Sore gums—can they be cleaned without a dentist?

Aim of the study: To evaluate the efficacy of professional mechanical plaque removal (PMPR) for treating naturally occurring dental biofilm-induced gingivitis (i) compared to no treatment or oral hygiene instructions (OHI) (FQ1), (ii) when performed through different modalities (FQ2) or (iii) when combined with professionally administered local adjuncts (FQ3).

Results: Heterogeneous evidence shows with low certainty that PMPR has no efficacy in patients continuing with ineffective self-performed oral hygiene regimens but enhances OHI outcomes (FQ1; three RCTs, one CT). Split-mouth RCTs consistently indicated with very low certainty that ultrasonic scaling (US) plus air polishing is as effective but less time consuming than US plus polishing with rubber cup and prophylaxis paste. Furthermore, diode laser shows no adjunctive benefit (FQ2; five RCTs). Although some professionally administered local adjuncts have shown positive outcomes in patients receiving PMPR, their broader clinical application is limited due to unresolved clinical issues and uncertain cost effectiveness (FQ3; two RCTs). OHI should be the first-line treatment for dental biofilm-induced gingivitis. Combination of PMPR and OHI provides an adjunctive benefit over OHI alone. Air polishing may be combined with US to reduce the time for PMPR administration.

Aim of the study: Periodontal disease continues to be prevalent globally, but little clinical research has been undertaken to evaluate the long-term benefits of a daily oral hygiene regimen on progression of gingivitis/early periodontitis. The objective of this study was to evaluate the effects of an oral hygiene regimen (OHR) on the periodontal health of adults in good general health with established gingivitis and early periodontitis over 24 months.

Results: A total of 107 individuals were enrolled; 87 completed the study. Mean GBI-BS, Modified Gingival Index, and Probing Pocket Depth (PPD) scores were significantly lower at each visit for the OHR versus usual care group by 28% to 39%, 12% to 18%, and 6% to 13%, respectively (p≤ 0.0009). The magnitude of reduction in median number of ≥2 mm PPD loss events for OHR versus the usual care group at 24 months was 74%. Long-term use of the OHR produced significant periodontal health improvements versus the usual care products.

Aim of the study: To investigate the effects of combinations of mechanical (brushing and flossing) and chemotherapeutic regimens which included essential oils (EO) non-alcohol and alcohol-containing mouthrinses compared to brushing only in the prevention and reduction of plaque, gingivitis, and gingival bleeding.

Results: After 12 weeks, both BA and BZ and the BFZ group were superior in reducing interproximal plaque (30.8%, 18.2%, 16.0%, respectively), gingivitis (39.0%, 36.9%, 36.1%, respectively), and bleeding (67.8%, 73.6%, 79.8%, respectively) compared to B. The BF group did not provide significant reductions in interproximal plaque but did reduce interproximal gingivitis (5.1%, p = 0.041) at Week 4 and bleeding at Weeks 4 and 12 (34.6%, 31.4%, p < 0.001 respectively) compared to B. The BFZ group did not significantly reduce interproximal plaque, gingivitis or bleeding compared to BZ. This study demonstrated that the addition of EO non-alcohol containing mouthrinse to the manual toothbrushing and flossing regimen further reduces plaque, gingivitis and bleeding showing that addition of EO mouthrinses (alcohol or non-alcohol containing) to the oral hygiene regimen provides sustained reductions in plaque to help maintain gingival health after a dental prophylaxis.

Aim of the study: The objective of this study was to evaluate the effectiveness of oral health educational actions in the school context in improving oral hygiene and dental caries in schoolchildren through systematic review and meta-analysis.

Results: A total of 4417 references were found, from which 93 full texts were evaluated and 12 included in this meta-analysis. Five studies showed a reduction in plaque levels, and two studies with gingivitis as the outcome found no effect. There was not enough evidence on the effectiveness of the interventions in reducing dental caries. Traditional oral health educational actions were effective in reducing plaque, but not gingivitis. There is no long-term evidence in respect of the effectiveness of these interventions in preventing plaque accumulation, gingivitis and dental caries in the school environment.

Aim of the study: Effective self-performed oral hygiene is fundamental to the prevention and control of dental biofilm-induced gingivitis. While reinforcement strategies and behavioural interventions (including technologies/digital adjuncts) may improve adherence, advances in oral hygiene devices may enhance the mechanical efficacy of plaque removal.

Results: Thirty-seven randomised controlled trials (RCTs) were included (PICOS 1: n = 7, PICOS 2: n = 9, PICOS 3: n = 21). Enhanced oral hygiene instruction produced a statistically significant but modest reduction in gingival bleeding compared with standard instruction. Behavioural/motivational/technological interventions yielded small but statistically significant and consistent benefits, with low-to-moderate heterogeneity. In contrast, powered toothbrushes demonstrated substantially greater reductions in gingival bleeding and plaque compared with manual brushing. Network meta-analysis ranked oscillating-rotating and high-frequency sonic powered toothbrushes as the most effective interventions, with large effect sizes and consistent findings across studies. Reinforced instruction and behavioural interventions produce meaningful improvements in gingival inflammation. Powered toothbrushes consistently provide improvements in gingival health over manual toothbrushes.

Aim of the study: Effective toothbrushing is central to plaque control and periodontal health, yet brushing technique and adherence are often inadequate. Smart toothbrushes and digitally assisted oral hygiene systems record brushing behaviour and return feedback to patients and, in some models, to clinicians.

Results: Two randomised trials in patients with periodontitis reported additional short-term improvements in periodontal parameters when AI-assisted monitoring was added to periodontal care. However, many commercial devices use fixed thresholds rather than adaptive machine learning, and most trials cannot separate the effects of powered brushing, feedback, app support, and AI. Current evidence suggests that smart toothbrushes and digitally assisted oral hygiene systems may improve plaque control, brushing behaviour, adherence, and short-term gingival outcomes. The incremental benefit specifically attributable to AI-based functions and their impact on long-term periodontal outcomes remain to be established.

Aim of the study: Children and adolescents with autism spectrum disorder (ASD) are prone to poor oral hygiene due to motor and sensory challenges. This trial evaluated whether a triple-headed toothbrush (THT) improves gingival health and plaque control more effectively than a conventional toothbrush (CT).

Results: At 3 months, THT use produced significantly greater reductions in plaque (Hodges-Lehmann estimator, -0.50; 95% CI, -0.63 to -0.31; P < .001; r = 0.60) and gingival (Hodges-Lehmann estimator, -0.25; 95% CI, -0.44 to -0.13; P < .001; r = 0.39) scores than CT, with pronounced improvements on the lingual surface. Both groups showed significant within-group reductions. THT acceptability improved significantly over the study period. A THT produced superior plaque and gingival improvements compared with a CT in children and adolescents with ASD, with pronounced lingual surface benefits and increasing acceptability over time.