Preventive strategies in order to obtain healthy teeth for life.

Background:
It is generally accepted that bacterial plaque is an important etiological factor of periodontal disease. Mechanical plaque removal is the primary method for controlling supra-gingival plaque. Patients' efforts are however often compromised by the presence of hard-to-reach areas as well as inadequate skill, poor motivation and lack of compliance. Consequently above the age of 35 almost everybody has inflamed periodontal tissues. Antimicrobial mouthrinses as adjuncts to mechanical oral hygiene regimens have been introduced as a means to enhance plaque removal. In 2 recent studies a stringent protocol of 1 oral hygiene instruction,1 session of professional and 3 weeks of rinsing with chlorhexidine and sodiumperoxyborate significantly improved the level of gingival health which was maintained up to a subsequent period of 9 months. The design of the present study is based on a model as previously published by Svatun et al. (Svatun et al. 1987, Svatun et al. 1989) and will test the concept that good gingival health can be maintained by the use of a prophylactic aid.



Objective:
The objective of the study is to evaluate the long-term effect of a short preventive intervention on oral health.



Study design:
240 subjects will be divided ¡n 6 randomised groups. All 6 groups will perform a basic regime of 2x daily brushing with a standard toothbrush and toothpaste. Group 1 and 2 will brush only, group 3 will receive additionally 1 oral hygiene instruction, group 4 will receive 1 professional prophylaxis, group 5 will rinse for 3 weeks with chlorhexidine and sodiumperoxyborate and group 6 will receive all 3 supplementary preventive interventions.

The present study aims at testing whether the positive effect of rinsing 3 weeks with a combination of chloorhexidine and sodiumperoxyborate will last up to 9 months and possibly up to 12 months. This concept placed in a future prospective could lead to a preventive strategy whereby people can rinse every year for 3 weeks with chlorhexidine and sodium-peroxyborate and improve the oral health for the year to come. In turn it is beneficial to the patient's general health and quality of life and will reduce the costs of dentistry for the society.

1. Group 1: baseline, 3 weeks and 12 months;

2. Group 2-6: baseline, 3 weeks, 3, 6, 9 and 12 months.

A basic regime of 2x daily brushing with a standard toothbrush and toothpaste.

1. Group 1 + 2: with no additional regimen;

2. Group 3: with additionally 1 professional oral hygiene instruction;

3. Group 4: with additional 1 professional prophylaxis;

4. Group 5: with additional rinsing for 3 weeks with chlorhexidine and sodiumperoxyborate;

5. Group 6: with additional a combination of 1 professional oral hygiene instruction, 1 professional prophylaxis and for 3 weeks rinsing with chlorhexidine and sodiumperoxyborate.