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Objectives: This multicentre, assessor‐blinded, two‐arm cluster randomized trial evaluated the clinical and cost‐effectiveness of a behaviour change intervention promoting toothbrushing for preventing dental caries in UK secondary schools. Methods: Pupils aged 11–13 years with their own mobile telephone attending secondary schools with above average free school meals eligibility were randomized (at year‐group level) to receive a lesson and twice‐daily text messages or to usual care. Year‐groups (n = 84) from 42 schools including 4680 pupils (intervention, n = 2262; control, n = 2418) were randomized. Results: In 2383 participants with valid data at baseline and 2.5 years, the primary outcome of presence of at least one treated or untreated carious lesion (D4‐6 MFT [Decayed, Missing and Filled Teeth] in permanent teeth using International Caries Detection and Assessment System) was 44.6% in the intervention group and 43.0% in control (odds ratio [OR] 1.04, 95% CI 0.85–1.26, p =.72). There were no statistically significant differences in secondary outcomes of presence of at least one treated or untreated carious lesion (D1‐6 MFT), number of D4‐6 MFT and D1‐6 MFT, plaque and bleeding scores or health‐related‐ (Child Health Utility 9D) or oral health‐related‐ quality of life (CARIES‐QC). However, twice‐daily toothbrushing, reported by 77.6% of pupils at baseline, increased at 6 months (intervention, 86.9%; control, 83.0%; OR 1.30, 95% CI 1.03–1.63, p =.03), but returned to no difference at 2.5 years (intervention, 81.0%; control, 79.9%; OR 1.05, 95% CI 0.84–1.30, p =.69). Estimated incremental costs and quality‐adjusted life‐years (QALYs) of the intervention, relative to control, were £1.02 (95% CI −1.29 to 3.23) and −0.003 (95% CI −0.009 to 0.002), respectively, with a 7% chance of being cost‐effective (£20 000/QALY gained threshold). Conclusion: There was no evidence of statistically significant difference for caries prevalence at 2.5‐years. The intervention's positive 6‐month toothbrushing behaviour change did not translate into caries reduction. (ISRCTN 12139369). COVID‐19 pandemic adversly affected follow‐up. [ABSTRACT FROM AUTHOR]

Step 2 of periodontal therapy primarily aims at the non-surgical, mechanical disruption of the subgingival biofilm and removal of plaque-retentive factors, allowing a shift from disease to health. Numerous therapeutic agents have been proposed as adjuncts to non-surgical periodontal therapy, generally through either aiding disruption of the dental plaque biofilm, or though alteration of the host immune response. This article reviews the British Society of Periodontology's implementation of the S3-level guidelines in relation to adjunctive therapies. CPD/Clinical Relevance: Recommendation to use adjunctive therapies in the treatment of periodontitis requires careful consideration of the available evidence as well as the wider effects of the proposed therapy. [ABSTRACT FROM AUTHOR]

Loven Ganeswaran emphasises the importance of patients understanding gingival disease. [ABSTRACT FROM AUTHOR]

The purpose of this outcome audit is to evaluate the influence of the clinicians' experience on the outcome of dental implants. In addition, it is to identify the associated risk factors that might influence the success and survival of these implants. Methodology: The records of patients treated with SLA/SLActive Straumann implants were screened. This enabled us to have a minimum of 12 months of follow-up. Eligible patients, according to the inclusion criteria, were contacted and invited to undergo a follow-up assessment. Success was accounted for and defined in a comprehensive manner by considering four different categories: implant perspective, peri-implant soft tissue perspective, prosthetic perspective, and patient satisfaction. The patient investigations included a clinical examination of the implant mobility, suppuration, width of keratinized mucosa, probing depth, plaque accumulation, prosthetic complications, and patient satisfaction. In addition, a periapical radiograph was taken to evaluate bone loss and peri-implant radiolucency. The data were analysed using SPSS version 26. Results: Thirty-eight patients with 84 SLA/SLActive Straumann implants were available for the assessment. The mean age of the patients at implant surgery was 49.05 ± 13.19 years. Over the mean follow-up period of 26 months, no implant fractures were noted. Overall, eight implants were considered failures (9.5%). Two out of six patients with a history of periodontitis (HoP) and two out of five smokers exhibited failed implants. The patients' satisfaction responses showed that all the responses were statistically higher than the test median value of three. The median value of general satisfaction using a visual analogue scale was 9 out of 10. Conclusions: The implants placed on partially and fully edentulous patients revealed high survival and success rates (100% and 90.5%, respectively) at a mean follow-up time of 26 months. It can be concluded that the implant practise among trainees in the programme is satisfactory. A history of periodontitis and a lack of patient compliance with supportive periodontal therapy in some cases have been shown to be risk factors associated with increased implant failure, mainly peri-implantitis. [ABSTRACT FROM AUTHOR]

Anne Symons reviews alcohol's impact on oral health. [ABSTRACT FROM AUTHOR]

Aim: To discover and validate differential protein biomarker expression in saliva and gingival crevicular fluid (GCF) to discriminate objectively between periodontal health and plaque‐induced periodontal disease states. Materials and Methods: One‐hundred and ninety participants were recruited from two centres (Birmingham and Newcastle upon Tyne, UK) comprising healthy, gingivitis, periodontitis, and edentulous donors. Samples from the Birmingham cohort were analysed by quantitative mass spectrometry proteomics for biomarker discovery. Shortlisted candidate proteins were then verified by enzyme‐linked immunosorbent assay in both cohorts. Leave‐one‐out cross validation logistic regression analysis was used to identify the best performing biomarker panels. Results: Ninety‐five proteins were identified in both GCF and saliva samples, and 15 candidate proteins were selected based upon differences discovered between the donor groups. The best performing panels to distinguish between: health or gingivitis and periodontitis contained matrix metalloproteinase‐9 (MMP9), S100A8, alpha‐1‐acid glycoprotein (A1AGP), pyruvate kinase, and age (area under the curve [AUC] 0.970); health and gingivitis contained MMP9, S100A8, A1AGP, and pyruvate kinase, but not age (AUC 0.768); and mild to moderate and advanced periodontitis contained MMP9, S100A8, A1AGP, pyruvate kinase, and age (AUC 0.789). Conclusions: Biomarker panels containing four proteins with and without age as a further parameter can distinguish between periodontal health and disease states. [ABSTRACT FROM AUTHOR]

Children's dental health in England has shown improvement in recent decades. However, 24.7% of 5 year-olds have obvious decay, with the average number of affected teeth being 3.4, and tooth decay is the most common reason for hospital admissions in 5-9 year-olds. Public Health England advises that foods and drinks containing free sugars are limited because of the increased risk of dental caries associated with frequent intakes. Although dried fruit contains more sugars than fresh fruit by weight due to the dehydration process, the portion size of dried fruit is 30 g compared with 80 g for fresh fruit. Additionally, these sugars are not defined as 'free' according to the current UK definition. However, unlike other sources of natural sugars, dried fruit is recommended to be eaten with meals only rather than as a snack because there is a supposition that it 'sticks' to teeth. A comprehensive review of the evidence published last year found a lack of good quality studies to support this advice. In the absence of data from intervention and cohort studies for effects of dried fruit on dental caries endpoints, studies of proxy measures of tooth demineralisation show inconsistent effects on plaque pH and acidogenicity. Measurement of net demineralisation, following consumption of raisins seven times a day for 10 days, showed comparable effects with fresh fruit and vegetables under similar conditions. Oral retention ('sticking') has been investigated in few subjects. The results do not demonstrate that dried fruit is worse in terms of oral clearance than alternative snack foods. More robust research with validated methods is needed before firm conclusions can be drawn about the retention of dried fruit, and hence its potential for adverse effects on teeth. This is important because eating traditional dried fruits can help towards the achievement of a number of dietary recommendations, including contributing to the 5 A DAY target and increasing fibre intake. [ABSTRACT FROM AUTHOR]

Aim To introduce dental hygienists ( DHs) in the UK to the principles of research through a practice-based product evaluation programme. Methods The programme consisted of an initial training and orientation day with presentations on evidence-based practice, research methods and the structure of research papers. The programme and its aims were explained in detail, and participants were briefed on the methods to be used. Participants then recruited seven to ten patients from their practices (offices), carried out a baseline assessment of: plaque, gingival health, calculus and staining at anterior teeth, and gave the patients a questionnaire asking about their teeth and then provided a 3-month supply of a test toothpaste. About 10 weeks later, a follow-up assessment of the same variables was performed and the questionnaire was repeated. A second training day followed during which the DHs provided feedback of their experiences and received training in literature searching and critical appraisal of literature including interpretation of results. Results Sixty-five DHs attended the first training day; 31 were able to recruit sufficient patients and attend the second training day. The DHs recruited 168 patients who received baseline and follow-up assessments. All the variables improved overall. Feedback from the DHs was very positive, and patients expressed delight with the care they had received. Conclusions Qualitative feedback for participating DHs suggests the programme met its aim and could be used in the future as a mechanism for helping DHs who want to increase their understanding of research methodology. [ABSTRACT FROM AUTHOR]

Aim To evaluate the impact of a structured plaque control intervention on clinical and patient-centred outcomes for patients with gingival manifestations of oral lichen planus. Materials and Methods Eighty-two patients were recruited into a 20-week randomized controlled trial. The intervention was structured plaque control comprising powered tooth brushing and inter-dental cleaning advice. Control subjects continued with their normal dental plaque control regimen. The primary outcome measure was the oral health impact profile ( OHIP) with secondary outcomes of pain, plaque index, mucosal disease score and cost-effectiveness. Results Overall, the intervention patients showed statistically significant improvements in OHIP sum ordinal and OHIP dichotomous scores compared with control. There were improvements in the functional limitation, psychological discomfort and physical disability domains at 4- and 20-weeks and in the psychological disability domain at 20-weeks. The intervention was successful in reducing plaque compared to control ( p < 0.001) and improvements were observed using the mucosal disease indices at the 4- and 20-week follow-ups ( p < 0.001). Conclusion A structured plaque control intervention was effective in improving the oral health-related quality of life and clinically observed gingival lesions. This study provides evidence to include intensive plaque control within patients' initial and on-going management. [ABSTRACT FROM AUTHOR]

Background Dietary modification may be important in the prevention and control of chronic adult periodontitis. The role of promoting an adequate consumption of fruits, vegetables and whole grains in chronic periodontitis has not been thoroughly investigated. The main aim of this dietary intervention study was to assess the influence of a customised dietary intervention (aiming to increase the consumption of fruits, vegetables and whole grains) on antioxidant status in adults with chronic periodontitis. Methods Fifty-one participants, aged 30-65 years, were recruited from a UK Dental Hospital and randomly allocated to an intervention or control group. Both groups received normal clinical treatment but customised dietary advice was delivered to the intervention group by a community nutrition assistant. Dietary intakes, anthropometric parameters and biochemical indices with respect to blood and saliva and periodontal indices were evaluated at baseline, as well as at 3 and 6 months post-dietary intervention. Results At 3 and 6 months post-intervention, the intervention group showed a significant ( P < 0.05) increase in plasma total antioxidant capacity measured by Trolox equivalent antioxidant capacity assay compared to the control group. At 3 and 6 months after dietary intervention, the intervention group had significantly higher intakes of fruits and vegetables compared to the control group. The intake of whole grain was significantly higher in the intervention group than in the control group, 6 months post-intervention. No significant differences were observed with respect to periodontal indices between groups. Conclusions It is suggested that dietary advice may help to improve dietary habits and, consequently, the antioxidant status of patients with chronic periodontitis. However, the impact of such intervention on periodontal indices needs further investigation. [ABSTRACT FROM AUTHOR]

Aim To undertake cost-effectiveness and cost-benefit analyses of an intervention to improve oral health in patients presenting with the gingival manifestations of oral lichen planus ( OLP). Materials & Methods Eighty-two patients were recruited to a 20-week randomized controlled trial. The intervention was personalized plaque control comprising powered tooth brushing and inter-dental cleaning advice. The primary outcome measure was the oral health impact profile ( OHIP) with secondary outcomes of pain, plaque index, mucosal disease score and cost-effectiveness. Private cost data and stated willingness-to-pay ( WTP) values for treatment were obtained from intervention patients at 20 weeks. Results Overall, 81% of intervention patients showed improvement in both plaque index and mucosal disease score at 20 weeks compared to 30% of controls that continued with their usual plaque control regimen. All intervention group patients stated a positive WTP value. The mean net value of the treatment was £172 compared to the incremental cost of the treatment estimated at £122.75. The cost-effectiveness analysis resulted in an incremental cost-effectiveness ratio of £13 per OHIP point. Conclusions The tailored plaque control programme was more effective than control in treating the gingival manifestations of oral lichen planus. The programme is cost effective for modest values placed on a point on the OHIP scale and patients generally valued the treatment in excess of the cost. [ABSTRACT FROM AUTHOR]

Aim To investigate the effect of hospitalization on oral health as assessed by dental plaque. Materials and Methods Observational study in a critical care unit ( CCU). Participants were recruited within 24 h of admission. Dental plaque amount was assessed at baseline, 1 and 2 weeks using the Debris index-soft deposits (Greene & Vermillion 1960). Results Fifty participants were recruited with 36 available for outcome assessment at 1 week and 10 at 2 weeks. The principal reason for losses was early discharge with no evidence of a difference between patients present only at baseline and those present at 1 week. The median value for dental plaque at baseline was 4 (95% CI: 4, 6). The median dental plaque increase from baseline to week 1 was 1.5 (95% CI: −1, 4), and this was statistically significant ( p = 0.04). The median increase from week 1 to week 2 was 1.0 (95% CI −8, 6) and not statistically significant ( p = 0.68). Conclusions Oral health as assessed by dental plaque deteriorates following hospitalization in CCU. Such change could lead to impairment of quality of life and well-being as well as to increasing the risk of important healthcare-associated infections such as nosocomial pneumonia. [ABSTRACT FROM AUTHOR]

Objective: While gingivitis and caries continue to be prevalent issues, there is growing concern about dental erosion induced by dietary acids. An oral hygiene product that protects against all these conditions would be beneficial. This study investigated the potential of two anti-erosion dentifrices to inhibit plaque. Methods: This was a randomized, three-period, two-treatment, double-blind, crossover study evaluating a stannous chloride / sodium fluoride dentifrice (SnCl2 / NaF, blend-a-med® Pro Expert) and a popular anti-erosion dentifrice (NaF, Sensodyne® ProNamel™). During Period 3, subjects were randomized to repeat one treatment to evaluate any product carryover effects. Each treatment period was 17 days. Test dentifrices were used with a standard manual toothbrush. Digital plaque image analysis (DPIA) was employed at the end of each period to evaluate plaque levels (i) overnight (AM prebrush); (ii) post-brushing with the test product (AM post-brush); and (iii) mid-afternoon (PM). Analysis was conducted via an objective computer algorithm, which calculated total area of visible plaque. Results: Twenty-seven subjects completed the study. At all time points, subjects had statistically significantly (P ≤ 0.0001) lower plaque levels after using the SnCl2 / NaF dentifrice than the NaF dentifrice. The antiplaque benefit for the SnCl2 / NaF dentifrice versus the NaF dentifrice was: AM prebrush = 26.0%; AM post-brushing = 27.9%; PM = 25.7%. Conclusions: The SnCl2 / NaF dentifrice provided significantly greater daytime and overnight plaque inhibition than the NaF toothpaste. When recommending dentifrice to patients susceptible to dental erosion, clinicians can consider one that also inhibits plaque. [ABSTRACT FROM AUTHOR]

This report is part of a prospective study on dietary behaviours, feeding practices, oral hygiene and dental health during the first 18 months of life in a cohort of infants living in southern England. In this part of the study the prevalence of mutans streptococci in the plaque of 1-year-old children and its correlation with sociodemographic status, dietary behaviour and oral hygiene practices over the first 12 months of life were studied. Dietary habits, oral hygiene and dental health at 18 months were also studied. The study group comprised 163 infants. At 12 months of age all children had a dental examination and a plaque sample was removed from the labial surfaces of upper incisors for microbiological examination. A further dental examination took place at 18 months of age; no plaque was sampled. Longitudinal dietary information was obtained with a 3-day food diary at 6, 12 and 18 months of age. Parents/carers completed two structured questionnaires on sociodemographic factors, oral hygiene and feeding behaviour over the first 18 months of life when their children were 12- and 18-month-old. No child exhibited dental caries at 12 and 18 months of age; 18 and 25% had visible dental plaque at 12 and 18 months, respectively. Seven children (4%) had detectable mutans streptococci in their plaque at 12 months of age. Children who had started brushing their teeth or who had had their teeth brushed by 12 months of age were less likely to have detectable mutans streptococci in their plaque than those who had not (P=0.02). The amount of mutans streptococci was significantly correlated with the total number of eating/drinking events per day (P<0.001) and bordered on significant correlation with the mean daily frequency of consumption of foods and drinks containing non-milk extrinsic sugars (P=0.05). None of the sociodemographic variables—sex, social class, mother’s level of education—were associated with the detection of mutans streptococci in this group of infants. Multiple logistic regression analysis revealed that two variables were independently and positively correlated with the presence of mutans streptococci in the plaque; these were age when tooth brushing started and total eating and drinking events per day. [Copyright &y& Elsevier]

AbstractBackground: Previous studies have shown that polyvinyl pyrrolidone (PVP) added to a chlorhexidine rinse reduced extrinsic dental stain but at the expense of a reduction in plaque inhibitory activity. This effect appeared due to a reduction in the effective chlorhexidine dose to levels where dose response studies show plaque inhibition falls off rapidly. The aim of these 2 clinical studies was to determine if PVP could be added to chlorhexidine rinses to maintain efficacy and reduce staining. Method: Study 1 involved 42 healthy dentate volunteers and was a blind, randomised, 7 treatment, crossover design balanced for residual effects. The rinses were: 1. 0.09% chlorhexidine to which was added, 2. 1% PVP, 3. 3% PVP, 4. 5% PVP, 5. 7% PVP, 6. Placebo, 7. Essential oil product. Rinses were used 2× on day one of each period after a prophylaxis. Subjects suspended tooth cleaning for 24 h and were then scored for plaque area. Study 2 used the experimental gingivitis model, involved 24 healthy dentate subjects and was a blind, randomised, 3 treatment, crossover design balanced for residual effects. The rinses were 1. 0.2% chlorhexidine, 2. 0.2% chlorhexidine/10% PVP, 3. Placebo. At baseline and the end of each study period subjects were rendered plaque, stain and calculus free, suspended oral hygiene and rinsed 2× per day. Plaque, gingivitis and stain were scored at baseline, 1, 2, and 3 weeks. Calculus was scored at baseline and 3 weeks. Results: Study 1: Buccal plaque scores were significantly lower with all rinses compared to placebo. Also all buccal plaque scores were significantly lower with chlorhexidine and chlorhexidine/PVP rinses compared to the essential oil/phenolic rinse. There were no significant differences between the chlorhexidine rinse and the chlorhexidine/PVP rinses. Analyses for buccal and lingual plaque combined produced, with one exception, the same results for rinse comparisons as for buccal plaque alone. Thus the essential... [ABSTRACT FROM AUTHOR]

The article discusses the issue if periodontal disease is preventable in Great Britain. The requirement for the prevention of a disease is the knowledge of its aetiology. The nonspecific plaque theory asserts the primary role of oral bacteria and state that gingival inflammation is produced by accumulations of bacterial plaque in proximity to the gingival margin. A summary of the body of evidence is also emphasized in the article.

Introduces dental products, processes and services available in Great Britain. care. Trycare's Gojo skin care product; Brush-Aways plaque remover; Busch diamond instruments for teeth polishing; British Dental Health Foundation's appointment books.

This article focuses on a study regarding the oral health of a group of non-institutionalised mentally handicapped adults in Great Britain, published in the December 1991 issue of the journal "Community Dentistry and Oral Epidemiology." In 1989, 350 of the 418 mentally handicapped adults attending social services day centres were examined. Diagnosis of dental caries was mainly visual. Assessments of plaque, gingivitis and calculus were made by mouth sextant. The whole study population had a mean age of 33.92. There was identification cohort of severely affected individuals, who had particularly poor plaque control and severe gingivitis.

The article discusses the health benefits of chewed sugarfree gum for dental treatment and promote oral health among people in Great Britain.

The article reports on a review of six randomized controlled trials of two major methods recommended for removing plaque from dentures. A Cochrane report in Great Britain indicated that it is unclear as to which method of cleaning dentures is the most effective. However, it stated that the available evidence suggests that active treatments, such as brushing, are more effective than inactive methods.

The article reports on the study carried out on behalf of Wrigley Oral Healthcare Programs highlighting the confusion over plaque in Great Britain. According to the research, that 97 percent of dental professionals researched believe they talk to their patients about plaque, but less than half of adults in the same survey knew what plaque was. Clear differences between the thoughts of hygienists and dentists were shown.