Four years of monthly professional toothcleaning and topical fluoride application in Brazilian schoolchildren.. I. Effect on gingivitis

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Abstract
The effect on gingivitis of monthly professional toothcleaning, without oral hygiene instruction, was evaluated in 103, 7- to 11-yr-old Brazilian children. Plaque and gingivitis (PII and GI) were recorded initially and after 1, 2, 3 and 4 yr. The baseline examination showed a similar high level of plaque (PII .apprx. 1.55) and low level of gingivitis (GI .apprx. 0.32) around permanent teeth of the test and control groups. The test children were given monthly professional toothcleaning followed by topical application of fluoride gel (APF [acidulated phosphate fluoride]), totaling 32 sessions. At all annual follow-up examinations, the Mean PII in the test group was significantly lower than in the control group. Even in the test group, at least 80% of the tooth surfaces harbored plaque. In spite of this, no child in the test group showed overt gingivitis (mean individual GI .gtoreq. 1.0) and the distribution of GI score = 2 was very low. In the control group the percentage of children with overt gingivitis increased from 3% at the baseline to 20% at the final examination and areas scoring GI = 2 doubled in number. For young children, monthly thorough removal of plaque is probably sufficient to prevent the development of gingivitis.