Híreink/Kongresszusok

The use of chemical anti-plaque agents in mouth rinses or

The use of chemical anti-plaque agents in mouth rinses or in fluoridated dentifrice can bring clear and significant improvements in managing gingival inflammation and preventing plaque accumulation.

Following detailed evidence-based reviews of years of studies, 'Prevention Workshop' researchers found in favour of the use of adjunctive chemical approaches in biofilm control in support of mechanical plaque removal protocols, "but it is not a suitable substitute for the latter, or a more time-efficient method for effective biofilm control."

And the experts warn against the use of chemical agents without professional consultation to check for oral health conditions. Working group 3 of this key European Workshop in Periodontology stated: "The public should be aware that self-medication with effective chemical plaque control agents may mask more serious underlying periodontal disease and should seek professional advice following periodontal examination."

Peri-implant mucositis

This warning against self-medication is of equal relevance with regard to treating peri-implant mucositis (PM), with the conclusion of one key study recommending that "professionally-and patient-administered mechanical plaque control alone should be considered the standard of care in the management of PM. Therapy of PM is a prerequisite for the prevention of peri-implantitis."

Gingivitis

In general, though, the evidence reviewed supports the use of chemical agents in the prevention of periodontal disease.

In the case of gingivitis, "current evidence shows that the use of anti-plaque chemical agents delivered in a mouth rinse or dentifrice format adjunctive to tooth brushing is beneficial."

One systematic review – available here – looked at 87 articles with 133 comparisons in evaluating the efficacy of anti-plaque chemical formulations for managing gingivitis in 6-month, home-use, randomised clinical trials (RCTs), concluding: "Within the limitations of the present study, formulations with specific agents for chemical plaque control provide statistically significant improvements in terms of gingival, bleeding and plaque indices."

A worldwide public health recommendation of products containing chemical agents must, in the eyes of the 'Prevention Workshop' researchers, respect the following proviso:

"Decisions on recommendation should account for the economic cost and adverse effects (e.g. staining) associated with long-term use of such agents and should also account for country-specific regulations and environmental implications."

Dentine hypersensitivity

Certain ingredients in some toothpastes were shown to reduce pain in patients with dentine hypersensitivity.

NSAIDS

Only the weakest evidence supports the use of local or systemic non-steroidal anti-inflammatory drugs (NSAIDs) "in reducing the clinical signs of gingival inflammation expressed as bleeding on probing and a variety of gingival indices."

NSAIDS "cannot be recommended at this time due to lack of sufficient scientific evidence."

"There is no evidence that local NSAID application impacts positively upon gingival inflammation."

Vitamin D

Can vitamin D reduce gingival inflammation? This is a question that can only be answered by further studies, since "only one RCT has demonstrated a positive effect of systemic vitamin D intake in reducing gingival inflammation in gingivitis patients."