Subgingival Root Brushing in Deep Human Periodontal Pockets

Authors: Lawrence R. Page and Thomas E. Rams


Objective: The short-term clinical and microbiological effects of patient-applied subgingival root brushing were assessed on untreated deep human periodontal pockets. Methods: Assessments of plaque, bleeding on probing, probing depth, total cultivable subgingival counts, and cultivable counts and proportions of six putative periodontal pathogens were carried out at baseline and after 14 days on two contralateral ≥ 6 mm bleeding interproximal posterior sites in each of 11 adults with untreated chronic periodontitis. One of the sites was randomly assigned to daily patient-applied subgingival root brushing for 14 days, and the other to remain with the patient's pre-existing tooth brushing and flossing regimen. No other periodontal therapy was performed during the 14 test days. Results: Significant reductions in plaque, bleeding on probing, probing depth, total subgingival counts, and levels of putative periodontal pathogens were found after 14 days of subgingival root brushing. Subgingival root brushing nearly eliminated bleeding on probing at test sites, reduced probing depths by a mean of 1.8 mm, and reduced cultivable subgingival proportions of six evaluated putative periodontal pathogens from a cumulative total of 14.1% to 0.8%. In comparison, no significant clinical or microbiological changes were detected after 14 days where the patient's pre-existing oral hygiene regimen remained unaltered. Conclusions: Subgingival root brushing over 14 days, in properly trained patients, induced favorable clinical and microbiological changes in deep periodontal pockets ≥ 6 mm even in the absence of professional subgingival debridement

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