Search

The relative effectiveness of different methods used for delivery of information regarding oral health in children has not been widely raised in the literature. This study aimed at evaluating the effect of verbal oral hygiene instruction (OHI) against the verbal instruction supplemented by three different methods (written, teeth teaching model, and videotape) on the mean plaque scores and to determine factors that may influence the effectiveness of methods used. Prospective-comparative randomized controlled trial carried out on 120 children aged 8–9 years. Participants were randomly divided into four groups (verbal, verbal and written, verbal and teeth teaching model, and verbal and video). Plaque Control Index was evaluated at baseline and 4 weeks after OHI. ANOVA and post hoc, t test, and ANCOVA were used for statistical analysis. A statistically significant decrease of the mean percentage of plaque scores was found indicating the effectiveness of different methods of delivery of OHI (p

OBJECTIVES To compare the efficacy and patient-reported outcome measures of oral hygiene instruction methods for calibrated interdental brush. MATERIALS AND METHODS A total of 60 participants, with 30 each in control and test group, participated in the study. Clinical examination included gingival index, full mouth bleeding scores and approximal plaque index. Supragingival scaling was performed. Interdental access probe was used to assess the size of interdental brush and corresponding interdental brush were given to the participants. For the control group, oral hygiene instructions were given through demonstration with model and video. For the test group, oral hygiene instructions were given through 'Touch-to-Teach' method. At 4-week follow-up, oral hygiene instructions were repeated to respective groups. After 3 months, clinical examination was done and exit survey on patient-reported outcome measures was administered. Statistical analysis was done. RESULTS Intergroup comparison of gingival index, full mouth bleeding index and approximal plaque index showed statistically significant difference between test and control group. 'Touch-to-Teach' method of oral hygiene instruction was found to be 'Good'. Acceptance of interdental brush was regarded to be 'Good'. CONCLUSION Within limitations of the study, Touch-to-Teach method of oral hygiene instruction method was found to be effective and more acceptable and participants used the interdental brush regularly.

AIM: This study compared the effect of traditional and virtual oral hygiene instruction to school health instructors on plaque index (PI) of elementary schoolchildren. METHODS AND MATERIALS: In this descriptive, analytical study, 66 elementary schools in Kermanshah city were selected by cluster sampling. The school health instructors first participated in a pretest and filled out a questionnaire. The O’Leary’s index of 339 elementary schoolchildren was measured at baseline. Next, the school health instructors received oral hygiene instructions in two groups (n = 33) of virtual instruction through an online course and traditional classroom setting. After 3 weeks, a post-test was held and school health instructors filled out the same questionnaire for the 2nd time. After 3 months, the PI of students was measured again. Data were analyzed using the Chi-square test, t-test, Mann–Whitney U-test, and ANOVA. RESULTS: Both instruction methods significantly enhanced the oral hygiene knowledge of instructors (p < 0.001) but virtual instruction was significantly more effective (p = 0.02). No significant association was noted between age, work experience of instructors, or their level of education with their knowledge level in the virtual group (p > 0.05). An inverse correlation was noted between age and work experience of instructors with their knowledge level in the traditional instruction group (p < 0.05). Both instruction methods caused significant improvement of PI of students (p < 0.001) but virtual instruction was more effective (p < 0.001). CONCLUSION: Correct oral hygiene instruction to school health instructors (preferably by virtual instruction) can reduce PI elementary schoolchildren.

Purpose The purpose of this study was to evaluate the effect of oral rehabilitation (maxillofacial prosthetic intervention and oral hygiene instruction) on oral health-related Quality of Life (OHRQoL) and oral hygiene condition in patients with maxillofacial defects and to explore the correlation between them in these patients. Methods Twenty-five patients with maxillofacial defects who had been treated since April 2016 to March 2018 were included in this study. The scores of the Oral Health Impact Profile (OHIP) and O’Leary’s Plaque Control Record (PCR) were also identified as the scores of OHRQoL and oral hygiene condition, respectively. Statistical analyses were performed to compare between the scores of “pre” and “post” prosthetic treatment and to evaluate patient-related factors influencing these variables (age, the number of residual teeth and occlusal supports, and occlusal units (OUs)). The effect of combined chemo-radiotherapy (CRT) on each score was also assessed statistically. Furthermore, the correlation of OHIP and PCR scores was explored statistically. Results Both oral rehabilitations could significantly improve OHIP and PCR scores. Significant correlations of the change of OHIP scores with age and OUs were detected. CRT had no significant effect on OHIP and PCR scores. No correlations between OHIP and PCR were observed. Conclusions Although oral rehabilitation such as maxillofacial prosthetic treatment and oral hygiene instruction would be highly effective for improvement of OHRQoL and oral hygiene condition in patients with maxillofacial defects, there was no correlation between them.

AimsTo determine whether personalised Oral Hygiene Advice (OHA) using an intra-oral-camera (IOC) combined with standard OHA as provided in general dental practice reduces plaque levels after 4 weeks more than the provision of standard OHA.Materials and Methods22 healthy adult participants diagnosed with gingivitis took part in this pilot parallel-designed, randomised, examiner-blind, 2x-treatment, study regarding their home-care oral hygiene habits and attitudes to oral health. An IOC-image was taken and plaque, gingival and bleeding scores were recorded. Test group participants received standard OHA with IOC-images to indicate areas for improvement, control group participants received standard OHA. Questionnaires and plaque, gingival and bleeding scores were repeated after 4 weeks. Plaque was scored from the IOC-images and scores compared to clinical plaque scores.ResultsLifestyle habits, attitudes to oral health, plaque (0.63vs0.61, control vs test) and bleeding scores (1.17vs0.96, control vs test) were similar at baseline. After 4-weeks, plaque scores improved more in test as compared to control group (39.4vs20.6%, pConclusionsUse of IOC further personalises the prevailing standard of oral hygiene advice and generates great patient engagement with pictorial reports to facilitate a more in-depth patient explanation of their gingival health, resulting in significant plaque reduction and improved gingival health compared to the standard OHA alone.

Currently, oral health issues are increasingly been addressed and virtual reality (VR) is being used as an aid in health areas. However, there is little evidence of VR being used in preventing oral health problems. To evaluate the effectiveness of VR in oral hygiene education. Three hundred pupils, aged between 9 and 12 years, received instructions in oral hygiene by immersion VR and they gave their opinions about the performed activities. Chi-square and Fisher's exact tests were applied, with a significance level of 5%. Part perception of oral hygiene showed no statistically significant difference (P>0.550). There was an increase in the use of dental floss (P0,550). Hubo un aumento en el uso de hilo dental (P

Objective: To evaluate the effectiveness of oral hygiene performed by caregivers of children and adolescents with cerebral palsy (CP) during the moments before and after three months of oral health instructions. Methods: In a longitudinal study, 102 participants were joined in two groups: G1 (n=51) composed of children and adolescents (C/A) with CP and G2 (n=51), composed of their caregivers. Sociodemographic and oral hygiene habits were collected and evaluated using the Visible Plaque Index (VPI) and Gingival Bleeding Index (GBI), before and after oral hygiene orientation. The Qui-Squared, ANOVA 1, and tStudent tests were applied. P < 0,05. Results: The C/A group with pattern clinical CP tetraparesis, diparesis and hemiparesis were homogeneous in terms of gender (P = 0,07), however differed in age (P < 0,05), the youngest being diparetic. No difference was observed when comparing VPI and GBI before and after instructions in oral health for the three clinical types (P> 0,05). However, a reduction in the VPI and GBI indexes (P < 0,05) before and after, in each of the three clinical patterns. Most of the caregivers were female, married, with a high school degree, and they performed oral hygiene three times per day. The caregivers presented significant drops in VPI and GBI after receiving oral hygiene instructions. (P < 0,05). Conclusion: Oral hygiene instruction is fundamental for the caregivers of children and adolescents with cerebral palsy since it is an effective form of controlling health problems. Objetivo: Evaluar la efectividad de la higiene bucal que realizan los cuidadores de niños y adolescentes con parálisis cerebral (PC) antes y después de tres meses de instrucciones en salud bucal. Métodos: En un estudio longitudinal prospectivo, 102 participantes fueron divididos en dos grupos: G1 (n = 51) niños y adolescentes (N / A) con PC; G2 (n = 51) sus cuidadores. Se recogieron datos sociodemográficos y hábitos de higiene bucal, evaluados mediante índices de placa visible (IPV) y sangrado gingival (ISG), antes y después de las pautas de higiene bucal. Se utilizó la prueba de Chi-cuadrado, la prueba de criterio ANOVA 1 y la prueba de la t de Student. P 0.05). Sin embargo, se puede observar una reducción en los índices IPV e ISG (P 0,05). Entretanto, pode-se observar redução nos índices IPV e ISG (P < 0,05) antes e após, nos três padrões clínicos. A maioria dos cuidadores era do sexo feminino, casada, ensino médio completo e realizavam higiene bucal três vezes ao dia. Os cuidadores apresentaram redução significante do IPV e ISG após instruções de higiene oral (P < 0,05). Conclusão: É fundamental a instrução de higiene oral aos cuidadores de crianças e adolescentes com paralisia cerebral, pois esta é uma forma eficaz para o controle dos agravos a saúde.

The World Dental Federation (FDI) policy statement in 2016 advocated evidence-based caries-control measures for managing dental caries. The caries management philosophy has shifted from the traditional surgical manners to minimal intervention dentistry. Minimal intervention dentistry aims to extend the longevity of natural teeth. It places the nonrestorative approaches as a priority. The nonrestorative approaches for caries management aim to tackle the etiological factors of dental caries. Caries can be prevented or reversed by restricting the sugar intake and its frequency in the diet, improving oral hygiene practices, and using fluoride toothpaste. This article aims to present strategies for the nonrestorative management of dental caries, which are divided into four components to address the different etiological factors of dental caries. The first component is controlling dental plaque. Strategies for plaque control include oral hygiene instruction, motivational interviewing, mechanical plaque control, and chemical plaque control. The second component for nonrestorative management is reducing the risk of caries by identifying caries risk factors and protective factors, assessing personal caries risk, and customizing a treatment plan. Evidence-based measures for caries prevention include using fluoride, and dental sealants should be provided. The third component includes topical treatment to remineralise early carious lesions. The last component is long-term follow-up. Appropriate strategy adoption for the nonrestorative management of dental caries prolongs the life span of the teeth and sustains the good oral health of patients.

Promover saude bucal consiste em capacitar uma populacao para melhorar a sua tecnica de higiene oral, qualidade de vida e de saude de maneira geral. Os estudantes de odontologia serao os futuros promotores de condicoes favoraveis para que se torne possivel manter a saude bucal. O objetivo desse estudo foi avaliar a efetividade da instrucao de higiene bucal em alunos do primeiro ano do curso de graduacao em Odontologia da Universidade Metropolitana de Santos-SP. Foram avaliados 34 participantes por meio de sessoes de evidenciacao de placa bacteriana atraves do Indice de O`Leary e Indice Periodontal de Sangramento a Sondagem. Os Indices foram realizados entre e apos a orientacao e motivacao de higiene bucal. Verificou-se que apos adquirido os conhecimentos, os Indices de placa bacteriana e sangramento reduziram e a maioria dos alunos responderam satisfatoriamente na adocao de novos habitos de higiene bucal saudaveis.

Introduction: Fixed orthodontic therapy is considered to be one of the important risk factor for plaque accumulation, since various orthodontic components serves as the retentive areas for plaque accumulation and thus increasing the risk of caries and periodontitis. Therefore these patients must be encouraged to maintain good oral health throughout the treatment. Objective: To investigate the effects of reinforced oral hygiene instruction programme with and without professional tooth cleaning on the plaque accumulation and gingival health of orthodontic patients wearing fixed multibracket appliances. Material and Methods: Forty patients with fixed orthodontic appliances in the age range of 12–28 years were divided randomly into Group I (n=20) and Group II (n=20). Group I received oral hygiene instructions and Group II received similar instructions supplemented with one sitting of professional tooth cleaning. The plaque and gingival index were recorded at the baseline (before the instructions), after 4 and 8 weeks in both the groups. At each visit all the instructions were reinforced in both the groups. Results: Intergroup comparison showed significant decrease in the mean plaque score at 4 weeks in Group II (p Conclusion: Reinforced oral hygiene instruction programme with or without professional prophylaxis can lead to efficient control of plaque accumulation as well as improvement in the gingival health of orthodontic patients wearing multibracket appliances. However, provision of professional tooth cleaning should be based on individual plaque control needs.

Background Cleft lip and/or palate (CLP) patients are at high risk of developing dental caries and show a greater prevalence of dental defects.Aims To establish if CLP patients who attended the 18-month clinic had local dentists, were complying with oral hygiene instruction and had stopped bottle-feeding as per guidelines.Design Data were collected retrospectively over a 24-month period in which a total of 62 records were assessed.Results Data analyses revealed that 42% of patients who attended the clinic were registered with a dentist. Fifty percent of patients had stopped bottle-feeding and 67% were brushing two or more times a day. Although all patients reviewed on the clinic were caries free, 57% presented with a dental anomaly (hypodontia, hypomineralisation or hypoplasia).Conclusion Despite CLP patients being at high risk for developing dental caries, results showed that significant proportions of parents/carers were not following national guidelines for prevention. This evaluation highlights that shared preventive support between primary care dentists and specialist cleft dentists is not being achieved in the majority of cases. It also recognises that parents of CLP patients are either not receiving, or are failing to implement, preventive care advice.

Background: The aim of the present study was to determine the most effective oral hygiene method in fixed orthodontic patients. Methods: A total of 125 patients who had recently started their orthodontic treatment and had not received oral hygiene instructions were randomly assigned to 5 groups (n=25): verbal instructions (V), verbal instructions plus pamphlet (V+P), verbal instructions plus video film (V+F), verbal instructions plus the use of disclosing agents (V+D), and pamphlet plus the use of disclosing agents (P+D). One week after the installation of orthodontic appliance, plaque index (PI) and gingival index (GI) were recorded and oral hygiene instructions were provided. One week and 4 weeks after oral hygiene instructions, PI and GI were recorded again. Results: PI and GI showed significant decreases in 5 groups after 1 week and 4 weeks (P ˂ 0.05). No statistically significant differences were detected between the 5 study groups in terms of plaque reduction after one week. However, after 4 weeks PI values were significantly lower in V+D group compared to P+D group. Regarding GI, V+D method resulted in a significantly lower GI than P+D after 1 week and 4 weeks. Conclusions: To sum up, all the oral hygiene motivation methods applied in this study can be effective in decreasing PI and GI. However, it appears that the best way is the verbal oral hygiene instruction plus the use of disclosing agents.

Background As parents increasingly turn to online videos for paediatric dental information, it is important to assess the content of those videos and determine whether parents are receiving accurate information. Aim To describe and assess the video characteristics, viewer engagement, and content of the most-viewed YouTube videos about a child's first dental visit. Design The 100 most popular YouTube videos related to a child's first dental visit were assessed for consistency with current professional guidelines, which included a first visit by age 1, tooth cleaning or prophylaxis, fluoride application, caries risk assessment, dietary counseling, oral hygiene instruction, frequency of dental visits, and anticipatory guidance. Differences in video characteristics (length, age, and viewer engagement) were assessed using the Kruskal-Wallis test and the post hoc Mann-Whitney U test, and differences in content and characteristics by video upload source (healthcare professionals, parents/caregivers, and independent media outlets) were examined using the chi-square test and the Fisher's exact test. Results The predominant upload source was parents/caregivers (40%) followed by independent media outlets (32%) and healthcare professionals (28%). Median video length was 2 min, 24 s (IQR = 2:05-3:49), and median video age was 4 years (IQR = 3-4 years). Most videos were filmed in a paediatric dental office (73%) and focused on motivational vs. educational content (77% vs. 23%, respectively). With regard to viewer engagement, videos uploaded by media outlets generated higher viewing rates than those uploaded by parents/caregivers (mean rank [MR] = 44.7 vs. 24.8, respectively) and healthcare professionals (MR = 34.8 vs. 31.5) and higher interaction rates than those uploaded by parents/caregivers (MR = 50.8 vs. 25.0) and healthcare professionals (MR = 39.1 vs. 20.6). Videos uploaded by healthcare professionals were more likely to provide educational content consistent with professional recommendations, particularly regarding caries risk assessment (32.1%), dietary counseling (21.4%), and frequency of dental visits (10.7%), than videos uploaded by parents/caregivers (5.0%, 5.0%, and 0%, respectively) and media outlets (0%, 3.1%, and 0%, respectively). Conclusions This study found that the most popular videos related to a child' first dental visit, as measured by viewer engagement, were uploaded by parents or caregivers, were longer and newer, and featured motivational rather than educational content. The 100 most-viewed videos rarely presented information that was consistent with professional recommendations for children's oral health, particularly regarding caries risk assessment and anticipatory guidance.

The aim of this study was to evaluate the changes in periodontal parameters solely using free gingival grafts during orthodontic treatment without any oral hygiene re-enforcement. Methods: A total of 19 patients underwent periodontal examination before orthodontic treatment. Patients received oral hygiene instruction and professional hygiene therapy. Where needed, full periodontal treatment was completed. Only periodontally stable patients were included in the study. Periodontal indices and keratinized tissue were recorded at time 0 (T0) (delivery of orthodontic appliances), and at three months (T1) during orthodontic therapy, when surgery was performed. At T1, orthodontically treated sites with minimum keratinized tissue (&le, 1 mm) received a free gingival graft to enhance the band of keratinized tissue. At three months after surgery (T2), new measurements were recorded. The orthodontics-treated sites after three months (T1) were used as control. The same sites were used as a test three months after mucogingival correction (T2). Between T1 and T2, orthodontics was suspended, no professional oral hygiene was performed, and no additional oral hygiene instructions were given to the patient. No oral hygiene procedures were administered for 15 months (T3), when the final recordings were taken. Results: The results showed that there was a worsening of gingival index (GI) and plaque index (PI) of the treated sites between T0 and T1 during initial orthodontics treatment, whereas there was an improvement of the gingival inflammation at T2 when compared with T1. At T2, there was also a statistically significant improvement in GI and PI compared with T0. A T3 improvement in periodontal parameters was sustained. A non-parametric test (Wilcoxon signed-rank test) was used for statistical analysis. Conclusions: Augmentation of the width of keratinized gingiva, as the sole treatment, favors the improvement of GI and PI during orthodontic therapy.

Considering the widespread use of smartphones and their applications (apps), as well as the undeniable role of reminders and apps in behavioral interventions, this study aimed to assess the efficacy of a smartphone app (Brush DJ) for oral hygiene compliance of patients with fixed orthodontic appliances. In this randomized clinical trial, 120 patients between 15 to 25 years who had just started fixed orthodontic treatment were randomly divided into two groups (n = 60). Control patients received conventional oral hygiene instruction, while patients in the intervention group were asked to use the Brush DJ smartphone app, after receiving conventional oral hygiene instruction. The plaque index (PI) and gingival index (GI) were measured at baseline (T0), and at 4 weeks (T1), 8 weeks (T2) and 12 weeks (T3) after the onset of study. A questionnaire was given to all patients to assess the frequency and duration of tooth brushing per day, and the frequency of app usage and reminder noticing in the intervention group. Improvements in PI and GI were noted in the intervention group; while these parameters increased in the control group. Significant differences were noted in PI and GI changes between the two groups (p

Introduction YouTube is a popular social media platform that is being increasingly used for the distribution of healthcare-related information. To date, there appear to be no published studies assessing the quality of oral hygiene instruction provided by YouTube videos.Objective To assess the availability, quality and accuracy of patient-focused YouTube videos aiming to provide oral hygiene instruction.Method YouTube videos meeting the inclusion criteria were evaluated for quality and information accuracy using an eight-item, evidence-based checklist relating to important aspects in the prevention of caries and periodontal disease.Results Fifty-two relevant videos were included; 20 videos (38.5%) were produced by lay people (social media influencers and bloggers) who had no professional qualifications. None of the included videos contained accurate information relating to all eight items of the evidence-based checklist. Seven videos contained none of the information from the checklist. Numerous videos contained health advice which was not scientifically sound.Conclusion The results of this study highlight that currently available YouTube videos may not contain evidence-based information relating to oral hygiene instruction. There are also concerns regarding the lack of regulation and quality assurance processes in the development of healthcare-related YouTube videos. Currently, clinicians should be cautious when advising patients to utilise YouTube as a source of information regarding oral health.

Smoking can cause periodontal disease as well as lesions in the oral mucosa. Nicotine stomatitis is inflammation caused by heat stimuli injury on the hard and soft palate of the oral cavity; smokers commonly suffer from this condition. Knowledge of how oral hygiene affects the health of dental and oral cavity. The purpose of this study was to describe the differences in community periodontal index (CPI) and nicotine stomatitis in smokers after oral hygiene instruction. The study subjects were 54 men who have a history of active smoking for more than five years. The experiment was carried out in the Biomedical Laboratory of Faculty of Medicine Universitas Islam Bandung in September 2018–January 2019. Dental examination initiated before and after dental health instructions. CPI and nicotine stomatitis tests performed on all subjects by dentists using dental instruments. After six weeks of information about oral hygiene, all subjects re-examined. The results show that there is a statistically significant difference in the average CPI value in smokers before and after dental instruction with a p value

INTRODUCTION: Orthodontic treatment is widely acknowledged and accepted in everyday dental practice due to the positive effects it has on the dentofacial complex. Importance of oral hygiene in orthodontic patients is also important to prevent any further oral diseases.AIM: The aim of this study was to assess the knowledge, attitude, and practice of oral hygiene protocols among patients having orthodontic treatment.MATERIALS AND METHODS: The sample consisted of 90 patients who had permanent dentition from the Department of Orthodontics and Dentofacial Orthopedics and various questions were asked regarding the knowledge, attitude and practice on oral hygiene during the time of orthodontic treatment. All the responses were analysed statistically.RESULTS: The results of the study showed that nearly 40% of the patients were unaware about gingival health, 65% did not follow the oral hygiene instruction. Despite being given instructions, most of them were reluctant in practicing them strictly.CONCLUSION: The knowledge, attitude, practice of oral hygiene among orthodontic patients were poor and showed the need of better education and motivation. Many factors may be responsible for the non-maintenance of gingival health practices. There is a need to incorporate and evaluate more intense oral hygiene programs in the future.

The aim of this study was to assess the oral health literacy knowledge gained by patients who are refugees, community members, and medical and nursing students after participating in an interprofessional education collaborative of students and faculty from the University of Texas Health San Antonio Schools of Dentistry, Medicine, and Nursing. In this faculty-student collaborative practice, all patients were triaged (including oral hygiene status and alcohol/tobacco use), and tailored treatment options were offered following assessment of their dental, medical, and social histories. The study was designed as a pre-post assessment of an educational intervention on oral health literacy. In the pretest, all groups were invited to respond to questionnaires assessing their knowledge of oral health. After participants engaged in oral hygiene instruction demonstrations and received information about an oral health literacy campaign, a posttest was conducted to assess knowledge gained. A total of 151 patients who were refugees, 38 medical students, 34 nursing students, and 17 community/parish members voluntarily participated in this initiative. Each group had a significant increase in mean oral health literacy score from pre- to posttest: patients 33.5%, community/parish members 22.3%, nursing students 20.8%, and medical students 13% (all p

The ‘Integra’ project – Smile Action is developed by undergraduate and Master's degree students in Dentistry – UEL/PR with the objective of promoting dental care for children in situation of social vulnerability assisted by the institution Casa Acolhedora Mae e Senhora de Todos os Povos-Londrina-PR. The students promoted cultural and educational actions with 85 children and their families, including dental care, oral hygiene instruction and supply of oral hygiene materials. Workshops were organized addressing oral health, pregnancy and sexually transmitted diseases, diet, smoking and dental trauma. The students developed educational and cultural activities, such as the Solidarity campaign at the beginning of the school semester and celebration of festive dates with the purpose of drawing attention to health lifestyle and collecting school material and toys. The integration of undergraduate and graduate students with the community allowed the training of professionals in prevention and raised awareness of their role in addressing social demands. It was also possible to identify that it is necessary to extend dental care to parents, due to the progress of children’s and adolescents’ treatments.

The present article purports the aim of showing, in a series of cases, the application of excisional biopsy with gingivoplasty technique as treatment of pyogenic granuloma. It can be observed that accurate excision as well as elimination of contributing factors considerably decreases recurrence probabilities. Presence of pyogenic granuloma has been described in this report of a series of cases related to pregnancy, local factors such as absence of interproximal contact, presence of calculi and poor oral hygiene indexes. Moreover, it is recommended that oral hygiene instruction be the first step in treatment of pyogenic granuloma, and that after lesion excision patients receive supporting periodontal therapy.

Objective: To evaluate the factors associated with the occurrence of dental trauma in children up to six years of age and describe the results of clinical follow-up and possible sequelae. Material and Methods: A retrospective study was carried out with data collected from the dental records of 96 pediatric patients up to 6 years old with traumatized primary teeth who sought care from the. Pediatric Dental Trauma project of a private university in the city of Rio de Janeiro from July 2014 to July 2017, and who had clinical and radiographic follow-up for up to three months as of their initial visit. Results: 96 children (58.3% boys and 41.7% girls) included who presented 166 traumatized primary teeth. Intrusion was the most observed type of trauma and in 45.8% of cases, the care occurred one-week post trauma. The maxillary central incisors were the most affected teeth (97.6%). The prognosis of the dental elements with more than 3 months of follow-up was considered favorable, and 59.6% of the teeth did not present any clinical or radiological sequelae. Oral hygiene instruction and monitoring were the most common approaches. Conclusion: The prevalence of dental trauma in the present study was high and occurred mainly in domestic settings. The upper central incisors were the teeth that suffered the most injuries. The presence of patients at follow-up visits was an important factor for the positive result in most cases.

In some 15–30% of patients complaining of a serious breath odor problem, little or no ­malodor can be detected by the examiner either organoleptically by smelling the patient’s breath or using laboratory techniques (Quirynen et al. 2009; Seemann et al. 2006). These patients vary in their level of conviction regarding their perceived odor problem. Some are uncertain and just wish to confirm or rule out a breath odor problem, whereas others firmly believe that the problem exists. In extreme cases, patients may appear psychotic and/or contemplate suicide (Yaegaki and Coil 1999). Some researchers have dichotomously subclassified these patients into “Pseudohalitosis” and “Halitophobia” based on their treatment response and need of psychiatric consultation (Yaegaki and Coil 2000). Alternatively, other researchers regard “Halitophobia” as a “mild to severe” spectrum of conditions that includes any level of exaggerated concern of having a breath odor problem (Rosenberg and Leib 1997).

BACKGROUND This study aimed to understand trends in dentists' implant training attendance and correlation to treatment provision. Implant-specific oral hygiene instruction coverage in training programs was investigated. METHODS A cross-sectional web-survey of dentists registered in Australia was conducted. Respondents were asked about their background, implant training history and treatment provision. Results were analysed by implant provision characteristics and graduation decade. RESULTS Three hundred and three responses from general dental practitioners (GDPs) were received and analysed. The highest implant training levels attained post-graduation were postgraduate non-specialist qualification (7.9% of respondents), continuing professional development (CPD) (73.6%) versus none (18.5%), with differences between implant providers and non-providers (P

Objectives To describe the approach taken by dental hygienists and therapists (DH/Ts) in Wales regarding dental implant maintenance. To gather their opinions about the current level of implant education.Materials and methods Online questionnaires were distributed to 257 DH/Ts within Wales.Results The response rate was 35%. Dental implant care was within the remit of service for 92% of respondents. All respondents that provided implant care stated that they performed oral hygiene instruction, while 98% performed supragingival debridement, 85% subgingival debridement, and 64% clinical assessment of peri-implant health. A high proportion of DH/Ts in Wales did not feel entirely confident in carrying out procedures relating to peri-implant maintenance and only 27% felt confident in clinically assessing dental implants. The majority (83%) felt that postgraduate training in peri-implant maintenance should be obligatory. 'No available courses' was the main reason for not attending further postgraduate training in implantology.Conclusions A high proportion of responding DH/Ts practising in Wales do not feel entirely confident in carrying out procedures relating to peri-implant maintenance. Postgraduate training may be useful in addressing this issue and undergraduate training programmes may need to consider increasing trainees' exposure to dental implant maintenance.

Numerous oral hygiene products are currently available on the market, and dental care providers have to select suitable products for the individual patient. Successful oral hygiene should rely on the current best available evidence; hence, oral care providers should be up to date with the advantages and disadvantages of the available oral hygiene products in order to provide their patients with proper information during oral hygiene instruction sessions.

Introduction: Despite recent advancements in ridge preservation techniques, complete tissue regeneration remains difficult to achieve when managing multiple tooth loss in the esthetic zone. Guided bone regeneration has been shown to be effective in creating sufficient bone support, but post-surgical complications including soft tissue deficiencies have been reported. Obtaining “natural” esthetic results has proven challenging, especially when restoring adjacent implants in patients with a high smile line. The addition of extrusion and palatal positioning of the implant facilitates ridge preservation surgery as well as the esthetic outcome, but requires an additional treatment phase devoted to orthodontics.Case Presentation: A healthy 43-year-old female with a longstanding history of smoking presented with terminal periodontal disease on teeth #7 and #8 together with a wide diastema between teeth #8 and #9. Comprehensive dental treatment included smoking cessation, oral hygiene instruction, full-mouth scal...

Background/Purpose In Taiwan, more than 90% of people aged 35–44 years have periodontal disease. To reduce periodontal disease in Taiwanese people, the National Health Insurance (NHI) system included the comprehensive periodontal treatment project (CPTP) in 2010. The CPTP mainly emphasizes oral hygiene instruction, plaque control, and check-up compliance, with the goal of providing complete, continual, and high-quality periodontal care to patients. The purpose of this study was to assess whether the patients receiving comprehensive periodontal treatment had better clinical outcomes than those receiving conventional periodontal treatment. Methods Secondary data exploration was conducted in this study. Based on NHI data, patients who had participated in the CPTP and completed the three-stage periodontal treatments between 2011 and 2012 were recruited in the experimental group (65,342 patients). The patients who had not participated in the CPTP but had received conventional periodontal treatment during the same period were selected in the control group (106,740 patients). Using the four parameters (re-treatment, endodontic therapy, surgical restoration, and tooth extraction) as prognostic indicators, we performed logistic regression analyses to evaluate whether patients in the experimental group had better clinical outcomes than those in the control group. Results We found that patients participating in the CPTP for 545 days had substantially lower rates of re-treatment, endodontic therapy, surgical restoration, and tooth extraction than those in the control group ( p Conclusion We conclude that the patients receiving comprehensive periodontal treatment have better clinical outcomes than the patients receiving conventional periodontal treatment.

Gingivitis and periodontitis are known as the main causes of tooth loss in the world. Treatments of periodontitis include oral hygiene instruction, surgical therapy, and chemotherapy. Guided tissue regeneration (GTR) is one of the treatment modalities of periodontitis and resultant tooth loss. Nowadays, implant treatment is the most commonly available treatment modalities for tooth loss. GTR has an important role in bone and tissue regeneration of implant dentistry. GTR is based on three main parts: cells, signaling molecules, and scaffold (membranes). There are two types of scaffold for this purpose: nonresorbable membrane and resorbable membrane. In this section, different types of scaffold used in gingival regeneration have been investigated, and recent advances in this field, as well as different types of three-dimensional scaffolds and gene therapy have been discussed.

A typical implant maintenance visit is similar to routine maintenance for natural teeth. Emphasis should be placed on evaluating the implants for the presence of inflammation and/or bone loss. If disease is present around the implant extreme care should be taken in treating the problem. There is a controversy on the optimal approach to maintenance. Routine radiographs, evaluation of occlusal contacts and personal oral hygiene instruction should be part of these proceedures.

The purpose of this study was to identify the factors associated with medical care utilization, the level of recognition, satisfaction, revisit and recommendation after implementing the expanded health insurance coverage of dental scaling. A questionnaire survey was conducted and analyzed among 608 adults living in Seoul and Gyeonggi-do April 1st to 30th, 2014. The results of the survey are as follows: 76.9% of the respondents know the expanded health insurance coverage, which is influenced by educational background and monthly income. The level of satisfaction, revisit and recommendation intention is affected meaningfully by educational background. Two factors, high school graduate or less and dental hygienist, meaningfully affect patients' satisfaction with scaling, and recommendation from others and Internet searching contribute to revisit. High school graduate or less is also one of the factors affecting the intention of recommendation, along with recommendation from others, Internet searching, scaling by a dental hygienist, and oral hygiene education before scaling. Summing up the results, patient's satisfaction and intention to recommend are high when dental hygienists provide oral hygiene instruction prior to scaling. This study suggests that dental hygienists help patients feel comfortable before treatment by building rapport with them. In addition, it is required that consistent efforts for quality improvement in scaling be sustained, that the patient's needs be identified to increase their satisfaction with scaling, and that studies to verify relevant factors be conducted.

Objectives: To determine the level of compliance with Oral Hygiene Instruction ( OHI) of 12 to 18 years old adolescent patient receiving orthodontic treatment at Dhaka Dental College and Hospital.Materials and Methods : In this descriptive observational study, a total number of 100 patients (37 boys & 63 girls) were selected (with convenient sampling) from Orthodontics and Dentofacial Orthopedics Department in Dhaka Dental College & Hospital. As the number of female patient is higher than that of male patient at Orthodontics and Dentofacial Orthopedics Department in Dhaka Dental College & Hospital and the samples were selected with convenient sampling, the number of female patient was higher in this study.Results: This was an observational study conducted among 100 patients in the department of Orthodontics and Dentofacial Orthopedics, Dhaka Dental College and Hospital. The result of this study indicates that after five month of insertion of orthodontic appliance, 76% patients were good complier with Oral Hygiene instruction (OHI).Conclusion: The insertion of orthodontic appliances can result in changes in the oral environment, such as causing higher concentration of acid-producing bacteria due to the difficulty of performing oral hygiene after the insertion of appliance. Orthodontic appliances can also be associated with white spots, enamel decalcification, periodontal breakdown, and development of carious lesions. Continual plaque build-up may thus jeopardize the continuity of orthodontic treatment and the achievement of successful treatment outcome. So it is very important to give Oral Hygiene Instruction (OHI) at the commencement of orthodontic treatment and close supervision of the patient during treatment.Ban J Orthod & Dentofac Orthop, April 2013; Vol-3, No.2

Periodontitis is a ubiquitous and irreversible inflammatory condition and represents a significant public health burden. Severe periodontitis affects over 11% of adults, is a major cause of tooth loss impacting negatively upon speech, nutrition, quality of life and self-esteem, and has systemic inflammatory consequences. Periodontitis is preventable and treatment leads to reduced rates of tooth loss and improved quality of life. However, successful treatment necessitates behaviour change in patients to address lifestyle risk factors (e.g. smoking) and, most importantly, to attain and sustain high standards of daily plaque removal, lifelong. While mechanical plaque removal remains the bedrock of successful periodontal disease management, in high-risk patients it appears that the critical threshold for plaque accumulation to trigger periodontitis is low, and such patients may benefit from adjunctive agents for primary prevention of periodontitis.AimThe aims of this working group were to systematically review the evidence for primary prevention of periodontitis by preventing gingivitis via four approaches: 1) the efficacy of mechanical self-administered plaque control regimes; 2) the efficacy of self-administered inter-dental mechanical plaque control; 3) the efficacy of adjunctive chemical plaque control; and 4) anti-inflammatory (sole or adjunctive) approaches.MethodsTwo meta-reviews (mechanical plaque removal) and two traditional systematic reviews (chemical plaque control/anti-inflammatory agents) formed the basis of this consensus.ResultsData support the belief that professionally administered plaque control significantly improves gingival inflammation and lowers plaque scores, with some evidence that reinforcement of oral hygiene provides further benefit. Re-chargeable power toothbrushes provide small but statistically significant additional reductions in gingival inflammation and plaque levels. Flossing cannot be recommended other than for sites of gingival and periodontal health, where inter-dental brushes (IDBs) will not pass through the interproximal area without trauma. Otherwise, IDBs are the device of choice for interproximal plaque removal. Use of local or systemic anti-inflammatory agents in the management of gingivitis has no robust evidence base. We support the almost universal recommendations that all people should brush their teeth twice a day for at least 2 min. with fluoridated dentifrice. Expert opinion is that for periodontitis patients 2 min. is likely to be insufficient, especially when considering the need for additional use of inter-dental cleaning devices. In patients with gingivitis once daily inter-dental cleaning is recommended and the adjunctive use of chemical plaque control agents offers advantages in this group.

Background: Noninvasive measures involving fluoridation, dietary control, and oral hygiene instruction, as well as invasive restorative methods, are the standard treatment options for interproximal caries. Intermediate treatment options, similar to pit-and-fissure sealing on occlusal surfaces that has been shown to be effective in preventing and inhibiting caries, have not yet been established on interproximal surfaces. Recently, the application of resins on interproximal caries lesions has been studied and improved, leading to the development of new materials, which infiltrate and seal the carious lesion, improving the inhibition of caries progression. Aim: The aim of this literature review was to revise the in vivo and in vitro scientific evidence of the ability of resin infiltration (RI) to arrest non-cavitated proximal caries lesions. Materials and methods: Electronic search of English scientific papers from 2007 to 2017 was accomplished using Pub Med search engine. The keywords used were ‘resin infiltration, dental caries’, ‘resin infiltration, carious lesions’, ‘resin infiltration, caries lesions’, ‘caries infiltration’ and ‘Icon DMG’ with the ‘clinical trial’ filter activated. Results: One hundred and forty articles were reviewed as well as some references of selected articles. Fifty studies described the ability of resin infiltration to arrest non-cavitated caries lesions. Conclusion: Data show this new technique complements existing treatment options for interproximal caries by delaying the time point for a restoration and consequently closing the gap between noninvasive and invasive treatment options.

BACKGROUND: The longitudinal aspect of dental caries has not been previously reported for the Italian population. The primary object of the present study is to collect information of the prevalence of dental decay among the schoolchildren of primary school of Gradisca d'Isonzo (GO) and to analyze the tendency of caries among the students followed since the first year of school. METHODS: Subsequent examinations hold from 2011 to 2015 has been conducted by two calibrated examiners. Oral hygiene instruction and motivation followed the visits. According to WHO principals DMFT and dmft were recorded. The children in the survey were divided into 5 groups according to their ages (6, 7, 8 and 9 years), and these groups were considered separately. Descriptive and statistical analysis of the data was conducted. RESULTS: More than 400 pupils were recruited, resulting in almost 900 examinations during 5 years. Overall, the %dft ≥1 children range from 18.9% (10 years, 2013) to 53.5% (8 years, 2011) across the different age groups. Overall, the %DFT≥1 children range from 8.3% (6 years, 2011) to 44.1% (10 years, 2012) across the different age groups. CONCLUSIONS: Within the limits of the present study, the WHO goals are still not met, among the population in exam. Our results show a trend of decay diminution that enhances in the cohort of 10-aged children suggesting the importance of dental education. Furthermore, the lack of pediatric initiatives of oral hygiene may be overcome by a national intensive educational program, supported by further scientific evidence.

Background: Dental caries and periodontal disease are admittedly the most common oral diseases and are one of the main oral health problems, affecting the quality of life of the individuals. The aim of this study was to evaluate patient’s education level and knowledge on dental treatment of caries/periodontal disease and oral hygiene through a specific questionnaire. Materials and Methods: A group of 600 adults aged between 18 and 80 years old were evaluated. After the evaluation of the answers given, the participants in the survey were instructed regarding the main oral health preventive measures. The obtained data were submitted to descriptive statistical analysis. Results: The results showed that 59% of the patients were female at age range of 31‐40 years‐old. The patients with a higher educational level had more previous information about caries, periodontal diseases, and oral health preventive measures. The dentist was pointed out as the person responsible for the oral hygiene instruction for 73.83% of the patients. The lack of oral hygiene were said to be the main factor accounting for both caries and periodontal disease etiology (79.85% and 62.93%, respectively). Pain was the motivating factor for seeing a dentist (44.50) whereas 55.50% of the patients were motivated by a preventive care (routine appointment). Dental floss was used by only 49.50% of the patients and 34.90% that did not use it by saying that it provokes gingival bleeding. Conclusion: The evaluated patients presented an uneven knowledge level on caries, periodontal disease, and oral hygiene preventive measures. The educational level had a direct influence on both patient’s knowledge and behavior regarding to the main oral diseases. There is the need for a continued instruction on caries and periodontal disease preventive measures, with emphasis on diet role and dental floss use in dental educational programs.

The type of used rotating-oscillating toothbrush was incorrectly assigned; correct used rotating-oscillating toothbrush is Pro1000 Precision Clean, Procter&Gamble GmbH, Schwalbach, Germany.

We evaluated changes in clinical variables and microbiological profiles of periodontopathogens among 56 patients with moderate to severe CP who were randomly assigned to oral hygiene instruction (OHI; n = 28) or nonsurgical periodontal treatment (NSPT; n = 28). Periodontal variables were assessed and subgingival plaque samples were obtained from deep pockets (≥5 mm) at baseline and 3 months after treatment. Real-time polymerase chain reaction was used to quantify Actinobacillus actinomycetemcomitans, Tannerella forsythia, Porphyromonas gingivalis, and Prevotella intermedia. All clinical variables significantly improved in both groups. Improvements in gingival bleeding index (GBI), probing pocket depth (PPD), and periodontal attachment loss (PAL) were significantly greater at 3 months after treatment in the NSPT group. At baseline, the prevalences of all pathogens were high. Significant reductions in microbial count were observed for A. actinomycetemcomitans and T. forsythia (P ≤ 0.05) in the NSPT group. None of the improvements in clinical variables was associated with changes in microbiological profiles. At 3 months after treatment, NSPT was associated with significantly greater improvements in GBI, PPD, and PAL as compared with OHI. A. actinomycetemcomitans and T. forsythia counts were significantly lower in the NSPT group.

The purpose of this study was to investigate the actual condition of communication of dental hygienist in oral hygiene instruction during scaling. The research was intended for 67 dental hygienists who worked dental hospitals and clinics. Oral hygiene instruction during scaling was audio- taped. Pearson correlation analysis, t-test, one-way ANOVA, and chi-squared test were conducted. The results gained by the research were as follows. An analysis of 67 dental hygienists has found that 63 dental hygienists (94%) educated the patients with dentiform and 65 of them (97%) did rolling method. Thirty-three of them (49.3%) recommended oral care products to the patients. Only 14 of all educators (21%) said simple greetings and educated importance of care of subjectsʼ teeth, side effect of scaling, when they finished all the scaling stage. The average time of oral hygiene education was 161.3 seconds. In detail, the dental hygienists told 155.0 seconds, the patients did 6.3 seconds on average. The percentage of education time without patientsʼ comments and dialogue each other were 35.8% and 37.3% respectiv ely. The conversation frequency according to the education level of dental hygienist showed significant difference (p

Video observation studies of habitual oral hygiene from the 1970s revealed a striking neglect of brushing oral surfaces and unsystematic brushing patterns with frequent movements between areas. These findings were not systematically followed up; furthermore, nothing is known about whether subjects are able to floss sufficiently. Therefore, the aim of this video study was to analyse the performance of habitual toothbrushing and flossing. A random sample of 101 18-year-olds was included. Toothbrush and floss were provided; habitual brushing/flossing was videotaped in a standardised setting and analysed with the video coding software INTERACT. Parameters of interest were toothbrushing duration, type of brushing strokes, brushing patterns, flossed interproximal spaces and flossing technique. The mean brushing duration was 156.0 ± 71.1 s; duration differed only slightly between the upper and lower jaw as well as between the right, left and anterior areas. However, oral surfaces were brushed distinctly shorter than vestibular surfaces (27.1 ± 27.8 s versus 72.1 ± 31.8 s; p ≤ 0.001). Participants brushed different areas of the mouth with different types of strokes, predominantly with horizontal and circular strokes. Brushing movements frequently alternated between areas (45.1 ± 22.4) not randomly but accumulated within a jaw with a tendency to move from the right to the left. Half of the participants flossed, but only one performed sufficiently. There was a significant neglect of brushing oral surfaces and insufficient use of floss. Brushing patterns were similar to those observed in the 1970s. Understanding habitual oral hygiene behaviour is essential for improving oral hygiene instruction strategies.

OBJECTIVE: To investigate the effects on plaque index (PI) scores of manual or electric toothbrush with or without repeated oral hygiene instructions (OHI) and motivation on patients wearing fixed orthodontic appliances. MATERIALS AND METHODS: One month after the orthodontic fixed appliance bonding on both arches, 60 patients were randomly assigned to four groups; groups E(1) (n = 15) and E(2) (n = 15) received a powered rotating-oscillating toothbrush, and groups M(1) (n = 15) and M(2) (n = 15) received a manual toothbrush. Groups E(1) and M(1) received OHI and motivation at baseline (T0) and after 4, 8, 12, 16, and 20 weeks (T4, T8, T12, T16, and T20, respectively) by a Registered Dental Hygienist; groups E(2) and M(2) received OHI and motivation only at baseline. At each time point a blinded examiner scored plaque of all teeth using the modified Quigley-Hein PI. RESULTS: In all groups the PI score decreased significantly over time, and there were differences among groups at T8, T12, T16, and T20. At T8, PI scores of group E(1) were lower than those of group E(2), and at T12, T16, and T20, PI scores of groups M(1) and E(1) were lower compared to those of groups M(2) and E(2). A linear mixed model showed that the effect of repeated OHI and motivation during time was statistically significant, independently from the use of manual or electric toothbrush. CONCLUSIONS: The present results showed that repeated OHI and motivation are crucial in reducing PI score in orthodontic patients, independent of the type of toothbrush used.

A B S T R A C T To assess the oral health status and treatment needs of an ambulant population of older adults, living in the Maule Region, Chile, and provide descriptive information on its distribution by selected sociodemographic characteristics. The source of primary data was the Regional Oral Health Survey. A stratified random sample of 438 older adults, aged 65–74 years, living independently in the community was orally examined, and underwent an oral health interview. The sample was largely a dentate one (74.9%); with a mean DMFT score of 25.7 (s.d. 6.5) and an average number of missing teeth of 22.4 (s.d. 5.8). Dentate participants had 41% of their restorative care needs unmet, and 68.4% needed oral hygiene instruction plus removal of calculus on their teeth. Almost 30.1% required complex periodontal therapy. 21% of those fully edentulous were in need of full dentures. Comparing these findings with existing data on the oral health of older adults in Chile, participants in this study appear to have lower missing teeth scores and less need for complex periodontal treatment. Inequities were apparent in the proportion of unmet restorative and prosthetics needs. Community-based preventive care programs specifically tailored to older adults are needed to address this challenge.

Clinical evidence suggests an association between preterm birth and periodontal disease. This study explores whether specific genetic polymorphisms are associated with success of periodontal therapy in pregnant women with periodontal disease and, further, whether any of these same polymorphisms are also associated with spontaneous preterm birth (sPTB).One hundred sixty high-risk pregnant women (6 to 20 weeks of gestation) with periodontal disease (≥ 3 sites with attachment loss ≥ 4 mm) were studied. All women received scaling and root planing plus oral hygiene instruction. Periodontal examinations were performed before treatment and 20 weeks later. Participants were classified according to two study outcomes: 1) success or failure of periodontal treatment; and 2) presence or absence of sPTB. Maternal DNA samples from mucosal swabs were characterized using a 1536-SNP (single-nucleotide polymorphism) custom polymerase chain reaction chip. A probabilistic model of each dichotomous outcome, derived using a stepwise Bayesian procedure, was compared to respective null hypotheses on the basis of Monte Carlo simulations and significance estimates obtained using three measures (z-test, Welch t-test, and probability convolution). The models were further confirmed by logistic regression analyses.The models revealed a significant relation between a specific polymorphism of prostaglandin E receptor 3 (a gene associated with inflammatory response) and both periodontal treatment failure (odds ratio 11.09, P0.0002) and sPTB (odds ratio 6.89, P0.0032).These results demonstrate that the risk of unsuccessful periodontal treatment is associated with tag SNPs in specific genes that regulate the inflammatory response, one of which is also associated with sPTB.

The assessor-blinded, parallel-design, quasi-randomized study (alternating allocation) aimed to determine the effects of the six-step method on postoperative numbers of oral bacteria, periodontal status, and atrial fibrillation (AF) among inpatients with heart diseases and periodontitis. Seventy inpatients who received preoperative periodontal treatment were quasi-randomly assigned to intervention and control groups at University Hospital. The intervention group received intensive oral hygiene instruction using a six-step method for 15 minutes per week and the control group received routine oral hygiene instruction. Significantly fewer oral bacteria were identified on the tongue at discharge compared with baseline in the intervention than the control group (ANCOVA) (large effect size, p = 0.02). Changes in scores for self-efficacy, plaque scores, probed pocket depth, and bleeding on probing between baseline and discharge were significantly greater in the intervention, than in the control group (p &lt, 0.05). The period of postoperative AF (days) was significantly shorter in the intervention, than in the control group (p = 0.019). In conclusion, oral hygiene instruction using the six-step method decreased the numbers of oral bacteria on the tongue and improved self-efficacy, oral health behaviors, oral hygiene status, periodontal status, and period of postoperative AF among inpatients with periodontitis and heart diseases.

Background This study evaluated the available online information regarding a child's first dental visit (CFDV) and compares this with internationally recognized guidelines for the timing of CFDV. Methods Online information regarding CFDV was searched using the Google search engine under the Australian domain for four selected search terms and limited to the first 50 results. The websites of selected professional dental associations were also investigated for recommended CFDV timing. Guidelines recommended the CFDV from when the first tooth erupts or by the age of one year. Results Information on timing for CFDV was available on the internet and consistent with recognized guidelines for almost half of the 157 sites examined. Information on CFDV was consistent with guidelines when mentioned in professional dental association and public (government and corporate) sites. Misinformation regarding CFDV was primarily associated with dental forums and sites owned by dental professionals. The three most popular topics of additional information included oral hygiene instruction, procedures for age-one CFDV and preparing the child for the CFDV. Conclusions Internet information regarding a child's first dental visit was generally informative but not always in agreement with the recommendations of professional dental associations. Misinformation regarding CFDV was primarily associated with dental forums and dental professional owned sites.

Purpose The aims of this study were: (1) to determine which step in tooth brushing is most difficult for individuals with developmental disabilities and (2) to determine if oral hygiene instruction improves technique. Material and methods Once per week for 6 weeks, disclosing solution was applied to the teeth of 14 subjects who were observed individually in their tooth brushing technique. Fourteen distinct steps were measured on a 4-point Likert scale. Plaque score was measured after brushing. Results The step causing greatest difficulty was “able to brush off residual, identified plaque.” Steps that showed greatest improvement were “open toothpaste” and “place toothpaste on brush.” The change in plaque score from the initial visit to the final visit was not statistically significant. Conclusion Oral hygiene instruction in a group and individual setting increased compliance in the initial steps of tooth brushing.

Provision of orthodontic care is increasingly the remit of a highly skilled and qualified team, led by a specialist orthodontist. Often separate patient clinics are held in specialist practice for oral hygiene instruction and for impression taking. These tasks are increasingly delivered, under prescription from the specialist orthodontist, by orthodontic nurses (ON) with appropriate post-registration training and/or orthodontic therapists (OT). Nurse or therapist-led clinics can be beneficial in stimulating patient co-operation, enhance both practice efficiency and staff involvement and maximise the patient experience.