Effectiveness of the Touch-to-Teach Method for Interdental Brushing in Patients With Stage II Grade B Periodontitis.

Effectiveness of the Touch-to-Teach Method for Interdental Brushing in Patients With Stage II Grade B Periodontitis. A Randomized Clinical Trial

In 2018, a collaboration between American Academy of Periodontology (AAP) and European Federation of Periodontology (EFP) yielded a new classification system for periodontal diseases and conditions. The new classification categorized periodontitis into stages from I to IV based on the severity of the disease. Besides the stages, cases were also categorized into A, B and C grades based on the probable progression of the disease. Likewise, cases with interproximal clinical attachment loss of 3-4 mm in the worst affected teeth are considered to be stage II periodontitis.[3] These patients usually do not have tooth loss, can be suffering from localized or generalized type and mostly show horizontal bone loss. There are three types of gingival embrasures. In type I embrasure, the gingival embrasure is filled by the interproximal papilla; whereas in type II and III embrasures interdental papilla loss is seen. Interdental brushing has a vital role in maintaining good oral hygiene and previously published reports have evidenced that successful interdental brushing eliminated interdental plaque below the gingival margin up to 2-2.5 mm. According to the old school of thought, dental floss was advised for type I embrasures, interdental brushes for type II embrasures and unitufted brushes for type III embrasures. Usage of dental floss has been identified to be cumbersome and especially challenging in posterior regions of the oral cavity. Additionally, a recent systematic review in the Cochrane database highlighted the effectiveness of interproximal brushes over dental floss.[9] Recently, the implementation of calibrated interdental brushes use with the availability of interdental brushes with varying sizes, added effectively in creating a healthy interdental papilla in a safe manner. Essentially, a patient-centered and personalized approach named "individually trained oral prophylaxis (iTOP)" has recently been suggested as a solution to remove dental plaque effectively.[10] This concept known as the "Touch-to-Teach" concept provides the patients with an effective method to educate the patients an effective and non-traumatic way of removing interdental plaque.[10] Although, the effectiveness of calibrated interdental brushes showed high efficacy in cases of gingivitis, currently, the effectiveness of these brushes in stage II periodontitis has not been comprehensively studied yet in literature.

Study Overview

• Status: Active, not recruiting
• Conditions: Periodontitis; Oral Hygiene
• Intervention / Treatment: Procedure: Interproximal standard hygiene care control group; Procedure: Interproximal "Touch-to-Teach" method hygiene care test group

• Study Type: Interventional
• Enrollment (Actual): 40
• Phase: Not Applicable

Contacts and Locations

Study Locations

• United Arab Emirates
  • Ajman, United Arab Emirates
    • Gulf Medical University

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult; Older Adult
• Accepts Healthy Volunteers: Yes

Description

Inclusion Criteria:

1. Patients with generalized Stage II periodontitis, diagnosed based on the 2018 classification of periodontal diseases and conditions.[7]
2. Patients with presence of interproximal clinical attachment loss of ≥ 3-4 mm was used for the diagnosis of periodontitis.
3. Patients with more than 30% of sites with true periodontal pockets of more than 4 mm with bleeding on probing in the interproximal region.

Exclusion Criteria:

1. Patients with uncontrolled diabetes mellitus,
2. Patients smoking ≥ 10 cigarettes per day.
3. Patients who have undergone scaling and root debridement within the past six months
4. Patients who were on antimicrobial therapy in the past three months
5. Patients who were on regular use of anti-plaque mouth rinses in the past three months

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Supportive Care
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: Single

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Active Comparator: Interproximal standard hygiene care control group: The control group was provided with standard oral hygiene instructions (Bass method) and videos regarding maintenance of interdental oral hygiene were provided. Videos regarding oral hygiene maintenance were downloaded from the website of the EFP. Briefly, these animated videos are generated from PerioPixel, which specializes in the generation of animated videos in dentistry, explaining the different oral hygiene techniques and treatments for gingival and periodontal diseases.	Procedure: Interproximal standard hygiene care control group; The control group was provided with standard oral hygiene instructions (Bass method) and videos regarding maintenance of interdental oral hygiene were provided. Videos regarding oral hygiene maintenance were downloaded from the website of the EFP. Briefly, these animated videos are generated from PerioPixel, which specializes in the generation of animated videos in dentistry, explaining the different oral hygiene techniques and treatments for gingival and periodontal diseases.
Experimental: Interproximal "Touch-to-Teach" method hygiene care test group; The test group received interdental hygiene care using the "Touch-to-Teach" method. The Curaprox chairside system includes a range of color-coded interdental brushes selected according to the size of the patient's interdental spaces. The brushes are color-coded as blue, red, pink, yellow, and green, with blue with an interdental accessibility diameter of 0.6m, 0.7 mm, 0.8 mm, 0.9 mm, and 1.1 mm respectively . The kit also contains color-coded colorimetric probes (interdental access probes) that can be used to measure the size of the interproximal space.	Procedure: Interproximal "Touch-to-Teach" method hygiene care test group; The test group received interdental hygiene care using the "Touch-to-Teach" method. The Curaprox chairside system includes a range of color-coded interdental brushes selected according to the size of the patient's interdental spaces. The brushes are color-coded as blue, red, pink, yellow, and green, with blue with an interdental accessibility diameter of 0.6m, 0.7 mm, 0.8 mm, 0.9 mm, and 1.1 mm respectively. The kit also contains color-coded colorimetric probes (interdental access probes) that can be used to measure the size of the interproximal space.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Time Frame
Plaque index	baseline and 3 months

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Bleeding index		baseline and 3 months
Patient Satisfaction VAS scale 0-5	VAS scale 0-5	3 months

Collaborators and Investigators

• Sponsor: Gulf Medical University

Study record dates

Study Major Dates

• Study Start (Actual): January 1, 2025
• Primary Completion (Actual): February 1, 2026
• Study Completion (Estimated): June 10, 2026

Study Registration Dates

• First Submitted: June 7, 2026
• First Submitted That Met QC Criteria: June 10, 2026
• First Posted (Actual): June 16, 2026

Study Record Updates

• Last Update Posted (Actual): June 16, 2026
• Last Update Submitted That Met QC Criteria: June 10, 2026
• Last Verified: June 1, 2026

More Information

Terms related to this study

• Additional Relevant MeSH Terms: Periodontal Diseases; Mouth Diseases; Stomatognathic Diseases; Periodontitis
• Other Study ID Numbers: 2022MDSPerio04

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: UNDECIDED

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No