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The good, the bad and the unproven: Study examines consumer oral care tools

U.S. researchers say that only insufficient evidence supports the efficacy of most consumer oral care products. (Image: alazur/Shutterstock)
Jeremy Booth, Dental Tribune International

Jeremy Booth, Dental Tribune International

Wed. 13. October 2021


BUFFALO, New York, U.S.: Does using an interdental brush help to prevent periodontal disease, and will taking dietary supplements or probiotics actually improve periodontal health? Researchers at University at Buffalo in New York have waded into the murky waters of consumer dental products with the aim of separating fact from fiction to help dental professionals and the public to identify best practices for the prevention of periodontal disease.

The researchers conducted an umbrella review of the literature relating to periodontal disease and primary prevention, aiming to provide a summary of findings on oral care interventions that prevented periodontal disease. They found that only a select number of self-administered interventions were proved in the literature to offer greater protection against periodontitis and gingivitis than daily toothbrushing with a basic toothbrush does.

In a University at Buffalo press release, Dr. Frank Scannapieco, principal investigator of the study and State University of New York Distinguished Professor of Oral Biology at the University at Buffalo School of Dental Medicine, said that only insufficient evidence supported the efficacy of most consumer oral care products.

Which oral care products have been proved to prevent periodontal disease?

Scannapieco said that toothbrushing was the foundation of daily oral care and a reliable method for controlling plaque. The research showed that interdental brushes and oral irrigators were more effective than other interdental oral care products at reducing gingivitis and should be used together with daily toothbrushing. Mouthrinses based on chlorhexidine gluconate, cetylpyridinium chloride and essential oils (such as Listerine) were also proved to reduce dental plaque and gingivitis.

Toothpicks, Scannapieco said, were found useful for monitoring gingival health, since consumers could check for signs of periodontal disease by gently prodding their gingivae.

Evidence lacking on efficacy of electric toothbrushes, dental floss and dietary supplements

The researchers found that electric toothbrushes were no more effective at reducing dental plaque and gingivitis than a basic toothbrush was and that there was little evidence in the literature to support the use of dental floss. However, Scannapieco commented in the press release: “While there are few studies available that specifically examined toothbrushes or floss alone, both are still essential. Floss is especially useful to remove interdental plaque for people who have tight space between their teeth. Floss also likely reduces the risk for cavities that form between the teeth.”

“While there are few studies available that specifically examined toothbrushes or floss alone, both are still essential– Dr. Frank Scannapieco, Buffalo School of Dental Medicine

The researchers found little evidence that proved that the use of mouthrinses based on tea-tree oil, green tea, hydrogen peroxide, stannous fluoride, sodium benzoate, hexetidine or delmopinol effectively reduced gingivitis.

Little evidence was found to prove that the use of probiotics and dietary supplements improved gingival health.

The researchers reported that toothpastes and mouthrinses that contained triclosan reduced dental plaque and gingivitis, but that the compound was linked to the development of reproductive defects and various types of cancers, according to the press release.

Dr. Eva Volman, first author of the study and resident dentist at Eastman Institute for Oral Health at the University of Rochester in New York state, said that the findings of the study could help both consumers and dental professionals. “It is my hope that this piece consolidates the relevant evidence in a way that is comprehensive, readable and uniquely helpful to all oral health professionals as well as patients,” she commented.

The study, titled “Proven primary prevention strategies for plaque-induced periodontal disease—an umbrella review,” was published in the October 2021 issue of the Journal of the International Academy of Periodontology.

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