With declining caries experience, increasing numbers of people retaining their teeth and new emphasis on cosmetically attractive dentitions, there is an increasing public awareness of the value of personal oral hygiene. This has been fostered also by market expansion in oral hygiene products, especially those with therapeutic or cosmetic attributes. Personal oral hygiene is the maintenance of oral cleanliness for the preservation of oral health, whereby microbial plaque is removed and prevented from accumulating on teeth and gingivae. Plaque is the primary aetiological factor in gingivitis and periodontal diseases, so these diseases are largely preventable by plaque control. Although plaque removal also contributes to the prevention of dental caries, fluoride delivered by fluoride toothpaste provides the major cariostatic effect. Current oral hygiene measures include mechanical aids toothbrushes, floss, interdental cleansers, chewing gums) and chemotherapeutic agents (in mouthrinses, dentifrices and chewing gums). The benefit derived from oral hygiene depends upon the manual dexterity, lifestyle, motivation and oral condition of the individual.

Most periodontal diseases originate interproximal, including gingivitis, which is most frequent and severe at these sites. Dental floss is the most effective means for removing interdental plaque and reducing interdental gingival inflammation. No significant differences in efficacy of plaque removal have been reported for waxed versus unwaxed floss but tufted floss facilitates cleaning under bridge pontics. Unfortunately, most people do not floss routinely. The patient-preferred method, flossing with floss aids, can remove plaque and decrease inflammation and bleeding as effectively as hand-held floss. This method is of particular benefit for children or non-dextrous adults. Flossing in toddlers is valuable for caries prevention and should be commenced as soon as primary teeth establish proximal contacts. At this time, the incidence of proximal caries and gingivitis increases significantly. In a fluoridated community, daily flossing by hygienists of the teeth of preschool children reduced interproximal caries by 30 per cent. Manual dexterity and training are needed for effective flossing and since this is not expected of children under 8, parents should floss for young children. Floss incorporating sodium or amine fluoride can promote fluoride uptake in vitro by molar proximal surfaces and demineralised primary enamel but caries reductions have yet to be shown.

Regards

Sarah eve
Editorial Assistant
Journal of Oral Hygiene and Health