One-to-one oral hygiene advice provided in a dental setting for oral health

Soldani, Francesca; Lamont, Thomas; Jones, Katharine; Young, Linda; Walsh, Tanya; Lala, Rizwana; Clarkson, Jan E

doi:10.1002/14651858.cd007447.pub2

Cited by 33 publications

(26 citation statements)

References 152 publications

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“…Bleeding from gums was reported by less than 28.1% of patients with MS, compared to a 50% incidence of gingival bleeding in healthy Poles [24]. The average age of responders in that study was higher, by more than a dozen years, than in our group and gingival bleeding was largely related to the fact of brushing the teeth and the type of toothbrush bristles (soft, medium, hard).…”

Section: Discussioncontrasting

confidence: 61%

Multiple sclerosis: oral health, behaviours and limitations of daily oral hygiene — a questionnaire study

Łabuz-Roszak

Niewiadomska

Starostka-Tatar

et al. 2019

Neurol Neurochir Pol.

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clinical rationale for the study. Neurological deficits and progressing disability in patients with multiple sclerosis (MS) may hamper daily oral hygiene, but their relations with oral problems have not yet been clearly determined. Aim of the study. The aim of this study was to identify the most significant dental problems and limitations of daily oral hygiene in Polish patients with MS. Material and methods. 199 patients with diagnosed MS (median age 37 years) treated in the neurological outpatient clinic were interviewed using a paper-based questionnaire. They provided answers on oral health, behaviours and the limitations of their daily oral hygiene. Clinical information regarding symptoms, MS phenotype, relapses, medication and degrees of disability was based on medical records. results. The most frequent symptoms were dry mouth (43.2%) and bleeding from gums (28.1%). Dry mouth was more frequent in patients with secondary-progressive MS (SPMS) than relapsing-remitting MS (65.4% vs 41.3%, p = 0.023). Patients with bleeding from gums had had MS for a longer duration (median 6 vs 4 years, p = 0.002). Difficulties in daily oral hygiene were more frequent in patients with SPMS (24.0% vs 8.1%; p = 0.016). Greater proportions of patients with muscle weakness of limbs, imbalance or pain brushed their teeth irregularly. Frequent (i.e. at least every six months) visits to the dentist's surgery were uncommon in patients with SPMS (12.0% vs 39.7%, p = 0.010). conclusions and clinical implications. Dry mouth and bleeding from gums are more frequent in patients with longer lasting and more advanced types of MS. Daily oral hygiene and oral health self-control is limited in patients with MS, mainly due to motor deficits, balance problems and pain, and this becomes worse with disease duration. To minimise the burden of the disease, patients with MS require better education and improvement in their awareness regarding proper oral health control, such as the use of electric toothbrushes. In addition, patients with chronic and progressive disability from multiple sclerosis may benefit from better organised access to dental care.

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Section: Discussioncontrasting

confidence: 61%

Multiple sclerosis: oral health, behaviours and limitations of daily oral hygiene — a questionnaire study

Łabuz-Roszak

Niewiadomska

Starostka-Tatar

et al. 2019

Neurol Neurochir Pol.

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“…71,72 The NICE guideline on dental recall reiterated the need for research in this area to examine the effects of varying dental recall intervals on oral health. 59 The NICE guideline also concluded that the research base was severely lacking in terms of determination of the optimal dental recall intervals on the basis of cost-effectiveness. 60 There is, therefore, an urgent need to assess the relative effectiveness and cost-effectiveness of different dental recall intervals in a robust, sufficiently powered randomised control trial (RCT) in primary dental care.…”

Section: Evidence Basementioning

confidence: 99%

“…56,57 The dental care professionals' role in primary prevention involves assessment of an individual's risk of developing oral disease and tailoring preventative advice, including oral hygiene and dietary advice based on this risk assessment, although the evidence relating to the beneficial effects of chairside provision of dental health education advice is conflicting. 58,59 In 2004, the National Institute for Health and Care Excellence (NICE) published a guideline entitled Dental Recall: Recall Interval Between Routine Dental Examinations, 60 following a remit received from the Department of Health and Social Care and the Welsh Assembly Government. Within this guideline, the role of the oral health review, or dental check-up, in providing primary prevention and secondary prevention is highlighted.…”

Section: Introductionmentioning

confidence: 99%

“…Analysis of dental attendance patterns in NHS primary dental care using the Dental Practice Board's longitudinal data demonstrates an attendance pattern that is variable, with many patients attending less frequently than every 6 months. 59 Data from the Information Services Division (ISD) in Scotland show that the vast majority of Scottish adults did not attend NHS primary care dental services on an annual basis, with only 23% attending at least once per year in each of the previous 6 years, and 21% not attending at all in the past 6 years. 62 In addition, it has been consistently observed that caries experience is generally more extensive in lower socioeconomic status groups, 63 reinforcing the case for patient-specific recall intervals, based on an assessment of the patient's risk of oral disease.…”

Section: Introductionmentioning

confidence: 99%

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Risk-based, 6-monthly and 24-monthly dental check-ups for adults: the INTERVAL three-arm RCT

Clarkson

Pitts

Goulão

et al. 2020

Health Technol Assess

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Background Traditionally, patients are encouraged to attend dental recall appointments at regular 6-month intervals, irrespective of their risk of developing dental disease. Stakeholders lack evidence of the relative effectiveness and cost-effectiveness of different recall strategies and the optimal recall interval for maintenance of oral health. Objectives To test effectiveness and assess the cost–benefit of different dental recall intervals over a 4-year period. Design Multicentre, parallel-group, randomised controlled trial with blinded clinical outcome assessment at 4 years and a within-trial cost–benefit analysis. NHS and participant perspective costs were combined with benefits estimated from a general population discrete choice experiment. A two-stratum trial design was used, with participants randomised to the 24-month interval if the recruiting dentist considered them clinically suitable. Participants ineligible for 24-month recall were randomised to a risk-based or 6-month recall interval. Setting UK primary care dental practices. Participants Adult, dentate, NHS patients who had visited their dentist in the previous 2 years. Interventions Participants were randomised to attend for a dental check-up at one of three dental recall intervals: 6-month, risk-based or 24-month recall. Main outcomes Clinical – gingival bleeding on probing; patient – oral health-related quality of life; economic – three analysis frameworks: (1) incremental cost per quality-adjusted life-year gained, (2) incremental net (societal) benefit and (3) incremental net (dental health) benefit. Results A total of 2372 participants were recruited from 51 dental practices; 648 participants were eligible for the 24-month recall stratum and 1724 participants were ineligible. There was no evidence of a significant difference in the mean percentage of sites with gingival bleeding between intervention arms in any comparison. For the eligible for 24-month recall stratum: the 24-month (n = 138) versus 6-month group (n = 135) had an adjusted mean difference of –0.91 (95% confidence interval –5.02 to 3.20); the risk-based (n = 143) versus 6-month group had an adjusted mean difference of –0.98 (95% confidence interval –5.05 to 3.09); the 24-month versus risk-based group had an adjusted mean difference of 0.07 (95% confidence interval –3.99 to 4.12). For the overall sample, the risk-based (n = 749) versus 6-month (n = 737) adjusted mean difference was 0.78 (95% confidence interval –1.17 to 2.72). There was no evidence of a difference in oral health-related quality of life between intervention arms in any comparison. For the economic evaluation, under framework 1 (cost per quality-adjusted life-year) the results were highly uncertain, and it was not possible to identify the optimal recall strategy. Under framework 2 (net societal benefit), 6-month recalls were the most efficient strategy with a probability of positive net benefit ranging from 78% to 100% across the eligible and combined strata, with findings driven by the high value placed on more frequent recall services in the discrete choice experiment. Under framework 3 (net dental health benefit), 24-month recalls were the most likely strategy to deliver positive net (dental health) benefit among those eligible for 24-month recall, with a probability of positive net benefit ranging from 65% to 99%. For the combined group, the optimal strategy was less clear. Risk-based recalls were more likely to be the most efficient recall strategy in scenarios where the costing perspective was widened to include participant-incurred costs, and in the Scottish subgroup. Limitations Information regarding factors considered by dentists to inform the risk-based interval and the interaction with patients to determine risk and agree the interval were not collected. Conclusions Over a 4-year period, we found no evidence of a difference in oral health for participants allocated to a 6-month or a risk-based recall interval, nor between a 24-month, 6-month or risk-based recall interval for participants eligible for a 24-month recall. However, people greatly value and are willing to pay for frequent dental check-ups; therefore, the most efficient recall strategy depends on the scope of the cost and benefit valuation that decision-makers wish to consider. Future work Assessment of the impact of risk assessment tools in informing risk-based interval decision-making and techniques for communicating a variable recall interval to patients. Trial registration Current Controlled Trials ISRCTN95933794. Funding This project was funded by the National Institute for Health Research (NIHR) Health Technology Assessment programme [project numbers 06/35/05 (Phase I) and 06/35/99 (Phase II)] and will be published in full in Health Technology Assessment; Vol. 24, No. 60. See the NIHR Journals Library website for further project information.

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“…15,16 A recent systematic review reported that there is insufficient high-quality evidence to recommend any specific one-to-one oral hygiene instruction method as being effective in improving oral health. 17 Also, a network meta-analysis on interproximal oral hygiene aids reported that the patient-reported outcomes of the interdental aids are not clear because most of the studies have investigated disease-oriented outcomes of gingival health, providing only limited information what matters to patients. 5 Hence, this study aims to evaluate the efficacy of oral hygiene instruction methods and patient-reported outcome measures for calibrated interdental brush.…”

mentioning

confidence: 99%

Comparative evaluation of efficacy and patient‐reported outcome measures of oral hygiene instruction methods for calibrated interdental brush

Subramanya

Prabhuji

2021

Int J Dental Hygiene

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Mechanical plaque control is the cornerstone in management of dental biofilm. 1 Tooth brushing is the most widely known self-performed mechanical plaque biofilm removal/control method at home. While toothbrushes are effective in removing dental plaque from buccal, lingual and occlusal aspects of teeth, by virtue of their design, they have limited access to interdental areas and are inefficient in cleaning interproximal surfaces of teeth. 2 Plaque control in interdental areas is particularly important because these areas are more susceptible for periodontal diseases with greater severity. 3 European Federation of Periodontology recommends that-'Daily cleaning between your teeth using special "interdental" brushes is essential for treating and preventing gum disease '. 4 As per a recent network meta-analysis on interproximal oral hygiene methods in the reduction in clinical indices of inflammation,

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One-to-one oral hygiene advice provided in a dental setting for oral health

Cited by 33 publications

References 152 publications

Multiple sclerosis: oral health, behaviours and limitations of daily oral hygiene — a questionnaire study

Multiple sclerosis: oral health, behaviours and limitations of daily oral hygiene — a questionnaire study

Risk-based, 6-monthly and 24-monthly dental check-ups for adults: the INTERVAL three-arm RCT

Comparative evaluation of efficacy and patient‐reported outcome measures of oral hygiene instruction methods for calibrated interdental brush

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