Main Article Content

Authors

Background: The implementation of the self-cleaning practice is of fundamental importance for the maintenance of oral health and to remove the human dental biofilm which is considered the main etiological factor for the development of caries and periodontal diseases.                     


Objective: This study aimed to evaluate the use of chewing gum, Rolly Brush® and apples as forms of mechanical control and removal of the dental biofilm in the absence of brushing.


Materials and Methods: Eighteen volunteers were submitted to plaque index evaluation after a period of 24 hours of no oral hygiene. Then, they would use one of the methods: chewing gum, Rolly Brush®, apple or tooth brushing, chosen by a draw, for one minute, and then, plaque index was evaluated again. This stage was repeated until all participants were submitted to all selected methods, in periods of 24 hours each.  


Results: Dental brushing was more effective when compared to each of the other methods applied and there was a statistically significant reduction of dental plaque index after apllying all methods of cleaning in all groups.


Conclusion: Chewing gum, Rolly Brush® and apple may be used as auxiliary to dental brushing or when such method is impossible to be performed.


Clinicaltrials.gov: number of protocol NCT 03.601.585.

Luana Moreira, Departmento de Odontología, Faculdade de Ciências Biológicas e da Saúde, Universidade Federal dos Vales do Jequitinhonha e Mucuri, Diamantina, Minas Gerais, Brazil.

Departmento de Odontología, Faculdade de Ciências Biológicas e da Saúde, Universidade Federal dos Vales do Jequitinhonha e Mucuri, Diamantina, Minas Gerais, Brazil.

Mariana Pontes, Departmento de Odontología, Faculdade de Ciências Biológicas e da Saúde, Universidade Federal dos Vales do Jequitinhonha e Mucuri, Diamantina, Minas Gerais, Brazil.

Departmento de Odontología, Faculdade de Ciências Biológicas e da Saúde, Universidade Federal dos Vales do Jequitinhonha e Mucuri, Diamantina, Minas Gerais, Brazil.

Egina Brum, Departmento de Odontología, Faculdade de Ciências Biológicas e da Saúde, Universidade Federal dos Vales do Jequitinhonha e Mucuri, Diamantina, Minas Gerais, Brazil.

Departmento de Odontología, Faculdade de Ciências Biológicas e da Saúde, Universidade Federal dos Vales do Jequitinhonha e Mucuri, Diamantina, Minas Gerais, Brazil. 

Larissa Silva, Departmento de Odontología, Faculdade de Ciências Biológicas e da Saúde, Universidade Federal dos Vales do Jequitinhonha e Mucuri, Diamantina, Minas Gerais, Brazil.

Departmento de Odontología, Faculdade de Ciências Biológicas e da Saúde, Universidade Federal dos Vales do Jequitinhonha e Mucuri, Diamantina, Minas Gerais, Brazil.

Dhelfeson Douglas de Oliveira, Departmento de Odontología, Faculdade de Ciências Biológicas e da Saúde, Universidade Federal dos Vales do Jequitinhonha e Mucuri, Diamantina, Minas Gerais, Brazil.

Departmento de Odontología, Faculdade de Ciências Biológicas e da Saúde, Universidade Federal dos Vales do Jequitinhonha e Mucuri, Diamantina, Minas Gerais, Brazil.

Amanda Figueiredo, Departmento de Odontología, Faculdade de Ciências Biológicas e da Saúde, Universidade Federal dos Vales do Jequitinhonha e Mucuri, Diamantina, Minas Gerais, Brazil.

Departmento de Odontología, Faculdade de Ciências Biológicas e da Saúde, Universidade Federal dos Vales do Jequitinhonha e Mucuri, Diamantina, Minas Gerais, Brazil.

Patricia Gonçalves, Departmento de Odontología, Faculdade de Ciências Biológicas e da Saúde, Universidade Federal dos Vales do Jequitinhonha e Mucuri, Diamantina, Minas Gerais, Brazil.

Departmento de Odontología, Faculdade de Ciências Biológicas e da Saúde, Universidade Federal dos Vales do Jequitinhonha e Mucuri, Diamantina, Minas Gerais, Brazil.

Olga Flecha, Departmento de Odontología, Faculdade de Ciências Biológicas e da Saúde, Universidade Federal dos Vales do Jequitinhonha e Mucuri, Diamantina, Minas Gerais, Brazil.

Departmento de Odontología, Faculdade de Ciências Biológicas e da Saúde, Universidade Federal dos Vales do Jequitinhonha e Mucuri, Diamantina, Minas Gerais, Brazil.

Evandro Oliveira, Departmento de Odontología, Faculdade de Ciências Biológicas e da Saúde, Universidade Federal dos Vales do Jequitinhonha e Mucuri, Diamantina, Minas Gerais, Brazil.

Departmento de Odontología, Faculdade de Ciências Biológicas e da Saúde, Universidade Federal dos Vales do Jequitinhonha e Mucuri, Diamantina, Minas Gerais, Brazil.

Moreira, L., Pontes, M., Brum, E., Silva, L., de Oliveira, D. D., Figueiredo, A., Gonçalves, P., Flecha, O., & Oliveira, E. (2021). The effectiveness of apple, sugar-free chewing gum and Rolly Brush® in the reduction of plaque index: crossover randomized clinical trial. Revista Estomatología, 29(1). https://doi.org/10.25100/re.v29i1.11011 (Original work published April 28, 2021)

Schwarzer R Antoniuk A Gholami M. A brief intervention changing oral self-care, self-efficacy, and self-monitoring. Br J Health Psychol. 2015;20:56–67

Buischi YP, Axelsson P, Siqueira TRF. Controle mecânico do biofilme dental e a prática da promoção de saúde bucal. In: Buisch YP. Promoção de saúde bucal na clínica odontológica. São Paulo: Artes Médicas; 2000. p.69-214.

Singla D, Sharma A, Sachdev V, Chopra R. Distribution of Streptococcus mutans and Streptococcus sobrinus in Dental Plaque of Indian Pre-School Children using PCR and SB-20M Agar Medium. J Clin Diagn Res. 2016;10(11):ZC60-ZC63.

Kakodkar P, Mulay S. Effect of sugar-free gum in addition to tooth brushing on dental plaque and interdental debris. Dent Res J (Isfahan). 2010;7(2):64-69.

Mouton C, Scheinin A, Makinen KK. Effect of a xylitol chewing gum on plaque quantity and quality. Acta Odontol Scand. 1975;33(5):251-257.

Addy M, Perriam E, Sterry A. Effects of sugared and sugar‐free chewing gum on the accumulation of plaque and debris on the teeth. J Clin Periodontol. 1982;9(4):346-354.

Barnes VM, Santarpia P, Richter R, Curtis J, Xu T. Clinical evaluation of the anti-plaque effect of a commercial chewing gum. J Clin Dent. 2005;16(1):1-5.

Keukenmeester RS, Slot DE, Rosema NA, Van Loveren C, Van der Weijden GA. Effects of sugar‐free chewing gum sweetened with xylitol or maltitol on the development of gingivitis and plaque: a randomized clinical trial. Int J Dent Hyg. 2014;12(4):238-244.

Hanham A, Addy M. The effect of chewing sugar‐free gum on plaque regrowth at smooth and occlusal surfaces. J Clin Periodontol. 2001;28(3):255-257.

Scheinin A, Mäkinen KK, Tammisalo E, Rekola M. Turku sugar studies XVIII. Incidence of dental caries in relation to 1-year consumption of xylitol chewing gum. Acta Odontol Scand. 1975;33(5):269-278.

Leach SA, Lee GT, Edgar WM. Remineralization of artificial caries-like lesions in human enamel in situ by chewing sorbitol gum J Dent Res. 1989;68(6):1064-1068.

Dawes C, Macpherson LMD. Effects of nine different chewing-gums and lozenges on salivary flow rate and pH. Caries Res. 1992;26(3):176-182.

Dawes C. Salivary flow patterns and the health of hard and soft oral tissues. J Am Dent Assoc. 2008;139 Suppl:18S-24S.

Schwartz N, Kaye EK, Nunn ME, Spiro A 3rd, Garcia RI. High-fiber foods reduce periodontal disease progression in men aged 65 and older: the Veterans Affairs normative aging study/Dental Longitudinal Study. J Am Geriatr Soc. 2012;60(4):676-683.

Jevtić M, Pantelinac J, Jovanović-Ilić T, Petrović V, Grgić O, Blažić L. Uloga ishrane u prevenciji karijesa i očuvanju oralnog zdravlja u trudnoći. Medicinski pregled. 2015; 68(11-12):387-393.

Manchanda K, Sampath N, Fotedar S, De Sarkar A. The amazing periodontal health benefits of apples. Eur J Gen Dent. 2015; 4(1):29-30.

Govindaraju L, Gurunathan D. Effectiveness of Chewable Tooth Brush in Children – A Prospective Clinical Study. J Clin Diagn Res. 2017;11(3):ZC31-ZC34.

Keukenmeester RS, Slot DE, Putt MS, Van der Weijden GA. The effect of sugar-free chewing gum on plaque and clinical parameters of gingival inflammation: a systematic review. Int J Dent Hyg. 2013;11(1):2-14.

Hashiba T, Takeuchi K, Shimazaki Y, Takeshita T, Yamashita Y. Chewing xylitol gum improves self-rated and objective indicators of oral health status under conditions interrupting regular oral hygiene. Tohoku J Exp Med. 2015;235(1):39-46.

Moher D, Hopewell S, Schulz KF et al. CONSORT 2010 explanation and elaboration: Updated guidelines for reporting parallel group randomised trials. J Clin Epidemiol. 2010;63(8):e1-e37.

Varma, SR, Sherif H, Sefari A et al. The antiplaque Efficacy of Two Herbal-Based Toothpastes: A Clinical Intervention. J Int Soc Prev Community Dent. 2018;8(1):21-27.

Turesky S, Gilmore ND, Glickman I. Reduced plaque formation by the chloromethyl analogue of vitamin C. J Periodontol. 1970;41(1):41-43.

Addy M, Renton-Herper P, Myatt G. A plaque index for occlusal surfaces and fissures. Measurement of repeatability and plaque removal. J Clin Periodontol. 1998;25(2):164-168.

Tangade P, Mathur A, Chaudhary S, Gupta R. The effect of sugar-free and sugar chewing gums on plaque deposition. Dent Res J (Isfahan). 2012;9(3):309-313.

Pedrazzi V, Souza SLS, Oliveira RR, Cimões R, Gusmão ES. Métodos mecânicos para o controle do biofilme dentário supragengival. R. Periodontia. 2008; 18(3):60-67.

Seki M, Karakama F, Kawato T, Tanaka H, Saeki Y, Yamashita Y. Effect of xylitol gum on the level of oral mutans streptococci of preschoolers: block randomised trial. Int Dent J. 2011;61(5):274-280.

Shinga-Ishihara C, Nakai Y, Milgrom P, Söderling E, Tolvanen M, Murakami K. Xylitol carryover effects on salivary mutans streptococci after 13 months of chewing xylitol gum. Caries Res. 2012;46(6):519-522.

Ferraz Mello, SM. Avaliação das condições de saúde bucal e presença de anemia falciforme em escolares no município de São Francisco do Conde, Bahia. [Tese de doutorado]. Universidade Federal da Bahia, Instituto de Ciências da Saúde; 2014. available from: http://repositorio.ufba.br/ri/handle/ri/15293

Suzuki N, Yoneda M, Naito T, Iwamoto T, Hirofuji T. Relationship between halitosis and psychologic status. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2008;106(4):542-547.

Nunes JC, Oliveira L, Martínez-Sahuquillo Á. Halitose: estudo de prevalência e factores de risco associados numa Unidade de Saúde Familiar. Rev Port Med Geral Fam. 2012; 28(5):344-349.

West NX, Addy M, Jackson RJ, Ridge DB. Dentine hypersensitivity and the placebo response. A comparison of the effect of strontium acetate, potassium nitrate and fluoride toothpastes. J Clin Periodontol. 1997;24(4):209-215.

Received 2021-02-12
Accepted 2021-04-28
Published 2021-05-04