Acess^® toothpaste includes formulation ingredients (latania, chamomile, and myrrh) and reportedly improves periodontal disease by exerting gingival convergence and anti-inflammatory effects. Although each of these ingredients has antibacterial effects, the effects of Acess^® on the oral bacteria remain unknown. The present study was aimed at examining the effects of brushing teeth with Acess^® on periodontal disease and the oral bacterial population.

This was a randomized, open-label, parallel, intergroup trial. Each participant was randomly assigned to receive either Acess^® or a control tooth paste formulation. Participants brushed their teeth twice daily, once in the morning and once in the evening, for five minutes per session. We then assessed clinical parameters such as gingival index (GI), pocket depth (PD), bleeding on probing (BOP) and plaque control record (PCR), and carried out salivary bacteriological examination at baseline and at two and four weeks post-baseline.

In the Acess^® group, we observed significant improvement over baseline levels of GI, BOP and PD at two and four weeks. The control group exhibited no significant improvement in any of the clinical parameters. In addition, the Acess^® group showed a significant reduction in the total bacterial count as compared with that in the control formulation group. Specific bacteria that were significantly reduced in the Acess^® group were Tannerella forsythia, Treponema denticola, and Prevotella intermedia. Furthermore, the rate of bacterial reduction in the Acess^® group was significantly improved for the total bacteria, the Red complex, and 5 other strains in the Acess^® group.

Acess^® significantly reduced the expression of the oral bacteria, including periodontal pathogens, and produced significant improvements in the clinical parameters.

Periodontal disease is an infectious disease that occurs at a high prevalence, although many periodontitis patients do not have any subjective symptoms and the disease often goes untreated. Recognition of periodontitis in its early (mild) stage is extremely useful for effective treatment and prophylaxis. Therefore, the purpose of the present study was to identify appropriate questions to be asked in the screening for periodontal disease.

We enrolled 990 patients with cardiovascular diseases from Tokyo Medical and Dental University Hospital for this study from 2012 to 2015. The subjects were given a self-administered questionnaire to describe their periodontal condition. Clinical periodontal examination was performed to determine the probing pocket depth (PPD), clinical attachment level (CAL), and bleeding on probing (BOP) as a clinical periodontal examination.

We found that the patients who answered "yes" to the questions, "Do you think you have gum disease?", "Do you feel your teeth are unstable?" and "Have you ever been told by a dental specialist that you have lost bone around your teeth?", had statistically significantly higher frequencies of unfavorable results of examination for PPD, CAL and BOP. They also had a higher frequency of deep periodontal pockets of 4 mm or more.

The results indicated the validity of the questionnaire for the screening of periodontitis patients.

This is a case report of generalized severe chronic periodontitis that was treated by initial periodontal therapy alone. The patient was a 42-year-old female who had been referred to our clinic three months earlier with the chief complaint of gingival redness, swelling and bleeding.

Clinical observation revealed generalized gingival redness and swelling, especially, inflammatory gingival hyperplasia on the left maxillary alveolar ridge.

Clinical examination revealed 31.9% bleeding on probing (BOP), 52.1% periodontal pocket probing depth (PPD) >4 mm, and 50% O'Leary's plaque control record (PCR).

Radiographic examination showed a localized vertical bone defect in the anterior mandible and some defects in the posterior mandible.

After explaining the results of the periodontal tissue examination and providing repeated oral hygiene instructions, scaling and root planing were performed. To keep the patient motivated, we confirmed the possible prolonged treatment course and patient background with her and ensured that she fully understood her oral condition.

As the initial therapy progressed, the oral hygiene improved, with disappearance of the gingival swelling.

At the re-evaluation, we confirmed the improvement of the alveolar bone defect on the radiographs, so that we could proceed to prosthodontic treatment without any need for periodontal surgery. After completion of the restorative therapy, we started the patient on supportive periodontal therapy in September 2015.