Are oral hygiene instructions with aid of plaque-disclosing methods effective in improving self-performed dental plaque control? A systematic review of randomized controlled trials.

Objectives: To systematically evaluate the literature on whether plaque-disclosing (PD) methods, applied by dental professionals (FQ1) or at-home (FQ2), combined with verbal oral hygiene instructions and brushing demonstration (standard OHI) lead to improvements in self-performed dental plaque control in comparison to standard OHI alone.

Materials And Methods: Seven databases were searched by two independent reviewers according to pre-specified eligibility criteria up to September 2020. No restrictions regarding language, date and type of report were imposed. The Cochrane Collaboration's Risk of Bias tool (RoB 2.0) was used for quality appraisal. Multiple comparisons referring to a single study were included if the articles evaluated different PD agents. Narrative synthesis using evidence tables were performed.

Results: Seven eligible studies were retrieved, including data of 430 individuals (159 wearers of orthodontic appliances). The studies exhibited considerable heterogeneity regarding outcome assessments and follow-up. Eleven (eight corresponding to FQ1 and three to FQ2) out of 13 relevant comparisons found no significant difference between techniques for dental plaque outcomes and three (two corresponding to FQ1 and one to FQ2) out of five comparisons indicated a positive effect of standard OHI with aid of PD methods on gingival inflammation scores. With respect specifically to orthodontic patients, three out of four comparisons indicated significant improvements on gingival inflammation scores for individuals instructed with PD methods.

Conclusion: Clinicians should consider PD agents as adjunct to standard OHI in orthodontic patients. For those without appliances, PD methods can be used as an alternative.