Gengivite e qualidade de vida relacionada à saúde bucal: uso adjunto do fio dental e autopercepção após treinamento de higiene oral

Abstract

Gingivitis caused by dental biofilms is considered the most common oral disease and the most frequent type of periodontal disease. In addition to oral repercussions, gingivitis is associated with reduced quality of life. Manual toothbrushing is the principal method for mechanical biofilm self-control and, consequently, prevention and treatment of gingivitis. The efficacy of brushing, however, is questionable in interdental areas. Thus, interdental cleaning is recognized as an essential part of maintaining gingival health and dental floss is the most recommended interdental device for spaces without attachment loss. However, despite the importance of this issue, there is limited scientific evidence available on the impact of flossing on oral healthrelated quality of life (OHRQoL). In addition, the impact of self-perception on improved quality of life after oral hygiene training is not known. To answer these questions, we used a sample from a randomized clinical trial, which evaluated the effectiveness of flossing in addition to toothbrushing, compared with brushing alone, in the treatment of gingivitis in adults. Sixty-five subjects were randomized into two experimental groups: Manual toothbrushing without flossing (brush) group, Manual toothbrushing and flossing (brush + floss) group, the individuals received weekly oral hygiene instructions for 60 days. To assess self-perception of improvement in OHRQoL, the difference clinically important minimum (MID) was estimated using a combination of anchor and distribution measures to triangulate towards a MID value that was estimated to be 6.4 points on the Oral Health Impact Profile (OHIP-14), classifying subjects into those who achieved (≥MID) or not (<MID) that value. OHIP-14 and Gingival Index (GI) were used to evaluate the outcomes of this thesis were gingival bleeding and OHRQoL over time. Poisson multilevel regression analysis for repeated measures was performed to compare OHIP-14 scores between groups. Differences in mean percentages of GI over time were analyzed using mixed linear models. After 60 days, oral hygiene regimens contributed to a better perception of OHRQoL regardless of flossing. During follow-up, individuals in the ≥MID group maintained lower levels of gingival bleeding up to two months after the interventions, however, after six months there was no difference between the groups. Therefore, it can be concluded that oral hygiene regimens contribute to improving OHRQoL, in addition, individuals who perceive improvement in OHRQoL after oral hygiene training present lower rates of gingival bleeding over time.