Efficacy of dental prophylaxis (rubber cup) for the prevention of caries and gingivitis: a systematic review of literature

Abstract

acted as a barrier, inhibiting fl uoride uptake and consequently reducing the clinical efficacy of the topical fl uoride application. 2,3 Many clinicians believe that the removal of the acquired pellicle, plaque and other substances adhering to the enamel by professionally applied prophylaxis results in a greater amount of fl uoride contacting the enamel surface, thus enhancing the efficacy of a PATF, 2,4 and an expected increase in the reduction in the incidence of caries. The removal of plaque can be effectively accomplished with a toothbrush. However, the belief is that the acquired pellicle, a thin organic layer adherent to the surface enamel, can only be removed by pumice or other abrasive prophylaxis. 2 The role of bacterial dental plaque in the aetiology of gingivitis and periodontal disease has been well established. 5 Part of the prevention of such conditions is based on limiting the accumulation of micro-organisms on the teeth and maintaining a fl ora that is consistent with periodontal health.Three separate studies have evaluated the effect of dental prophylaxis before PATF on the amount of fl uoride uptake by BACKGROUNDDental prophylaxis typically consists of placing pumice or an abrasive paste in a rubber cup and applying the paste to the clinical crowns of the teeth using rotating rubber cup at slow speed. This aims at the complete removal of plaque, salivary pellicle, materia alba and extrinsic stains found on the crowns of teeth to reduce and prevent future dental caries. The clinical protocol for performing a routine dental prophylaxis before professionally applied topical fl uoride (PATF) was fi rst advanced by Knutson. 1 The rationale behind this was the belief that materia alba, plaque and other natural coatings on tooth surfaces Background The purpose of this systematic review was to assess the effi cacy of routine dental prophylaxis applied before professionally applied topical fl uoride (PATF) or at a regular recall visit in the prevention of caries or gingivitis. Types of studies reviewed Ovid MEDLINE and its allied versions; CINAHL; Cochrane Library; EMBASE; Health and Psychosocial Instruments; HealthSTAR; International Pharmaceutical Abstracts; and ACP Journal Club were searched for English and Human articles from 1966 to 2007 for original in vivo English publications assessing rubber cup dental prophylaxis. In vitro studies, case series, case reports or letters to editors (not containing primary data), editorials, review articles and commentaries were excluded but were read to identify any potential studies. Results One hundred and eighty-nine articles were searched for relevancy resulting in six original studies that met our inclusion criteria. There was a unanimous agreement in four studies that a dental prophylaxis is not warranted before a PATF for caries prevention in children. A generalisation on dental prophylaxis before PATF cannot be applied to adolescents and adults. Available evidence (two other studies) fails to demonstrate any benefi t in the prevention of gingivitis from ...

Personal oral hygiene and dental caries: A systematic review of randomised controlled trials

“…So, in effect, personal oral hygiene was shown to be an inactive delivery mechanism for an active pharmaceutical, fluoride. Our findings are furthermore consistent with systematic reviews on the ineffectiveness of selfperformed flossing, [23][24][25] professional dental plaque removal 26,27 and removal of dental plaque prior to fluoride applications for preventing coronal dental caries. 28 Controlled trials on topical chemotherapeutics provide additional insights on the validity of the oral hygiene hypothesis.…”

Estimating the Cost Savings of Preventive Dental Services Delivered to Medicaid‐Enrolled Children in Six Southeastern States

“…Basic pediatric dental preventive services include dental prophylaxis (teeth cleaning), topical fluoride application, and dental sealants. There is no evidence that dental prophylaxis is effective in preventing dental caries (Badersten, Egelberg, and Koch ; Azarpazhooh and Main ; Sampson ). In contrast, there is strong evidence that the application of dental sealants (Werner, Pereira, and Eklund ; Beauchamp et al.…”

Patient-Centered Caries Prevention in Children may be More Cost-Effective in the Long Term than Traditional Dental Care

“…As well, the experimental group received a professional cleaning before fluoride and chlorhexidine varnish application, which is of little clinical value. 6 Utilization of less costly staff, such as dental assistants or training school nurses to apply varnish on initial lesions may have been a more cost-effective use of staff and resulted in an earlier cost benefit within the experimental group. Other studies in Scandanavia have attributed personnel costs to account for roughly half of the cost of providing preventive services in a school-based environment.…”