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Meta-Analysis
. 2017 Dec;67(6):332-343.
doi: 10.1111/idj.12317. Epub 2017 Jun 23.

The association between oral hygiene and periodontitis: a systematic review and meta-analysis

Attawood Lertpimonchai  1   2 , Sasivimol Rattanasiri  1 , Sakda Arj-Ong Vallibhakara  1 , John Attia  3   4 , Ammarin Thakkinstian  1
Affiliations
Meta-Analysis

The association between oral hygiene and periodontitis: a systematic review and meta-analysis

Attawood Lertpimonchai et al. Int Dent J. 2017 Dec.

Abstract

Objective: Dental plaque accumulation and inadequate personal oral hygiene (OH) are known major risk factors of periodontitis. Nevertheless, the magnitude of their effects has not yet been the subject of a meta-analysis.

Material and methods: The Medline and Scopus databases were searched up to May 2016. Observational studies were eligible if they assessed associations between OH and periodontitis in adult subjects. A multivariate random-effects meta-analysis was used to pool the effects of fair/poor OH versus good OH on periodontitis across studies. The associations between oral care habits and periodontitis were also assessed.

Results: A total of 50 studies were eligible; 15 were used for pooling the effect of fair OH versus good OH and poor OH versus good OH on periodontitis, with pooled odds ratios (ORs) of 2.04 [95% confidence interval (CI): 1.65-2.53] and 5.01 (95% CI: 3.40-7.39), respectively. Eleven studies examined oral care habits measured according to toothbrushing regularity and dental visit frequency; pooled ORs of 0.66 (95% CI: 0.47-0.94) and 0.68 (95% CI: 0.47-0.98) were obtained, respectively.

Conclusions: Fair to poor OH increases the risk of periodontitis by two- to five-fold. This risk can be reduced by regular toothbrushing and dental visits.

Keywords: Meta-analysis; oral hygiene; periodontitis; risk factor; systematic review.

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Figures

Figure 1.
Figure 1.
Flow chart of identification and selection of studies. OH, oral hygiene; OHI, Oral Hygiene Index; PI, Plaque Index; PSc, plaque score.
Figure 2.
Figure 2.
Pooling effects of fair oral hygiene (OH) versus good OH (a) and poor OH versus good OH (b) on periodontitis. 95% CI, 95% confidence interval; OR, odds ratio.
Figure 3.
Figure 3.
Pooling odds ratios (ORs) of plaque index (a) and plaque score (b) on periodontitis.
Figure 4.
Figure 4.
Pooling effect of oral care habits – toothbrushing (a), flossing (b) and dental visits (c) –on periodontitis.
Figure 5.
Figure 5.
Summary of pooled effect of oral hygiene (OH) and oral care habits on periodontitis. OR, odds ratio.
See this image and copyright information in PMC

Comment in

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