Association of tracking oral hygiene with dental outcomes in a general dental practice

Purpose: To track plaque scores on a subset of teeth in general dental practice patients to determine if plaque scores could improve along with periodontal, restorative and extraction outcomes. Methods: Percentage of surfaces with subgingival plaque were recorded and graphed on five teeth (#3, 8, 14, 19, 30) at each appointment, followed by focused oral hygiene instructions, in 343 patients over a 5-10-year period. Patient age, gender, prophylaxes/year, and experimental teeth periodontitis stage, % 4-5 and >= 6 mm pockets, % bleeding on probing, % surfaces restored and patients with extractions were recorded. Relationships among average plaque scores and the longitudinal periodontal, restorative and extraction changes were analyzed using Chi-Square, Kruskal-Wallis, and Wilcoxon Rank Sum tests. Results: Plaque scores improved from median 40% to 25% (P<0.0001) over the 5-10 years. Plaque scores and periodontitis stages were associated (P=0.03) with few periodontally healthy patients (9%) having poor plaque scores (> 50% plaque surfaces). Furthermore, good plaque scores (<= 25%) and periodontal health (Stage I) were linked to the need for few restorations (P<0.0001), while prophylaxes/year had no significant relationship. Extractions were related more with Stage III/IV (advanced) periodontitis (P<0.0001) than with plaque score (NS). CLINICAL SIGNIFICANCE: In a general dental practice, tracking plaque scores at each appointment on a subset of representative teeth can be time-efficient, and is associated with improved oral hygiene, stable periodontal status and reduced restorative needs.