Medical treatment of systemic sclerosis (SSc), and its complications involves the use of immunosuppressants and calcium channel blockers which are known to increase the risk of developing gingival hyperplasia . In addition defective vascularity and alterations of the microcirculation of the gingival tissues may lead to gingival inflammation. Sicca symptoms (including dry mouth) are also are common in SSc.
The aim of this study was to evaluate the effect of a multi-faceted oral health intervention for improving gingival health among adults with SSc.
Participants were randomised to the multi-faceted oral health intervention group (Test) or control. The test group received a rechargeable, Oral-B® powered toothbrush and a Reach® Access™ Flosser. For those with an oral aperture of less than 40 mm, manual mouth-stretching and oral augmentation exercises were taught. The control group were each given an Oral-B® manual and dental floss. Both groups received instructions and demonstrations and requested to perform these intervention twice a day.
The main outcome was gingival index (GI), which was evaluated at baseline and at 3-, and 6- months.
The researchers found that:-
- Both groups showed significant reduction in GI scores at 6 months (ps<0.005)
- Reduction in GI scores of the test group at 6 months was 20.8%
- Reduction inGI in the test group was 8% larger than the control group (p=0.0007).
They concluded that:-
Results support the use of adaptive devices and orofacial exercise to improve gingival health in adults with SSc when compared to use of manual toothbrushing and finger-held flossing. Recommending and educating patients with SSc to use adaptive devices to clean the tooth surfaces looks promising for long-term oral healthimprovement.
Yuen HK, Weng Y, Bandyopadhyay D, Reed SG, Leite RS, Silver RM. Effect of a multi-faceted intervention on gingival health among adults with systemic sclerosis. Clin Exp Rheumatol. 2011 Mar-Apr;29(2 Suppl 65):S26-32. Epub 2011 May 12. PubMed PMID: 21586215.