Self-performed supragingival biofilm control: qualitative analysis, scientific basis and oral-health implications

Abstract

Patients frequently fail to achieve an optimal mechanical plaque control. However, many patients are not confident about using mouthrinses, and many professionals refuse to prescribe them for regular daily use. Aiming at achieving a better understanding of the use and prescription of mouthrinses in periodontics, 24 dentists with different dental educational levels were purposively chosen and interviewed in a qualitative research. Partial data was presented at the 15th Congress of the Brazilian Association for Oral Health Promotion (ABOPREV), and full data was presented at the 88th General Session and Exhibition of the International Association for Dental Research (IADR). The professionals' answers were confirmed or rejected through scientific data analysis. Additionally, scientifically supported answers were provided for the interviewees' most frequent unanswered questions. Around half of the participants (46%) reported that they recommended the use of mouthrinses, although a high percentage (64%) of the dentists answered that they knew very little about the efficacy of mouthrinses and also about the oral benefits (54%) provided by them. All interviewees reported that they were aware of the fact that their patients, and themselves, failed to floss and, less frequently, to brush their teeth, and all of them believed that oral health impacts overall systemic health. Seventy five percent answered that using mouthrinses was safe. Most participants (55%) did not declare themselves as mouthrinse users. We concluded that dentists with different levels of dental education have only partial knowledge related to mouthrinse use in periodontics. The use of effective mouthrinses on a daily basis is justified and can help patients achieve or maintain a healthier mouth. A healthier mouth will positively impact patients' quality of life and could also benefit their overall systemic health

Comparative efficacy of two daily use mouthrinses: randomized clinical trial using an experimental gingivitis model

“…26 The use of effective mouthrinses on a daily basis is proven through scientific data and is indicated to achieve or maintain a healthier mouth leading to a better overall systemic health. 20 EOs containing mouthwashes present a better 26 and deeper 27 bacterial reduction in laboratory biofilm models when compared with several other mouthwashes indicated for daily use and therefore provides support for the clinical superiority in controlling the plaque biofilm. Furthermore, while the cationic properties of CPC help maintain its relatively high substantivity, CPC can interact with negatively charged particles found in other mouthrinses, dentifrices, serum, tissue fluids, lipids, phospholipids, and proteins.…”

“…20,21 This study was conducted to determine the comparative efficacy to a higher level (0.07%) CPC rinse. This model has demonstrated the clinical superiority of the EOs mouthrinse in reducing supragingival plaque and gingivitis, compared to that of the 0.07% CPC rinse in the absence of mechanical oral hygiene.…”

“…25 This fixed combination EOs mouthrinse containing 0.064% thymol, 0.092% eucalyptol, 0.060% methyl salicylate, and 0.042% menthol has been previously shown to be an effective antiplaque/antigingivitis product in numerous six-month clinical trials. [2][3][4][5][6][7][8][20][21] The experimental gingivitis model used for this study, in which subjects abstain from all mechanical oral hygiene procedures for the two-week study period, 11 provides a rigorous test for antiplaque/antigingivitis products and enables a determination to be made of relative chemotherapeutic effectiveness against the dental plaque biofilm in situ.…”

“…• a minimum of 20 Teeth that were grossly carious, fully crowned or extensively restored, orthodontically banded, abutments, or third molars were not included in the tooth count. Exclusion criteria included:…”

Clinical applicability of natural product(s)-containing mouthwashes as adjunctive treatment of biofilm-induced gingivitis: a systematic review

“…The use of antimicrobial mouthrinses as an adjuvant to mechanical methods for controlling dental biofilms and gingival inflammation is well established (Cortelli, 2010;Gunsolley, 2010;Marsh, 2010). In addition, some clinical trials have demonstrated that the clinical value of a mouthrinse may meet or exceed the value of flossing for interproximal cleaning (Sharma et al, 2002;Bauroth, 2003).…”