epidemiological studies of periodontal disease. [8][9][10] For clinical trials with denture cleansing products however, a broader approach can be taken, in that scores per denture surface are suffi cient and appropriate to judge the effi cacy of products. Current methods tend to rely on subjective or image analysis derived estimates of area coverage of dentures by stained plaque. 5,7,[11][12][13] For denture plaque assessment most methods assess plaque coverage by staining with a disclosing agent, most commonly erythrosine. Budtz-Jörgensen and Bertram 11 proposed a simple index to grade plaque coverage on the denture fi tting surface: excellent -none or only a few spots of plaque; fair -<50% denture base covered; and poor ->50% denture base covered. A slightly more sensitive method was described in 1978 14 where the amount of denture plaque on the fi tting surface was graded 0 = non-visible, 1 + = less than one third covered, 2 + = one third to two thirds covered, and 3 + = more than two thirds covered. Augsberger and Elahi 12 developed a well-used index for
INTRODUCTIONMeasurement and assessment of denture plaque can provide valuable information regarding oral health status associated with denture wearing and assessment of new treatments or products. The potential pathogenic aspects of denture plaque have been recently reviewed. 1 Methods for assessing plaque quantity have included dry or wet weight measurement, biochemical assays, oxygen consumption assays, microbiological counts and visual indices or planimetric assessments (area measurement) of plaque coverage or biofi lm thickness in situ.2-7 Many scoring systems used for dentures have derived from studies on natural teeth, in which individual tooth plaque measurements have been used in Background Measurement and assessment of denture plaque can provide valuable information regarding an individual's oral health status and assessment of new treatments or products. Current methods tend to rely on subjective indices or image analysis derived planimetric (area measurement) assessment of stained plaque on dentures. Plaque indices are most commonly used to assess plaque coverage without image capture. This is not ideal because the methods are subjective, examiner bias may occur, there is no reproducibility between studies, the methods have lower accuracy and sensitivity than image analysis, and there is no record. To the authors' knowledge, no standardised published method of denture plaque assessment is currently employed for product development and testing. Method In this study visual and planimetric plaque assessment methods were compared using reference dentures. In addition, an in vivo study compared these methods for evaluating denture cleanser effi cacy. Results and conclusions The results show that blinded image scoring is more representative of the true plaque area coverage than 'live' denture scoring, detecting signifi cant decreases in plaque coverage. Planimetric analysis provides a more sensitive and less subjective technique with greater differentia...