Oral hygiene advice: insufficient evidence for best way of providing one to one advice

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This Cochrane review of the effects of one-to-one oral hygiene advice, provided by a member of the dental team in a dental setting included 19 RCTs providing insufficient evidence to recommend any specific 1:1 method.

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Periodontal health: no additional benefit from 6 monthly Scale and Polish

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This large multicentre, cluster randomised controlled compared the clinical effectiveness and cost-effectiveness of theory-based, personalised oral hygiene advice or scale and polish’ with routine care in improving periodontal health in dentate adults attending general dental practice.

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Chlorhexidine-fluoride mouthwash efficacy

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This review of the efficacy of a chlorhexidine mouthwash containing sodium fluoride compared to a chlorhexidine mouthwash alone includes 10 small short term studies that suggests the findings are similar for both preparations.

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Periodontal disease and pregnancy outcomes

Routine specialist pregnancy care involved an initial meeting to discuss quitting smoking and set a quit date, followed by 4 weekly telephone calls, and free nicotine replacement therapy for 10 weeks.

Twenty three systematic reviews were included in this overview of reviews reviews assessing the link between periodontal disease and adverse periodontal outcomes. While a majority of the available reviews suggest an association there are concerns regarding the quality of the primary studies.

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School-based oral health education only has short term impact

The review found that adding family-based interventions to school-based interventions may reduce the onset of smoking by 4-25%.

This review of school-based oral health education included 12 trials and found it was effective in reducing plaque accumulation over a short period. there was no long-term evidence on the effectiveness.

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Periodontitis: risk increased by poor oral hygiene

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50 observational studies were included in this review of the effect of oral hygiene on periodontitis. The data suggests that poor oral hygiene increases the risk of periodontitis by around two- to five-fold compared with good OH. However the quality of the data is considered to be of low quality.

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Chlorhexidine mouthrinse: Reduced plaque and gingivitis when used as adjunct to mechanical oral hygiene procedures

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51 studies were included in this Cochrane review of chlorhexidine mouthwash as an adjunct to mechanical oral hygiene measures. The review provides high quality evidence for a large reduction in the build-up of plaque at 4 to 6 weeks or 6 months. There is also high quality evidence of a moderate reduction in gingivitis in patients with mild gingivitis which may not be clinically important.

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Psychological interventions to improve oral health

This meta-analysis claims to be the first evaluating mindfulness-based interventions in primary care.

This review of psychological interventions to improve oral health identified 9 RCTs reported in 11 papers. A small statistically significant improvement in plaque index was noted but the quality of the available evidence is low. More higher quality studies are needed.

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Toothbrushing, plaque removal and gingivitis

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The aim of this review was to appraise and summarise systematic reviews of the efficacy and safety of available homecare toothbrush regimens for mechanical plaque removal on plaque and gingivitis in adults. Ten systematic reviews were included confirming that toothbrushing is effective in reducing levels of dental plaque.

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Which interdental cleaning aids for managing gingivitis?

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A number of reviews have been conducted of interdental cleaning aids. This meta-review brings together 6 reviews and finds only evidence of low quality for interdental brushes, floss, woodsticks and oral irrigators.

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