Interdental Hygiene Methods in Young Adults

Hospices Civils de Lyon55 enrolled

Overview

Oral health is essential for overall well-being and systemic health. A key factor in preserving this health is maintaining the balance of the interdental microbiota, which involves regulating the quantity of pathogenic bacteria in interdental spaces (IS). These IS represent a unique ecological niche where the body has limited specific defense mechanisms, making them vulnerable to infections. In adults, the colonization of interdental spaces by pathogenic bacteria increases the risk of periodontal diseases, which are themselves associated with non-communicable diseases such as cardiovascular diseases, diabetes, and certain types of cancer. Preventing interdental microbiota dysbiosis from a young age is therefore a priority to maintain quality oral health and contribute to good systemic health throughout life. However, conventional brushing techniques cover only accessible tooth surfaces and cannot reach the interdental spaces. Currently, the use of interdental brushes (IDBs) is recognized as the most effective method for interdental hygiene. There are various types of IDBs, differing in several aspects that influence their effectiveness and usability. The main differences relate to their shape, size, and calibration using an interdental probe or not, allowing adaptation to different interdental space sizes. To date, only one study has demonstrated the effectiveness of daily calibrated interdental brush use in reducing dysbiosis and interdental inflammation among young adults. However, no research has yet been conducted to compare the effectiveness of the various types of IDBs available on the market (calibrated versus non-calibrated).

Study Type

INTERVENTIONAL

Allocation

RANDOMIZED

Purpose

PREVENTION

Masking

SINGLE

Enrollment

Conditions

Eligibility

Sex: ALLMin age: 18 YearsHealthy volunteers:

Medical Language ↔ Plain English

Inclusion Criteria: * Person between 18 and 30 years old * Person who has given free, informed, express written consent * Person affiliated to a French social security system * Person living or working in Lyon or the Lyon conurbation served by public transport (TCL) Exclusion Criteria: * Person with a smoking addiction * Person participating in another study related to oral hygiene * Patients at high risk of infective endocarditis * Person with chronic pathologies * Person having taken antibiotic treatment during the month preceding the start of the study * Pregnant, parturient or breastfeeding woman * Persons deprived of liberty by a judicial or administrative decision * People receiving psychiatric care * Persons admitted to a health or social establishment for purposes other than research * Adults subject to a legal protection measure (guardianship, curatorship) * Persons not affiliated to a social security scheme or beneficiaries of a similar scheme * Person with fewer than 20 natural teeth * Person performing interdental hygiene and/or daily mouthwashes. * Person wearing orthodontic appliance * Person with periodontal disease (stage ≥ II periodontal lesions according to the Chicago 2017 classification (i.e. PD ≥ 4 mm, and/or CAL ≥ 4 mm) and/or generalized (\>30% of sites )), active caries or during dental care

Outcomes

Primary Outcomes

Interdental bleeding at month 3 (in percentage)

Comparison of interdental inflammation (interdental bleeding) following the daily use of calibrated versus non-calibrated interdental brushes at month 3 (T3, expressed as a percentage and assessed at four sites per tooth following probing with a periodontal probe).

Time frame: Baseline (T0), 3 months after baseline (T3)

Secondary Outcomes

Composition of the Interdental microbiome (diversity and total bacteria count)

Identification of the composition of the interdental microbiome in healthy young adults using sequencing techniques at T0, in four standardized sites (between teeth 15-16, 25-26, 35-36, and 45-46). If the specified teeth are missing, exhibit pathologies, or have diastemas preventing interdental cleaning, the sample will be taken from the nearest healthy mesial interdental space.

Time frame: Baseline (T0)

Periodontal health analysis

Comparison of periodontal for all participant's teeth (plaque index, gingival index, interdental inflammation, pocket depth and loss of clinical attachment) before (T0), 1 week after baseline (T1), 1 month after baseline (T2) and 3 months after baseline (T3) following the daily use of calibrated versus non-calibrated interdental brushes

Time frame: Baseline (T0), 1 week later (T1), 1 month after baseline (T2), 3 months after baseline (T3)

Periodontal health analysis - salivary pH

Comparison of periodontal for all participant's teeth (salivary pH) before (T0), 1 week after baseline (T1), 1 month after baseline (T2) and 3 months after baseline (T3) following the daily use of calibrated versus non-calibrated interdental brushes

Time frame: Baseline (T0), 1 week later (T1), 1 month after baseline (T2), 3 months after baseline (T3)

Interdental microbiota at T3 (diversity and total bacteria count)

Comparison of the composition of the interdental microbiome in healthy young adults using sequencing techniques after 3 months of calibrated versus non calibrated interdental brushed, in four standardized sites (between teeth 15-16, 25-26, 35-36, and 45-46). If the specified teeth are missing, exhibit pathologies, or have diastemas preventing interdental cleaning, the sample will be taken from the nearest healthy mesial interdental space.

Time frame: Baseline (T0), 3 months after baseline (T3)

Daily use acceptability of interdental brushes

Evaluation and comparison of the acceptability and ease of integration (by TFA questionnaire) of daily use of calibrated versus non-calibrated interdental brushes, 1 week after baseline (T1), 1 month after baseline (T2) and 3 months after baseline (T3)

Time frame: 1 week after baseline (T1), 1 month after baseline (T2), 3 months after baseline (T3)