (Crest SpinBrush Pro) delivered statistically significant (p < 0.001) adjusted (via analysis of covariance) mean reductions from baseline in Lobene composite stain scores of 1.90 and 2.11 after 2 weeks and 4 weeks of use, respectively. These results represent 56-62% reductions in extrinsic stain compared to baseline. The commercially available powered toothbrush (Crest SpinBrush) also delivered statistically significant (p < 0.001) adjusted (via analysis of covariance) mean reductions from baseline in Lobene composite stain scores, with magnitudes of 1.95 and 2.22 after two and four weeks of use, respectively. These results represent 60-68% reductions in extrinsic stain compared to baseline. In conclusion, both the experimental prototype powered toothbrush and the commercially available powered toothbrush were effective in removing extrinsic tooth stain.

Adult↗