Western Society of Periodontics

Clinical Studies

Volume Number 3, 1995

A comparison of partial and full-mouth scoring of gingivitis in oral hygiene studies.

The clinical testing necessary to demonstrate the safety and efficacy of new toothbrushes is complex and expensive. The authors evaluated various sampling methods, limited to half or fewer of the teeth, for potential use in toothbrush efficacy studies, with the objective of reducing examination time and cost, while maintaining overall reliability. A second objective was to determine whether or not a minimal sulcular bleeding evaluation might offer a more objective index of gingivitis than the traditional modified gingival index.

Thirty-four adults were enrolled in this study. A baseline dental examination was carried out in which gingivitis, plaque, and sulcular bleeding scores were determined on all teeth. Gingivitis was assessed visually, based on color and texture in the margin and papillary areas, using the modified gingival index. A modified bleeding index, based on minimal penetration and stimulation of the gingival sulcus, was used to measure early gingival changes. Thirty-one subjects completed the study. There were no statistically significant differences in the application of scoring criteria between the two examiners, nor did the scoring practices of the two examiners change over time. The mean modified gingival index and plaque index scores for all teeth were 1.18 and 2.03, respectively, indicating significant levels of gingivitis and plaque at baseline. The mean absolute decrements in modified gingival index, plaque, and bleeding indices after eight weeks of brushing were found to be statistically significant.

The authors suggest that their results show that in toothbrush evaluation studies, increased objectivity and reduced study costs may be achieved with minimal modification of traditional methods. These changes may be accomplished by the use of a sulcular bleeding index and by the examination of selected teeth. Indices of gingivitis based on subjective assessment of gingival color, form, and texture have the advantage of allowing noninvasive evaluation of gingival inflammation [MO]