There is a growing number of clinical studies showing that periodontal disease is associated with systemic diseases. For many years, bacteria was thought to be the factor linking periodontal diseases to other diseases in the body. But what we have been able to establish is that the chronic inflammatory reactions that occur with periodontal diseases parallel what is seen in other major chronic inflammatory diseases, especially cardiovascular disease, diabetes, respiratory diseases, and rheumatoid arthritis, as well as recent data with Alzheimer’s disease.
That is why it is important for patients to stay on top of their at-home oral care. It would be extremely naive to think that what we do in a dental office is sufficient. The bacteria will come back very quickly because the mouth is just a great vessel to grow those bacteria. It is important for our patients to manage biofilm at home. One way for them to do that effectively is by brushing their teeth for at least 2 minutes twice per day, preferably with a power toothbrush. I don’t want to belittle our manual toothbrushing, but my goodness, this morning you did not get up and make a call on a rotary or push-button phone? In addition, be sure to provide options for patients to remove biofilm between the teeth as well.
We all know how important managing biofilm is to all our patients, but it’s especially true for our patients with periodontal disease. A new study was recently released that looks at patients with Stage I and II periodontitis. The objective of this study was to compare the effects of use of home oral hygiene with either a manual toothbrush or a Philips Sonicare DiamondClean Smart brush with a Premium Gum Care brush head on biofilm and periodontal inflammation. The patient population had a diagnosis of Stage I/II periodontitis, following scaling and root planing up to 6 months. This was a randomized, parallel, single-blind clinical trial conducted in the United States.
Subjects were randomized to a home oral hygiene regimen of either twice daily use of a manual toothbrush (MTB) or a Philips Sonicare DiamondClean Smart (DCS) used in Gum Health mode at high intensity with a Premium Gum Care brush head. Subjects returned to the clinic every 4 weeks (except weeks 8 and 12 due to pandemic-related stay-at-home orders) for safety and efficacy evaluation, up to month 6. The following efficacy parameters were assessed: bleeding on probing (BOP), modified plaque index (MPI), probing pocket depth (PPD) and clinical attachment level (CAL). Safety was evaluated via a subject diary report and an intraoral exam. There were 299 subjects in this study. As shown in Figure 2, following scaling and root planing, twice-daily home use of the DiamondClean Smart with a Premium Gum Care brush head was significantly more effective in reducing plaque and symptoms of periodontal inflammation (data on file), including bleeding and pocket depths, compared to use of a manual toothbrush.
Why is this important? We can get our patients healthy and reduce biofilm and resulting inflammation when they leave our practices. It’s what they do at home with daily frequency that will determine the long-term success of the treatments we provide. Therefore, don’t we want our patients using products that have been shown to help reduce periodontitis and the symptoms of periodontal inflammation between visits to our practices? I think so. It makes sense to recommend products like the Philips Sonicare DiamondClean Smart with a Premium Gum Care toothbrush to complement the treatment provided to improve patient outcomes.
Consequently, in addition to managing periodontal diseases by treating inflammation, there may also be benefits with the management of other chronic inflammatory conditions. Keep in mind that good oral health has implications far beyond the mouth, so it is important patients understand it is in their best interest to stay on top of it.