The plaque control through oral hygiene is the most efficient measure to reduce chronic oral diseases related to lifestyle. Several studies pointed the difficulty of changing daily hygiene habits and the plaque index is the method of choice for measuring the oral hygiene quality. Considering smartphones penetration in today's society and its acceptance, this study aims to compare plaque index methods as the O´leary index (IPC), the visible plaque index (IPV), and the use of a smartphone camera, as an alternative method to obtain the plaque index without a health professional. A systematic review of the literature and meta-analysis was also carried out in order to categorize the plaque index, relating numerical plaque values to the periodontal condition (without disease, gingivitis and periodontal disease related to dental biofilm).The analysis of the use of the selfie was performed by comparing the clinical data, in 48 participants, with the images obtained by the use of smartphones. Initially, the linear regression equation was developed, using the smile image in a sample of 10 participants, with a camera. Measuring the selfie index of visible plaque (ISPV) and disclosed (ISPC) was done through the area with plaque of each participant in relation to the total area included in the image processing. Spearman's correlation test showed a moderate correlation between IPV and ISPV (rho = 0.6, p <0.001), whereas between IPC and ISPC the correlation was weak (rho = 0.2, p = 0.13). The correlation between the plaque index using all the teeth present, showed a strong correlation with the analysis only of the anterior teeth (rho = 0.8, p <0.001). There is a gap in health promotion in self-monitoring of the plaque index using the available mobile technologies, for an effective control of dental biofilm. The use of anterior teeth image to obtain the plaque index is promising, especially when considering the development and implementation of artificial intelligence.

Periodontitis is a chronic multifactorial inflammatory disease associated with a dysbiotic biofilm and characterized by progressive destruction of the tooth-supporting apparatus. This systematic review aimed to establish the quantitative association between dental plaque index and plaque-induced periodontal outcomes, as well as, clinical plaque index (PI) cut-off points. MEDLINE electronic searches were performed with at least two outcomes (healthy, G or P). 124 articles met the eligibility criteria and were included in meta‐analysis. Healthy (H) group had a PI three times lower than G group (ROM 3.21; 95% CI 2.35-4.39) and P group (ROM 3.34; 95% CI 2.97-3.76); P group had 32% higher PI than G group (ROM 1.32; 95% CI 1.15-1.50). The meta‐analyses of different PI (Silness and Löe, PI-SL; and percentage of faces, PI-%), PI-SL H group (MRAW 0.52) differed from G group (MRAW 1.58) and P group (MRAW 1.83) although it was not possible to distinguish the G group (95% CI 1.28-1.89) from the P group (95% CI 1.67-1.98). This was also observed in the PI-% (MRAW 22% H, MRAW 68% G and P group). PI was able to distinguish periodontal health individuals from whom with periodontal conditions associated with plaque. This systematic review proposes the following PI values cutoff points: H group lower than 0.7 (PI-SL), 30% (PI-%); G group 0.7 to 1.6 (PI-SL) or 31% to 60% (PI-%); and P group up to 1.6 (PI-SL) or 60% (PI-%). The results have clinical application on health promotion and disease prevention through population-based interventions.

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