The Effect of Toothbrushing and Scaling in Periodontal Therapy

Abstract

The efficacy and limitation of toothbrushing (rolling method) and scaling in the treatment of periodontal disease were examined in 14 patients, who were suffering from gingivitis and mild periodontitis not due to poor restoration and malocclusions. The periodontal status was measured with Gingival Index system (GI), periodontal pocket depth, purulent exudation and bone score. The oral hygiene was expressed as debris index (DI) and calculus index (CI).
The results were summarized as follows:
1. Brushing and scaling was effective in removing a dental plaque.
2. Gingival inflammatory intensity was reduced by removing a dental plaque (DI=0), but gingival inflammation was not improved in about 15% of that group.
3. Scaling was effective in the reduction of gingival inflammation. The deposition of a dental plaque was found in 49% of the group in which gingival inflammatory status was not improved by scaling.
4. The effect of brushing and scaling on a periodontal pocket:
1) The deeper the periodontal pocket, the lower the rate of healing of a periodontal pocket.
2) Correlation between a periodontl pocket depth and a degree of a dental plaque deposit was not found.
3) It was shown that the improvement of gingival inflammation followed by removing a dentalplaque deposit was necessary in the healing of a periodontal pocket.
4) The improvement of gingival inflammation with removing a dental deposit was observed in about 25% of the group in which a periodontal pocket was not still diminished by brushing and scaling. It was assumed that many other factors except a dental deposit played an important role in the pathosis of a periodontal pocket formation.
5) The percentage of purulent exudation was higher in the group in which a periodontal pocket was not diminished than in the group in which a pocket was healed. The periodontal pocket with purulent exudation was one of the criteria of the limitation of brushing and scaling.