Forget Toothpicks and Electric Brushes?

Forget Toothpicks and Electric Brushes?

A new umbrella review of the effectiveness of oral hygiene tools has shown that other than toothbrushing, relatively few additional interventions carried out by patients have been proven to prevent gingivitis and periodontitis.

Researchers at the University of Buffalo’s School of Dental Medicine found that electric toothbrushes are no more effective at reducing plaque and gingivitis than a basic toothbrush.  

The paper, published in the Journal of the International Academy of Periodontology  said there was also little evidence of studies that came out in support of dental floss as an effective means of reducing plaque and gingivitis.

But lead investigator Professor Frank Scannapieco, Chair of the Department of Oral Biology told the University of Buffalo’s website UBNow, that patients needn’t throw out the floss just yet, since it IS beneficial.

“While there are few studies available that specifically examined toothbrushes or floss alone, both are still essential. Floss is especially useful to remove interdental plaque for people who have tight space between their teeth. Floss also likely reduces the risk for cavities between the teeth,” said Prof Scannapieco.

The study found that Only a handful of self-administered interventions gave additional protection against gingivitis and periodontitis beyond toothbrushing with a basic toothbrush.

All other oral hygiene interventions carried out by patients are only supported by insufficient evidence.

Toothpicks were also found not to be effective at fighting gingivitis, but they WERE useful for self-monitoring of gum health.

Prof Scannapieco told UBNow, “By gently prodding the gums with a toothpick and monitoring for bleeding, patients could detect signs of gum disease.”

According to Prof Scannapieco, tooth brushing is the ‘cornerstone’ of daily oral hygiene and a reliable way to control dental plaque.  

The research found “Interdental brushes and water picks performed better than other interdental oral hygiene devices at reducing gingivitis, and both should be used in combination with daily tooth brushing to prevent gum disease,” UBNow reported.

Although Triclosan toothpastes and mouth rinses were found to significantly reduced plaque and gingivitis, the compound has now been removed from most popular toothpastes, including Colgate,  in the US.

Triclosan has been linked to the development of some cancers and reproductive defects.

But the Buffalo systematic review did find that chlorhexidine gluconate (CHX), cetylpyridinium chloride (CPC) and essential oil (Listerine) mouth rinses were found to be effective at significantly reducing plaque and gingivitis.

“Investigators found insufficient evidence that mouthwashes based on tea tree oil, green tea, anti-inflammatory agents, hydrogen peroxide, sodium benzoate, stannous fluoride, hexetidine or delmopinol reduced gingivitis,” UBNow reported.

And the use of probiotics is also not backed up by evidence.  

While the study didn’t look at oil-pulling, there is still a large portion of the public that swears by the practice

@aahpothecary Reply to @ashybearwood you can use coconut oil or sesame oil 🌱❤ #oilpulling #teethcare #teethpain #dentalcare ♬ original sound - Alien

The researchers found little evidence that supports the claim that dietary supplements improve gum health.

"Patients can be confident that the oral care tools and practices supported by research, as described in the paper, will prevent the initiation and progression of periodontal disease, if they are performed regularly and properly," Prof Scannapieco told UBNow.

Dr Eva Volman, first author and resident dentist at the Eastman Institute for Oral Health, said

“It is my hope that this piece consolidates the relevant evidence in a way that is comprehensive, readable and uniquely helpful to all oral health professionals, as well as patients.”

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