Interdental hygiene index - A proposal of dual-purpose tool for patient assessment and motivation

Abstract

Background: Interdental areas are more prone to plaque accumulation, thereby increasing the susceptibility for periodontal diseases. Proper method of interdental hygiene assessment and motivation to use interdental aids can potentially reduce the burden of periodontal diseases.

Materials and methods: Fifty consecutive volunteer participants who presented with gingival inflammation were recruited based on the set of inclusion criteria. Further, proposed interdental hygiene index (IDHI) and gingival index were recorded by the examiner. Patient-reported outcome measures (PROMs) were recorded on the baseline and 4-week follow-up visits. Descriptive statistics and correlation analysis were performed.

Results: The study comprised 50 participants with 22 male and 23 female participants. At baseline, the mean/standard deviation of IDHI was 1.32 ± 0.10 and 0.62 ± 0.21 on follow-up, respectively. For Gingival Index (GI) at baseline, the mean/standard deviation was 1.61 ± 0.15 and 0.70 ± 0.24 on follow-up, respectively. Correlation analysis revealed a significant correlation between IDHI and GI at baseline and follow-up. Majority of the participants scored 0 on the Visual Analogue Scale (VAS) for pain, rated "Good" for acceptability of procedure and perceived efficacy of interdental brush. Participants reported to have acquired "High level of motivation" to use an interdental brush.

Conclusion: IDHI is a simple and reliable tool to assess the interdental areas of the patient and motivate to use interdental brush for the maintenance of good oral hygiene. PROMs also revealed positive responses from participants.

Keywords: Dental hygiene; gingivitis; index; interdental access probe; interdental brushes; interproximal cleaning; preventive dentistry.

Figure 1

Interdental brush and interdental access probe, IDB - Interdental brush: IAP - Interdental Access Probe

Figure 2

Illustration of use of interdental access probe and interdental brush. (a) (Left) interdental access probe indicates – Blue (0.6mm) and corresponding interdental brush is used. (Right); (b) (Left) interdental access probe indicates – Red (0.7mm) and corresponding interdental brush is used. (Right); (c) (Left) interdental access probe indicates – Pink (0.8mm) and corresponding interdental brush is used. (right); (d) (Left) interdental access probe indicates – Yellow (0.9mm) and corresponding interdental brush is used. (Right); (e) (Left) interdental access probe indicates – Yellow (1.1mm) and corresponding interdental brush is used. (Right)

Figure 3

Chart for Interdental brush size determination and recording of interdental hygiene index. Arrows indicate the interdental area, mention the color obtained in interdental access probe. Mention the Interdental hygiene scores in the respective boxes

Figure 4

Illustration of scoring data and calculation of interdental hygiene index – interdental hygiene index