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The effectiveness of a dentifrice without sodium lauryl sulphate on dental plaque and gingivitis - a randomized controlled clinical trial.
Sälzer, S, Rosema, N, Hennequin-Hoenderdos, NL, Slot, DE, Timmer, C, Dörfer, CE, Van der Weijden, GA
International journal of dental hygiene. 2017;(3):203-210
Abstract
OBJECTIVES The purpose of the study was to evaluate the effect on dental plaque and gingivitis of a dentifrice without sodium lauryl sulphate (SLS) compared to two SLS-containing dentifrices. MATERIAL AND METHODS For this double-blind, parallel study, 90 volunteers having moderate gingival inflammation (≥40%) were randomly divided among three groups: one group using non-SLS dentifrice containing enzymes, colostrum and low concentrations of zinc and two control groups each using different SLS-containing dentifrices. Dental plaque scores (Turesky modification of Quigley & Hein) and gingivitis scores (Bleeding On Marginal Probing) were assessed at baseline, after 2 and 4 weeks. RESULTS Eighty-nine participants provided evaluable data. A slight decrease in gingivitis scores was observed for all groups over 4 weeks, which was statistically significant for the non-SLS group. Mean values for dental plaque scores did not show major differences over 4 weeks. For both parameters, no significant differences between groups could be observed at any time point. Patient appreciation was in favour of the SLS groups especially regarding the foaming effect. CONCLUSION No significant differences could be observed with respect to the effect on plaque and gingivitis between SLS-containing and SLS-free dentifrice containing enzymes, colostrum and low concentration zinc. Patients enjoyed the duration of taste and the 'foaming effect' of SLS-containing dentifrices better.
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Comparison of triclosan and stannous fluoride dentifrices on parameters of gingival inflammation and plaque scores: a systematic review and meta-analysis.
Sälzer, S, Slot, DE, Dörfer, CE, Van der Weijden, GA
International journal of dental hygiene. 2015;(1):1-17
Abstract
OBJECTIVE To systematically review the literature to compare the efficacy of triclosan (Tcs) and stannous fluoride (SnF) dentifrices on parameters of gingivitis and plaque scores. MATERIALS AND METHODS Medline, EMBASE and Cochrane Central Register of Controlled Trials were searched up to March 2013 to identify appropriate studies. Studies regarding self-performed manual brushing by adults with a minimum 4 weeks of follow-up were included. Primary outcomes were parameters of gingivitis. Secondary outcome was plaque score. RESULTS Of 55 publications, 11 met the eligibility criteria. Additionally, four unpublished papers were added after contacting the manufacturers of the leading brands. In total, 15 studies [10 medium term and five long term (>6 months)] were processed for data analysis. There was no difference in gingival index (or its modification) between the two types of dentifrice [DiffM-0.04, 95% confidence interval CI (-0.11; 0.04); P = 0.34]. The change in the average gingival bleeding score was significantly in favour of SnF [DiffM0.02, 95% CI (0.01; 0.02); P < 0.00001]. Plaque scores demonstrated a statistical significant difference in favour of Tcs, according to Quigley-Hein Plaque Index (Q&H PI; DiffM-0.29, 95% CI [-0.45; -0.13]; P = 0.0004), but there was no difference according to Rustogi Modified Navy Plaque Index (RMNPI) [DiffM-0.09, 95% CI (-0.01; 0.18); P = 0.07]. Long-term results supported these findings. CONCLUSIONS In the context of inconclusive results for the primary outcome variable of gingival health, it can be concluded that there was a minor and most likely clinically insignificant difference between Tcs- and SnF-containing dentifrices. Meta-analysis of plaque score reduction was also inconclusive; whereas Tcs was more effective when assessed by the Q&H PI, it was not when scored with the RMNPI.
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The effect of medicated, sugar-free chewing gum on plaque and clinical parameters of gingival inflammation: a systematic review.
Keukenmeester, RS, Slot, DE, Putt, MS, Van der Weijden, GA
International journal of dental hygiene. 2014;(1):2-16
Abstract
OBJECTIVE This study aimed to systematically review the present literature to establish the clinical effect of medicated, sugar-free chewing gum on plaque indices and parameters of gingival inflammation. MATERIALS AND METHODS MEDLINE-PubMed, Cochrane CENTRAL and EMBASE databases were searched up to April 2012 to identify appropriate studies. Included studies used an intervention of medicated, sugar-free chewing gum containing antimicrobial agents or herbal extracts compared with a control gum. Plaque and gingivitis scores were selected as outcome variables. RESULTS Independent screening of 594 unique titles and abstracts identified 10 non-brushing and four brushing studies that met the eligibility criteria. Means and standard deviations were extracted. A sufficient number of studies evaluated chlorhexidine gum to perform a meta-analysis. Although this review provides evidence for the comparative effectiveness of chewing gums containing various ingredients, the results must be weighed carefully against the methods that were used to assess their outcomes. CONCLUSION Most of the chewing gums with antimicrobial agents or herbal extracts were shown to have a positive effect with respect to plaque and gingivitis scores. The most compelling evidence was provided for chewing gum containing chlorhexidine. Meta-analysis and individual results indicate a beneficial effect of chlorhexidine on plaque inhibition. However, GRADE evidence profile shows that the recommendation to use CHX-gum to reduce plaque scores in the absence of brushing is considered to be 'weak'. Other ingredients with positive outcomes on plaque scores are eucalyptus, acacia, funoran, Pycnogenol and mastic. Limited data with respect to gingivitis scores were available, and the following agents showed a positive effect: magnolia, eucalyptus and CHX.
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The effect of sugar-free chewing gum on plaque and clinical parameters of gingival inflammation: a systematic review.
Keukenmeester, RS, Slot, DE, Putt, MS, Van der Weijden, GA
International journal of dental hygiene. 2013;(1):2-14
Abstract
OBJECTIVE The aim of this study was to systematically review the current literature on the clinical effects of sugar-free chewing gum on plaque indices and parameters of gingival inflammation. MATERIAL AND METHODS The MEDLINE-PubMed, Cochrane-CENTRAL and EMBASE databases were searched up to 20 April 2012 to identify any appropriate studies. Plaque indices and parameters of gingival inflammation were selected as outcome variables. RESULTS An independent screening of the 594 unique titles and abstracts identified six non-brushing and four brushing studies that met the eligibility criteria. In the non-brushing studies, the use of chewing gum did not significantly affect the parameters of interest. In the descriptive analysis of the brushing studies, four of five comparisons showed a statistically significant effect in favour of the sugar-free chewing gum with respect to plaque scores. The meta-analysis for the Quigley & Hein (J Am Dent Assoc 1962; 65: 26) plaque index scores in the brushing studies also showed a significant difference (DiffM -0.24, 95% CI [-0.41; -0.08]). For bleeding tendency, the descriptive analysis showed that one of the two comparisons identified a significant difference in favour of chewing gum. The meta-analysis, however, did not substantiate this difference. CONCLUSION Within the limitations of this systematic review, it may be concluded that the use of sugar-free chewing gum as an adjunct to toothbrushing provides a small but significant reduction in plaque scores. Chewing sugar-free gum showed no significant effect on gingivitis scores. In the absence of brushing, no effect on plaque and gingivitis scores could be established.
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The effects of hydrogen peroxide mouthwashes on the prevention of plaque and gingival inflammation: a systematic review.
Hossainian, N, Slot, DE, Afennich, F, Van der Weijden, GA
International journal of dental hygiene. 2011;(3):171-81
Abstract
OBJECTIVES The purpose of this review was to describe systematically the effects of hydrogen peroxide mouthwashes as an adjunct to daily oral hygiene or as a mono-therapy in the prevention of plaque accumulation and gingival inflammation. MATERIALS AND METHODS PubMed-MEDLINE and the Cochrane-CENTRAL were searched up to December 2009 to identify appropriate papers. The primary outcome measures included plaque accumulation and parameters of gingivitis. RESULTS Independent screening of titles and abstracts of 229 articles resulted in 10 publications that met the criteria for eligibility. Descriptive comparisons are presented for hydrogen peroxide mouthwash as compared with control mouthwashes or no oral hygiene. Mean values and standard deviations were obtained by data extraction. Based on a quality assessment, three studies, of which one evaluated H(2)O(2) over a period of 6 months, were considered to represent a low risk of bias. This 6-month study showed a positive effect of the use of H(2)O(2) on the modified gingival index. CONCLUSIONS The results of the studies included in this review showed that H(2)O(2) mouthwashes do not consistently prevent plaque accumulation when used as a short-term mono-therapy. When used as a long-term adjunct to daily oral hygiene, the results of one study indicate that oxygenating mouthwashes reduce gingival redness.
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The effect of chlorhexidine varnish on root caries: a systematic review.
Slot, DE, Vaandrager, NC, Van Loveren, C, Van Palenstein Helderman, WH, Van der Weijden, GA
Caries research. 2011;(2):162-73
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Abstract
OBJECTIVE The aim of this study was to systematically review the present literature on the effect of chlorhexidine varnish (CHX-V) on root caries. MATERIALS AND METHODS The MEDLINE-PubMed, the Cochrane-CENTRAL and EMBASE databases were searched through December 2010 to identify any appropriate studies. Root caries incidence and root caries activity were selected as outcome variables. RESULTS An independent screening of the unique titles and abstracts of 24 MEDLINE-PubMed, 14 Cochrane-CENTRAL and 18 EMBASE papers resulted in 6 publications that met the eligibility criteria. Data extraction provided no conclusive evidence that the application of CHX-V is effective in patients when regular professional oral prophylaxis is performed. If effective, the 40% CHX-V was found to provide a benefit over a control or fluoride varnish. CHX-V at lower concentrations (1 and 10%) may provide protection against root caries in high-risk patients (such as geriatric and xerostomia patients) in the absence of regular professional oral prophylaxis. CONCLUSION Within the limitations of this review, it may be concluded that in the absence of regular professional tooth cleaning and oral hygiene instructions, CHX-V may provide a beneficial effect in patients in need of special care. The strength of this recommendation is graded as 'weak'.
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Effect of a combination of amine/stannous fluoride dentifrice and mouthrinse in periodontal maintenance patients.
Paraskevas, S, Danser, MM, Timmerman, MF, Van der Velden, U, Van der Weijden, GA
Journal of clinical periodontology. 2004;(3):177-83
Abstract
AIM: The purpose of the present study was to evaluate the beneficial effect of using a dentifrice and mouthrinse containing amine fluoride (AmF) and stannous fluoride (SnF(2)) in a group of periodontal maintenance patients. Efficacy parameters were plaque, gingival inflammation, pocket depth and attachment loss. An additional parameter was development of stain. MATERIAL AND METHODS In total, 80 patients who had been treated for moderate-to-severe periodontitis agreed to participate in this study. Subjects received supportive periodontal therapy at regular intervals of 3-4 months for at least a period of 1 year. The patients were randomly divided into two groups: (1). the test group used an AmF/SnF(2) dentifrice and mouthrinse and (2). the control group used a sodium fluoride (NaF)-containing dentifrice and mouthrinse. Clinical assessments were performed at baseline, 3, 6, 12, 18 and 24 months. RESULTS The mean plaque index score after 3 months in the test group (0.24) was significantly lower than that in control group (0.34) (p CONCLUSION The combined use of an AmF/SnF(2) dentifrice and mouthrinse did not affect the parameters of inflammation (bleeding upon marginal probing and probing pocket depth), but it has shown to be more effective in terms of plaque reduction when compared with the use of an NaF dentifrice and mouthrinse in a group of periodontal patients placed under regular maintenance care.
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Tongue coating and tongue brushing: a literature review.
Danser, MM, Gómez, SM, Van der Weijden, GA
International journal of dental hygiene. 2003;(3):151-8
Abstract
The present paper reviews the role of the tongue as a habitat for oral microorganisms and the potential need for tongue cleaning as part of daily oral hygiene. In addition tongue coating is described. Many microorganisms have been found colonizing the dorsum of the tongue. Some studies find a positive effect to tongue brushing on bacterial counts on the tongue. On the other hand there are also studies that do not find any differences in bacterial counts before or after tongue brushing. Bacteria colonizing the tongue and periodontal pockets play an important role in the production of volatile sulphur compounds in periodontal health and disease. These compounds can be the cause of oral malodour. The amount of tongue coating in patients complaining of halitosis was significantly greater than in patients without halitosis. Tongue brushing on a regular basis, particular aiming at removing the coating on the dorsum of the tongue, has been found to be fruitful in reducing oral malodour. Studies investigating the role of tongue brushing and plaque accumulation or gingival inflammation show conflicting results. It is clear that the tongue forms the largest niche for microorganims in the oral cavity. However, on the basis of literature, there appears to be no data to justify the necessity to clean the tongue on a regular basis. One exception would be oral malodour.