Oral Health and Preventive Dentistry

Purpose: To trace the history of interdental brushes (IDBs) from their origins to the present, highlighting their development and future prospects compared to other interdental hygiene aids. Methods and Materials: A literature search using digital databases, manual reviews and on-site research in museums were carried out. Results: Although extensive literature exists on toothbrushes, flosses and toothpicks, there has been no comprehensive study of IDBs. Twisted brushes for oral hygiene were mentioned as ear-ly as the late 19th century. The exact origins of their use in interdental spaces remain unclear, but evidence narrows it to the early 20th century. IDBs have been in documented use since at least 1960, with publications emerging in the 1970s. Historically, evaluations of IDBs have been mixed, balancing high expectations with scepticism regarding efficacy and safety. By the early 21st century, IDBs were often considered superior for interdental cleaning. Advances included modifications in brush head designs, handle types, and the establishment of standards like ISO 16409, though these did not always facilitate proper selection and use. Conclusion: Recent literature still highlights limited evidence-based statements on IDB efficacy, with some questioning their superiority over other aids like dental floss. Consumer-friendly alternatives, such as rubber picks, are sometimes rated higher, however, without allowing for a final assessment. For IDBs to meet the standards of Frugal Dentistry, they must improve oral health, be widely demanded, and cost-effective. Future research should provide more precise indications for IDBs and scientifically sound recommendations for various sizes and designs, ensuring they are easy to use and effective for different interdental spaces. Keywords: historical milestones of interdental brushes, interdental cleaning, developments in interdental brushes, future indications for interdental brushes

Purpose: To examine the alterations in oral healthcare indicators subsequent to the administration of cetylpyridinium chloride. Materials and Methods: In this retrospective study, clinical data of 58 patients who received orthodontic treatment using removable appliances at our medical facility were collected. Patients were divided into two groups based on whether they used cetylpyridinium chloride during orthodontic treatment: the combined group (n = 31, received 0.1% cetylpyridinium chloride gargle in addition to periodontal cleaning during the use of orthodontic appliances, with gargling applied three times daily for at least 1 min after meals) and the cleaning group (n = 27, received only periodontal cleaning). Data on oral healthcare were collected and analysed at 1, 3, and 6 months into the treatment regimen. The indices evaluated were gingival index (GI), sulcus bleeding index (SBI), probing depth (PD), and plaque index (PLI). Results: Subsequent evaluations revealed that, at 3 and 6 months post-intervention, patients in the intervention group exhibited statistically lower scores in GI, SBI, and PLI when compared to the control group. Similarly, the PD measurements showed more statistically significant reductions at each follow-up interval — 1, 3, and 6 months — in the intervention group. IL-10 levels were notably higher in the intervention group at 6 months. Conclusion: Integrating cetylpyridinium chloride into the oral healthcare regimen for patients using removable orthodontic appliances has been shown to statistically significantly improve oral health, enhance periodontal functions, and reduce inflammatory responses in the gingival sulcus. Keywords: cetylpyridinium chloride, inflammatory cytokines, oral healthcare, removable orthodontic appliance

Purpose: Although fluoride is known to be effective and safe, an increasing number of parents refuse to allow fluoride applications for their children. This study aimed to compare the parents who accepted and rejected fluoride application for their children in terms of their attitudes toward fluoride and vaccinations, sociodemographic characteristics, and source of knowledge. Materials and Methods: In this cross-sectional study, a previously validated questionnaire was administered to 85 parents who did not consent to have topical fluoride applied to their children’s teeth (AF group) and the 143 parents who consented to have it applied (F group) in a pediatric dentistry clinic. Data were analysed using the independent t-test and chi-squared test. Results: In the F group, the number of those who disagreed with the statement that fluoride causes intellectual disability, autism, and damages the pineal gland was statistically significantly higher than in the AF group (p 0.05). The most common source of information for the AF group was the internet/social media (67.06%), while for the F group, it was dentists/medical doctors (62.24%). More parents in the F group stated that childhood and Covid-19 vaccinations must be performed; this was a statistically significant difference (p 0.05). Conclusion: No relationship was found between fluoride hesitancy and the educational level of the parents. Most parents in the AF group have doubts and concerns about fluoride rather than being strongly opposed to it. Therefore, educational programs given to parents are likely to have a positive effect on their acquisition of correct information.

Purpose: Health education programmes play a crucial role in enhancing oral health literacy and improving treatment out-comes. However, myths and misconceptions about oral health are widespread, affecting individuals’ behaviours and their willingness to seek appropriate treatment. This study aimed to investigate the prevalence of oral health myths and miscon-ceptions among adults in Taif, Saudi Arabia, and to explore potential associations with demographic factors. Materials and Methods: Participants from community health programmes in Taif (March–June 2024) completed a Google Forms questionnaire on dental myths. Eligibility criteria: adults (≥18 years) without cognitive, hearing, or vision impairments. The questionnaire included sociodemographic details and 22 myth-related questions. Data analysis involved descriptive statistics and multiple linear regression using the Statistical Package for Social Sciences (SPSS), with significance set P ≤ 0.05. Results: The study included 429 participants. Knowledge of dental myths was highest in the ‘Dental Treatment’ domain (mean score: 6.42), followed by ‘Oral Hygiene Practices’ (3.46) and ‘Deciduous Teeth and Pregnancy’ (3.48). Higher education and healthcare-related majors were statistically significantly associated with better knowledge. Conversely, males and older age groups had lower knowledge scores. Conclusion: This study highlights the prevalence of dental myths in Taif and their association with demographic factors. Higher education- and healthcare-related fields correlate with better knowledge, but statistically significantly gaps remain, particu-larly among the less educated, certain occupational groups, males, and single individuals. Targeted educational interventions are essential to improving dental health knowledge and practices and enhancing oral health outcomes in the community. Keywords: demographic factors, health education, myths and misconceptions, oral health

Purpose: The purpose of this study was to evaluate the occurrence of peri-implant diseases and their potential risk indicators in a private practice setting. Materials and Methods: This cross-sectional study evaluated data from 390 subjects (mean age 55.8 ± 11.6 years) with implant-supported prosthetic reconstructions, who were enrolled in a maintenance program for 6.25 ± 3.36 years. Clinical evaluation included peri-implant probing pocket depth (PPD), bleeding on probing (BOP) and full-mouth plaque scores (FMPS). Radiographic evaluation was performed using retro-alveolar radiographs for each implant. Further, smoking habits, history of periodontitis, or tooth loss due to periodontal disease, presence/absence of keratinized mucosa ≥ 2 mm and the quality of the prosthetic restoration were also assessed. The prevalence of the peri-implant disease (at the subject/implant level) was determined and various potential risk indicators were evaluated by multi-level logistic regression analysis. Results: The prevalence of peri-implant diseases was 37.7% and 23.3% at the subject and implant level, respectively. 14.3% of the subjects were diagnosed with peri-implant mucositis and 8.9% were diagnosed with advanced peri-implantitis (PI). PI was statistically significantly associated with poor (FMPS > 0.45, p 0.001) or moderate oral hygiene (FMPS: 0.3–0.45, p 0.001), a history of periodontitis (p 0.001), lack of keratinized tissue ≥2 mm (p 0.001) or implant function time > 5 years (p 0.001). Conclusion: In a private practice setting, a prevalence of peri-implant diseases of 37.7%/ 23.3% (subject/implant level) was found. Poor oral hygiene, history of periodontitis, a keratinized mucosa 2 mm and a time in function ≥ 5 years have been associated with the occurrence of peri-implant diseases.

Purpose: This in-vitro study was conducted to assess the fracture resistance of resin-bonded ceramic endocrowns with different designs at varying intracoronal depths. Materials and Methods: Forty-eight (n = 48) extracted mandibular first molar teeth were randomly divided into four groups (n = 12). In the control group, the specimens remained untreated. Whereas the specimens in the test groups A, B, and C were decapitated 2 mm above the cementoenamel junction (CEJ) and endodontically treated. The test groups were prepared with a butt-joint design in a standardised manner with varying intracoronal depths. Groups A, B, and C were prepared to receive lithium disilicate endocrown with intracoronal cores at 0 mm, 2 mm, and 4 mm, respectively. Crowns were fabricated as a non-anatomical design with a thickness of 3 mm. After ceramic bonding procedures, specimens underwent thermocyclic ageing prior to the fracture resistance test. Specimens were loaded at a 15-degree angle using the Universal Testing Machine and the failure modes were observed. One-way analysis of variance (ANOVA) and Chi-square were utilised for data statistical analyses. Results: Significant statistical results in fracture resistance tests were found in all experimental groups. The highest load was found in group B, followed by group C, and lastly group A (P 0.05). Although endocrowns with no extension had the lowest fracture resistance, they showed a favourable cohesive failure with statistically no significant difference from the control group. Conclusion: In bonded ceramic endocrowns, the fracture resistance is not newcessarily proportional to the intracanal depth. The intrcoronal cores of 4 mm did not show the highest fracture resistance, and their mode of failure was catastrophic compared to endocrowns with no intracoronal extensions. Keywords: endocrown, fracture, intracoronal depth, resistance