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 Table of Contents  
ORIGINAL ARTICLE
Year : 2018  |  Volume : 5  |  Issue : 2  |  Page : 115-118

Oral hygiene and maintenance habits among fixed partial denture wearers


Departments of Prosthodontic, College of Dentistry, Riyadh Elm University, Riyadh, Saudi Arabia

Date of Web Publication14-Sep-2018

Correspondence Address:
Lama Mana AlQabbaa
Riyadh Elm University, P. O. Box: 36517, Riyadh 11429
Saudi Arabia
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/sjos.SJOralSci_12_18

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  Abstract 


Aim: This study aimed to investigate oral hygiene and maintenance habits of fixed partial denture (FPD) wearers.
Materials and Methods: A total of 200 patients (93 males, and 107 females) answered a questionnaire regarding their oral hygiene habits and awareness of specific measures to maintain proper hygiene underneath their FPDs.
Results: The most patients (n = 166, 83%) did not use any special aid to maintain hygiene underneath pontics. The majority of them (n = 178, 89%) reported that their dentist did not inform them about these aids. In addition, 150 patients (75%) reported that they were not advised by the dentist to book recall visits.
Conclusion: There is a lack of awareness among FPD wearers regarding the specific measures needed to maintain proper hygiene underneath FPDs. Dentists should be obligated to educate their patients regarding the maintenance of proper oral hygiene under their prostheses.

Keywords: Fixed prosthesis, oral hygiene, pontics


How to cite this article:
AlQabbaa LM, Rayyan MR. Oral hygiene and maintenance habits among fixed partial denture wearers. Saudi J Oral Sci 2018;5:115-8

How to cite this URL:
AlQabbaa LM, Rayyan MR. Oral hygiene and maintenance habits among fixed partial denture wearers. Saudi J Oral Sci [serial online] 2018 [cited 2023 Mar 22];5:115-8. Available from: https://www.saudijos.org/text.asp?2018/5/2/115/241164




  Introduction Top


Many studies have investigated the influence of fixed partial dentures (FPDs) on the health of alveolar mucosa underneath pontics.[1],[2] In patients with average oral hygiene, plaque accumulates more underneath pontics in comparison to axial surfaces of FPDs.[3] Even with a desirable pontic design and favorable material selection, applying oral hygiene measures is necessary for removing the bacterial plaque and preventing mucosal inflammation.[4] In addition to regular tooth brushing, the use of special aids such as superfloss, interdental brush, and water flossers can improve the biological maintenance of fixed prostheses.[5],[6]

The dentist has a major role in oral hygiene education and patient motivation.[7] Educating the patients regarding their oral hygiene status can motivate them to improve their oral hygiene measures.[2] Furthermore, detailed explanation of the importance of postcementation instructions, proper/daily practice of dental aids (such as floss, special end-tufted, and interdental brushes), and strengthening the instructions by demonstrations on models will improve the patient acceptance. As a result, the condition of the alveolar mucosa will improve and remain healthy.[8],[9],[10]

Moreover, patients with FPDs require regular, life-long professional maintenance providing repeated oral hygiene interventions, and reinstructions regarding maintaining proper oral hygiene around fixed prosthesis. In addition, the use of special aids such as electric toothbrush, interdental brush, and water flossers can improve the biological maintenance of fixed prosthesis.[2],[11],[12],[13],[14],[15] Thus, the purpose of the current study was to investigate oral hygiene habits among a random group of patients wearing FPDs and their awareness of the specific measures to maintain proper hygiene underneath their FPDs.


  Materials and Methods Top


The study was approved by the Review Board and Ethics Committee of Riyadh Elm University (IRB approval number: RC/IRB/2016/164). In the period between February 12, 2017, and May 11, 2017, a random sample of 200 patients who have FPDs were interviewed at the Academic Hospital of Riyadh Elm University in Riyadh, Saudi Arabia. The patients answered a questionnaire of 25 closed-ended questions investigating their oral hygiene habits and awareness of the specific measures to maintain proper hygiene underneath their FPDs in addition to their sociodemographic characteristics. For the inclusion and exclusion criteria, all patients were above 18 years old and were free of any neuromuscular disorders, mental disorders, or impairments which may limit their ability to maintain oral hygiene. The data were collected and analyzed by Statistics Package for Social Sciences version 24 (SPSS Inc. Chicago, IL USA) to produce descriptive and cross-tabulation statistics.


  Results Top


Demographic characteristics and general information about patients' FPDs are shown in [Table 1] and [Table 2], respectively.
Table 1: Demographic characteristics of the patients

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Table 2: General information about fixed partial dentures

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Oral hygiene and maintenance habits of FPDs are shown in [Table 3]. The majority of patients reported that they did not receive instructions from their dentists regarding maintaining proper hygiene underneath their FPDs (75%, n = 150). Moreover, the majority of the patients reported that they do not use any special aid for this purpose (83%, n = 166). Among those who use special aids, interdental brushes were the most commonly used (41%, n = 14).
Table 3: Reported oral hygiene habits and maintenance of fixed partial dentures

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A majority of patients who are not using special aids stated that they were not informed by the dentists (89%, n = 147), and most of them reported that they wish to know more about special cleaning aids (83%, n = 138). The patients who were advised by the dentist to use special aids were more likely to use special aids (62%) than the patients who were not advised by their dentist (2%) (P < 0.001). Furthermore, the patients treated in academic hospitals were more likely to use special aids (62%) compared to governmental (17%) and private clinics (9%) (P < 0.001) [Table 4].
Table 4: Cross tabulation of special aid use with dentist-related variables and attending recall visits

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Regarding recall regime, a majority of patients reported they were not advised by their dentist to book recall visits (75%, n = 150), and only few patients attend regular recall visits (6%, n = 12). The patients who attend regular recall visits were more likely to use special aids (67%) than ones who do not (14%) (P < 0.001) [Table 4].


  Discussion Top


Gingival disease and periodontal inflammation are the common biological complications of the fixed dental prosthesis which can be prevented by meticulous hygiene regime and regular maintenance.[2],[5],[11] Nevertheless, the majority of patients in the current study reported that they were not using any adjunct method to clean under their FPDs other than regular tooth brushing.

The role of the dentist in oral hygiene education and patient motivation is not less important than delivering a desirable prosthesis.[16],[7] The current study revealed that the majority of the patients were not informed by their dentists about the importance of special dental aids to maintain healthy tissue underneath their FPDs. According to the patients, negligence of dentists to give postcementation instructions was the most reported reason for not using special cleaning aids. This was supported by the fact that a significantly higher percentage of patients who received instructions by their dentists used special aids than those who have received no such instructions. Moreover, the patients who attended regular recall visit were more committed to the use of special aids and maintenance of hygiene underneath their FPDs. These results agreed with the previous reports which concluded that the patients tend to follow their dentist's instructions and patient's oral hygiene behavior tends to improve with regular professional reinstructions and recall visits.[2],[6]

Posttreatment instructions and recall visit are often a mandatory requirement on dental students and intern which could explain why patients who were treated in academic hospitals were more aware of the importance of using special cleaning aids. Unfortunately, the dentists in the governmental and private setup seemed to neglect this aspect and the majority of their patients did not seem to be aware of the importance of posttreatment maintenance and recall visits.

It worth mentioning that the sample under investigation was randomly selected and results obtained might not represent all the patients wearing FPDs. Oral hygiene measures can vary according to the place where the FPD was done, patient's education and social background, and other patient- and dentist-related factors.


  Conclusion Top


Within the limitations of the current study, it can be concluded that there is a noticeable lack of awareness among FPD wearers regarding the specific measures needed to maintain proper hygiene underneath FPDs. Dentists should be obligated to educate their patients and advise them to maintain proper oral hygiene under their prostheses and book regular recall visits.

Acknowledgment

The authors would like to thank Dr. Fahad AlTekhaifi, the President of General Authority for Statistics.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

1.
Silness J, Gustavsen F, Mangersnes K. The relationship between pontic hygiene and mucosal inflammation in fixed bridge recipients. J Periodontal Res 1982;17:434-9.  Back to cited text no. 1
    
2.
Kc Basnyat S, Sapkota B, Shrestha S. Oral hygiene and gingival health in patients with fixed prosthodontic appliances – A six month follow-up. Kathmandu Univ Med J (KUMJ) 2015;13:328-32.  Back to cited text no. 2
    
3.
Silness J, Ohm E. Periodontal conditions in patients treated with dental bridges. V. Effects of splinting adjacent abutment teeth. J Periodontal Res 1974;9:121-6.  Back to cited text no. 3
    
4.
Tolboe H, Isidor F, Budtz-Jörgensen E, Kaaber S. Influence of oral hygiene on the mucosal conditions beneath bridge pontics. Scand J Dent Res 1987;95:475-82.  Back to cited text no. 4
    
5.
Bidra AS, Daubert DM, Garcia LT, Gauthier MF, Kosinski TF, Nenn CA, et al. A systematic review of recall regimen and maintenance regimen of patients with dental restorations. Part 1: Tooth-borne restorations. J Prosthodont 2016;25 Suppl 1:S2-15.  Back to cited text no. 5
    
6.
Geiballa GH, Abubakr NH, Ibrahim YE. Patients' satisfaction and maintenance of fixed partial denture. Eur J Dent 2016;10:250-3.  Back to cited text no. 6
  [Full text]  
7.
Balshi TJ, Mingledorff EB. Maintenance procedures for patients after complete fixed prosthodontics. J Prosthet Dent 1977;37:420-31.  Back to cited text no. 7
    
8.
Barnes CM, Russell CM, Reinhardt RA, Payne JB, Lyle DM. Comparison of irrigation to floss as an adjunct to tooth brushing: Effect on bleeding, gingivitis, and supragingival plaque. J Clin Dent 2005;16:71-7.  Back to cited text no. 8
    
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Goyal CR, Lyle DM, Qaqish JG, Schuller R. Evaluation of the plaque removal efficacy of a water flosser compared to string floss in adults after a single use. J Clin Dent 2013;24:37-42.  Back to cited text no. 9
    
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Goyal CR, Lyle DM, Qaqish JG, Schuller R. The addition of a water flosser to power tooth brushing: Effect on bleeding, gingivitis, and plaque. J Clin Dent 2012;23:57-63.  Back to cited text no. 10
    
11.
Jackson MA, Kellett M, Worthington HV, Clerehugh V. Comparison of interdental cleaning methods: A randomized controlled trial. J Periodontol 2006;77:1421-9.  Back to cited text no. 11
    
12.
Kiger RD, Nylund K, Feller RP. A comparison of proximal plaque removal using floss and interdental brushes. J Clin Periodontol 1991;18:681-4.  Back to cited text no. 12
    
13.
Nayak RP, Wade AB. The relative effectiveness of plaque removal by the proxabrush and rubber cone stimulator. J Clin Periodontol 1977;4:128-33.  Back to cited text no. 13
    
14.
Rosema NA, Hennequin-Hoenderdos NL, Berchier CE, Slot DE, Lyle DM, van der Weijden GA, et al. The effect of different interdental cleaning devices on gingival bleeding. J Int Acad Periodontol 2011;13:2-10.  Back to cited text no. 14
    
15.
Waerhaug J. The interdental brush and its place in operative and crown and bridge dentistry. J Oral Rehabil 1976;3:107-13.  Back to cited text no. 15
    
16.
Ortolan SM, Viskić J, Stefancić S, Sitar KR, Vojvodić D, Mehulić K, et al. Oral hygiene and gingival health in patients with fixed prosthodontic appliances – A 12-month follow-up. Coll Antropol 2012;36:213-20.  Back to cited text no. 16
    



 
 
    Tables

  [Table 1], [Table 2], [Table 3], [Table 4]



 

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