Influence of oral hygiene on the mucosal conditions beneath bridge pontics

The purpose of the present study was to elucidate the relationship between the oral hygiene at the bridge pontic and the inflammatory changes in the adjacent mucosa. The study consisted of three 4-wk periods with different hygienic measures: 1) no oral hygiene around and beneath the pontic, 2) thorough hygiene using toothbrush and toothpicks and 3) thorough hygiene using a toothbrush and dental floss every day. The amount of accumulated bacterial deposits on the pontic and the inflammation in the pontic area were estimated using quantitative microbiologic tests, and clinical and histologic examinations. When dental floss had been used the mucosa was healthy while it showed mild or moderate inflammation after the other experimental periods. There was a high correlation between the amount of mucosal exudate and the inflammation in the mucosa as measured by a modified Gingival Index. Daily use of dental floss resulted in a significantly lower number of microorganisms per mm2 compared with the other hygienic measures. Histologic sections of the biopsies showed changes in form of parakeratosis with thinning or loss of stratum corneum. The investigations have demonstrated that insufficient oral hygiene is an important factor in the development of inflammatory changes in the oral mucosa beneath bridge pontics. Regular use of dental floss ought to be a part of the oral hygiene regimen in patients wearing fixed bridges.