Practice Excellent Home Dental Care

OVERVIEW

Of course, it is important to have regular visits with your dentist and hygienist. But, it is equally essential to practice excellent home dental care. Though teens lead very busy lives, it is crucial that they make time for brushing their teeth a minimum of two times per day and flossing a minimum of once per day. For teens who are wearing dental braces or other orthodontic devices, brushing and flossing may be a little more challenging. Ask your dental provider to recommend products that will improve your ability to brush and floss effectively. Often, teens and others are able to obtain samples from dental professionals. If possible, it is a good idea to keep a small toothbrush and small tube of toothpaste in your locker at school. This is especially important for teens who eat larger amounts of sugary foods and sugary snacks. It is best not to eat these foods, but many teens do.

WHAT THE EXPERTS SAY

Text Messages Tend to Improve Oral Hygiene in Orthodontic Patients

In a prospective, randomized study published in 2014 in Angle Orthodontist, researchers from Richmond, Virginia, wanted to learn if text message reminders would improve oral hygiene compliance among patients. Forty-two patients, with a mean age of 14.2 years, were given detailed oral hygiene instructions and assigned to one of two groups. In one group, parents received one weekly oral hygiene text message. In the second group, no one received oral hygiene text messages. The text messages reminded the parents that their teens should brush their teeth for three minutes after every meal or at least three times each day. Then it noted that “cleaning your teeth will help to keep them healthy and beautiful.” On average, subjects remained in the groups for almost 11 months. Oral compliance was assessed using a number of different clinical factors, such as bleeding index and modified gingival index. The researchers found the children of the parents receiving the oral hygiene text messages had significantly better hygiene than the other participants. The researchers noted that the technology to add this service to a dental practice is already readily available. While they are now generally used to remind patients about upcoming appointments, these messages could be easily modified to serve other functions. The researchers noted that “providing such a service will maintain good communication between the orthodontist and the patient and shows that the orthodontist is concerned about each patient’s well-being.” 1

Difficult Economic Times Do Not Necessarily Mean Inadequate Dental Care 2

Fluoride May Be an Integral Component of Dental Home Care for Some Children and Teens

In an article published in 2014 in Compendium of Continuing Education in Dentistry, dentists from several locations in the United States noted that the home dental care of some children and teens should include fluoride. According to these researchers, some children, teens, and parents may not have the time or ability to provide adequate flossing and brushing. Moreover, poor dietary choices may further place the teeth and gums at increased risk. Preadolescents and teens with dental braces often do not take the added time needed to clean their teeth. According to the authors, these are the children and teens who may benefit from an in home fluoride program. And, it is important that dentists explain to patients and their parents the need to adhere to the at home protocol. “The protocols take into consideration safety (to minimize ingestion of the material), costs, practicality, efficacy, frequency of intervention, and types of fluoride products to be used.” 3

Oscillating-Rotating Power Brushes Appear to Remove More Plaque Than Sonic Brushes

In a randomized, examiner-blind, four-week study published in 2014 in the American Journal of Dentistry, researchers from Ohio and Germany compared the plaque-removing ability of an oscillating-rotating power brush to a sonic brush. The cohort consisted of 131 subjects; 65 were assigned to the oscillating-rotating group and 66 were in the sonic group. Over the course of the trial, both brushes significantly reduced plaque. However, the oscillating-rotating brush removed significantly more plaque. “Compared to the sonic power brush, the adjusted mean plaque reduction scores for the oscillating-rotating power brush were more than five times greater for whole mouth and approximal areas.” 4

Use of a Disclosing Agent Appears to Improve Patient Compliance with Plaque Control

In a randomized, prospective study published in 2014 in Journal of Oral Research and Review, researchers from India wondered if the use of a disclosing agent would help individuals have better control of the plaque on their teeth. Disclosing agents are preparations that contain coloring that highlights bacterial plaque. The cohort consisted of 100 dental patients between the ages of 18 and 50 years who suffered from chronic gingivitis. Fifty of the patients were instructed to use the disclosing agent for 21 days; the 50 patients in the second group did not use a disclosing agent. At the end of the trial, the researchers assessed the plaque status of all the subjects. They found that the subjects using disclosing agents had significantly lower plaque scores than the other subjects. By using the disclosing agent, patients were able to detect the presence of plaque and focus on removing it. “It is imperative to remove plaque in [a] timely manner in order to limit the progression of periodontal disease process and further calculus formation.” 5

Lower-Priced Toothpaste Appears to Work as Well as High-Priced Alternatives

In a randomized, double-blind trial published in 2014 in the European Journal of Dentistry, researchers from India wanted to compare the antiplaque efficacy of lower-priced and higher-priced commercially available toothpastes. For four weeks, 65 patients with dental plaque and gingivitis were assigned to use either a lower-cost or a higher-cost toothpaste. Plaque and gingival assessments were made at baseline and at the end of the trial. The researchers found that both groups had significant reductions in plaque and gingival scores. The researchers concluded that “low cost dentifrice is equally effective to the high cost dentifrice in reducing plaque and gingival inflammation.” 6

BARRIERS AND PROBLEMS

People Wearing Fixed Orthodontic Appliances Have Higher Amounts of Plaque on Their Teeth 7

Dental Anxiety Appears to Negatively Impact Oral Hygiene

In a study published in 2015 in the journal Oral Health & Preventive Dentistry, researchers from Poland wanted to learn more about the oral health habits of people who experience dental anxiety, a disorder in which people have excessive amounts of anxiety associated with their dental visits. The researchers noted that in Poland it has been estimated that 40 percent of patients have dental anxiety. The cohort consisted of 117 consecutive dental patients between the ages of 18 and 77 years; their mean age was 36.57 years. All the participants completed questionnaires and had oral examinations by a dentist. The researchers found that increased dental anxiety was associated with higher levels of dental calculus (hardened dental plaque). So, dental anxiety appears to play a role in people failing to provide the best care for their teeth and oral health. This, in turn, has been associated with a “lower quality of life.” The researchers emphasized the need to develop psychosocial interventions “which may help patients deal with their dental anxiety.” 8

Mexican American Teens and Adults May Have Special Barriers to Adequate Home Dental Care 9 In reality, the gum bleeding was in all probability related to insufficient and/or inadequate dental hygiene.

NOTES

1. Matthew Eppright, Bhavna Shroff, Al M. Best et al., “Influence of Active Reminders on Oral Hygiene Compliance in Orthodontic Patients,” Angle Orthodontist 84, no. 2 (2014): 208-13.

2. C. B. McClure and S. R. Saemundsson, “Effects of National Economic Crisis on Dental Habits and Checkup Behaviors—A Prospective Cohort Study,” Community Dentistry and Oral Epidemiology 42, no. 2 (2014): 106-12.

3. T. P. Croll and J. H. Berg, “Use of Fluoride Products for Young Patients at High Risk of Dental Caries,” Compendium of Continuing Education in Dentistry 35, no. 8 (2014): 602-6.

4. Barbara Büchel, Markus Reise, Malgorzata Klukowska et al., “A 4-Week Clinical Comparison of an Oscillating-Rotating Power Brush Versus a Marketed Sonic Brush in Reducing Dental Plaque,” American Journal of Dentistry 27, no. 1 (2014): 56-60.

5. Mayuri Bhikaji Nepale, Siddhartha Varma, Girish Suragimath et al., “A Prospective Case-Control Study to Assess and Compare the Role of Disclosing Agent in Improving the Patient Compliance in Plaque Control,” Journal of Oral Research and Review 6, no. 2 (2014): 45-48.

6. Rahul Ganavadiya, B. R. Chandra Shekar, Pankaj Goel et al., “Comparison of Anti-Plaque Efficacy Between a Low and High Cost Dentifrice: A Short Term Randomized Double-Blind Trial,” European Journal of Dentistry 8, no. 3 (2014): 381-88.

7. M. Koukowska, A. Bader, C. Erbe et al., “Plaque Levels of Patients with Fixed Orthodontic Appliances Measured by Digital Plaque Image Analysis,” American Journal of Orthodontics and Dentofacial Orthopedics 139, no. 5 (2011): e463-e470.

8. Urszula Kanaffa-Kilijańska, Urszula Kaczmarek, Barbara Kilijańska, and Dorota Frydecka, “Oral Health Condition and Hygiene Habits Among Adult Patients with Respect to Their Level of Dental Anxiety,” Oral Health & Preventive Dentistry 12, no. 3 (2014): 233-39.

9. Gerardo Maupome, Odette Aguirre-Zero, and Chi Westerhold, “Qualitative Description of Dental Hygiene Practices Within Oral Health and Dental Care Perspectives of Mexican-American Adults and Teenagers,” Journal of Public Health Dentistry 75, no. 2 (2015): 93-100.

REFERENCES AND RESOURCES

Magazines, Journals, and Newspapers

Büchel, Barbara, Markus Reise, Malgorzata Klukowska et al. “A 4-Week Clinical Comparison of an Oscillating-Rotating Power Brush Versus a Marketed Sonic Brush in Reducing Dental Plaque.” American Journal of Dentistry 27, no. 1 (2014): 56-60.

Croll, T. P., and J. H. Berg. “Use of Fluoride Products for Young Patients at High Risk of Dental Caries.” Compendium of Continuing Education in Dentistry 35, no. 8 (2014): 602-6.

Eppright, Matthew, Bhavna Shroff, Al M. Best et al. “Influence of Active Reminders on Oral Hygiene Compliance in Orthodontic Patients.” Angle Orthodontist 84, no. 2 (2014): 208-13.

Ganavadiya, Rahul, B. R. Chandra Shekar, Pankaj Goel at al. “Comparison of Anti-Plaque Efficacy Between a Low and High Cost Dentifrice: A Short Term Randomized Double-Blind Trial.” European Journal of Dentistry 8, no. 3 (2014): 381-88.

Geisinger, M. L., N. C. Geurs, J. L. Bain et al. “Oral Health Education and Therapy Reduces Gingivitis During Pregnancy.” Journal of Clinical Periodontology 41, no. 2 (2014): 141-48.

Jordan, R. A., H. M. Hong, A. Lucaciu, and S. Zimmer. “Efficacy of Straight Versus Angled Interdental Brushes on Interproximal Tooth Cleaning: A Randomized Controlled Trial.” International Journal of Dental Hygiene 12 (2014): 152-57.

Kanaffa-Kilijańska, Urszula, Urszula Kaczmarek, Barbara Kilijańska, and Dorota Frydecka. “Oral Health Condition and Hygiene Habits Among Adult Patients with Respect to Their Level of Dental Anxiety.” Oral Health & Preventive Dentistry 12, no. 3 (2014): 233-39.

Koukowska, M., A. Bader, C. Erbe et al. “Plaque Levels of Patients with Fixed Orthodontic Appliances Measured by Digital Plaque Image Analysis.” American Journal of Orthodontics and Dentofacial Orthopedics 139, no. 5 (2011): e463-e470.

Maupome, Gerardo, Odette Aguirre-Zero, and Chi Westerhold. “Qualitative Description of Dental Hygiene Practice Within Oral Health and Dental Care Perspectives of Mexican-American Adults and Teenagers.” Journal of Public Health Dentistry 75, no. 2 (2015): 93-100.

McClure, C. B., and S. R. Saemundsson. “Effects of a National Economic Crisis on Dental Habits and Checkup Behaviors—A Prospective Cohort Study.” Community Dentistry and Oral Epidemiology 42, no. 2 (2014): 106-12.

Nepale, Mayuri Bhikaji, Siddhartha Varma, Girish Suragimath et al. “A Prospective Case-Control Study to Assess and Compare the Role of Disclosing Agent in Improving the Patient Compliance in Plaque Control.” Journal of Oral Research and Review 6, no. 2 (2014): 45-48.

Web Site

American Dental Association. www.ada.org .

  This information is not a tool for self-diagnosis or a substitute for professional care.