A 12-month study of the efficacy of a pre-brushing rinse in plaque removal The purpose of this investigation was to compare the effectiveness of a pre-brushing rinse (PBS) with water in reducing plaque scores following toothbrushing A second aim of the study was to measure the effectiveness of the PBS in reducing gingivitis scores over the study period. A total of 617 subjects, ages 18 to 65 years, completed the study. Exclusion criteria included advanced periodontal disease, oral ulceration, medication usage, and pregnancy. Subjects were randomly assigned to one of four groups. Group 1 rinsed with PBS before brushing group 2 rinsed with plain tap water before brushing; group 3 subjects did not use any rinse prior to brushing; and group 4 rinsed with sterile water prior to brushing. Examiners were blinded as to the group to which each subject had been allocated. The examiners were trained and calibrated to measure plaque and gingivitis, and each dentist examined the same subjects throughout the study. Plaque was scored at baseline and at 3, 6, and 12 months using the Turesky modification of the Quigley-Hein index. Gingivitis scores were recorded using a single-criterion index (bleeding: yes/no) based on a modification of the index described by Ainamo and Bay. At the baseline appointment the subjects¹ teeth were disclosed with a disclosing agent and the plaque index was assessed. The subject was then asked to rinse with the appropriate solution for 30 seconds and then to brush with a standard commercial toothpaste for 40 seconds. The teeth were then again disclosed and the plaque index recorded. Results showed that pre-brushing minus post-brushing plaque scores (decrease in plaque) were significantly higher in the PBS group at baseline, and 6, 9, and 12 months. There was, however, no change discernible in gingivitis scores within or between the groups over time. The authors therefore question the clinical significance of the higher plaque removal scores in the PBS group. [M.J.D.]
O'Mullane, D.M., H. Whelton, N. Galvin, J. Phelan, and P. Gleeson, J Periodont, 65:611,1994