Change in plaque control ability by the professional oral health care program

Boo-Deok Jo; Dong-Kie Kim; Byoung-Jin Lee

doi:10.11149/jkaoh.2015.39.1.25

Journal List > J Korean Acad Oral Health > v.39(1) > 1057657

Go to TopGo to Top Go to BottomGo to Bottom

TOOLS

Jo, Kim, and Lee: Change in plaque control ability by the professional oral health care program

Original Article

J Korean Acad Oral Health 2015;39(1):25-36.

Published online: 12 March 2015

DOI: https://doi.org/10.11149/jkaoh.2015.39.1.25

Change in plaque control ability by the professional oral health care program

Boo-Deok Jo, Dong-Kie Kim, Byoung-Jin Lee

Department of Preventive and Public Health Dentistry, Chosun University School of Dentistry, Gwangju, Korea

Corresponding Author: Byoung-Jin Lee Department of Preventive and Public Health Dentistry, Chosun University School of Dentistry, 303 Pilmun-daero, Dong-gu, Gwangju 501-759, Korea Tel: +82-62-220-3836 E-mail: prevdent@chosun.ac.kr

Received 27 October 2014 Revised 16 December 2014 Accepted 7 January 2015

This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/), which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Objectives

This study aimed to examine the impact of a regular professional oral health care program and the accompanying oral health education.

Methods

We included 552 patients who visited the C dental hospital more than 5 times as part of a regular professional oral health care program from January 2009 to March 2014. This program comprised of an O’Leary plaque control record, tooth brushing instructions, professional tooth brushing, professional tooth cleaning, periodontal or operative treatment (optional), and education on auxiliary devices. The O’Leary plaque control record was evaluated at the fifth consecutive visit, from the first visit to the recent visit.

Results

The study data revealed that patient plaque control rate significantly increased with a lapse in care provided from the baseline. However, no intergroup differences were observed with respect to age and sex. The plaque controlling ability of a patient who was educated on the Watanabe’s brushing method, which was a combination of the Watanabe’s brushing method and rolling method, was significantly increased. Use of an interdental brush, attending the 5-time tooth brushing instruction program, and tooth polishing aided to enhance the plaque-control rate. Further, the plaque control rate of a patient with a pontic, fully covered tooth and implant was significantly higher than those without the same. The Watanabe’s brushing method, number of fully covered teeth, and number of implants were significant variables that impacted the final plaque control rate, as ascertained using multiple linear regression analysis. Increased plaque control rate was maintained till the recent evaluation from the fifth visit.

Conclusions

The ability of patients to reduce plaque formation was improved after the educational program, which comprised of tooth brushing instructions as part of a regular professional oral health care program.

Keywords: Dental plaque, Dental plaque index, Professional oral health care, Regular oral health care, Toothbrushing instruction

References

1. Renz A1, Ide M, Newton T, Robinson PG, Smith D. Psychological interventions to improve adherence to oral hygiene instructions in adults with periodontal diseases. Cochrane Database Syst Rev. 2007; 18(2):CD005097.

2. Pastagia J1, Nicoara P, Robertson PB. The effect of patient-centered plaque control and periodontal maintenance therapy on adverse outcomes of periodontitis. J Evid Based Dent Pract. 2006; 6:25–32.

3. Berchier CE, Slot DE, Haps S, Van der Weijden GA. The efficacy of dental floss in addition to a toothbrush on plaque and parameters of gingival inflammation: a systematic review. Int J Dent Hyg. 2008; 6:265–279.

4. Needleman I, Suvan J, Moles DR, Pimlott J. A systematic review of professional mechanical plaque removal for prevention of periodontal diseases. Review. J Clin Periodontol. 2005; 32(Suppl 6):229–282.

5. Worthington HV, Clarkson JE, Bryan G, Beirne PV. Routine scale and polish for periodontal health in adults. Cochrane Database Syst Rev. 2013; 11:CD004625.

6. Smiech-Slomkowska G, Jablonska-Zrobek J. The effect of oral health education on dental plaque development and the level of caries-related Streptococcus mutans and Lactobacillus spp. Eur J Orthod. 2007; 29:157–160.

7. Hanioka T, Shigemoto Y, Matsuse R, Ojima M, Shizukuishi S. Effect of follow-up intervention of toothbrushing on periodontal health in workplace dental examination. J Occup Health. 2004; 46:199–204.

8. Han GS, Choi JS, Hong HK, Lee MJ, Bae KH. The effect of professional tooth cleaning and plaque control instruction according to the characteristics of subjects. J Korean Acad Dent Health. 2008; 32:453–463.

9. Lembariti BS, van der Weijden GA, van Palenstein Helderman WH. The effect of a single scaling with or without oral hygiene instruction on gingival bleeding and calculus formation. J Clin Periodontol. 1998; 25:30–33.

10. Chawla TN, Nanda RS, Kapoor KK. Dental prophylaxis procedures in control of periodontal disease in Lucknow (rural) India. J Periodontol. 1975; 46:498–503.

11. Jo BD, Jeong SK, Lee KH, Kim AH, Lee BJ, Kim DK. Effect of regular oral health care on aggressive periodontitis using Watanabe’s tooth brushing method: case report. J Korean Acad Oral Health. 2012; 36:333–340.

12. Won JY, Sin SC, Seo HS, Lyu H. A study on the incremental dental caries of giving the first consideration to prevention in dental clinic. J Korean Acad Dent Health. 2003; 27:329–346.

13. O’Leary T, Drake R, Naylon JE. The plaque control record. J Periodontol. 1972; 43:38.

14. Lee SS, Paik DI, Kim JB. A study on the effects of the toothbrushing instruction methods in dental health education. J Korean Acad Dent Health. 1990; 14:233–242.

15. Peek EH. Application of oral health educational program and it's effects among elementary students. J Dental Hygiene Science. 2011; 11:279–284.

16. Hong SJ, Lee SD, Bae JS. Reduction of plaque and gingival bleeding by toothbrushing education and scaling. J Korean Acad Dent Health. 1994; 18:434–440.

17. Chang KW, Kim JB. An experimental study on the effects of the toothbrushing instructional methods. J Korean Acad Dent Health. 1987; 11:85–98.

18. Kim DK, Seong JH. A study on the relationship between the frequency of toothbrushing instruction and change of oral microorganism. J Korean Acad Dent Health. 1993; 17:147–166.

19. Choi YK, Park DY. Comparison of rolling method with Bass method toothbrushing practices for efficacy in plaque removal and degree of easiness. J Korean Acad Dent Health. 2008; 32:329–338.

20. Eom MR, Jeong DB, Park DY. Enhancement of plaque control score following individualized repeated instruction. J Korean Acad Dent Health. 2009; 33:10–18.

21. Jo MJ, Min KJ. Effect of repeated directing tooth-brushing education on plaque control. Journal of the Korea Academia-Industrial Cooperation Society. 2010; 11:2088–2092.

22. Woo HS, Kim DK. The effect of TBI on PHP index of workers need scaling. J Korean Acad Oral Health. 2010; 34:65–71.

23. Cho MM, Lee YH, Kim JB, Lee JH. Promotion of periodontal health through professional toothbrushing and education on the use of the interdental brush in the elderly. J Korean Acad Oral Health. 2013; 37:132–140.

24. Park JR, Lee YK, Son HK, Hong MH. Comparison of oral hygiene status by clinical dental hygiene care performance. J Korean Soc Dent Hyg. 2014; 14:25–32.

25. Axelsson P, Lindhe J. Effect of oral hygiene instruction and professional tooth cleaning on caries and gingivitis in schoolchildren. Community Dent Oral Epidemiol. 1981; 9:251–255.

26. Zanatta FB, Pinto TM, Kantorski KZ, Rösing CK. Plaque, gingival bleeding and calculus formation after supragingival scaling with and without polishing: a randomised clinical trial. Oral Health Prev Dent. 2011; 9:275–280.

27. Morita M, Nishi K, Watanabe T. Comparison of 2 toothbrushing methods for efficacy in supragingival plaque removal. The Toothpick method and the Bass method. J Clin Periodontol. 1998; 25(10):829–31.

28. Kim CH, Kim J, Kim CW. Change in periodontal status by professional toothbrushing, and patients’ satisfaction. J Dental Hygiene Science. 2008; 8:261–266.

29. Bae KH, Moon HS, Paik DI, Kim JB. Comparison of two toothbrushing instruction methods for adults. J Korean Acad Dent Health. 2000; 24:33–47.

30. Jeong HJ, Kim HJ, Jeong AH. A study of change of oral health state score from gingivitis patients using toothbrushing method. J Korean Soc Dent Hyg. 2011; 11:595–602.

31. Kim SH. The effect of plaque control (tooth brushing instruction) for oral health improvement on periodontitis patients. J Korean Soc Dent Hyg. 2011; 11:293–301.

32. Han YS. Lim SR, Cho YS. Comparison of dental biofilm reduction between Rolling method and modified Stillman method. J Dent Hyg Sci. 2012; 12:660–665.

33. Slot DE, Dörfer CE, Van der Weijden GA. The efficacy of interdental brushes on plaque and parameters of periodontal inflammation: a systematic review. Int J Dent Hyg. 2008; 6:253–64.

34. Gray D, McIntyre G. Does oral health promotion influence the oral hygiene and gingival health of patients undergoing fixed appliance orthodontic treatment? A systematic literature review. J Orthod. 2008; 35:262–269.

35. Subramani K, Jung RE, Molenberg A, Hammerle CH. Biofilm on dental implants: a review of the literature. Int J Oral Maxillofac Implants. 2009; 24:616–626.

36. Elter C, Heuer W, Demling A, Hannig M, Heidenblut T, Bach FW, Stiesch-Scholz M. Supra- and subgingival biofilm formation on implant abutments with different surface characteristics. Int J Oral Maxillofac Implants. 2008; 23:327–334.

37. Grössner-Schreiber B, Griepentrog M, Haustein I, Müller WD, Lange KP, Briedigkeit H, Göbel UB. Plaque formation on surface modified dental implants. An in vitro study. Clin Oral Implants Res. 2001; 12:543–551.

38. Schlueter N, Klimek J, Ganss C. Relationship between plaque score and video-monitored brushing performance after repeated instruction-a controlled, randomised clinical trial. Clin Oral In-vestig. 2013; 17:659–667.

39. Graetz C, Bielfeldt J, Wolff L, Springer C, El-Sayed KM, Sälzer S, Badri-Höher S, Dörfer CE. Toothbrushing education via a smart software visualization system. J Periodontol. 2013; 84:186–195.

40. Almomani F, Williams K, Catley D, Brown C. Effects of an oral health promotion program in people with mental illness. J Dent Res. 2009; 88:648–652.

41. Zenthöfer A, Dieke R, Dieke A, Wege KC, Rammelsberg P, Hassel AJ. Improving oral hygiene in the long-term care of the elderly-a RCT. Community Dent Oral Epidemiol. 2013; 41:261–268.

42. Samson H, Berven L, Strand GV. Long-term effect of an oral healthcare programme on oral hygiene in a nursing home. Eur J Oral Sci. 2009; 117:575–579.

43. Ribeiro DG, Pavarina AC, Giampaolo ET, Machado AL, Jorge JH, Garcia PP. Effect of oral hygiene education and motivation on removable partial denture wearers: longitudinal study. Gerodontology. 2009; 26:150–156.

44. Watt RG, Marinho VC. Does oral health promotion improve oral hygiene and gingival health? (review) Periodontol. 2000. 2005; 37:35–47.

45. Goldman N, Glei DA, Chang MC. The role of clinical risk factors in understanding self-rated health. Ann Epidemiol. 2004; 14:49–57.

46. Firmstone VR, Bullock AD, Jackson D, Manning R, Davies-Slowik J, Frame JW. Using evaluation to enhance educational support for dental teams in the UK. J Dent Educ. 2010; 74:892–901.

47. Uitenbroek DG, Schaub RM, Tromp JA, Kant JH. Dental hygienists’ influence on the patients’ knowledge, motivation, self-care, and perception of change. Community Dent Oral Epidemiol. 1989; 17:87–90.

Fig. 1.

Change of plaque control rate (PCR) evaluated at from 1^st to 10^th and final visit (N=188, Female=111, Male=77).

Table 1.

Distribution of study subjects by age groups and gender

Age	Total	Female	Male
Age	N (%)
Total	552 (100.0)	312 (56.5)	240 (43.5)
Under 24	73 (13.2)	39 (12.5)	34 (14.2)
25-34	59 (10.7)	32 (10.3)	27 (11.2)
35-44	59 (10.7)	36 (11.5)	23 (9.6)
45-54	154 (27.9)	81 (26.0)	73 (30.4)
55-64	155 (28.1)	95 (30.4)	60 (25.0)
Over 65	52 (9.4)	29 (9.3)	23 (9.6)

Table 2.

O’Leary plaque control rate evaluated from 1^st to 5^th and final visit by gender groups

Gender	N	1^st visit (Baseline)	2^nd visit	3^rd visit	4^th visit	5^th visit	Final visit	P-value*	ΔPCR_Final-1st**
Gender	N	Mean±SD	Mean±SD	Mean±SD	Mean±SD	Mean±SD	Mean±SD	P-value*	ΔPCR_Final-1st**
Total	552	39.08±16.40	43.81±18.69	46.33±19.04	46.91±19.39	48.48±19.40	48.80±18.32	<0.001	9.72±17.74
Female	312	39.72±16.46	43.97±18.69	46.06±19.45	47.48±19.73	48.15±18.96	48.52±17.69	<0.001	8.80±18.19
Male	240	38.25±16.31	43.60±18.71	46.67±18.52	46.17±18.96	48.91±19.99	49.15±19.14	<0.001	10.91±17.09

*P-value obtained from repeated measure ANOVA. **No statistically difference between groups in PCR change by repeated measure ANOVA (P=0.478). **No statistically difference between groups in PCR value by repeated measure ANOVA (P=0.878).

Table 3.

O’Leary plaque control rate evaluated from 1^st to 5^th and final visit by age groups

Age	N	1^st visit (Baseline)	2^nd visit	3^rd visit	4^th visit	5^th visit	Final visit	P-value*	ΔPCR_Final-1st**
Age	N	Mean±SD	Mean±SD	Mean±SD	Mean±SD	Mean±SD	Mean±SD	P-value*	ΔPCR_Final-1st**
Total	552	39.08±16.40	43.81±18.69	46.33±19.04	46.91±19.39	48.48±19.40	48.80±18.32	<0.001	9.72±17.74
24 or less	73	25.10±14.39	32.26±17.50	33.03±19.54	31.79±17.69	34.56±19.08	35.69±18.00	<0.001	10.27±18.35^a)
25-34	59	37.81±13.98	42.42±18.55	47.81±15.98	46.55±18.55	49.66±18.98	47.19±17.82	<0.001	9.38±19.17^b)
35-44	59	40.73±16.09	44.83±17.92	45.90±21.38	48.46±20.78	52.07±20.48	49.81±19.07	<0.001	9.47±17.48^b,c)
45-54	154	39.39±15.75	42.58±18.67	46.85±18.66	47.98±19.35	49.90±18.82	50.05±16.90	<0.001	10.65±18.13^b,c)
55-64	155	42.89±15.23	48.05±16.83	49.05±16.76	50.80±16.91	50.24±17.81	51.76±17.51	<0.001	9.02±17.13^b,c)
65 or more	52	47.16±16.34	51.38±19.22	54.12±18.23	52.27±18.42	52.39±18.71	55.92±15.92	<0.001	8.92±16.75^c)

*P-value obtained from repeated measure ANOVA. **No statistically difference between groups in PCR change by repeated measure ANOVA (P=0.612). **Statistically difference between groups in PCR value by repeated measure ANOVA (P<0.001). Same charater means statistically same group (post hoc Tukey’s HSD test, P>0.05)

Table 4.

O’Leary plaque control rate evaluated from 1st to 5th and final visit by tooth brushing method

Tooth brushing method	N	1^st visit (Baseline)	2^nd visit	3^rd visit	4^th visit	5^th visit	Final visit	P-value*	ΔPCR_Final-1st**
Tooth brushing method	N	Mean±SD	Mean±SD	Mean±SD	Mean±SD	Mean±SD	Mean±SD	P-value*	ΔPCR_Final-1st**
Total	552	39.08±16.40	43.80±18.68	46.33±19.04	46.91±19.39	48.48±19.40	48.80±18.32	<0.001	9.72±17.74
Watanabe	337	40.79±15.40	45.43±18.13	48.64±17.58	48.87±17.96	51.19±18.22	50.70±17.63	<0.001	9.91±18.13^a)
Watanabe combined	93	41.96±16.61	44.50±19.05	49.79±18.24	51.71±20.16	48.72±19.58	52.20±17.05	<0.001	10.24±17.12^a)
Rolling	38	32.63±16.10	41.75±19.19	38.21±20.51	38.18±21.02	43.63±21.88	41.22±18.55	0.004	8.60±14.57^a,b)
Bass	21	38.18±15.66	36.80±18.79	38.97±16.83	41.79±18.00	42.27±20.01	42.80±19.59	0.544	4.62±17.73^a,b)
Orthodontic	40	25.12±15.37	33.13±18.83	33.50±21.95	34.77±20.74	36.36±17.96	37.89±18.74	0.001	12.76±20.94^b)
Professional brushing	23	38.16±19.35	45.47±18.12	40.93±22.73	38.95±18.57	42.54±22.81	44.16±20.39	0.197	6.00±12.52^a,b)

*P-value obtained from repeated measure ANOVA. **No statistically difference between groups in PCR change by repeated measure ANOVA (P=0.110). **Statistically difference between groups in PCR value by repeated measure ANOVA (P<0.001). Same charater menas statistically same group (post hoc Tukey’s HSD test, P>0.05)

Table 5.

O’Leary plaque control rate evaluated from 1^st to 5^th and final visit by using interdental brush, dental floss or applying programmed TBI and tooth polishing

Variables	N	1^st visit (Baseline)	2^nd visit	3^rd visit	4^th visit	5^th visit	Final visit	P-value*	ΔPCR_Final-1st
Variables	N	Mean±SD	Mean±SD	Mean±SD	Mean±SD	Mean±SD	Mean±SD	P-value*	ΔPCR_Final-1st
Total	552	39.08±16.40	43.80±18.68	46.33±19.04	46.91±19.39	48.48±19.40	48.80±18.32	<0.001	9.72±17.74
Interdental brush
Yes	383	40.35±16.14	44.46±18.23	48.10±18.57	49.20±18.94	50.15±18.97	7 50.29±18.10	<0.001	9.94±17.71
No	169	36.21±16.66	42.32±19.65	42.31±19.52	41.72±19.45	44.69±19.88	45.43±18.42	<0.001	9.22±17.84
P=0.034 *P<0.001
Dental floss
Yes	252	39.22±16.46	43.33±18.28	46.38±18.19	46.80±18.64	49.50±19.46	48.28±18.26	<0.001	9.06±17.49
No	300	38.96±16.37	44.20±19.04	46.28±19.75	47.00±20.03	47.62±19.34	4 49.24±18.39	<0.001	10.27±17.95
P=0.455 *P=0.978
Programmed toothbrushing instruction
Yes	267	38.79±15.05	40.85±17.14	45.52±17.93	46.56±18.47	47.16±18.48	49.30±17.69	<0.001	10.52±18.12
No	285	39.36±17.59	46.57±19.66	47.08±20.02	47.23±20.25	49.72±20.18	48.33±18.91	<0.001	8.97±17.37
P<0.001 *P=0.179
Tooth polishing
Yes	306	38.79±15.75	41.96±17.75	45.47±18.52	46.29±18.66	48.12±18.55	49.58±17.24	<0.001	10.79±17.65
No	246	39.44±17.20	46.10±19.58	47.39±19.65	47.67±20.28	48.93±20.43	3 47.83±19.57	<0.001	8.39±17.79
P=0.006 *P=0.344

*P-value obtained from repeated measure ANOVA. **P-value obtained from repeated measure ANOVA between groups in PCR change. ***P-value obtained from repeated measure ANOVA between groups in PCR value.

Table 6.

O’Leary plaque control rate evaluated from 1st to 5th and final visit by tooth status

Variables	N	1^st visit (Baseline)	2^nd visit	3^rd visit	4^th visit	5^th visit	Final visit	P-value*	ΔPCR_Final-1st
Variables	N	Mean±SD	Mean±SD	Mean±SD	Mean±SD	Mean±SD	Mean±SD	P-value*	ΔPCR_Final-1st
Total	552	39.08±16.40	43.80±18.68	46.33±19.04	46.91±19.39	48.48±19.40	48.80±18.32	<0.001	9.72±17.74
Have place the missing tooth
Have	195	38.38±17.16	43.84±20.55	45.37±20.39	44.97±20.35	45.99±20.26	47.34±19.40	<0.001	8.96±17.03
Not have	357	39.46±15.98	43.79±17.62	46.85±18.26	47.97±18.79	49.84±18.80	49.59±17.68	<0.001	10.13±18.12
P=0.157 *P=0.139
Have fully covered tooth
Have	337	43.81±14.77	47.98±17.30	50.43±17.31	51.39±17.94	52.16±17.80	53.35±16.82	<0.001	9.53±17.40
Not have	215	31.66±16.10	37.26±18.93	39.89±19.86	39.89±19.54	42.72±20.42	41.67±18.34	<0.001	10.01±18.29
P=0.543 *P<0.001
Have pontic
Have	148	46.75±15.12	51.98±17.38	54.34±17.28	53.40±17.74	53.74±18.52	58.01±16.85	<0.001	11.26±16.17
Not have	404	36.27±15.96	40.81±18.26	43.39±18.82	44.53±19.45	46.55±19.38	45.42±17.68	<0.001	9.15±18.27
P=0.026 *P<0.001
Have implant
Have	82	45.38±15.74	50.59±18.16	51.64±18.66	53.48±17.99	53.35±16.72	57.69±14.99	<0.001	12.31±15.55
Not have	470	37.98±16.28	42.62±18.54	45.40±18.97	45.76±19.42	47.63±19.72	47.25±18.42	<0.001	9.27±18.07
P=0.291	*P<0.00	1

Table 7.

Multiple linear regression analysis of oral health factors and final plaque control rate

Independent variable	Unstandardized coefficient		Standardized coefficient	t	P-value*
Independent variable	B	SE	Beta	t	P-value*
Gender (Female=0, Male=1)	1.213	1.422	0.033	0.853	0.394
Age (40 or less=0, 41 or more=1)	1.791	1.895	0.045	0.945	0.345
Toothbrushing method (Other method=0, Watanabe method=1)	4.332	2.071	0.098	2.091	0.037
Interdental brush (Not use=0, Use=1)	1.342	1.706	0.034	0.787	0.432
Dental floss (Not use=0, Use=1)	―0.959	1.504	―0.026	―0.638	0.524
Programed (Not apply=0, Apply=1)	―0.028	1.543	―0.001	―0.018	0.986
Tooth polishing (Not apply=0, Apply=1)	2.047	1.494	0.056	1.371	0.171
No. of missing tooth	―0.882	0.483	―0.075	―1.828	0.068
No. of fully covered tooth	1.686	0.278	0.309	6.064	<0.001
No. of pontic	0.816	0.852	0.047	0.958	0.339
No. of implant	1.721	0.503	0.136	3.418	0.001
Overall significance of the model: F=13.472 (P<0.001), R²=0.215, adj. R²=0.199

TOOLS

Similar articles