Mini Review Adv Dent & Oral Health
Volume 7 Issue 3 - January 2018
Copyright © All rights are reserved by Rumi Tano
DOI: 10.19080/ADOH.2018.07.555714
Literature Review of Gingival Massage
Rumi Tano*
Department of Health Sciences, Saitama Prefectural University, Japan
Submission: November 06, 2017; Published: January 22, 2018
*Corresponding author: Rumi Tano, Department of Health Sciences, Saitama Prefectural University, Japan, Tel: +81-48-971-0500;
Fax: +81-48-973-4807; Email:
Abstract
Prevention and treatment for periodontal disease have emphasized brushing using a toothbrush as a means of controlling plaque. However,
gingival massage, which is one of the main objectives of brushing using a toothbrush, is also known to be effective and has been employed using
a variety of approaches in recent years. After a multifaceted and comprehensive review of major research reports on gingival massage, we
discovered the importance of gingival massage and simultaneously realized the need to build research outcomes in order to transfer these to
more effective gingival massage practice.
Keywords: Gums; Massage; Literature review
Introduction
Gingival Massage
The main objective of brushing using a toothbrush is to remove
dental plaque and to massage the gums [1]. However, since the role Massage by means of brushing with a toothbrush is only
of dental plaque in the onset of gingivitis was first identified [2], effective immediately below the gums where the toothbrush
plaque control by means of brushing with a toothbrush has been makes contact. Massage reportedly has no effect at 0.5mm or
emphasized in prevention and treatment for periodontal disease. beyond the point of contact with the toothbrush [16] and the
increase in hemoglobin oxygen saturation in the gums only lasts
Some studies have pointed out that gingival massage has a greater
30 minutes [11]. In regard to massage by means of tools other than
promotional effect on gingival cell growth than the removal of
a toothbrush, it is reported from the viewpoint of cell proliferation
dental plaque [3], and that overstimulation from brushing using a
that the efficacy of massage using a sonic toothbrush made of
toothbrush causes gingival laceration and retraction [4]. In recent
silicone rubber can be obtained in a shorter period of time than
clinical dentistry practice in Japan, gingival massage done by hand
massage using a regular manual toothbrush [17]. Furthermore, it
by dental professionals has been performed as part of professional
is reported that a greater post-massage increased blood flow and
care at some clinics to alleviate mental strain and increase gingival
a longer duration of increase are achieved through massage with
blood flow in patients during dental consultations [5]. We hereby
an originally developed electric gum massager with a rubber tip
review previous research into gingival massage by considering the
than through massage with a normal bristled toothbrush or the
effects of gingival mechanical stimulation.
fingers [18].
Effects of Mechanical Stimulation of the Gums
Many previous studies regarding gingival massage using the
The efficacy of gingival massage in increasing peripheral fingers have been done in young people and merely evaluate
circulation [6], promoting metabolic function and improving temporary changes measured in gingival blood flow before
inflammation in the gums has long been disputed [7,8]. Animal and after gingival massage by a practitioner [5,18]. The effects
experiments have shown that mechanical stimulation of the of materials and shapes that come into direct contact with the
gums activates microcirculatory function in gingival tissue [9], gums during gingival massage therefore need to be elucidated
promotes keratinization of gingival epithelium [10], improves and discussed. Investigation into changes over time and the long-
oxygen sufficiency of the gums [11], reduces gingival crevicular term effects of gingival massage using clinical evaluations is also
fluid volume [12], increases capillary permeability [13], and needed in subjects of a wider range of ages.
enhances proliferative activity of crevicular epithelial basal cells
It is important to apply stimulation as far as the attached
[3]. Mechanical stimulation by brushing using a toothbrush is
gingiva in gingival massage in order to achieve a greater and more
also reported to lead to increased gingival oxygen saturation and
prolonged effect that extends to the attached gingiva as well as the
temperature in human gums [14,15].
marginal gingiva [11]. Furthermore, to achieve a lasting gingival
Adv Dent & Oral Health 7(3) : ADOH.MS.ID.555714 (2018) 001
Advances in Dentistry & Oral Health
massage effect, gingival massage needs to be performed at least 7. Leonard HJ (1948) Is massage a valuable treatment in gingivitis and
once a day [19]. The functions of both mechanical stimulation periodontitis? J Periodontol 19(2): 63-79.
using devices such as toothbrushes and physical stimulation using 8. Hirschfeld I (1951) Gingival massage J Am Dent Assoc 43(3): 290-304.
the fingers therefore need to be clarified and applied in clinical 9. Tanaka M, Hanioka T, Kishimoto M, Shizukuishi S (1998) Effect of
practice. Future research should focus especially on clarifying the mechanical toothbrush stimulation on gingival microcirculatory
action and effects at the point of contact with the finger during functions in inflamed gingiva of dogs. J Clin Periodontol 25(7): 561-
565.
gingival massage and on proposing methods of gingival massage
supported by scientific evidence. 10. Caffesse RG, Nasjleti CJ, Kowalski CJ, Castelli WA (1982) The effect of
mechanical stimulation on the keratinization of sulcular epithelium. J
Conclusion Periodontol 53(2): 89-92.
11. Tanaka M, Hanioka T, Kishimoto M, Shizukuishi S (1997) Comparisons
Gingival massage is important for the removal of dental plaque of modalities of mechanical stimulation with a toothbrush on
and the prevention and treatment of periodontal disease. Research improvement of oxygen sufficiency in dog gingiva. J Clin Periodontol
to date into the effects of gingival massage has been conducted with 24(9 Pt 1): 632-635.
a focus on basic research. Moving forward, scientific evidence for 12. Mackenzie IC (1972) Does tooth brushing affect gingival keratinization?
gingival massage needs to be accumulated through investigative Proc R Soc Med 65(12): 1127-1131.
research focusing on clinical evaluations, which should contribute 13. Brill N (1959) Influence of capillary permeability on flow of tissue
to the study of more effective gingival massage measures. fluids into gingival pockets. Acta Odontologica Scandinavica 17(1): 23-
33.
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(2002) Tooth brushing promotes gingival fibroblast proliferation more Spatial extent of gingival cell activation due to mechanical stimulation
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4. Smukler H, Landsberg J (1984) The toothbrush and gingival traumatic Gingival cell proliferation induced by use of a sonic toothbrush with
injury. J Periodontol 55(12): 713-719. warmed silicone rubber bristles. J Periodontol 75(12): 1636-1639.
5. Tamiyo Asaga, Tomoko Aso, Yuko Suzuka, Kazuyo Kusaka, Naomi 18. Atsue Matsumoto (2008) Evaluation of Usefulness of Self-made
Yoshida, et al. (2014) Changes in physiological responses through gum Electronic Device for Gingival Massage Part 1: Effects on Changes of
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002 How to cite this article: Rumi Tano. Literature Review of Gingival Massage. Adv Dent & Oral Health. 2018; 7(3): 555713. DOI: 10.19080/ADOH.2018.07.555714
