The removal of dental plaque by daily toothbrushing plays a major role in preventing tooth decay and gum disease, the two main causes of tooth loss. Toothbrushing is a skill that can be difficult for people with intellectual disabilities; they may require help and people who care for them may need training in how to help them. For this research, we used the World Health Organization’s definition of intellectual disability which is: “a significantly reduced ability to understand new or complex information and to learn and apply new skills. This results in a reduced ability to cope independently, and begins before adulthood, with a lasting effect on development.” Continue reading
Tooth decay and gum diseases affect most people. They can cause pain, difficulties with eating and speaking, low self-esteem, and, in extreme cases, may lead to tooth loss and the need for surgery. The cost to health services of treating these diseases is very high.
As dental plaque is the root cause, it is important to remove plaque from teeth on a regular basis. While many people routinely brush their teeth to remove plaque up to the gum line, it is difficult for toothbrushes to reach into areas between teeth (‘interdental’), so interdental cleaning is often recommended as an extra step in personal oral hygiene routines. Different tools can be used for interdental cleaning, such as dental floss, interdental brushes, tooth cleaning sticks, and water pressure devices known as oral irrigators. Continue reading
Scaling and polishing removes deposits such as plaque and calculus (tartar) from tooth surfaces. Over time, the regular removal of these deposits may reduce gingivitis (a mild form of gum disease) and prevent progression to periodontitis (severe gum disease). Routine scale and polish treatment is sometimes referred to as “prophylaxis”, “professional mechanical plaque removal” or “periodontal instrumentation”. Many dentists or hygienists provide scaling and polishing for most patients at regular intervals even if the patients are considered to be at low risk of developing gum disease. There is debate about whether scaling and polishing is effective and the best interval between treatments. Scaling is an invasive procedure and has been associated with a number of negative side effects including damage to tooth surfaces and tooth sensitivity.
For the purposes of this review, a ‘routine scale and polish’ was scaling and polishing of both the tooth and the root of the tooth to remove plaque deposits (mainly bacteria), and calculus. Calculus is so hard it cannot be removed by toothbrushing alone and this along with plaque, other debris and staining on the teeth is removed by the scale and polish treatment. Scaling or removal of hardened deposits is done with specially designed dental instruments or ultrasonic scalers, and polishing is done mechanically with special pastes. In this review, we included scaling above and below the gum level; however, we excluded any surgical procedure on the gums, any chemical washing of the space between gum and tooth (pocket) and root planing, which is more intense scraping of the root than simple scaling.
Gingivitis is a reversible condition when gums become red, swollen and can bleed easily. Gingivitis is also very common – studies suggest that as many as 50% to 90% of adults in the UK and USA suffer from it. In susceptible people gingivitis may lead to periodontitis, which is not reversible. In periodontitis inflammation is accompanied by loss of ligaments and bone supporting the teeth. If untreated it may eventually lead to tooth loss. Severe periodontitis is the sixth most widespread disease globally.
It is recognised that maintaining a high standard of oral hygiene is important for the prevention and treatment of gingivitis. Toothbrushing is the main method for maintaining good oral hygiene. Other cleaning methods commonly used include dental floss, interdental brushes and scaling and polishing carried out by a dental professional. Some people have difficulty controlling plaque build-up and preventing gingivitis using only conventional tooth cleaning. Therefore people sometimes use mouthrinses containing chlorhexidine in addition to conventional tooth cleaning. These mouthrinses are readily available over the counter; prescriptions generally not being required outside the USA. Continue reading
Gum disease treatment is used to reduce swelling and infection from gum disease. Keeping blood sugar levels under control is a key issue for people with diabetes, and some clinical research suggests a relationship exists between gum disease treatment and glycaemic control. As a result, it is important to discover if gum disease treatment does improve glycaemic control to encourage better use of clinical resources.
There is a broad range of gum disease treatments available for treating patients with diabetes. This review considered:
1. Does gum disease treatment improve blood sugar control in people with diabetes?
2. Does one type of gum disease treatment have a bigger effect than another in improving blood sugar control?
Gum disease (periodontitis) is a common chronic or persistent condition that can get worse over time. It involves inflammation of the gums, which surround and support the teeth, causing swollen and painful gums and in severe cases loss of the bone that supports the teeth. Clinical investigations have shown that there might be a link between chronic, ongoing gum disease and heart and blood vessel disease (cardiovascular disease). Some investigators believe that the treatment for gum disease, which gets rid of bacteria and infection and controls inflammation, might prevent the occurrence or recurrence of heart disease. Continue reading
Removing plaque through effective toothbrushing has an important role in the prevention of gum disease and tooth decay. Dental plaque is the primary cause of gum inflammation, and this can lead to more serious oral conditions. The build up of plaque can also lead to tooth decay. There are different kinds of powered or electric toothbrushes available to the public, at a range of prices. Powered toothbrushes work in different ways – some move from side to side, and some in a circular motion. Are these kind of toothbrushes better to use than a manual toothbrush? Does their use lead to less inflammation in the gums? Continue reading
Gum disease and tooth decay are the main reasons for tooth loss. Unless brushed away, plaque (a sticky film containing bacteria) can build up on the teeth, which can lead to gum inflammation. Plaque is also a key factor in the development of tooth decay. Interdental brushes are designed to clean between the teeth, to remove the plaque in harder to reach areas. They are small headed toothbrushes, available in a range of different widths to match the space between the teeth. They can be cone-shaped or cylindrical. Together with dental floss, interdental brushes are one of the most commonly recommended, advertised and available aids for cleaning between the teeth. But is there evidence that they really work to control tooth decay and reduce gum disease? Continue reading
Gum disease and dental decay are the main reasons for tooth loss. Plaque (a film of bacteria) can build up on the teeth, leading to swelling and redness of the gums (gingivitis) which if left untreated can develop into a more serious form of gum disease (periodontitis). Periodontitis can cause pain, eating difficulties and tooth loss. The build up of plaque can also cause teeth to decay. Adding an effective and safe antibacterial ingredient to toothpastes could be an easy and low-cost answer to these problems. Continue reading
Scaling and polishing of the teeth may help to reduce deposits such as plaque (bacteria) and hardened plaque (calculus or tartar). It may also reduce bleeding and inflammation of the gums. Many dentists and hygienists provide scaling and polishing for most patients at regular intervals, even if they are at low risk of developing gum disease. For this review, scaling and polishing was defined as the scaling and polishing of the crown and root surfaces to remove deposits of plaque and calculus. Calculus is so hard that it cannot be removed by toothbrushing alone, and it is generally removed by the scale and polish treatment. Removal of hardened deposits is done with specially designed dental instruments or ultrasonic scalers, and polishing is done mechanically with special pastes.
Is there evidence that this practice is effective? This review considers the data from randomized controlled trials. Continue reading