Combination Oral Hygiene Effects on Plaque and Gingivitis in Orthodontics

Objectives: A pilot clinical study evaluated use of a combined power brush, therapeutic dentifrice and rinse, plus floss on plaque accumulation and clinical gingivitis during orthodontic treatment.

Methods: After IRB review, informed consent and child assent were collected from adolescents who were undergoing routine orthodontics at a university dental clinic.  Enrolled subjects provided an anti-cavity dentifrice and regular manual toothbrush and instructions for 1-month acclimation.   Baseline measures were collected and subjects were provided a powered toothbrush (Oral-B® Professional Care® 5000 with SmartGuide and the Ortho brush head), 0.454% stannous fluoride dentifrice (Crest® Pro-Health Clinical Gum Protection), 0.0219% fluoride  rinse (Crest Pro-Health Complete), and floss (Oral-B Super-Floss).  Whole mouth gingivitis (Gingivitis Index) and overnight anterior facial plaque (Digital Plaque Image Analysis) were measured using standard methods to assess change in bleeding sites and plaque area coverage after 1-month combination product use.   

Results: Eighteen subjects were included in the research ranging in age from 13 to 17 years with an average of 14.6 years.  At baseline, subjects had a mean (SD) 75.9 (15.6) bleeding sites and 32.0% (20.3) plaque area coverage.  After 1-month combination hygiene, mean (SD) bleeding was reduced by 30.8 (13.7) sites, while mean (SD) overnight plaque was reduced by 16.4% (17.9) area coverage, differing significantly (p<0.002) from baseline for bleeding and plaque.  Combination product use was well-tolerated, and all adolescent subjects completed the study. 

Conclusions: Use of a rotation-oscillation power brush, stannous fluoride dentifrice, fluoride rinse and floss combination by orthodontic patients resulted in significant reductions in gingival bleeding sites (41%) and plaque area coverage (51%) in one month.