LACK OF EFFECT OF ORAL HYGIENE TRAINING ON PERIODONTAL-DISEASE PROGRESSION OVER 3 YEARS IN ADOLESCENTS

A COMPREHENSIVE NEW ORAL HYGIENE training program has lately been desc ribed and found effective in controlling dental plaque formation and i n significantly reducing the incidence of approximal dental caries and gingivitis in adolescents. This study investigated the long-term effe ct of plaque control on the progression of periodontal diseases in ado lescents. A group of 227 Brazilian schoolchildren were followed up ove r a period of 3 years. The children were divided randomly into 3 group s. The first group was given a needs-related intensive program which c ombined detailed information to parents and children pertaining to the etiology and prevention of dental diseases, instructions in self-diag nosis of plaque and gingivitis, and a detailed oral hygiene training b ased on individual needs, together with continued feedback and motivat ion during the entire 3 years. The second group was given a similar pr ogram, but through shorter sessions and with no motivation and feedbac k and no training in self-diagnosis. A control group received no motiv ation sessions or oral hygiene training. The 3 groups were examined ra diographically at baseline and annually at 3 subsequent occasions. The data were analyzed with a:multi-level variance analysis. The frequenc y of subjects showing sites with alveolar bone loss increased steadily during the entire period in all groups. Neither of the training progr ams had a significant effect on the alveolar bone level during 3 years compared to the control group. Generally, girls demonstrated higher p roportions of approximal tooth surfaces showing radiographic bone loss , though not statistically significant. In this population the supragi ngival plaque control lacked any significant effect on periodontal dis ease progression. This may indicate that secondary prevention of early periodontitis in adolescents is more appropriate than primary prevent ion, and stresses the importance of early identification of periodonti tis-risk subjects. The findings may also imply that the constituents o f the subgingival microflora and/or deficiencies in the host immune sy stem are significant determinants of early onset periodontitis.