The purpose of this randomized clinical trial was to assess the efficacy of gingival massage therapy with Aloe vera gel and sidr honey and to find out the difference in their efficacies, in reducing clinical parameters in gingival inflammation. Participants with gingivitis were selected in this randomised clinical trial (RCT). Scaling and root debridement (SRD) was performed and baseline plaque index (PI), gingival index (GI) and bleeding on probing (BOP) were recorded and participants were randomly allocated into three groups. Group A: SRD and gingival massage (GM) with Aloe vera gel, Group B: SRD and GM with Sidr honey and Group C: SRD only. On the 30th day all clinical parameters were re-evaluated. Gingival massage therapy with both interventions showed improvement in all clinical parameters, when used as an adjunct to non-surgical periodontal therapy. Aloe vera versus control showed improvements in PI (-0.57) and GI (-0.32); honey versus control in PI (-0.68) and GI (-0.63) and Aloe vera versus honey in PI (0.11) and GI (-0.57). BOP was also reduced in all three groups. This ClinicalTrial showed that gingival massage therapy with Aloe vera gel and sidr honey was effective in reducing plaque index, gingival index and bleeding on probing when used as adjuncts in patients with gingivitis. However, group B was more effective when compared with group A and group C. Future RCTs will further evaluate the synergistic effects of these adjuncts in periodontal treatments. ClinicalTrials.gov identifier: NCT05231096.

This randomized controlled split-mouth clinical trial aimed to assess, after 18 months, the retention, restoration quality, and caries progression or arrestment of active moderate carious lesions (International Caries Detection and Assessment System [ICDAS] 3-4) sealed with resin-modified glass ionomer cement (RMGIC) and 45S5 bioglass-enriched RMGIC (RMGIC/45S5). A total of 52 molars with occlusal caries (ICDAS 3-4) were selected. For this split-mouth clinical trial, the permanent molars without mechanical preparation were randomly sealed with RMGIC or RMGIC/45S5. After 18 months, the restorations were compared with the initial treatment (baseline) regarding retention, quality of the remaining material (anatomical shape, marginal adaptation, surface texture, and marginal discoloration), and clinical/radiographic caries progression. The Wilcoxon and Fisher's exact tests were used for data evaluation. After 18 months, no statistically significant differences were found in the retention and material quality of teeth treated with RMGIC or RMGIC/45S5 (p > 0.05). The clinical and radiographic evaluations showed no statistical difference between the materials when considering caries arrestment and progression (p > 0.05). The addition of 45S5 bioglass to RMGIC did not change the retention, restoration quality, and caries progression or arrestment levels after 18 months of follow-up.

There is a need for greater understanding of the average brushing time among individuals. Since the average brushing time remains unclear, this study involves a systematic review to assess this aspect of oral hygiene practices and how it has evolved over the years. The PubMed-MEDLINE and Cochrane-CENTRAL databases were searched from their inception until January 22, 2025, to identify relevant studies. Eligible clinical trials included healthy adults who performed self-brushing. The primary outcome was the average duration of a toothbrushing exercise in seconds/min, with an 'a priori' distinction made between PTB and MTB users. A secondary outcome assessed the correlation between publication year and brushing duration. Sub-analyses differentiated between powered toothbrush (PTB) and manual toothbrush (MTB) users. Twelve eligible papers were retrieved, providing 16 evaluations with considerable variability in clinical and methodological design. Fourteen evaluations involved MTB users, and two involved PTB users. The study found that uninstructed adults (≥ 18 years) brush their teeth with an MTB for an average of 87 s. Notably, with moderate strength in the observation, there is a trend that brushing duration among MTB users appears to increase over publication years. PTB users averaged 143 s of brushing time. Within the limitations of the present study design, there is moderate certainty that the average MTB toothbrushing duration among uninstructed adults is approximately one and a half minutes, with a trend suggesting an increase in brushing duration over the years. This duration falls short of the recommended guidelines, whereas PTB users brush for over 2 min on average. PROSPERO registration number: CRD42024565180.

The prime motive of this study was oral health promotion on the appropriate use of dental floss among women undergraduate students of South India. The aim is to measure the impact of health promotion in increasing awareness and enhancing attitudes and practices regarding the proper use of dental floss to improve their overall oral health. This is a multisite quasi-experimental pretest, posttest study among women undergraduate students aged 18-25 years. Data were recorded, and an oral health talk and demonstration on the appropriate use of dental floss was provided to the study subjects, who were again examined after 4 weeks, and their oral hygiene status and adherence to dental floss usage were assessed. Oral hygiene status of study subjects was measured using the Oral Hygiene Index-Simplified (OHI-S) and Patient Hygiene Performance Index (PHP) indices. Statistical analysis was done using paired t-test and Pearson's correlation. Debris Index-Simplified (DI-S), OHI-S and PHP indices showed a very highly significant reduction from baseline to 4-week follow-up (p < 0.000), indicating considerable improvement in the oral hygiene status of study subjects. PHP index scores significantly increased with age (p < 0.037, Pearson's correlation coefficient = 0.28), indicating that younger participants showed a higher reduction in PHP index scores. Significant improvement in oral hygiene status shows that oral health education and promotion of dental floss have inculcated the habit of regular flossing among women undergraduate students of South India. It is also seen that the younger age group showed better results, implying a more adaptable age for learning.

Among the several antiseptic mouthwashes, chlorhexidine is considered the gold standard owing to its better antigingivitis and antiplaque benefits; yet, its usage is restricted due to noteworthy adverse effects leading to an increasing demand for herbal alternatives that are natural, and have fewer side effects. The objective of the study was to assess the short-term effect of 30% Ocimum basilicum (OB) and 0.2% Chlorhexidine (CHX) mouthwashes on gingival health and plaque control when used as an adjunct to toothbrushing in patients with plaque-induced gingivitis. A parallel-arm, double-blinded, randomised controlled trial was conducted among 70 adult patients. The participants were randomly assigned to two groups: 30% OB mouthwash group (n = 35) and 0.2% CHX mouthwash group (n = 35) by the lottery method. Both participants and the examiner were blinded throughout the study period. The gingival index, plaque index and adverse effects were recorded at baseline, 7th and 21st day. Unpaired t-tests and repeated measures ANOVA tests were utilised to compare the mean gingival and plaque scores between the groups. Both groups exhibited a gradual and significant reduction in both gingival and plaque scores from baseline to days 7 and 21 (p < 0.001). However, the CHX group showed a significant reduction in GI (0.48 ± 0.18) and PI (0.59 ± 0.14) from baseline to 21 days, respectively when compared to the OB group GI (0.72 ± 0.22) and PI (0.77 ± 0.19). OB mouthwash demonstrated non-inferiority in anti-gingivitis and anti-plaque properties compared to CHX mouthwash, suggesting its potential suitability as an alternative to CHX when used alongside mechanical plaque control measures in the management of gingivitis. ClinicalTrials.gov identifier: CTRI/2022/07/044104.

This study aimed to associate the number of present teeth and pairs of natural teeth with obesity in older adults (≥ 60 years old). This study used a probabilistic and representative sample from two southern Brazilian cities (Cruz Alta and Veranópolis). Data collection took place at the participants' households. Obesity was defined as body mass index ≥ 30Kg/m2. Oral examination was performed by calibrated researchers. Pairs of natural teeth were defined as pairs of antagonistic teeth. Sociodemographic, behavioural, medical, and dental history variables were also collected. Adjusted models were constructed using Poisson, considering different definitions of pairs of natural teeth (α < 5%). Independent analyses were performed for the whole sample and for each city. The study included 559 individuals. Prevalence of obesity was 29.9%. Number of present teeth was 7.80 ± 8.68, while the total number of pairs of teeth was 2.16 ± 3.92. No significant association was detected between obesity and the number of teeth present (p = 0.254) or total pairs of natural teeth present (p = 0.065). However, for each pair of natural molars, the prevalence ratio (PR) of obesity was reduced by 22% (95% CI: 0.64-0.95). Similarly, for each functional tooth unit present, the PR for obesity was reduced by 4% (95% CI: 0.93-0.99). To the most significant associations, a weak effect size was detected. Similar results were detected in Veranópolis, but no significant association was observed in Cruz Alta. Higher numbers of pairs of natural molars, rather than the higher number of overall natural teeth, are associated with lower prevalence of obesity among older adults.

Replacing missing teeth has always been a priority in dentistry. With recent clinical advancements, dental implants are the treatment of choice and the global demand for implants has drastically increased. Implant maintenance is fundamental to its long-term success. This study aimed to assess the attitudes towards clinical assessment, radiographic protocols and overall knowledge of implant maintenance protocols among dentists in the Makkah region. A cross-sectional study was conducted among registered dentists of the Saudi Commission for Health Specialties (SCFHS) in the Makkah region using an electronic questionnaire. A total of 183 dentists were conveniently sampled and categorised into groups based on their years of clinical expertise and chronological generations: Generations (B), (X), (Y) and (Z). Holistic knowledge and clinical compliance were sorted into low, moderate and high levels. The study showed significance among expert dentists (95.3%, n = 41) for the evaluation of keratinised tissue adjacent to implants as compared to that among novice dentists (82.9%, n = 116; p = 0.040), and in the routine use of panoramic radiographs for examination of implants among different generations of dentists (p = 0.017). The total scores showed moderate overall knowledge and clinical compliance among dentists in the Makkah region. Generational differences were detected among different dentists in only a few minor aspects of the implant maintenance protocol, with moderate overall levels of knowledge and clinical compliance. Nevertheless, it is critical to understand that generation is simply one factor that determines behaviour. Continuing education and cumulative clinical expertise throughout the years of practice have an impact on implant maintenance practices.

This study aimed to quantify common microorganisms present in the toothbrushes of the participants and assess the level of their knowledge regarding this issue. Participants (n = 30) answered a questionnaire designed to elicit information which could be used to identify the habits regarding the use of toothbrushes and their storage. The participants were randomly selected and divided into two groups: Group 1 used a new toothbrush for 1 month and Group 2 used a new toothbrush for 3 months. Each participant was then instructed to store the toothbrush as usual and return it in a sterile bag. The toothbrush heads were cut for microbiological analyses. Cultivation media for the identification of Streptococcus mutans, Staphylococcus aureus, and Enterobacteriaceae were used and colony-forming units were counted after the incubation period. Statistical analyses were performed by using a two-way ANOVA test. The majority of the participants had never received professional advice regarding the storage and disinfection of toothbrushes (93%) and they were unaware of the contamination degree of their toothbrushes (73%). It was not possible to verify a statistically significant difference between the 1-month and 3-month groups for S. mutans (p > 0.05). However, the evaluation of contamination by S. aureus and Enterobacteriaceae revealed statistically significant differences between these groups (p < 0.05). It was concluded that S. mutans, S. aureus, and Enterobacteriaceae were found in the toothbrushes analysed. However, the poor knowledge of the participants about the degree of contamination of their toothbrushes is a challenge to overcome, as most of them were unaware of the care required for toothbrush storage.

This study aimed to compare the distribution of subgingival periodontal pathogens following the non-surgical periodontal treatment (NSPT) in smoking and non-smoking periodontitis patients. A total of 48 patients (24 smokers and 24 non-smokers) with stage III/IV, grade B/C periodontitis were included and NSPT was performed. Clinical measurements were recorded, and subgingival plaque samples were obtained from periodontal pockets at the onset and after 4 weeks of treatment. The level of periodontopathogens was determined by a polymerase chain reaction-based method. Clinical and microbiological data were analysed by using Chi-square, Student-t and Pearson correlation tests. The levels of periodontopathogens (except Eikenella corrodens and Capnocytophaga spp.) diminished significantly following NSPT (p < 0.05). Although the decrease in the levels of periodontopathogens was lower in smokers, the difference was statistically insignificant except for Tannerella forsythia. A statistically significant reduction was recorded for all clinical parameters following NSPT (p < 0.001). The rate of decrease in non-smokers was higher, but this difference was statistically insignificant (p > 0.05). Only the reduction in pocket depth was higher in non-smokers (p < 0.05). The present findings indicate that smoking did not significantly impact subgingival microflora, except for Tannerella forsythia, although the elimination of certain periodontopathogens proved more challenging in smokers following NSPT. Furthermore, among the changes in clinical parameters, a statistically significant difference was observed only in the changes in pocket depth. ClinicalTrials.gov identifier: NCT06383455.