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A clinical study to assess the ability of a powered toothbrush to remove chlorhexidine/tea dental stain.

AIM: A single-center, single-blind, two-way crossover study was performed to compare the effects of an electric powered toothbrush with a conventional manual toothbrush at removing chlorhexidine/tea tooth staining. METHODS: This study used 24 subjects. During the week before the study, the subjects received a prophylaxis to remove all staining, plaque and calculus deposits. On the Monday of the following week, subjects returned to the clinic to receive a further prophylaxis. Under direct supervision, they then rinsed with a 0.2% chlorhexidine mouthrinse, immediately followed by a rinse with a warm black tea solution. This cycle was repeated hourly eight times throughout the day and on the following days until the Friday. Throughout this period, volunteers omitted all other forms of oral hygiene except rinsing with the chlorhexidine mouthwash. On the Friday, the level of stain was assessed both prior to and immediately after brushing with the allocated brush with toothpaste for 1 min. This was done in an adjoining room (out of sight of the clinical scorer). Subjects were then instructed to use the toothbrush at home according to their normal oral hygiene practices. On the following Friday, subjects returned to the clinic when the stain present was re-assessed. Each subject received a thorough prophylaxis to remove all plaque calculus and staining before starting the second period of the study and again on completion of the study. RESULTS: The study showed relatively little difference between the ability of the two brushes to remove stain at a single test brushing. However, there was some evidence that the powered brush was more effective than the manual brush in minimising stain level during the home use period, overall and in particular for gingival crescent sites. CONCLUSIONS: This study has suggested that the powered brush may become more effective at reducing dental stain, the longer the brush is used under normal home conditions.

Adult↗

Oral candidiasis prevention in transplantation patients: a comparative study.

AIM: Oral candidiasis occurs commonly in haematopoietic -stem cell transplantation (HSCT) patients carrying a risk of systemic candidemia and mortality. The aim of this pilot study was to design an effective protocol that prevents oral candidiasis and improves tolerability. METHODS: A prospective, randomized, longitudinal study with two treatment groups, (A) chlorhexidine (CHX) and (B) CHX combined with medium-dose amphotericin B (AMB), was performed. The investigators were blinded to the treatment arm. RESULTS: No clinical signs of oral candidiasis were observed in any of the 20 patients. All patients experienced neutropenia and were treated with antibiotics. The duration of antibiotic treatment was longer in group A than that in group B. The difference in systemic anti-fungal treatment was insignificant. Compliance was achieved in both groups, although tolerability was better in group A than that in group B. CONCLUSION: Effective oral anti-fungal prevention based on topical AMB was suggested. CHX mouthwash was also suggested to be effective as a single topical agent for the prevention of oral candidiasis in HSCT patients. The combination of topical CHX and medium-dose AMB-prophylactic protocol may achieve the same level of candidial prevention with better tolerability than that by AMB alone. More research is warranted.

Adult↗

Comparison of the bisbiguanide antiseptics alexidine and chlorhexidine. I. Effect on plaque accumulation and salivary bacteria.

A blind crossover trial was carried out to compare the effects of a 0.2% chlorhexidine gluconate mouthrinse and a 0.035% alexidine mouthrinse on plaque accumulation and salivary bacteria in a group of volunteers. The subjects refrained from all forms of oral hygiene during two 10-day periods and rinsed twice a day with the mouthwash randomly allocated to the respective period. Prerinse, day 4 and day 10 total salivary aerobic and anaerobic bacterial counts were determined during each period. Plaque scores were recorded at the end of each 10-day period. Significantly more plaque accumulated in subjects rinsing with alexidine when compared with chlorhexidine. Significant and comparable reductions in salivary bacterial counts were observed with both chlorhexidine and alexidine on day 4 and day 10 when compared with pre-rinse counts. Although at the concentrations used alexidine was less effective than chlorhexidine, it may be of value as a short-term adjunct to oral hygiene.

Adult↗

Effects of extended systemic and topical folate supplementation on gingivitis of pregnancy.

A former double-blind study evaluated the effect of a 14-day period of systemic and topical folate supplementation on gingival inflammation during pregnancy (Pack & Thomson 1980). The current experiment was similar to the earlier one except that supplementation was for 28 days during the eighth month only. Thirty women during their 32nd week of pregnancy were randomly divided into three equal groups. Control Group A received placebo mouthwash (MW) and placebo tablets; Group B received placebo MW and one 5 mg folate tablet daily; Group C received placebo tablets and rinsed with folate MW twice daily for 1 min. At the beginning and end of the experimental period, oral status was determined using a plaque index (PlI) and a gingival index (GI). Each subject furnished a 1-week diet record which was analysed for dietary folate. No differences in parameters existed between groups at the commencement of the study except for folate levels which were lower in Group B. Results confirmed the findings of the former experiment. Group C showed highly significant improvement in GI despite no significant changes in PlI (0.001 less than P less than 0.01), whilst in Group B, changes in gingival health were not statistically significant (0.05 less than P less than 0.10). No significant changes were demonstrated in Group A. Folate levels increased significantly in Groups B and C. Dietary folate was similar in all groups.

Administration, Oral↗

Efficacy of Listerine, Meridol and chlorhexidine mouthrinses on plaque, gingivitis and plaque bacteria vitality.

The experimental gingivitis model was used to compare the anti-plaque, anti-gingivitis and anti-microbial efficacies of a phenolic compound (Listerine) and an amine/stannous fluoride mouthwash (Meridol), using a placebo preparation as negative control and a chlorhexidine solution as positive control in a double-blind study. After professional toothcleaning, 36 volunteers performed optimal oral hygiene for a period of 2 weeks. They then ceased all oral hygiene procedures for 21 days during which they rinsed twice daily with 1 of the 4 mouthrinses. After 3 weeks of rinsing, plaque indices remained the lowest in the chlorhexidine group, while subjects using Listerine or Meridol harbored similar indices significantly lower than that of individuals rinsing with the placebo solution. Up to that time, the gingival index scores were equal in all groups except for the chlorhexidine group in which the values only amounted to half of these encountered in the other groups. The plaque vitality scores showed a bactericidal effect in vivo of chlorhexidine during the entire time of experimental gingivitis. In contrast, the data gave no evidence of an antibacterial effect in vivo of Listerine. The efficacy of Meridol to kill micro-organisms was similar to chlorhexidine during the early stages of plaque accumulation and, with time, became insignificant. This study has demonstrated that chlorhexidine was superior to Listerine and Meridol in its ability to maintain low plaque scores and gingival health during this 3-week period of no mechanical oral hygiene. Moreover, it was also shown that Meridol was as effective as Listerine in reducing plaque accumulation and, in contrast to Listerine, possessed a remarkable but transient antibacterial effect in vivo.

Adult↗

The effect of a combination of chlorhexidine diacetate, sodium fluoride and xylitol on plaque wet weight and periodontal index scores in military academy cadets refraining from mechanical tooth cleaning for 7-day experimental periods.

45 subjects participated in a double-blind cross-over mouthwash study where a new tablet-form combination of chlorhexidine, fluoride and xylitol (XYLIHEX) was studied together with solutions of chlorhexidine (CHX) and sodium fluoride (NaF). The preparation XYLIHEX was developed as a dental chemotherapeutic that could easily be added to the soldiers' kit to be used under circumstances where practising normal oral hygiene habits is restricted. For comparative purposes, XYLIHEX was prediluted in this study to make a solution. Before starting, professional prophylaxis was given to the subjects to bring their gingivitis index scores as close to 0 as possible. The subjects refrained from mechanical tooth cleaning for three 7-day test periods. Plaque wet weight and periodontal index scores were recorded before and after the test periods. The results showed that the preparations XYLIHEX and CHX did not statistically differ from each other in reducing plaque wet weight values and the recorded periodontal index scores. Both these preparations were statistically highly significantly more effective antiplaque agents than NaF, as expected.

Adult↗

The magnitude and duration of the effects of some mouthrinse products on salivary bacterial counts.

The persistence of action or substantivity of an antimicrobial agent in the mouth relates to the plaque inhibitory action of that compound. Substantivity can be assessed by measuring the magnitude and duration of the fall in salivary bacteria following single rinses with antimicrobials. This was a randomised single-blind, cross-over study measuring the effects of single 60-s rinses of 5 mouthwash products on salivary bacterial counts in 14 healthy human volunteers. Effects over a 7-h period were compared with a chlorhexidine rinse product (positive control) and saline (negative control). All but one rinse, containing cetylpyridinium chloride (CPC), significantly reduced bacterial counts compared to saline up to 5-7 h. No rinse produced the magnitude or duration of effect noted for chlorhexidine and decrements from baseline, with one exception, were highly significantly lower than with the chlorhexidine product. Comparing the 2 CPC rinses, the findings suggest that the activity of one product was vitiated by some other ingredient. The triclosan/copolymer, the essential oil/phenolic and one CPC products exhibited similar persistence. In those cases where information is available, these data are consistent with comparative plaque inhibitory findings for the products or their active ingredients. Again, it is concluded that the method is a useful screening and comparison test for the potential plaque inhibitory activity of antimicrobial oral hygiene products.

Adult↗

The efficacy of an anti-gingivitis chewing gum.

Chlorhexidine is a well-established agent used for the control of supragingival plaque but is not without disadvantages, such as tooth staining, which limits its clinical applications to short-term use. This clinical trial studied the clinical effectiveness and stain-forming potential of chlorhexidine in a chewing gum base. Subjects (151) were screened for baseline plaque and gingival indices before receiving a dental prophylaxis and randomized into 3 treatment groups: group 1 chewed 2 pieces of chlorhexidine diacetate gum for 10 min 2x a day (total daily chlorhexidine = 20 mg), group 2 chewed 2 pieces of placebo gum for 10 min 2x a day and group 3 rinsed with 10 ml of 0.2% chlorhexidine gluconate mouthwash for 1 min 2x per day (total daily chlorhexidine = 40 mg). Plaque, gingivitis and stain evaluations were made at 4 and 8 weeks. Plaque and bleeding scores were significantly lower at 4 and 8 weeks in the chlorhexidine gum group compared to the placebo gum group and similar at 8 weeks to the rinse group. Stain intensity at week 8 was significantly less for the chlorhexidine gum than rinse. The staining measured by extent was also less with the chlorhexidine gum than the rinse, but the difference was not significant at week 4. At week 8, stain extent was significantly lower in the chlorhexidine gum group than chlorhexidine rinse. In conclusion, the results of this study demonstrate that this chlorhexidine chewing gum used with normal tooth cleaning provides similar adjunctive benefits to oral hygiene and gingival health as a 0.2% chlorhexidine rinse.

Anti-Infective Agents, Local↗

The use of 0.2% chlorhexidine in the absence of a structured mechanical regimen of oral hygiene following the non-surgical treatment of periodontitis.

The aim of the present study was to evaluate a 0.2% chlorhexidine mouthrinse following the non-surgical treatment of advanced human periodontitis in the absence of a structured mechanical oral hygiene regimen. 10 patients and a total of 1483 sites were used. Recordings for plaque, bleeding, pocket depth and attachment levels were made at baseline and at 3, 6, 9, and 12 months. Debridement was performed under local anaesthesia. No instruction or reinforcement in mechanical oral hygiene procedures was given at any time. However, at each visit the patients were instructed in the 2x daily use of 0.2% chlorhexidine mouthwash. The plaque indices, scored as % of sites with removable deposits, showed negligible improvement from baseline scores of 80%-100% for all categories of initial probing depth. Mean bleeding score was reduced to 10-20% irrespective of initial probing pocket depth, site location or tooth surface location. Sites > or = 7 mm at baseline demonstrated a reduction in mean probing pocket depth of 3.9 mm and a gain in mean probing attachment level of 2.5 mm. Moderately deep sites (4-6.5 mm) demonstrated a reduction in mean probing pocket depth of 2 mm and a gain in mean probing attachment level of 0.8 mm. Shallow sites (< or = 3.5 mm) demonstrated a reduction in mean probing pocket depth of 0.5 mm and a loss in mean probing attachment level of 0.2 mm. Site-specific attachment level analysis demonstrated that over 80% of losing sites were shallow with low bleeding frequency, indicating that the loss of attachment may have occurred for reasons other than inflammatory periodontal disease. The results indicate that chlorhexidine can be used as an adjunct to inadequate mechanical oral hygiene over an observation period of 1 year.

Adult↗

6-month use of 0.2% delmopinol hydrochloride in comparison with 0.2% chlorhexidine digluconate and placebo (II). Effect on plaque and salivary microflora.

This double-blind, randomised, 6-month clinical trial with parallel group design in 68 subjects with gingivitis was conducted to study the effects on the oral flora of delmopinol hydrochloride 2 mg/ml (0.2% w/v, Decapinol Mouthwash), when used for partly supervised mouthrinsing in comparison with placebo and chlorhexidine digluconate 2 mg/ml (0.2% w/v, Hibitane Dental, ICI Pharmaceuticals, UK). Apart from estimating the total cultivable microbial dental plaque flora and salivary flora, analyses were focused on bacterial groups associated with gingivitis/periodontitis and dental caries. Furthermore, the presence of staphylococci, gram-negative enteric bacteria and yeasts in saliva were evaluated. The minimal inhibitory concentration (MIC) was determined for isolates belonging to the predominating micro-organisms in samples of both dental plaque and saliva. In relation to the findings in the placebo group, the use of delmopinol during the rinsing period did not produce an undesirable shift in the bacterial populations considered to be related to dental caries or periodontal diseases. These groups remained virtually unchanged during the study. In relation to the observations in the placebo group, slight reductions in the total cultivable plaque and salivary flora were observed during the study and no change was found in the ratio total anaerobically/aerobically cultivable microbial flora. Furthermore, no increased growth in staphylococci, enteric bacteria or yeasts was observed in the saliva samples. The pattern of changes taking place in the composition of the plaque and salivary microbial flora in samples from the participants rinsing with chlorhexidine were in most aspects similar to that observed in the delmopinol group. In the delmopinol group, no microbiologically significant changes were observed over time in the MIC-values for the isolates, neither in the plaque nor in the saliva samples, which indicates that no adaptation to delmopinol had taken place during the rinsing period. Similar observations were made for the plaque isolates in samples from the participants in the chlorhexidine group. On the other hand, when gram-positive and catalase-negative cocci from the saliva samples of the latter group were tested against chlorhexidine, 4-6 times higher MIC-values were obtained at 3 and 6 months both when compared to baseline and in comparison with the other two rinsing groups (p<0.01 or p<0.05). Neither delmopinol nor chlorhexidine showed any residual effect on the studied microbial groups in the plaque and the saliva samples 3 months after the end of treatment. In conclusion, delmopinol was accompanied by a composition of the plaque and salivary flora associated with healthy conditions in the oral cavity.

Bacteria↗

6-month use of 0.2% delmopinol hydrochloride in comparison with 0.2% chlorhexidine digluconate and placebo. (I). Effect on plaque formation and gingivitis.

A double-blind, randomised, 6-month clinical trial with parallel group design in 149 patients with gingivitis was conducted to study the efficacy and safety of delmopinol hydrochloride 2 mg/ml (0.2% w/v, Decapinol Mouthwash) used for partly supervised mouthrinsing in comparison with chlorhexidine digluconate 2 mg/ml (0.2% w/v, Hibitane Dental, ICI Pharmaceuticals, UK) and placebo as an addition to normal oral hygiene. Assessments of efficacy were performed using the plaque index and bleeding on probing (BOP). Delmopinol showed 22% lower plaque index scores than placebo after 3 months (p<0.01) and 13% lower scores after 6 months. The corresponding figures for chlorhexidine were 38% (p<0.001) and 38% (p<0.001) after 3 and 6 months, respectively. Bleeding on probing was reduced for delmopinol in comparison with placebo by 11% after 3 months and by 18% (p<0.05) after 6 months. For chlorhexidine the corresponding figures were 18% (p<0.01) and 22% (p<0.01) after 3 and 6 months, respectively. While chlorhexidine showed greater plaque reduction than delmopinol (p<0.01 at 6 months), no statistically significant difference was reached between these two solutions regarding BOP. Both active solutions showed an increased amount of dental calculus in comparison with placebo. A transient anaesthetic sensation in the oral mucosa and taste affection were commonly reported adverse events in both the delmopinol and the chlorhexidine groups. The number of patients withdrawn from treatment due to adverse events or lack of cooperation was 7 in the chlorhexidine group, 4 in the placebo group and 1 in the delmopinol group. The results showed that rinsing with either 0.2% delmopinol hydrochloride or 0.2% chlorhexidine digluconate twice daily for 60 secs for 6 months results in less plaque formation and gingivitis than rinsing with placebo. Mouthrinsing with the 0.2% delmopinol hydrochloride solution was well accepted in this study.

Adult↗

Dentine hypersensitivity: development and evaluation ofamodel in situ to study tubulepatency.

BACKGROUND AND AIMS: Lesions of dentine hypersensitivity have numerous tubules open at the dentine surface as opposed to non-sensitive dentine where tubules are mostly covered by a smear layer. The present two studies were designed to model both states in situ and evaluate the effects of agents on the model. METHOD: Etched (sensitive) and smeared (non-sensitive) dentine specimens prepared from human third molar teeth were retained in lower buccal acrylic appliances. The results of Study 1 led to the development of a method to ensure tubules were sectioned at right angles. Study 1 was a 5-day period, seven treatment regimens randomised, part blind cross over design involving five subjects. Treatments were 2x day application of a desensitising (SA) or non-desensitising toothpastes (F) or chlorhexidine (CHX) mouthwash with or without drinking orange juice (OJ)(1 l/day). A no treatment group (P) allowed plaque to accumulate. The evaluation of effects was observational by scanning electron microscopy (SEM). Study 2 involved 1 subject, 4 treatments applied once and studied after 0, 6, and 12 h by SEM with image analysis. The 12 h groups were studied with and without imbibing water or OJ. Treatments were two desensitising (SA & SC) and one non-desensitising (F) toothpastes and an in office product (DS). RESULTS: Study 1: Treatment SA resulted in occlusion of tubules an outcome little changed by OJ. Treatment P produced a bio-film, which covered the dentine surface. CHX produced some tubule occlusion in three of the five subjects. F+/-OJ and CHX+OJ had little effect and tubules remained open. For smeared specimens toothpastes and OJ removed the smear layer but SA+/-OJ blocked tubules. P and CHX had no effect on the smear layer. Study 2: At 0 h, tubule occlusion was in order of magnitude DS>or=SA>SC>F. After 6 and 12 h with SA, SC and F some loss of occlusion occurred but not DS. Water and OJ by 12 h decreased occlusion for SA, SC and particularly F. Water and OJ removed virtually all of DS. CONCLUSIONS: The aims of Study 1 were achieved and effect of treatments was not inconsistent with data in vitro. The need for more standardisation of specimens was appreciated and applied in Study 2 to allow image analysis to quantitatively record data. Further use of the model in randomised controlled clinical trials is envisaged.

Acid Etching, Dental↗

Clinical study to compare the effectiveness of a test whitening toothpaste with a commercial whitening toothpaste at inhibiting dental stain.

AIMS: A single centre, randomised single-blind, three-way crossover study was performed, to compare the effect of an experimental test toothpaste with a commercially available whitening toothpaste and water control at inhibiting extrinsic stain promoted by repeated chlorhexidine/tea rinses. METHODS: This study used 23 subjects. During the week before the study the subjects received a prophylaxis to remove all staining, plaque and calculus deposits. On the Monday of the following week subjects returned to the clinic to receive their rinses and to check their dentition was stain free. Under direct supervision at both 09:00 and 13:00 hours they rinsed with either a toothpaste slurry or water control that was repeated daily up to and including the following Thursday. Additionally from the Monday to the Thursday each subject rinsed with a 0.2% chlorhexidine mouthrinse, immediately followed by a rinse with a warm black tea solution. This cycle was repeated hourly eight times throughout the day and on the following days until the Friday. Throughout this period volunteers omitted all other forms of oral hygiene except rinsing with the chlorhexidine mouthwash. On the Friday the level of stain on the teeth and dorsum of tongue was assessed using the Lobene stain index for both stain area and intensity. At the end of each trial period each subject received a thorough prophylaxis to remove all plaque, calculus and staining before starting the second and third period of the study. RESULTS: As expected appreciable amounts of extrinsic stain accumulated on the teeth over each study period. The amount of stain following use of the toothpastes and water control was least with the experimental toothpaste, followed by water control and lastly the commercial whitening paste. For all sites combined there was evidence that the experimental paste was significantly superior to both the commercial paste and water control at reducing stain area (p<0.001), a product of stain area and intensity (p<0.001 and 0.05, respectively) but not stain intensity (p>0.05). CONCLUSIONS: In this stain-prevention model the use of an experimental paste showed a significant reduction in stain accumulation on the teeth compared with a (placebo) negative water control and a commercially available whitening paste. As such the experimental paste would be expected to be of benefit in controlling extrinsic dental staining.

Adult↗

The effect of a polyhexamethylene biguanide mouthrinse compared with a triclosan rinse and a chlorhexidine rinse on bacterial counts and 4-day plaque re-growth.

OBJECTIVES: For various clinical applications, polyhexamethylene biguanide hydrochloride (PHMB) has been used for many years as an antiseptic in medicine. Recently, a 0.04% and a 0.12% PHMB mouthwash were shown to inhibit plaque re-growth and to reduce oral bacterial counts. In this study, a 0.2% PHMB mouthrinse (A) was compared with a positive control 0.12% aqueous chlorhexidine solution (B), a commercially available 0.3% triclosan/2.0% polyvinyl methyl ether maleic acid copolymer mouthrinse (Colgate Total Plax) (C), and a negative control placebo rinse (10% ethanol, flavour) (D). MATERIALS AND METHODS: The controlled clinical study was a double blind, randomized, four replicate cross - over design. Plaque re-growth was assessed with the Turesky et al. (1970) modification of the Quigley & Hein (1962) plaque index. The antibacterial effect was assessed by taking bacterial counts on the tooth surface (smears from the buccal surface of 16/26) and mucosa (smears from the buccal mucosa in opposite of area 16/26) after the professional prophylaxis and after the first rinse with the preparations on day 1 and prior to the clinical examination on day 5. Sixteen volunteers participated and, on day 1 of each study period were rendered plaque-free, ceased toothcleaning, and rinsed twice daily with the allocated mouthrinse. On day 5, plaque was scored and smears were collected according to the protocol. A 10-day wash-out period was carried out between each rinse evaluation. Data were analysed using ancova with Bonferroni HSD adjustment for multiple comparisons (colony forming units per sample) with a significance level alpha=0.05. RESULTS: The 0.2% PHMB mouthrinse (A) was significantly better at inhibiting plaque than the placebo (D), but significant less effective than the 0.12% aqueous chlorhexidine solution (B). There is no significant difference between A and the 0.3% triclosan/2.0% copolymer mouthrinse (C). Bacterial count reductions (tooth surface and mucosa) with PHMB (A) were significantly greater compared with the placebo (D) and triclosan (C), but significantly lower compared with chlorhexidine (B) (tooth surface) and equally effective compared with chlorhexidine (B) (mucosa). CONCLUSION: Consistent with previous studies, a PHMB mouthrinse was shown to inhibit plaque re-growth and to reduce oral bacterial counts, indicating that PHMB could be an alternative to established mouthrinses in preventive applications.

Adult↗

The effect of a mouth rinse containing phenolic compounds on plaque formation and developing gingivitis.

BACKGROUND: The clinical effect of Listerine, a mouth rinse containing a mixture of phenolic compounds, is ascribed to its bactericidal properties. However, phenolic compounds are also known to interfere with the inflammatory process. OBJECTIVE: The purpose of this clinical trial was to evaluate the effect of regular mouth rinsing with Listerine on plaque and gingivitis during a 2-week period of no mechanical oral hygiene. MATERIAL AND METHODS: Twenty-one subjects were recruited for the study. On Day 0 of each 2-week experimental period, the participants were told to abstain from all mechanical plaque-control measures but to rinse twice a day with 10 ml of the assigned solution (test: Listerine, positive control:0.1% chlorhexidine (CHX), negative control: saline) for 60 s. Each experimental period was preceded by a 2-week period including oral hygiene instruction, scaling and professional mechanical tooth cleaning. Examinations included assessments of plaque and gingivitis (Days 0 and 14), sampling of plaque and collection of gingival crevicular fluid (GCF) (Days 0, 7 and 14). From the supragingival plaque samples, six different morphotypes of bacteria were counted using dark-field microscopy. The GCF collected was analysed with respect to the content of lactoferrin and albumin. RESULTS: During the experimental periods, it was observed that significantly less plaque formed and less gingivitis developed when the participants rinsed with the Listerine mouthwash than with saline solution. However, significantly more plaque formed during the Listerine than during the CHX rinse period, while there was no significant difference in the development of gingival bleeding between the Listerine and the CHX rinse regimens. Significantly smaller proportions of motile rods and fusiforms were found in the List and CHX groups than in the control (Ctrl) group. The increase of the lactoferrin/albumin ratio in the List group was significantly smaller than that in the Ctrl group but significantly larger than in the CHX group. CONCLUSION: It was suggested that the effect of Listerine on gingivitis is more pronounced than on plaque formation. This indicates that the phenolic compound may have anti-inflammatory effects.

Adult↗

Assessing oral health-related quality of life in general dental practice in Scotland: validation of the OHIP-14.

OBJECTIVES: To validate the Oral Health Impact Profile (OHIP)-14 in a sample of patients attending general dental practice. METHODS: Patients with pathology-free impacted wisdom teeth were recruited from six general dental practices in Tayside, Scotland, and followed for a year to assess the development of problems related to impaction. The OHIP-14 was completed at baseline and at 1-year follow-up, and analysed using three different scoring methods: a summary score, a weighted and standardized score and the total number of problems reported. Instrument reliability was measured by assessing internal consistency and test-retest reliability. Construct validity was assessed using a number of variables. Linear regression was then used to model the relationship between OHIP-14 and all significantly correlated variables. Responsiveness was measured using the standardized response mean (SRM). Adjusted R(2)s and SRMs were calculated for each of the three scoring methods. Estimates for the differences between adjusted R(2)s and the differences between SRMs were obtained with 95% confidence intervals. RESULTS: A total of 278 and 169 patients completed the questionnaire at baseline and follow-up, respectively. Reliability - Cronbach's alpha coefficients ranged from 0.30 to 0.75. Alpha coefficients for all 14 items were 0.88 and 0.87 for baseline and follow-up, respectively. Test-retest coefficients ranged from 0.72 to 0.78. Validity - OHIP-14 scores were significantly correlated with number of teeth, education, main activity, the use of mouthwash, frequency of seeing a dentist, the reason for the last dental appointment, smoking, alcohol intake, pain and symptoms. Adjusted R(2)s ranged from 0.123 to 0.202 and there were no statistically significant differences between those for the three different scoring methods. Responsiveness - The SRMs ranged from 0.37 to 0.56 and there was a statistically significant difference between the summary scores method and the total number of problems method for symptomatic patients. CONCLUSIONS: The OHIP-14 is a valid and reliable measure of oral health-related quality of life in general dental practice and is responsive to third molar clinical change. The summary score method demonstrated performance as good as, or better than, the other methods studied.

Adolescent↗

Systemic absorption of lidocaine after topical application for the treatment of oral mucositis in bone marrow transplantation patients.

This paper evaluates lidocaine absorption via oral mucosa following its topical application for symptomatic treatment of bone marrow transplantation (BMT)-induced oral mucositis. Five patients with high-grade oral mucositis after allogeneic BMT were entered consecutively into the study. Five healthy individuals served as controls. All 10 participants rinsed their mouth with 5 ml of a 2% lidocaine solution for 1 min, after which they expectorated the liquid. Blood samples were drawn at 1, 5, 10, 20, 30 and 60 min after rinsing and centrifuged. Plasma lidocaine levels were measured by fluorescence polarization immunoassay. In the BMT patients, plasma lidocaine levels were lower than the therapeutic range of this drug (0.2 microg/ml vs 1.5-5.5 microg/ml), while in the controls no detectable lidocaine levels were noted. The data from this preliminary study indicate that lidocaine prescribed as an anesthetic mouthwash in BMT patients with oral mucositis results in minor systemic absorption of the drug.

Administration, Topical↗

Efficacy of mometasone furoate microemulsion in the treatment of erosive-ulcerative oral lichen planus: pilot study.

BACKGROUND: Oral lichen planus (OLP) is a frequent immunological chronic disease, having different clinical forms: asymptomatic and symptomatic. Symptomatic OLP has been palliated with topical corticosteroids with different levels of efficacy and safety. The purpose of this pilot phase II clinical trial was to determine the efficacy of mometasone furoate microemulsion upon the symptoms and signs of erosive-ulcerative OLP. METHODS: Forty-nine patients with clinical and histologically confirmed erosive-ulcerative OLP were enrolled in this study (36 women and 13 men). Their average age was 56.4 years (from 28 to 78). The treatment consisted of 0.1% mometasone furoate microemulsion mouthwash three times a day over 30 days. Pain, erythema and ulceration were assessed after 15 and 30 days of treatment. The data was processed and statistically analysed by student's t-test for paired samples. RESULTS: Mometasone caused a statistically significant reduction in pain (3.58 vs. 0.65, P = 0.0000). Treatment significantly reduced the surface area of erythema (155.2 vs. 21.9 mm(2), P = 0.0001) and ulceration (30.7 vs. 7.3 mm(2), P = 0.0000). None of these patients suffered severe adverse effects. CONCLUSIONS: Mometasone furoate microemulsion is a safe and effective therapy in the treatment of symptomatic erosive-ulcerative OLP.

Administration, Topical↗