Hygiene and health: the value of antiplaque agents in promoting oral health.

The improvements in human health and increased life expectancy which have come about in many societies in the past century have been due, predominantly, to improvements in hygiene--both personal and environmental. As the common oral diseases--caries and gingivitis and to some extent periodontitis--are bacterially mediated diseases, they are also amendable to control by oral hygiene. As commonly practised however, with modern diets, mechanical oral hygiene alone has limited effect on disease incidence. The supplementation of tooth brushing with chemical agents which modulate plaque metabolism and the effects of metabolites on the hard and soft tissues of the dento-gingival structures certainly has preventive and therapeutic value. This is particularly true of fluoridated dentifrices in the control of dental caries, and of dentifrices with antibacterial and anticalculus properties, such as those containing low concentrations of the phenolic compound Triclosan, in the control of gingivitis. Microbial colonisation of tooth and other body surfaces is normal and forms part of the natural defence against dangerous exogenous organisms: thus modulating or 'controlling' plaque, not eliminating it, is the purpose of oral hygiene. The goal is to maintain a microbial ecosystem consistently associated with healthy tissues.