三种控制牙间菌斑的辅助工具(牙线、水牙线和牙间刷)作为儿童刷牙的辅助工具的效果。

Q3 Dentistry
Annam George, Jayanthi Mungara, Poornima Vijayakumar, Deebiga Karunakaran, Shanthosh Raj, Abirami Kumar
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During the mixed dentition period, there is closure of all physiological spaces and establishment of tight proximal contact, increasing the risk of proximal caries and gingival diseases if appropriate plaque control measures are not undertaken.Numerous interdental cleaning aids are available in the market, such as dental floss, interdental brushes, wooden interdental aids, and oral irrigators, to support patients' self-care needs. Dental floss is used along with toothbrushing for interdental plaque removal in both primary and permanent dentition. It may act differently on the primary tooth due to its distinct anatomy-bulbous crowns, broad, flat contact areas, and cervical constrictions. Floss types include waxed, unwaxed, bonded, unbonded, and those with drug additives, with handles such as stick floss of F-type and Y-type.Interdental brushes are found to be effective in removing interdental plaque, as recommended by the European Federation of Periodontology 2015 workshop. 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Petroleum jelly was applied to the oral mucosa to prevent staining. After rinsing with water spray and suction for 30 seconds, plaque staining was evaluated. Each of the nine areas on buccal and lingual surfaces (including marginal and approximal regions) was scored, and the mean was calculated. Intraoral photographs were taken to reconfirm scores.Children were randomly divided into four groups of 25 each and trained in brushing and the use of interdental aids:Group I: Interdental floss (STIM flexible)Group II: Water flosser (Oracura-Prima)Group III: Interdental brush (STIM-Proxa angular brush)Group IV: Toothbrushing alone (Colgate Junior toothbrush)All groups practiced their assigned method for 4 weeks. Oral hygiene status was reassessed after 4 weeks using the same methodology. Data were tabulated in Microsoft Excel and analyzed using SPSS v22.0. 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Children with oral lesions, dental caries, or developmental disturbances of the teeth or systemic diseases affecting oral hygiene practices were excluded.At the initial visit, oral hygiene status was assessed and scored using the Rustogi Modified Navy Plaque Index (RMNPI) following standard protocols. Two-tone plaque disclosing solution was applied to all tooth surfaces using a cotton swab and left for 1 minute. Petroleum jelly was applied to the oral mucosa to prevent staining. After rinsing with water spray and suction for 30 seconds, plaque staining was evaluated. Each of the nine areas on buccal and lingual surfaces (including marginal and approximal regions) was scored, and the mean was calculated. 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引用次数: 0

摘要

个人的总体健康,特别是口腔健康,取决于保持最佳的口腔卫生。基于证据的研究已经确立了菌斑生物膜作为一种病因因素的作用,它增加了患口腔疾病(如龋齿、牙龈和牙周病)的风险。用手动或机械牙刷刷牙是清除牙菌斑最常用的方法,但其效率仅限于可触及的表面,即牙齿的面部、舌面和咬合表面。在混合牙列时期,所有的生理空间都被关闭,近端接触紧密,如果不采取适当的菌斑控制措施,近端龋齿和牙龈疾病的风险就会增加。市场上有许多牙间清洁辅助工具,如牙线、牙间刷、木制牙间辅助工具和口腔冲洗器,以支持患者的自我保健需求。牙线与牙刷一起用于去除初级和恒牙的牙间菌斑。由于其独特的解剖结构——球根状冠、宽而平的接触面积和颈部收缩,它对乳牙的作用可能不同。牙线种类有上蜡的、不上蜡的、粘接的、不粘接的和有药物添加剂的,有把手的如f型、y型棒状牙线。根据2015年欧洲牙周病联合会研讨会的建议,牙间刷可以有效清除牙间菌斑。它们可以到达其他设备无法到达的牙槽或牙缝,安全且易于使用,它们的选择取决于个人需求。口腔冲洗器,如1962年由科罗拉多州的一位牙医首次引入的牙科水射流,现在被称为水牙线,其优点是可以到达开放和封闭牙齿无法到达的区域。它们可以有效地去除牙菌斑,可以与化学牙菌斑控制剂一起使用,并且被认为比手动刷牙有效三倍。对于有特殊保健需要的儿童,水牙线也很有用。然而,完全去除牙菌斑生物膜仍然是一个挑战,这取决于儿童的手灵巧性、使用的器械、通过培训获得的技能、适当的技术和口腔卫生实践的频率。在此背景下,本研究评估并比较了三种牙间清洁装置作为混合牙列儿童刷牙辅助工具的牙菌斑清除效率。材料与方法:本研究由牙髓与预防科进行。总共筛选了308名儿童,选择了100名年龄在6-12岁、至少有20颗可评分牙齿、无全身性疾病且知情同意参与的儿童。患有口腔病变、龋齿、牙齿发育障碍或影响口腔卫生习惯的全身性疾病的儿童被排除在外。初次就诊时,按照标准方案使用Rustogi改良海军斑块指数(RMNPI)对口腔卫生状况进行评估和评分。用棉签将双色菌斑揭露液涂抹于所有牙齿表面,静置1分钟。凡士林涂于口腔黏膜防止染色。用喷水和吸力冲洗30秒后,评估菌斑染色。对颊和舌表面的9个区域(包括边缘和近似区域)分别进行评分,并计算平均值。口腔内拍照以再次确认分数。儿童随机分为四组,每组25人,接受刷牙和牙间辅助工具的使用训练:第一组:牙线(STIM柔性牙线)第二组:水牙线(Oracura-Prima)第三组:牙间刷(STIM- proxa角刷)第四组:单独刷牙(高露洁初级牙刷)所有组均按指定方法练习4周。4周后用相同的方法重新评估口腔卫生状况。数据在Microsoft Excel中制表,使用SPSS v22.0进行分析。组内比较采用配对t检验,组间比较采用方差分析(ANOVA),多组比较采用Bonferroni检验。结果的p值:结果显示刷牙后牙菌斑评分较基线显著降低(p = 0.000)。牙菌斑清除效率在刷牙和牙线之间无显著差异(p > 0.05),牙线、牙间刷和口腔冲洗器之间也无显著差异(p > 0.05)。然而,口腔冲洗器和牙间刷明显比单独刷牙更有效(p = 0.0087和p = 0.0027)。 结论:建议在刷牙的同时使用牙线、牙间刷、口腔冲洗器等辅助工具,可以更好地控制牙菌斑,预防儿童龋齿和牙龈疾病。如何引用本文:George A, Mungara J, Vijayakumar P等。三种控制牙间菌斑的辅助工具(牙线、水牙线和牙间刷)作为儿童刷牙的辅助工具的效果。中华临床儿科杂志,2015;18(6):637-640。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

Efficiency of Three Interdental Plaque Control Aids (Dental Floss, Water Flosser, and Interdental Brush) as an Adjunct to Toothbrushing in Children.

Efficiency of Three Interdental Plaque Control Aids (Dental Floss, Water Flosser, and Interdental Brush) as an Adjunct to Toothbrushing in Children.

Introduction: General well-being of an individual, particularly oral health, depends on the maintenance of optimal oral hygiene. Evidence-based research has established the role of plaque biofilm as an etiologic factor that increases the risk of developing oral diseases such as dental caries and gingival and periodontal diseases. Brushing with either manual or mechanical toothbrushes is most commonly practiced for the removal of plaque, but its efficiency is limited to surfaces it can access, i.e., facial, lingual, and occlusal surfaces of the teeth. During the mixed dentition period, there is closure of all physiological spaces and establishment of tight proximal contact, increasing the risk of proximal caries and gingival diseases if appropriate plaque control measures are not undertaken.Numerous interdental cleaning aids are available in the market, such as dental floss, interdental brushes, wooden interdental aids, and oral irrigators, to support patients' self-care needs. Dental floss is used along with toothbrushing for interdental plaque removal in both primary and permanent dentition. It may act differently on the primary tooth due to its distinct anatomy-bulbous crowns, broad, flat contact areas, and cervical constrictions. Floss types include waxed, unwaxed, bonded, unbonded, and those with drug additives, with handles such as stick floss of F-type and Y-type.Interdental brushes are found to be effective in removing interdental plaque, as recommended by the European Federation of Periodontology 2015 workshop. They can reach interdental grooves or fissures that are not physically accessible to other devices, are safe and easy to use, and their selection depends on individual needs. Oral irrigators, such as the dental water jet-first introduced in 1962 by a Colorado dentist and now known as the water flosser-have the advantage of reaching inaccessible areas in both open and closed dentitions. They are effective in plaque removal, can be used with chemical plaque control agents, and are considered to be three times more effective than manual brushing. Water flossers are also useful for children with special healthcare needs.However, complete removal of plaque biofilm remains a challenge and depends on a child's manual dexterity, devices used, skills acquired through training, appropriate technique, and frequency of oral hygiene practice. With this background, the present study was undertaken to assess and compare the plaque removal efficiency of three interdental cleaning devices as an adjunct to brushing in children with mixed dentition.

Materials and methods: The present study was conducted by the Department of Pedodontics and Preventive Dentistry. A total of 308 children were screened, and 100 children aged 6-12 years with a minimum of 20 scorable teeth, free of systemic diseases and willing to participate with informed consent, were selected. Children with oral lesions, dental caries, or developmental disturbances of the teeth or systemic diseases affecting oral hygiene practices were excluded.At the initial visit, oral hygiene status was assessed and scored using the Rustogi Modified Navy Plaque Index (RMNPI) following standard protocols. Two-tone plaque disclosing solution was applied to all tooth surfaces using a cotton swab and left for 1 minute. Petroleum jelly was applied to the oral mucosa to prevent staining. After rinsing with water spray and suction for 30 seconds, plaque staining was evaluated. Each of the nine areas on buccal and lingual surfaces (including marginal and approximal regions) was scored, and the mean was calculated. Intraoral photographs were taken to reconfirm scores.Children were randomly divided into four groups of 25 each and trained in brushing and the use of interdental aids:Group I: Interdental floss (STIM flexible)Group II: Water flosser (Oracura-Prima)Group III: Interdental brush (STIM-Proxa angular brush)Group IV: Toothbrushing alone (Colgate Junior toothbrush)All groups practiced their assigned method for 4 weeks. Oral hygiene status was reassessed after 4 weeks using the same methodology. Data were tabulated in Microsoft Excel and analyzed using SPSS v22.0. Paired t-test was used for within-group comparison, analysis of variance (ANOVA) for between-group comparison, and Bonferroni test for multiple comparisons. A p-value of <0.05 was considered statistically significant.

Results: The results showed a significant reduction in plaque scores from baseline following toothbrushing (p = 0.000). No significant difference in plaque removal efficiency was observed between toothbrushing and flossing (p > 0.05), nor between floss, interdental brush, and oral irrigator (p > 0.05). However, oral irrigators and interdental brushes were significantly more effective than toothbrushing alone (p = 0.0087 and p = 0.0027, respectively).

Conclusion: Adjunctive aids such as dental floss, interdental brushes, and oral irrigators are recommended along with toothbrushing for better plaque control and prevention of caries and gingival diseases in children.

How to cite this article: George A, Mungara J, Vijayakumar P, et al. Efficiency of Three Interdental Plaque Control Aids (Dental Floss, Water Flosser, and Interdental Brush) as an Adjunct to Toothbrushing in Children. Int J Clin Pediatr Dent 2025;18(6):637-640.

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