Power toothbrushes – Many power toothbrush technologies can provide more effective plaque removal than manual brushes. Certain power toothbrush models have compliance-enhancing features such as timers and multiple brushing modes. Power brush technologies available today include rotating, counter-rotational, sonic, ultrasonic, and oscillating-rotating. Results from an independent systematic review by the Cochrane Collaboration showed power toothbrushes with oscillating-rotating action removed plaque and reduced gingivitis more effectively than manual toothbrushes. No other power designs were as consistently superior to manual toothbrushes.71,72
Dental floss is another core component of mechanical plaque removal, particularly for removal of plaque biofilm just below the gingival margin and in interproximal regions. A recent clinical trial published in the Journal of Periodontology showed flossing with a monofilament shred-resistant floss significantly reduced bleeding among a population of fifty twin pairs in Brazil.73 Patients can also choose from other interproximal aids including interproximal brushes, floss picks, and floss holders.
Chemotherapeutic Inhibition of Plaque Biofilm
Chemotherapeutic dentifrices, containing either stannous fluoride or triclosan, are used to inhibit plaque regrowth between brushings and to reduce gingival inflammation and bleeding. However, only stannous fluoride also offers protection from sensitivity74,75 – a common condition reported to be even more prevalent among older patients and those with periodontal disease76 – in addition to its caries and gingival health benefits.77 The latest stannous fluoride dentifrice technology (Crest® Pro-Health™) contains stabilized stannous fluoride and a whitening, anticalculus agent.
Chemotherapeutic rinses are another important home care product often recommended in either prescription or over-the-counter versions.78 Dental professionals generally view chlorhexidine – now available in alcohol and alcohol-free forms — as the gold standard due to its efficacy and substantivity. However, its use is often limited to short-term use due to extrinsic stain and compliance challenges with taste. Other safe and effective options for long-term maintenance are over-the-counter chemotherapeutic rinses Cetylpyridinium chloride (CPC) is a broad spectrum antimicrobial available in an alcohol-free formulation. The alcohol-free form may provide a more pleasurable rinsing experience for patients with soft tissue sensitive to alcohol. Essential oils rinses containing alcohol are also available over-the-counter. Research demonstrates significant reductions in plaque and gingivitis for CPC and essential oils rinses when formulated appropriately.79,80