Perio Reports

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            <strong>Perio Reports</strong>&nbsp;&nbsp;Vol. 26, No. 11</td>
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            <td>Perio Reports provides easy-to-read research summaries on topics of specific
            interest to clinicians. Perio Reports research summaries will be included in each
            issue to keep you on the cutting edge of dental hygiene science.<br />
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            <td style="background-color: #e3d4d3;"><span style="font-weight: bold; color: #8d5aa3;">The Value of Free Toothbrushes Given to Patients</span><br />
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            Many times each day, patients leave their free unopened toothbrush at the front desk. This raises the question, do patients value the free toothbrush they are given at their dental hygiene visits? Dentists have wondered about this from the economic perspective as some provide goodie bags containing a toothbrush, toothpaste and dental floss. The cost of these products adds up over time, but the value realized by the patient hasn't been measured.
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            A dental hygienist who owns her own dental hygiene practice in Colorado wondered if the expense of complimentary toothbrushes translated into value for that toothbrush by the patient. She began to ask patients if they would like a free toothbrush. If they said no, she asked why. If they said yes, she asked what they intended to do with the complimentary toothbrush and several other questions related to use, cost and purchasing additional brushes.
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            A total of 21 patients were interviewed for this study and asked the questions around receiving a complimentary toothbrush. Most of the patients took the free toothbrush while four declined the offer. Only eight of the 17 accepting the toothbrush intended to use it themselves, replacing their current brush. Nine of those accepting the toothbrush did not plan to replace their current brush with the free toothbrush. Some use a power brush rather than a manual brush. The reasons for accepting the free toothbrush included using the brush for camping, travel, house guests and an upcoming hospital stay.
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            <strong>Clinical Implications: If value isn't created during the dental hygiene visit related specifically to the free toothbrush, it is likely the patient won't value it either. </strong>
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            <span style="line-height: 14px; font-style: italic; font-size: 10px;">Kahl, S.: Does the "Free" Complimentary Toothbrush Affect Patient Oral Health Behavior? OHU Action Research, 3A-14, 2014.</span>
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            <span style="font-weight: bold; color: #8d5aa3;">Will Children Choose Different Candy After Seeing the Low pH of Sour Candy?</span>
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            Recently, the number and kinds of sour candy offered to children has increased. Some advertise being intense or extreme in flavor. Many low pH candies, drinks and foods contribute to increased erosion in children.
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            Rather than simply telling kids that sour candies were harmful to their teeth, a hygienist decided to show them with experiments. It was hypothesized that personal experience would impact future candy choices. Mothers with children ranging in age from seven to 14 years were invited to learn about the oral impact of sour candies. A baseline questionnaire asked what their favorite candy was, and which of four choices was the worst for teeth: gum, chocolates, sour candy or gummy candies. The third question asked what should be done after eating sour candy: brush and floss, rinse with water or nothing.     <br />
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            Kids tested their own salivary pH. Six of the eight had a pH of 7, while two had a pH of 6. Children then measured the pH of several sour candies dissolved in hot water. All the candies measured between 1.5 and 3. Kids ate two pieces of sour candy until dissolved and re-measured their salivary pH. One child measured a pH of 4, eight measured 5 and three measured 6. A slide presentation was shown to the group explaining the pH and sour candies.
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            Ten days later children were asked to answer questions. Only two of the children had eaten sour candy and all said the experiments made them want to eat it less.
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            <strong>Clinical Implications: Kids participation in pH testing has the potential to reduce their sour candy intake.</strong>
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            <span style="line-height: 14px; font-style: italic; font-size: 10px;">Wilde, S.: Would Kids Choose a Different Type of Candy After Seeing What Sour Candy Can Do to Their Teeth? OHU Action Research, 3A-14, 2014.</span><br />
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            <td style="background-color: #e3d4d3;"><span style="font-weight: bold; color: #8d5aa3;">Oral Probiotics Reduce Pain and Discomfort of Lichen Planus</span><br />
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            Erosive lichen planus (ELP) is a chronic autoimmune disease of unknown etiology, affecting oral mucosal surfaces. Oral probiotics reduce gingival inflammation and may help ELP.
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            The effects of Sunstar Perio Balance oral probiotic was measured on the pain and discomfort of ELP in two patients with a long history of pain. Each underwent an oral exam measuring bleeding upon probing (BOP) and their pain level on a scale of 1 to 10, with 10 being the worst.
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            Each received a two month supply of oral probiotics. Patients were telephoned every two weeks and were clinically reassessed after six weeks. Patients were advised to avoid spicy and acidic foods and drinks, coffee and alcohol. Regular oral hygiene was encouraged and they were asked to avoid mouth rinse.
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            Initial pain levels were 5 and 8, respectively. Both patients consumed one to two cups of coffee daily. At two weeks, the first patient reported no change in pain, still 5. The second patient reported her pain was now 6, down from 8. Two weeks later, the first patient was at 3 instead of 5 and the second patient was at 3, down from 8.
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            At six weeks, the hygienist re-evaluated the patients. The first patient began with 22 BOP sites and a pain level of 5. She now had 9 BOP sites and a pain level of 2. The second patient began with 37 BOP sites and a pain level of 8. She now has 13 BOP sites and a pain level of 3. Both patients noticed their improvement and were happy to have less pain.
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            <strong>Clinical Implications: Oral probiotics provide an option for patients suffering from painful lichen planus.</strong>
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            <span style="line-height: 14px; font-style: italic; font-size: 10px;">Hays, C.: Can Oral Probiotics Help Alleviate Pain Associated with Oral Erosive Lichen Planus? OHU Action Research, 3A-14, 2014</span>
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            <span style="font-weight: bold; color: #8d5aa3;">Water Flossers Preferred Over String Floss</span>
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            Despite the focus on evidence-based decision making, some of the concepts used to indoctrinate dental and dental hygiene students lack scientific evidence. Dental floss is a good example. Dental floss continues to be part of the foundation message of disease prevention put out by both dental and dental hygiene associations and educational institutions.
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            Evidence is lacking that dental floss will reduce tooth decay or gingivitis when added to routine toothbrushing. Hygienists have been talking about floss for 100 years, yet the number of people who floss daily is surprising low: 10 to 30 percent. Despite these statistics and the availability of alternatives to dental floss for cleaning between the teeth, hygienists continue to push floss.
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            Other alternatives are available to disrupt interdental biofilm. One hygienist wanted to know if she could impact patient oral health by promoting the water flosser rather than traditional string floss for those who would not floss. The alternative to string floss was introduced to 10 patients who were all willing to try something other than string floss. This small pilot study followed up with the patients 10 days after their regular dental hygiene visit where the water flosser was introduced.
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            The patients all purchased a water flosser either from the dental practice or a retail store. Compliance was good, likely due to the novelty of the water flosser. Bleeding and probing depths were shallower at 10 days, which is to be expected following a dental hygiene visit. This study showed that patients are open to alternatives to string floss. Follow-up will determine if long term compliance is achieved.
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            Clinical Implications: For patients who can't or won't use string floss, suggest water flossing.</strong><br />
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            <span style="line-height: 14px; font-style: italic; font-size: 10px;">Flint, K.: Can Water Flossing be Promoted to Patients Over String Floss, Lead to Improved Oral Health. OHU Action Research, 3A-14, 2014. </span>
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