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Sizing The Gap A new tool on the tray Interdental cleaning just got a whole lot easier thanks to the colorimetric IAP probe By Dr Tihana Divnic-Resnik BDS, MSc, PhD
REGULAR REMOVAL AND disruption of oral biofilm is the goal of oral selfcare and an important component of primary prevention of dental caries, periodontal, as well as peri-implant diseases. Although tooth brushing is the primary and widely used mechanical method for controlling oral biofilms, the focus of modern prevention has been shifted towards shaping and improving mechanical devices used for cleaning of interproximal areas. Various anatomic characteristics make natural (between two teeth) or artificially created (between two restored teeth or implants) interdental space, unique and susceptible to disease. Its position renders it “hidden� and less accessible to natural-cleaning mechanisms such
as saliva, tongue/lips, thus making it a good ground for undisturbed biofilm accumulation and dysbiosis conductive to caries or periodontal diseases. Regular use of toothbrush is proven to be optimal for cleaning of flat tooth surfaces 1,2. However, the benefits of regular use of interdental cleaning devices as an adjunct to tooth brushing, have been confirmed with data from the National Health and Nutrition Examination Survey (NHANES 20112012 & 2013-2014) 3. Individuals who were using interdental cleaning devices on a regular basis, showed higher standards of oral health, with less prevalence of periodontal diseases, reduced coronal and interproximal caries, and fewer missing teeth 3.
About the author Dr Tihana Divnic-Resnik BDS, MSc, PhD is a clinical lecturer and Doctor of Dental Medicine (DMD) course coordinator in the Discipline of Periodontics at The University of Sydney. She was a lecturer in Periodontics and Oral Medicine at University of Belgrade (Serbia) for 10 years, where she also practiced as a specialist of Periodontology and Oral Medicine. She has published her work in several international journals and presented it at numerous professional conferences. She is a member of European Federation of Periodontology (EFP), Australian Society of Periodontics (ASP) and fellow of the International College of Dentists (ICD).
Dental floss has been routinely recommended by majority of dental professionals for cleaning of closed interdental spaces that may be seen in individuals with healthy periodontium, while interdental brushes are mainly recommended in periodontal patients or in those with open embrasures. There is still concern regarding their use in primary prevention at healthy sites, due to potential discomfort and trauma to interdental papilla 4. Existing clinical studies, however, did not find any associated papilla or hard-tissue damage after the use of interdental brushes 5. In addition, it has been observed that in a group of 99 young individuals with healthy periodontium, 92.3% of interdental sites were accessible to interdental brushing 6. As compared to dental floss, interdental brushes are easier to use and readily accepted by patients. They are more effective in cleaning of interproximal surfaces, especially in region of posterior teeth that feature mesial and distal concavities, inaccessible by dental floss 7. Proven to be superior than dental floss, interdental brushes are becoming the first choice for mechanical interdental hygiene. However, while recommending devices for mechanical biofilm control, including interdental brushes, we must
