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.