Comparison between mechanical cleaning and an antimicrobial rinse for the treatment and prevention of interdental gingivitis

Abstract

This study compared the efficacy of an antimicrobial mouthrinse (0.12% chlorhexidine gluconate) plus toothbrushing (mouthrinse group), mechanical interdental cleaning plus toothbrushing (mechanical group), and toothbrushing alone (control group), at reducing and preventing interdental gingival inflammation. 92 male subjects were examined for interdental inflammation using the Eastman interdental bleeding index at baseline, then monthly for 3 months after using one of the above oral hygiene regimens. The mechanical cleaning group had significant reductions in bleeding sites compared to baseline at 1 month (56.90% versus 13.17%) that persisted throughout the study (2 months = 6.65%, 3 months = 5.70%). The other regimens showed no significant bleeding reduction at any time point in the study. The mechanical interdental cleaning group showed improvement over baseline at 1 month with the full benefit apparent after 2 months. The effect of location in the mouth on bleeding reduction was also assessed. The % of posterior sites which bled was always higher than anterior sites. Analysis of maxillary versus mandibular, and buccal versus lingual sites showed no significant differences. Additional observations of the data demonstrated that sites which bled at baseline were more likely to stop bleeding in the mechanical cleaning group. Also, sites which did not bleed at baseline were unlikely to bleed subsequently when mechanical cleaning was used. Neither of these observations were true for the other cleaning regimens. These data show that only mechanical interdental plaque removal combined with toothbrushing is effective at reducing or preventing interdental inflammation. This underscores the importance of instituting mechanical interdental cleaning to eliminate interdental inflammation.

Oral Care Interventions and Oropharyngeal Colonization in Children Receiving Mechanical Ventilation

“…Clinical studies 24,28,29 involving critically ill patients have shown that inadequate salivary flow promotes the development of pharyngeal mucositis and increased colonization by aerobic pathogens. The presence of endotracheal or feeding tubes contributes to the formation of biofilms strongly resistant to antiseptics or antibiotics.…”

“…15 Caton et al 28 found that rinsing with chlorhexidine solution before mechanical cleaning had a profound and sustained effect on the aerobic and facultative flora of the oral cavity and may contribute to a variety of clinical benefits. A meta-analysis 29 of the efficacy of topical chlorhexidine for prevention of VAP indicated that topical chlorhexidine is beneficial in preventing VAP and that the benefit is most marked in cardiac surgery patients.…”

Efficacy of a herbal toothpaste on patients with established gingivitis: a randomized controlled trial

“…Self-performed mechanical plaque removal is an unquestioned method of controlling plaque and gingivitis 4,8,14 . However, toothbrushing and flossing are difficult tasks, and most of the patients are not able to completely remove plaque in all teeth surfaces 11 .…”

A Proposed New Index for Clinical Evaluation of Interproximal Soft Tissues: The Interdental Pressure Index

“…The opportunity to interact not only with bacterial deposits, but also with morphological and histological characteristics of gingival tissues [4, 5, 25], provides a valuable opportunity for the clinician. Many clinical and biological concepts support the relevance of correctly stimulated interproximal tissues.…”