Up to half of the population suffers from periodontitis and at-home daily dental plaque control between dental visits is key to maintaining oral health (Chapple, 2018).
Gingivitis and periodontitis are a continuum of the same inflammatory disease; however, it does not follow that gingivitis will always progress to periodontitis.
Evidence also indicates that interrupting the plaque colonisation process may well offer the most appropriate approach in helping to prevent the progression of periodontal diseases (Kinane, 2005).
Unfortunately, it is also known that, for a variety of reasons, brushing and interdental cleaning alone may be insufficient to maintain an adequate level of plaque control in many people (Barnett, 2006).
Limitations in the oral care routines of patients include:
- The average brushing time is 46 seconds (Gallagher, 2009)
- Only 31% of people claim to clean between their teeth with floss, despite agreement that flossing is necessary to protect oral health
- Patients can lack the manual dexterity, the time or find flossing painful.
When to take action
Offering insight into the reality of patients’ situation, speaking at the launch of Oral Health Month earlier this year, Professor Iain Chapple*, commented on the fact that periodontal disease prevalence has changed very little in the last 20 years. This is despite advancements in the understanding of, and approach to, periodontal disease.
Referencing the Economist Intelligence Unit’s White Paper on the societal and economic impact of periodontitis (2021), Professor Chapple asked: ‘What happens if we could eliminate incident gingivitis? The cost of doing that by empowering patients to look after for themselves at home more than halves the amount of money spent delivering that care.’
He continued: ‘The cost, however, of diagnosing and treating 90% of periodontitis, that is enormous. The costs of care tripled, and in some cases almost quadrupled because that’s a big dental workforce demand to get periodontitis managed.’
He added that if you neglect gingivitis, then the cost of care increases significantly, because more disease develops and healthy life years reduce, resulting in more time off work, etc. Offering further insight into what is needed going forward, he stated a focus on oral health, not disease, was needed.
Attack plaque from every angle
It is widely accepted that the bacteria present in dental plaque are a major cause of caries and periodontal disease, and that prevention of these conditions requires removal of that plaque (Anas, 2018)
Reinforcing this idea, Boyle and colleagues (2014) wrote: ‘Dental plaque is the main cause of oral diseases and can be removed mechanically by ‘effective’ brushing and flossing.’ (Boyle, 2014)
Whilst the standard recommendation is to brush the teeth and clean interdentally, evidence suggests that the adjunctive use of a mouthwash may provide benefits beyond mechanical cleaning (Lynch, 2018).
Rinsing reaches virtually 100% of the mouth and Listerine penetrates the plaque biofilm, kills 99.9% of germs and helps reduce the repopulation rate of bacteria (Johnson & Johnson, 2020 and 2021, Foster, 2004).
New published data reveals how to tackle interproximal plaque with essential oils-based Listerine
For patients who brush and floss, adding Listerine reduces interproximal plaque by 28.4% versus brushing and flossing alone (Milleman, 2022).**
And, for those who don’t floss, Listerine is shown to reduce interproximal plaque above the gumline by 4.6x versus floss (Bosma, 2022).***
Of course, not all patients are the same – attack plaque from every angle. Make an evidence-based recommendation with Listerine.
To view the full peer reviewed papers visit:
https://jdh.adha.org/content/96/3/8 – Bosma ML et al. Efficacy of flossing and mouthrinsing regimens on plaque and gingivitis: a randomized clinical trial. Journal of Dental Hygiene 2022; 96(3): 8-20
https://jdh.adha.org/content/96/3/21 – Milleman J et al. Comparative effectiveness of toothbrushing, flossing and mouthrinse regimens on plaque and gingivitis: a 12-week virtually supervised clinical trial. Journal of Dental Hygiene 2022; 96(3): 21-34
For further information, visit listerineprofessional.co.uk
* Director of Research within the Institute of Clinical Sciences, College of Medical and Dental Sciences, The University of Birmingham.
** Sustained plaque reduction above the gumline with continual twice daily use for 12 weeks after a dental cleaning. Flossing underwent once daily supervision on weekdays. Use Listerine as part of a 3-step routine.
*** Sustained plaque reduction above the gumline with continual twice daily use for 12 weeks after a dental cleaning. Flossing was performed by a dental hygienist.
References
- Department of Health and Social Care: Delivering better oral health: an evidence-based toolkit for prevention (2021): Chapter 5. Available at: https://www.gov.uk/government/publications/delivering-better-oral-health-an-evidence-based-toolkit-for-prevention/chapter-5-periodontal-diseases [Accessed May 2022]
- Chapple ILC et al. Periodontal health and gingival diseases and conditions on an intact and a reduced periodontium: Consensus report of workgroup 1 of the 2017 World Workshop on the Classification of Periodontal and Peri-Implant Diseases and Conditions. J Periodontol 2018; 89 Suppl 1: S74-S84
- Kinane DF, Attström R. Advances in the pathogenesis of periodontitis. Group B consensus report of the fifth European Workshop in Periodontology. J Clin Periodontol 2005; 32(Suppl. 6): 130-1
- Barnett ML. The rationale for the daily use of an antimicrobial mouthrinse. JADA 2006; 137: 16S-21S
- Gallagher A et al. The effect of brushing time and dentifrice on dental plaque removal in vivo. J Dent Hyg 2009; 83(3): 111-116
- Smith M. Three in ten Brits only brush their teeth once a day. https://yougov.co.uk/topics/politics/articles-reports/2017/10/23/three-ten-brits-only-brush-their-teeth-once-day (accessed 25 May 2022)
- FDI World Dental Federation. How to keep your mouth healthy throughout life. https://www.fdiworlddental.org/how-practice-good-oral-hygiene (accessed 25 May 2022)
- European Federation of Periodontology. Gum disease: Prevention. https://www.efp.org/gum-diseases/gum-disease-prevention/ (accessed 25 May 2022)
- Dentavox. Why people give up on flossing. Based on results from “Do you floss” survey, completed by 300 respondents in the period 09/07-07/08/2019. dentavox.dentacoin.com
- Ipsos. National Dental Hygiene Survey. Ipsos poll: June 27-28, 2017. https://www.ipsos.com/sites/default/files/ct/news/documents/2017-10/National-Dental-Hygiene-Survey-PR-2017-10-18-v1.pdf (accessed 25 May 2022)
- Time to take gum disease seriously. The societal and economic impact of periodontitis. The Economist Intelligence Unit Limited 2021
- Anas B et al. A single-brushing study to compare plaque removal efficacy of a manual toothbrush, an electric toothbrush and an ultrasonic toothbrush. J Oral Hyg Health 2018; 6(3): 1000249
- Boyle P et al. Mouthwash use and the prevention of plaque, gingivitis and caries. Head & Neck Oral Diseases 2014; 20(1): 1-76
- Lynch MC et al. The effects of essential oil mouthrinses with or without alcohol on plaque and gingivitis: a randomized controlled clinical study. BMC Oral Health 2018; 18: 6-15
- Kerr WJS, Kelly J, Geddes DAM. The areas of various surfaces in the human mouth from nine years to adulthood. J Dent Res 1991; 70: 1528-1530
- Johnson & Johnson internal in vitro study: 103-0391. Johnson & Johnson 2021
- Johnson & Johnson internal study: FCLGBP0048. Johnson & Johnson 2021.
- Johnson & Johnson internal study: CCSORC001793 (Serenity). Johnson & Johnson 2020
- Foster JS et al. Effects of antimicrobial agents on oral biofilms in saliva-conditioned flowcell. Biofilms 2004; 1: 5-12
- Milleman J et al. Comparative effectiveness of toothbrushing, flossing and mouthrinse regimens on plaque and gingivitis: a 12-week virtually supervised clinical trial. Journal of Dental Hygiene 2022; 96(3): 21-34
- Bosma ML et al. Efficacy of flossing and mouthrinsing regimens on plaque and gingivitis: a randomized clinical trial. Journal of Dental Hygiene 2022; 96(3): 8-20.
