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Dental needs of elderly hostel residents in inner Melbourne

Saub R, Evans RW

Aust Dent J, 2001 Sep;46(3):198-202.
PMID: 11695159

BACKGROUND: The purpose of this study was to determine the oral health status and treatment needs of elderly hostel residents in Melbourne.
METHOD: One hundred and seventy-five subjects aged 65+ were selected from 20 hostels within a 10 km radius of Melbourne's central business district.
RESULTS: Subjects were clinically examined and interviewed using a standard questionnaire. In the course of the clinical examination, coronal caries, root caries, periodontal disease, denture status and related treatment needs were assessed. The mean age of the subjects was 83.7, the majority of whom were female (80 per cent). About 35 per cent of the sample were dentate. The mean number of teeth present among dentate persons was 13.8, the mean coronal caries experience was 24.9 DMFT and mean root caries was 2.3 R-DF. Of the dentate subjects, 46 per cent required at least one restoration for coronal caries and 30 per cent required at least one restoration for root caries. Most dentate subjects had calculus and none had deep pockets, therefore, indications for periodontal treatment did not include complex care. More than 50 per cent of lower full dentures were retained unsatisfactorily and about half of the total number of subjects required prosthetic treatment.
CONCLUSIONS: Although there was a high number of treatment needs, most requirements involved simple technologies that could be delivered by auxiliaries.

Matched MeSH terms: Periodontal Diseases/epidemiology
Fulltext The Prevalenve And Impact Of Oro-Facial Pain Among 12-year-old School Children In An Epidemiological Survey Setting

Jaafar, N, Razak, I.A.

Ann Dent, 2002;9(1):-.
MyJurnal

The objective of the study was to attempt to verify the cause of self-reported oro-facial pain among 12-yearold children, objectively via a clinical examination. This is a descriptive, cross-sectional survey using a combination of self-reported questionnaire, face-to-face interview and clinical oral examination. The children were first asked to answer a self-filled questionnaire about their oro-facial pain experience in the past 4- weeks. In order to verify its cause, a clinical examination and an interview followed. Normative oral health status data was also collected. The sample was 1492 Malay schoolchildren with diverse socioeconomic background from the states of Johore, Kelantan and Sabah. The sample size for each state was calculated to give a sampling error of not more than 5 %. In each state, quota sampling was done to achieve a balanced distribution between gender and location. The data collected were normative status for caries, periodontal disease and traumatized teeth. Orofacial pain experience represented the subjective status for oral well-being. The cause of pain was confirmed through a clinical examination. The normative oral health status data implies a very low untreated disease and good oral health among the schoolchildren. However the subjective health status, as reflected by the prevalence of pain suggested that oro-facial pain and suffering was high (27.3%) with about 49% "of moderate and severe" intensity. The two main causes were caries and mouth ulcers. However in about onequarter of pain cases, diagnosis cannot be confirmed in the field survey setting. More than one-half of those with pain experienced disturbed sleep and study. It was concluded that overall oral health status and well-being can be better described if normative data is complemented with subjective data such as pain prevalence. The study shows that the majority (more than 75 %) of cases of subjective pain can be objectively verified in a field epidemiology survey setting. The reliability of the subjective data can be improved by a clinical examination as compared to unverified self-report. The study also confirms that the major source of oro-facial pain among the 12 year-olds were caries and mouth ulcers.

Matched MeSH terms: Periodontal Diseases
Oral health status of 16-year-old school children in Malaysia

Nik-Hussein NN, Abdul Muttalib K, Junid NZ, Wan MN, Abang A

Singapore Dent J, 2004 Dec;26(1):30-8.
PMID: 15736839

The aim of the present study was to determine the oral health status of 16-year-old Malaysian school children. The prevalence of caries was 75.5%. More than 60% of subjects had caries experience by teeth (DMFT) scores of 0-3. The largest component of the DMFT and caries experience by surface index was the filled component. Females had higher caries prevalence and caries scores than males. The mouth and tooth prevalences of enamel defects were 56% and 21.8%, respectively. The most common type of enamel defects observed were diffuse opacities, affecting 95.5% of affected subjects and 92.1% of affected teeth. One-third of subjects had healthy gingival conditions, 8.6% had bleeding gingivae, 55.1% had calculus and 3% had pockets. Less than 1% of subjects wore or required dentures. Cleft lip and/or palate was uncommon. This study shows that the prevalence of caries and DMFT scores have declined over the last 30 years.

Matched MeSH terms: Periodontal Diseases/epidemiology*
A retrospective study of periodontal disease severity in smokers and non-smokers

Razali M, Palmer RM, Coward P, Wilson RF

Br Dent J, 2005 Apr 23;198(8):495-8; discussion 485.
PMID: 15849588

Smoking has been associated with increased risk of periodontitis. The aim of the present study was to compare the periodontal disease severity of adult heavy smokers and never-smokers referred for assessment and treatment of chronic periodontitis.

Matched MeSH terms: Periodontal Diseases/complications*; Periodontal Diseases/radiography
Fulltext The prevalence of Actinobacillus actinomycetemcomitans in a healthy Malay population in Malaysia

Zahari, N.M., Ismail, R., Bunyarit, S.S., Shafiei, Z., Al Rawenduzy, K.C.M.A.

Malaysian Dental Journal, 2007;28(1):45-50.
MyJurnal

Actinobacillus actinomycetemcomitans is considered a major pathogen in periodontal disease. The aim of this study was to determine the prevalence of A. actinomycetemcomitans from 46 subjects aged 20-24 years old of who were all periodontally healthy Malays.

Matched MeSH terms: Periodontal Diseases
Fulltext The expert says...... oral microbiology, periodontal disease and cardiovascular disease

Nor Adinar Baharuddin

Malaysian Dental Journal, 2007;28(2):97-98.
MyJurnal

There are evidences that chronic oral infections are associated with cardiovascular disease (CVD). Periodontal disease is a common, mixed oral infection affecting the supporting structures around the teeth. It was reported that 75% of the adult population has gingivitis and 20% to 30% exhibits the severe destructive form of periodontitis. Although more than 500 bacterial species inhabit the human oral cavity, only a few Gram negative bacteria such as Prevotella intermedia, Fusobacterium nucleatum, Porphyromonas gingivalis, Tannerella forsythensis, Treponema denticola and Actinobacillus actinomycetamcomitans causes gingivitis and periodontitis. These periodontal pathogen occupy the subgingival space and organize as a bacterial biofilm. The bacterial biofilm will be in direct contact with host tissues along an ulcerated epithelial interface, called periodontal pocket. The break in the epithelial integrity directly exposes the host to bacteria and their products eg. lipopolysaccharide (LPS) endotoxin. (Copied from article).

Matched MeSH terms: Periodontal Diseases
Fulltext Periodontal disease as the initial oral manifestation of langerhans cell histiocytosis - a case report

Ahmad AR, Ismail SM, Zain RB, Mohamad Zaini Z

Ann Dent, 2009;16(1):31-36.
MyJurnal

Langerhans Cell Histiocytosis (LCH) refers to a group of lesions presenting with a spectrum of clinical. features but sharing similar histology. These lesions are rare and treatment has been quite variable with current treatment protocol recommended being dependent on whether it is a unifocal or multi focal bone disease or a multi focal multisystem disease. However, the clinical presentations of LCH are variable and the decision to place into the appropriate clinical types may sometimes be masked by the non-discovery of all the lesions. In the oral maxillofacial area, the clinical features of these lesions may further pose a problem by nondescript manifestations as dental/periodontal/oral mucosal disorders. These oral findings may sometimes lead to inappropriate choice of treatment and delay in the diagnosis of all the lesions involved. This paper describes one such case where LCH manifest itself as a periodontal disease thus leading to delay in identifying all the sites involved and consequently a delay in id~ntifying the appropriate clinical type.

Matched MeSH terms: Periodontal Diseases
Fulltext Dental knowledge and self-reported oral care practices among medical, pharmacy and nursing students

Tuti Ningseh Mohd-Dom, Shahida Mohd Said, Zamirah Zainal Abidin

Jurnal Sains Kesihatan Malaysia, 2009;7(1):13-23.
MyJurnal

A self-administered questionnaire survey was conducted to investigate the level of dental knowledge among senior medical, pharmacy and nursing students of Universiti Kebangsaan Malaysia, and to determine self-reported practices of oral care. Students were invited to complete a set of questionnaires on knowledge related to causes, prevention, signs and treatment of dental caries and periodontal disease; and practices related to oral hygiene and dental visits. A total of 206 questionnaire forms were distributed. 204 forms were returned complete (response rate = 99%). Dental knowledge scores ranged from 0 (no correct answer given) to 16 (gave all correct answers). The mean knowledge scores between the groups were statistically different (p < 0.05): pharmacy students scored highest (mean = 12.29, 95% CI 11.44, 13.14) followed by the medical students (mean = 12.02, 95% CI 11.33, 12.71) and nursing students (mean = 10.83, 95% CI 10.40, 11.26). Areas that had lowest knowledge scores were signs and treatment of gum disease. With regard to oral care practices, majority cited that they brushed teeth at least twice a day (94.6%) and used toothbrush and toothpaste (97.5%). Not many (21.8%) used dental floss and about half (54.2%) reported visiting the dentist more than twelve months ago. Reasons for dental visits included getting check-ups (64.6%), restorations (45.6%) and emergency care such as extractions (24.0%). In general students had at least a moderate level of dental knowledge but demonstrated poor knowledge in some areas. While most reported good oral hygiene habits, behaviour related to dental visits need to be improved. Findings suggest a need for inclusion of oral health education in the medical, pharmacy and nursing curriculum.

Matched MeSH terms: Periodontal Diseases
Fulltext Dental Students’ Knowledge and Perception of Elderly in Relation to Geriatric Dentistry Training

Medicine & Health, 2009;4(2):76-83.
MyJurnal

Dental students need to be equipped with skills, knowledge and positive attitudes while providing dental care to the elderly. Reports from Ministry of Health alaysia indicatedthat the prevalence of dental caries and periodontal disease was high among older people in the country. The aim of this study was to assess the knowledge and perception of final year dental students towards the elderly in relation to training of geriatric dentistry in Universiti Kebangsaan Malaysia edical Centre (UKMMC). All the final year dental students were required to complete a questionnaire that comprised of 3 sections: 1) Palmore’s Facts on Aging Quiz II, 2) Oral health and social concerns of patients, and 3) Perception towards the teaching of geriatric dentistry. A total of 83 students participated in the study. Twenty-four per cent (n=20) scored more than 70% to questions on knowledge about older people and 73% (n=61) scored between 50 -700%. The students had ranked physical disability, transportation problems andcomplex and overlapping priorities as reasons for elderly not keeping to their appointments. Majority of the students reported that lack of educational resourcematerials and very minimum clinical sites experience were the main barriers facedduring the course. In conclusion, majority of the students had moderate to goodknowledge about older people and were able to recognize issues of social oncerns that can influence their oral health. In general, there were not many changes in the perceived competencies of managing older patients following the geriatric module.

Matched MeSH terms: Periodontal Diseases
Fulltext Perceived knowledge and awareness of periodontal health amongst ante-natal mothers

Nurul Asyikin, Y., Nor Shaida, A., Nur Amirah, Z.

Malaysian Journal of Community Health, 2010;16(2):57-65.
MyJurnal

Introduction: Physiological changes in the oral cavity and dental-related complications may occur during pregnancy. These intraoral changes that occur during pregnancy combined with lack of routine dental check-ups and delays in treatment for oral disease, place pregnant women at higher risk for dental infections. The objectives of this study was to assess the knowledge and awareness of pregnant women on periodontal disease and its effect on pregnancy, to investigate the relationship of their knowledge and awareness with level of education and the barriers of oral healthcare utilization among pregnant women.
Methodology: A self-administered questionnaire with an introductory letter and consent form were given to pregnant women who came for their routine maternity check-up at the Obstetrics and Gynecology Clinic, Kuala Lumpur Hospital. Data entry and analysis was done using Statistical package for Social Sciences (SPSS) version 12.
Result: Ninety-two pregnant women responded to the questionnaire. Only 23.9% answered correctly to the question on what is plaque. However, 45.7% knew that plaque can cause gum disease and a majority of the respondents 72.8% also knew that bleeding gum is an indication to inflamed gums. The result shows that, although 59.8% of the respondents were aware that it is necessary to brush their teeth frequently during pregnancy, only less than half of the respondents (44.6%) were aware that dental plaque and poor plaque control may cause periodontal disease among pregnant women. The majority (33.7%) feels that the long waiting time in the clinic would be their main barrier in seeking dental treatment.
Conclusion: A majority of pregnant women have limited knowledge and poor awareness on periodontal disease and its effect on pregnancy.

Study site: Obstetrics and Gynecology Clinic, Kuala Lumpur Hospital

Matched MeSH terms: Periodontal Diseases
Fulltext Effects of tobacco use on oral health - an overview

Awan, K.H.

Ann Dent, 2011;18(1):18-23.
MyJurnal

Tobacco use is linked with many serious illnesses, such as cancer, cardiopulmonary diseases, as well as with many health problems. Every year, the use of tobacco products causes a heavy toll of deaths and severe human disease worldwide. One of the many health problems linked to tobacco use is its detrimental impact on oral health. Tobacco causes a whole series of oral health problems, ranging from life-threatening (precancerous changes leading to oral cancer) and serious (periodontal disease, teeth decay) to social (bad breath). Tobacco is consumed through the mouth in a variety of forms, varied from smoked tobacco to smokeless tobacco chewing on itself or combined with areca nut. All these forms of tobacco have damaging effects on the oral health. The most significant preventive measure to prevent the oral health problems caused by tobacco use is to stop using tobacco products. The risk of developing oral cancer drops rapidly when a smoker ceases tobacco use. After ten years of not using tobacco, an ex-smoker/user's risk of oral cancers is about the same as that for someone who has never smoked. To stop using tobacco products is not an easy task. Fortunately, there are a number of therapies available to assist in quitting of tobacco. It is important to remember that, while it will be difficult, ceasing to use tobacco has immediate health benefits, including increased life expectancy and reduced risk of tobacco related diseases and conditions.

Matched MeSH terms: Periodontal Diseases
Fulltext Proportion and factors related to periodontal disease among young adult attended Al-Fatah Dental Faculty, Libya

Fadilla, Y.I., Sutan, R.

Malaysian Journal of Public Health Medicine, 2011;11(2):40-43.
MyJurnal

This study was conducted to determine the proportion and factors associated with periodontal disease among younger adult attended Al Fatah Dental Faculty in Libya. A cross sectional study with universal sampling methods was carried out from July 2010 until September 2010 among 70 Libyan subjects aged between 20-35 years. The data in this study was collected using self administrated questionnaire, followed by oral examination done by trained dentists. The results of this study showed that, the prevalence of periodontal disease in Libyan subjects was 75.7%. Gender, oral care habits, smoking were found significantly associated with presence of periodontal disease. Gingivitis has been found the most common types of periodontal disease (94%). High percentage of periodontal disease in this study was among men (87.9%) compared to women (69.9%). In conclusion, modifiable factors like changing lifestyle such as avoiding smoking and practicing oral care can be promoted to prevent periodontitis.

Matched MeSH terms: Periodontal Diseases
Relationship of periodontal disease to pre-term low birth weight infants in a selected population--a prospective study

Ali TB, Abidin KZ

Community Dent Health, 2012 Mar;29(1):100-5.
PMID: 22482259

To assess effect of periodontal status of antenatal mothers on pregnancy outcomes in a selected population in Malaysia.

Matched MeSH terms: Periodontal Diseases/complications*
Fibrin sealant as an alternative for sutures in periodontal surgery

Pulikkotil SJ, Nath S

J Coll Physicians Surg Pak, 2013 Feb;23(2):164-5.
PMID: 23374528 DOI: 02.2013/JCPSP.164165

The trial compared wound healing clinically, histologically and morphometrically after the use of fibrin sealant and sutures for periodontal flap closure. Ten patients were selected for this split-mouth randomized controlled clinical trial. On the test site fibrin sealant (F) was applied for flap closure after periodontal flap surgery (n = 10) and on the control site sutures (S) were used (n = 10). Clinically wound healing was observed at 7, 14 and 21 days and biopsy was taken on the 8th day. At seventh day better healing was observed in fibrin sealant site. Histologically mature epithelium and connective tissue formation was seen in fibrin sealant site with increased density of fibroblasts (F = 70.45 ± 7.22; S = 42.95 ± 4.34, p < 0.001) and mature collagen fibers. The suture site had more number of inflammatory cells (S = 32.58 ± 4.29; F = 20.91 ± 4.46, p < 0.001) and more number of blood vessels (S = 11.89 ± 3.64; F = 5.74 ± 2.41, p = 0.005). Fibrin sealant can form a better alternative to sutures for periodontal flap surgery.

Matched MeSH terms: Periodontal Diseases/pathology; Periodontal Diseases/surgery*
Fulltext Genome Sequence of Parvimonas micra Strain A293, Isolated from an Abdominal Abscess from a Patient in the United Kingdom

Ang MY, Dymock D, Tan JL, Thong MH, Tan QK, Wong GJ, et al.

Genome Announc, 2013;1(6).
PMID: 24309744 DOI: 10.1128/genomeA.01025-13

Parvimonas micra is an important oral microbe that has the ability to grow and proliferate within oral biofilms and is involved in periodontal disease, leading to gingival bleeding, gingival recession, alveolar bone loss, and tooth mobility. However, occasionally these normally oral pathogens can cause infections at other sites in the body. We present the genome sequence of Parvimonas micra strain A293, a smooth Parvimonas micra strain isolated from an abdominal abscess from a patient at Barts Hospital, London, United Kingdom.

Matched MeSH terms: Periodontal Diseases
Fulltext Periodontal status and provision of periodontal services in Malaysia: trends and way forward

Tuti Ningseh Mohd-Dom, Khairiyah Abdul-Muttalib, Rasidah Ayob, Yaw, Siew Lan, Ahmad Sharifuddin Mohd-Asadi, Mohd Rizal Abdul-Manaf, et al.

Malaysian Journal of Public Health Medicine, 2013;13(2):38-47.
MyJurnal

The paucity of published literature on periodontal treatment needs and services in developing countries has undermined the significance of periodontal disease burden on healthcare systems. This study analyses periodontal status and population treatment needs of Malaysians, and patterns of periodontal services provided at public sector dental clinics. A retrospective approach to secondary data analysis was employed. Data for population treatment needs were extracted from three decennial national oral health surveys for adults (1990, 2000 and 2010). Annual reports from the dental subsystem of the government Health Information Management System (HIMS) provided information on oral health care delivery for years 2006-2010. They were based on summaries of aggregated data; analyses were limited to reporting absolute numbers and frequency distributions. Periodontal disease prevalence declined between 1990 (92.8%) to 2000 (87.2%) but a sharp rise was observed in the 2010 survey (94.0%). The proportion of participants demonstrating periodontal pockets of 6 mm and more increased in 2010 survey after showing improvements in 2000. Individuals not requiring periodontal treatment (TN0) increased in proportion from 1990 to 2000, only to drop in 2010. An increase in utilisation was observed alongside a growing uptake of periodontal procedures (62.2% in 2006 to 73.6% in 2010). Only about 10% of treatment was surgeries. While the clinical burden of periodontal disease is observed to be substantial, the types of treatment provided did not reflect the increasing needs for complex periodontal treatment. Emphasis on downstream and multi-collaborative efforts of oral health care is deemed fit to contain the burden of periodontal disease.

Matched MeSH terms: Periodontal Diseases
Lactate dehydrogenase activity during tooth movement under 1.0 N and 1.5 N continuous force applications

Shahrul Hisham Zainal Ariffin, Nurfathiha Abu Kasim, Rohaya Megat Abdul Wahab, Abdul Aziz Jemain

Sains Malaysiana, 2013;42:99-105.

The aim of this study was to observe the pattern of lactate dehydrogenase (LDH) activity in GCF and the rate of tooth movement at two different orthodontic forces (1.0 N and 1.5 N). Twelve subjects participated in this study and was chosen based on the inclusion criteria. Each subject received forces of 1.0 N and 1.5 N for tooth movement either on the left or right side of the maxillary canine. GCF sample was collected at mesial and distal sites of the canines before applying the appliance (week 0) and every week for 5 weeks after tooth movement (week 1 to week 5) where baseline activity served as control. LDH activity was assayed spectrophotometically at 340 nm. The tooth movements were measured from casted study models. LDH specific activity at mesial sites in 1.0 N and 1.5 N force groups, respectively increased significantly (p<0.05) only on week four and throughout the treatment when compared with baseline. At distal sites, LDH specific activity with 1.5 N was higher than 1.0 N throughout the five weeks of tooth movement. LDH specific activity with 1.5 N force increased at both mesial (week 2) and distal sites (week 3) with significant different (p<0.05) when compared with 1.0 N force. Tooth movement with 1.5 N showed significantly faster (p<0.05) at the end of week 5 when compared with 1.0 N. LDH has the potential as a biological marker of inflammation during tooth movement.A force of 1 N was more suitable to be used although less tooth movement was produced because less inflammation caused by the force can be useful in orthodontic treatment for patients with stabilised periodontal diseases compared with 1.5 N force.

Matched MeSH terms: Periodontal Diseases
Cost-Effectiveness of Periodontitis Management in Public Sector Specialist Periodontal Clinics: A Societal Perspective Research in Malaysia

Mohd-Dom TN, Wan-Puteh SE, Muhd-Nur A, Ayob R, Abdul-Manaf MR, Abdul-Muttalib K, et al.

Value Health Reg Issues, 2014 May;3:117-123.
PMID: 29702916 DOI: 10.1016/j.vhri.2014.04.012

OBJECTIVES: The aim of this study was to evaluate the cost-effectiveness of the national public sector specialist periodontal program in the management of periodontal disease.
METHODS: This was a multicenter, time motion, prospective, economic evaluation study involving a total of 165 patients with periodontitis recruited from five selected specialist periodontal clinics. Treatment costs were measured in 2012 Malaysian ringgit (MYR) and estimated from the societal perspective using step-down and activity-based costing methods, and substantiated by clinical pathways. A cost-effectiveness analysis was done to compare the specialist periodontal program with a hypothetical scenario in which patients attend biannual dental visits only for regular dental check-up and scaling. The incremental cost-effectiveness ratio was defined as the difference in cost per gain in quality-adjusted life-years (QALYs) and clinical attachment levels (CALs). One-way scenario-based sensitivity analyses were carried out to assess the uncertainty of inputs.
RESULTS: The average cost for managing patients with periodontitis was MYR 376 per outpatient visit and MYR 2820 per annum. Clinically, a gain of an average of 0.3 mm of CAL was attained at post-treatment (paired t test, P < .001). Patients gained an average of 3.8 QALY post-treatment (paired t test, P < .001). For cost-effectiveness analysis, the specialist periodontal program was more cost-effective than the hypothesized biannual dental visits, with incremental cost-effectiveness ratios of MYR 451 and MYR 5713 per additional QALY and millimeter CAL gained, respectively.
CONCLUSIONS: It is very cost-effective for the public sector to provide specialist periodontal treatment for patients with periodontitis according to the World Health Organization criteria and when compared with conventional biannual dental treatment.

Matched MeSH terms: Periodontal Diseases
Fulltext Powered versus manual toothbrushing for oral health

Yaacob M, Worthington HV, Deacon SA, Deery C, Walmsley AD, Robinson PG, et al.

Cochrane Database Syst Rev, 2014 Jun 17;2014(6):CD002281.
PMID: 24934383 DOI: 10.1002/14651858.CD002281.pub3

BACKGROUND: Removing dental plaque may play a key role maintaining oral health. There is conflicting evidence for the relative merits of manual and powered toothbrushing in achieving this. This is an update of a Cochrane review first published in 2003, and previously updated in 2005.
OBJECTIVES: To compare manual and powered toothbrushes in everyday use, by people of any age, in relation to the removal of plaque, the health of the gingivae, staining and calculus, dependability, adverse effects and cost.
SEARCH METHODS: We searched the following electronic databases: the Cochrane Oral Health Group's Trials Register (to 23 January 2014), the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library 2014, Issue 1), MEDLINE via OVID (1946 to 23 January 2014), EMBASE via OVID (1980 to 23 January 2014) and CINAHL via EBSCO (1980 to 23 January 2014). We searched the US National Institutes of Health Trials Register and the WHO Clinical Trials Registry Platform for ongoing trials. No restrictions were placed on the language or date of publication when searching the electronic databases.
SELECTION CRITERIA: Randomised controlled trials of at least four weeks of unsupervised powered toothbrushing versus manual toothbrushing for oral health in children and adults.
DATA COLLECTION AND ANALYSIS: We used standard methodological procedures expected by The Cochrane Collaboration. Random-effects models were used provided there were four or more studies included in the meta-analysis, otherwise fixed-effect models were used. Data were classed as short term (one to three months) and long term (greater than three months).
MAIN RESULTS: Fifty-six trials met the inclusion criteria; 51 trials involving 4624 participants provided data for meta-analysis. Five trials were at low risk of bias, five at high and 46 at unclear risk of bias.There is moderate quality evidence that powered toothbrushes provide a statistically significant benefit compared with manual toothbrushes with regard to the reduction of plaque in both the short term (standardised mean difference (SMD) -0.50 (95% confidence interval (CI) -0.70 to -0.31); 40 trials, n = 2871) and long term (SMD -0.47 (95% CI -0.82 to -0.11; 14 trials, n = 978). These results correspond to an 11% reduction in plaque for the Quigley Hein index (Turesky) in the short term and 21% reduction long term. Both meta-analyses showed high levels of heterogeneity (I(2) = 83% and 86% respectively) that was not explained by the different powered toothbrush type subgroups.With regard to gingivitis, there is moderate quality evidence that powered toothbrushes again provide a statistically significant benefit when compared with manual toothbrushes both in the short term (SMD -0.43 (95% CI -0.60 to -0.25); 44 trials, n = 3345) and long term (SMD -0.21 (95% CI -0.31 to -0.12); 16 trials, n = 1645). This corresponds to a 6% and 11% reduction in gingivitis for the Löe and Silness index respectively. Both meta-analyses showed high levels of heterogeneity (I(2) = 82% and 51% respectively) that was not explained by the different powered toothbrush type subgroups.The number of trials for each type of powered toothbrush varied: side to side (10 trials), counter oscillation (five trials), rotation oscillation (27 trials), circular (two trials), ultrasonic (seven trials), ionic (four trials) and unknown (five trials). The greatest body of evidence was for rotation oscillation brushes which demonstrated a statistically significant reduction in plaque and gingivitis at both time points.
AUTHORS' CONCLUSIONS: Powered toothbrushes reduce plaque and gingivitis more than manual toothbrushing in the short and long term. The clinical importance of these findings remains unclear. Observation of methodological guidelines and greater standardisation of design would benefit both future trials and meta-analyses.Cost, reliability and side effects were inconsistently reported. Any reported side effects were localised and only temporary.

Matched MeSH terms: Periodontal Diseases/prevention & control
Fulltext Is the burden of oral diseases higher in urban disadvantaged community compared to the national prevalence?

Jaafar N, Hakim H, Mohd Nor NA, Mohamed A, Saub R, Esa R, et al.

BMC Public Health, 2014;14 Suppl 3:S2.
PMID: 25438162 DOI: 10.1186/1471-2458-14-S3-S2

The urban low income has often been assumed to have the greatest dental treatment needs compared to the general population. However, no studies have been carried out to verify these assumptions. This study was conducted to assess whether there was any difference between the treatment needs of an urban poor population as compared to the general population in order to design an intervention programme for this community.

Matched MeSH terms: Periodontal Diseases/epidemiology*

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