Four years of monthly professional toothcleaning and topical fluoride application in Brazilian schoolchildren. I. Effect on gingivitis.

The effect on gingivitis of monthly professional toothcleaning, without oral hygiene instruction, was evaluated in 103, 7- to 11-year-old Brazilian children. Plaque and gingivitis (PlI and GI) were recorded initially and after 1, 2, 3 and 4 years. The baseline examination showed a similar high level of plaque (PlI approximately 1.55) and low level of gingivitis (GI approximately 0.32) around permanent teeth of both test and control groups. The test children were given monthly professional toothcleaning followed by topical application of fluoride gel (APF), totaling 32 sessions. At all annual follow-up examinations, the mean PlI in the test group was significantly lower than in the control group. However, even in the test group, at least 80% of the tooth surfaces harbored plaque. In spite of this, no child in the test group showed overt gingivitis (mean individual GI greater than or equal to 1.0) and the distribution of "GI score = 2" was very low. In the control group the percentage of children with overt gingivitis increased from 3% at the baseline to 20% at the final examination and areas scoring GI = 2 doubled in number. It is suggested that for young children, monthly thorough removal of plaque is sufficient to prevent the development of gingivitis.