To evaluate patient’ssubjective preferences to scaling with narrow probe-shaped EMS Perio Slim PS tips compared to conventional tip based on pain perception using the Visual Analogue Scale (VAS). Ten patients were treated using a piezoelectric ultrasonic device (EMS) and two different scaler tips representing a conventional scaler tip and a Perio Slim PS scaler tip in a split-mouth design. Pain was evaluated after 2 minutes scaling using Visual Analogue Scale (VAS). Data obtained was analysed by SPSS version 19.0 using Wilcoxon test. Pain assessment after treatment confirmed by the Visual Analogue Scale (VAS) showed that the Perio Slim PS scaler tip (maximum pain score: 4, minimum: 2) caused less pain than the conventional scaler tip (maximum: 8, minimum: 3) (p-value = 0.007). Using Perio Slim PS scaler tip caused less pain and discomfort during scaling treatment when compared with conventional scaler tip.

Background: The influence of scaler tip design on root surface roughness, tooth substance loss and patients' pain perception is investigated. Methods: This article was divided into the following parts: Part 1 Surface roughness and substance loss: an in vitro study, which involves intact extracted teeth sectioned and treated using a piezoelectric ultrasonic device (PM200 EMS Piezon, Switzerland) with a conventional scaler tip (FS-407) and a Perio Slim (PS) scaler tip (Perio Slim DS-016A). All sectioned samples for tooth surface roughness (n=20) and tooth substance loss (n=46) analyses were measured and compared using a 3D surface texture analyser and scanning electron microscope (SEM) respectively, at baseline and following scaling. Part 2 Pain Perception: a clinical study, which was a split-mouth study design including 30 participants with gingivitis and/or mild chronic periodontitis; treated with supra-gingival scaling from teeth #13 to #23. Subjects were randomised to group A or group B. Group A was treated first with PS scaler tips, whereas group B was treated first with conventional scaler tips. Pain perception was recorded using the visual analogue scale (VAS). Results: In vitro study: both scaler tips caused significant reduction in root substance roughness after scaling (p<0.05), but no significant difference between the two scaler tips (p>0.05) was observed. The PS scaler tip caused statistically significantly less root substance loss (p<0.05) when the initial thickness of the tooth was <1000 �m. Clinical study: the participants reported significantly lesser pain score during scaling using the PS scaler tip (median: 3) than when using the conventional scaler tip (median: 5) (p<0.05). Conclusions: In the in vitro study, using a slim scaler tip design causes less tooth substance loss compared to a wider scaler tip design. In the clinical study, less pain was observed compared than a wide (conventional) scaler tip design.

Objective Siwak is a chewing stick used to clean the teeth and oral structures. Many studies have been conducted to assess the potential use of siwak in dentistry and concluded that it can be an alternative to a toothbrush in reducing plaque and gingivitis. However, some observations have reported more periodontal attachment loss and gingival recession among siwak users. This study aimed to compare the periodontal health and oral microbial characteristics between siwak and toothbrush users. Materials and Methods This was a cross-sectional study, and participants were recruited from the public who attended community engagement programs. They were assigned to two groups based on whether they used siwak or a toothbrush. Participants who consented were examined for periodontal health. Supragingival and subgingival plaque samples were collected for bacterial identification and quantification. Statistical Analysis The SPSS package version 21.0 was used for data entry. Data normality was statistically tested using Kolmogorov–Smirnov and Shapiro–Wilk tests, while data comparison used either t-test or Mann–Whitney U test. Results A total of 36 participants were included in this study. The findings revealed that the plaque scores, bleeding scores, and periodontal pocket depths between siwak and toothbrush users were comparable (p > 0.05). Both groups had no evidence of gingival recession. Most participants had bacteria with characteristics of Streptococcus spp., which were present in 12 toothbrush users and 6 siwak users. Conclusions The periodontal health status of siwak users was comparable to that of toothbrush users. Despite this, siwak users had fewer types of bacteria than toothbrush users, suggesting that siwak may serve as an alternative device to conventional toothbrushes for oral hygiene when properly used.