J Korean Acad Oral Health.  2013 Sep;37(3):132-140.

Promotion of periodontal health through professional toothbrushing and education on the use of the interdental brush in the elderly

  • 1Department of Dental Hygiene, Dong-Eui University, Busan, Korea. yamako93@deu.ac.kr
  • 2Department of Oral Health, Kosin University Graduate School, Busan, Korea.
  • 3Department of Preventive and Community Dentistry, School of Dentistry, Pusan National University, Busan, Korea.


This study is intended to evaluate the effects of promotion of periodontal health in the elderly, through professional toothbrushing and education on the use of the interdental brush, using the Gingival Bleeding Index and the Patient Hygiene Performance Index (PHP index).
The study was conducted on 87 participants, who had given the informed consent to participate in the study at a general hospital 'B' in Busan from June to August, 2011. After assessing the general health condition and the medical history of the participants, the Watanabe toothbrushing method was used for professional toothbrushing on four different visits, along with imparting of education on the use of the interdental brush for self-management. The periodontal health of the participants was assessed based on the extent of gingival bleeding, by using the Gingival Bleeding Index, and the degree of plaque accumulation, by using the Patient Hygiene Performance Index. The data thus obtained was analyzed using Statistical Analysis Systems (SAS) (ver 9.13), followed by frequency analysis, analysis of variance (ANOVA), and the mixed effect model.
The average gingival bleeding index was 1.65 at the commencement of the study and 1.25, 0.88, and 0.65, after the first, second and third trial, respectively. The PHP index of dental plaque was 2.90 prior to commencement of the study, 2.79, 2.77, and 2.76 after the first, second, and third trials, respectively, thus significantly improving with every successive visit. Gingival bleeding index and PHP index significantly reduced with every visit, regardless of age, smoking habits, or systemic chronic diseases such as diabetes, hypertension, central nervous system or cardiovascular diseases.
Education on the use of the interdental brush and professional tooth brushing promotes periodontal health, regardless of the chronic diseases seen in the elderly. Education on self-management of oral health, along with professional care at regular intervals should be recommended to effectively maintain periodontal health in the elderly.


Dental plaque; Education; Gingival bleeding; Interdental brush; Periodontal health; Professional toothbrushing
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