The effect of Keyes' method of oral hygiene on the subgingival microflora compared to the effect of scaling and/or surgery

Abstract

This study was conducted on 18 individuals to determine if Keyes'' method of oral hygiene would present an alternative to traditional periodontal therapy in terms of establishing a subgingival microflora compatible with periodontal health. Oral hygiene, gingival conditions and subgingival microbial proportions assessed by dark field microscopy were measured at baseline, then once every 2 wk for the remainder of this 8 wk study. In addition, probing depths an bleeding on probing were evaluated; 9 patients were treated non-surgically, while 9 patients had received surgical therapy within the last 4 yr. Both groups received routine scaling and root planing (Sc/RP) on 1 arch at time 0; both were instructed to use Keye''s method of oral hygiene on 1 side of the mouth while the other side served as a control. This yielded a split-plot experimental design which permitted examination of the effects of Keyes'' method of oral hygiene, Sc/RP and surgery. Results revealed no statistically significant differences between Keye''s method of oral hygiene and conventional oral hygiene in patients treated with a single session of Sc/RP. When scaling was not employed. Keyes'' method was more effective than conventional oral hygiene. Surgical status was found to be the most significant factor in reducing clinical indicator values and establishing control of the subgingival microflora. Oral hygiene alone had only minimal effects on subgingival microbial proportions. The primary antimicrobial effect observed, as evidenced by shifts in subgingival morphotype proportions, was produced by the Sc/RP procedure. This effect was enhanced by improved access (surgical status).