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PubMed2006

The effects of load and toothpaste on powered toothbrush vibrations.

OBJECTIVES: The primary cleaning action of powered toothbrushes is the motion of the bristles in contact with the tooth surfaces. The aim of this study was to use scanning laser vibrometry to determine the effects of load and toothpaste on the bristle vibration characteristics of four powered toothbrushes (Oral-B Sonic Complete; Oral-B Professional Care 8000 Series; Sonicare Elite and Ultrasonex). METHODS: Toothbrushes were initially scanned, with the laser vibrometer, under unloaded conditions to provide baseline readings. Toothbrushes were then assessed under loaded conditions (1.00 N and 2.00 N), with and without toothpaste, to observe the effect on bristle motion. RESULTS: Application of 1.00 N load significantly reduced the displacement amplitudes of all powered toothbrushes (p<0.003) except for the Sonicare (p>0.497). With toothpaste, 1.00 N load caused a significant decrease in vibration displacement amplitude for all brushes (p<0.0001). The application of 2.00 N, with and without toothpaste, significantly reduced all toothbrushes vibration displacement amplitude (p<0.0001). Under all investigation conditions, the Oral-B 8000 had the largest vibration displacement amplitude of the toothbrushes tested. CONCLUSIONS: Load and toothpaste significantly affected the performance of powered toothbrushes. Understanding why these factors affect certain toothbrush designs more than others may lead to toothbrushes being designed with greater clinical efficacy.

Analysis of Variance↗
PubMed1998

Effect of brushing with sonic and counterrotational toothbrushes on the bond strength of full veneer crowns.

STATEMENT OF PROBLEM: Earlier studies on orthodontic brackets have shown a loss of bond strength after a sonic toothbrush was used. PURPOSE: This in vitro study evaluated the difference in bond strength of single complete veneer crowns after being subjected to the equivalent of 2 years of brushing with sonic and counterrotational toothbrushes. MATERIAL AND METHODS: Complete gold crowns were fabricated with a conventional indirect technique for 30 extracted, intact, prepared human premolar teeth. Castings were then luted to the teeth with glass ionomer cement. Teeth were randomly divided into 3 groups of 10 teeth each, 1 group to be brushed with Sonicare sonic toothbrush, 1 group to be brushed with Interplak counterrotational mechanical toothbrush, and 1 group as the control. Groups 1 and 2 were then brushed for the equivalent of 2 years per tooth. A uniform force of 50 g for the sonic toothbrush and 120 g for the counterrotational toothbrush was used. Control specimens were not brushed. Brush heads and sample teeth in contact with the toothbrush were kept moist at all times. Tensile dislodgment force was determined with an Instron universal testing machine. RESULTS: The castings brushed with a sonic toothbrush required a mean of 43.22 kg (+/- 11.16) force to remove the crowns from the teeth, whereas the counterrotational group required a mean of 42.87 kg (+/- 10.42) and the control group a mean of 42.12 kg (+/- 6.61). Analysis of variance on the force data indicated no differences among the 3 groups in the force needed to remove the castings (F[2,24] = 0.031, P = .97). CONCLUSION: This in vitro study demonstrated no significant differences between groups in the amount of tensile dislodgment force required to remove cemented full veneer crowns from prepared teeth after brushing for the equivalent of 2 years time with a sonic toothbrush or a counterrotational toothbrush.

Analysis of Variance↗
PubMed2004

Power toothbrushes: a critical review.

Although the first toothbrush is thought to have been used in about 1000 ad, tooth brushing in America did not gain popularity until after 1945. The introduction of the powered toothbrush in 1960 has led to a large number of studies comparing the safety and efficacy of powered toothbrushes to manual toothbrushes. There is a general agreement that powered toothbrushes are as safe as manual toothbrushes; however, studies show significantly differing conclusions regarding the efficacy of power toothbrushes for the removal of plaque. The recent amendment of the Cochrane report on this subject concluded that the only type of powered toothbrush that removes more plaque than a manual toothbrush is one with rotational oscillation movement. Their conclusion was based on the review of 29 published studies, conducted between 1964 and 2001, with a total of 2547 participants. All these studies used similar research design criteria. The Cochrane conclusion is in agreement with a 1996 study carried out in the Netherlands. Many of the conflicting study conclusions, to date, on powered toothbrushes, are the result of using differing study design criteria. While the dental profession desires evidence-based research, it is clear that dental schools will need to increase the level of attention in their curriculum to address disciplined techniques for research design in order to reconcile the large variances in reported research results.

Dental Plaque↗
PubMed2006

Caregivers' perceptions of electric versus manual toothbrushes for the institutionalised elderly.

OBJECTIVE: To evaluate how caregivers feel about the use of electric vs. manual toothbrushes for the elderly in long-term care. MATERIALS AND METHODS: After electric toothbrushes had been accessible in an institution for 15 months, a self-administered questionnaire was distributed to the nursing staff. The questions posed were whether the electric toothbrushes were being used, how much time was spent on brushing and if electric toothbrushes simplified the provision of oral care for the residents. RESULTS: The response rate was 79%. Of the 119 respondents, 78% replied that they always or frequently used an electric toothbrush. With regard to brushing times, 44% of the respondents reported that they spent less time on oral care procedures with an electric toothbrush than with a manual one. Equal amount of time for both types of toothbrushes was reported by 53%. Only 3% reported spending more time with an electric toothbrush than with a manual one. Oral care procedures were considered simpler with this device by 63% of the respondents, 22% registered no change and 15% found it more difficult. If patients suffering from dementia were considered separately, 45% found the procedures simpler when using electric toothbrushes, 24% registered no difference and 31% found it more difficult. CONCLUSION: The findings indicate that when given the choice, the caregivers prefer to use electric toothbrushes rather than manual ones as they feel this is simpler and often less time-consuming.

Aged↗
PubMed2004

Gingival cell proliferation induced by use of a sonic toothbrush with warmed silicone rubber bristles.

BACKGROUND: Toothbrushing promotes gingival cell proliferation, which may occur as the result of the physical stimulation of the gingiva. The present study evaluated the effects of temperature and silicone rubber bristles of a sonic toothbrush on gingival cell proliferation in dogs. METHODS: During the 5-week experimental period, one quadrant in each of eight dogs received a different toothbrushing regimen: a manual toothbrush or a sonic toothbrush with 1) nylon, 2) silicone rubber, or 3) warmed silicone rubber bristles. The proliferative activity of gingival cells was evaluated based on expression of proliferating cell nuclear antigen (PCNA). RESULTS: Use of the sonic toothbrushes produced a higher density of PCNA-positive and total fibroblasts than did use of a manual toothbrush. The warm silicone rubber bristles resulted in a higher density of PCNA-positive fibroblasts compared with the cooler silicone rubber bristle. The number of PCNA-positive basal cells in the junctional epithelium also increased following electric toothbrushing with warmed silicone rubber bristles. CONCLUSIONS: The sonic toothbrush with silicone rubber bristles induced gingival fibroblast proliferation to a greater degree than a manual toothbrush. Warming the silicone rubber bristles increased their stimulatory effects on the proliferative activity of gingival cells.

Analysis of Variance↗
PubMed2001

Longitudinal study to assess the effectivity of electric and manual toothbrushes for children.

BACKGROUND: Prophylaxis efforts for the maintenance of tooth health led to a distinctive decrease in caries frequency with children and young persons. Because the toothbrush can still be described as the most important oral hygiene aid, possible differences between the effectivity of electric and manual toothbrushes should be tested in the present study. Elementary school children had been instructed--within a special prophylaxis program--over a period of three years to clean their teeth partly with electric partly with manual toothbrushes. MATERIAL AND METHODS: In two parallel classes (1st class) of the same elementary school (Private Martinusschule Mainz-Gonsenheim) the A-class (n = 24 children) was instructed to clean their teeth with a manual toothbrush suitable for children (Oral-B, Power Tip, Braun AG, Kronberg, Germany) whereas the B-class (n = 26) received electric toothbrushes (Oral-B-7 EB 5 K, Braun AG, Kronberg, Germany). Every three months the children were instructed in group-preventive methods in school, followed by cleaning instructions, remotivations and the distribution of new electric respectively manual toothbrushes. In order to record the influence of the intensive quarterly oral hygiene instruction, elementary school children (1st class) of the same school type were looked after and examined within the yearly group prophylaxis (n = 40). The yearly dental examinations included the recording of carious frequency (DMF-T, dmf-t), approximal plaque accumulation (API), and the evaluation of the gingival state (GI-Index) as well as the present dental restorative materials. RESULTS: After an investigation period of three years no essential differences regarding caries frequency, proportion of dentitions of natural state of health and plaque involvement were found with the children of the respective classes. Children using electric toothbrushes showed after 3 years 27% of healthy-natured dentitions on average (46% of the children had got API-values of up to 30%) and the children who used manual toothbrushes showed 22% of nature-healthy dentitions (52% of the children had got API-values of up to 30%) and in 33% of the control children who received instructions only once a year healthy-natured dentitions were found after 3 years (75% of the children had got API-values of up to 35%). CONCLUSIONS: With regard to caries and gingivitis prevalence modern electric toothbrushes for children can be considered equally efficient like conventional manual toothbrushes for children with children of normal caries risk.

Child↗
PubMed2000

An advanced toothbrush with improved plaque removal efficacy.

PURPOSE: To compare the plaque removal efficacy and safety of a new advanced manual toothbrush, the Oral-B CrossAction, with seven other toothbrushes. MATERIALS AND METHODS: Seven independent, cross-over design clinical studies were conducted using the same examiner who was blind to the identity of the test products and treatment assignments. In each study, approximately 75 healthy adult subjects from a general population brushed with their randomly assigned toothbrush (CrossAction or comparison brush) at Visit 1 for 1 min without supervision or instruction in brushing technique. Subjects returned after a 1-week washout period and brushed with the alternate toothbrush (Visit 2). Plaque was evaluated before and after brushing using the Rustogi Modified Navy Plaque Index. Statistical analyses were conducted by an independent statistician who remained blind to the identity of all test products. RESULTS: Each of the toothbrushes tested provided significant (P < or = 0.0001) reductions in plaque scores after a single brushing. In each of the studies, the CrossAction toothbrush removed significantly (P < or = 0.0001) greater amounts of whole mouth, gingival margin, and approximal plaque than the compared toothbrush. All toothbrushes were found to be safe, with no changes in oral tissues or restorations observed over the course of each study. The results from these studies were consistent, demonstrating that the CrossAction toothbrush significantly enhances the ability of subjects to remove more plaque during normal brushing compared to seven other toothbrushes.

Adult↗
PubMed1999

The effectiveness of an ionic toothbrush in the removal of dental plaque and reduction on gingivitis in orthodontic patients.

This investigation was undertaken to determine if an ionic toothbrush was effective at removing plaque and reducing gingivitis in patients wearing orthodontic appliances. Fifty-two orthodontic patients were randomly assigned to one of two groups and completed a six-week double-blind study. Group 1 consisted of the test group using the ionic toothbrush with an active battery; group 2 consisted of the control group using the ionic toothbrush with an inactive battery. The plaque and gingival indices were measured at baseline, two weeks, and six weeks. The findings demonstrated that the active ionic toothbrush was no more effective at plaque removal and gingivitis reduction than the inactive toothbrush. Although the active toothbrush did effectively remove plaque and reduce gingivitis over the course of six weeks, it showed no significant improvement over the same toothbrush that contained an inactive battery. It was observed that the ionic toothbrush effectively reduced plaque and gingivitis regardless of the presence or absence of an active battery. The clinical findings demonstrated that an active ionic toothbrush was no more effective in removing plaque and reducing gingivitis in patients with orthodontic appliances than an inactive ionic toothbrush.

Adolescent↗
PubMed2002

Dental plaque removal with two battery-powered toothbrushes.

PURPOSE: To compare the plaque removal efficacy of a positive control power toothbrush (Colgate Actibrush) to an experimental power toothbrush (Crest SpinBrush) following a single use. MATERIALS AND METHODS: This study was a randomized, controlled, examiner-blind, 4-period crossover design which examined plaque removal with the two toothbrushes following a single use in 39 completed subjects. Plaque was scored before and after brushing using the Turesky Modification of the Quigley-Hein Index. RESULTS: Baseline plaque scores averaged 2.18 and 2.16 for the experimental toothbrush and control toothbrush treatment groups, respectively. With respect to all surfaces examined, the experimental toothbrush delivered an adjusted (via analysis of covariance) mean difference between baseline and post-brushing plaque scores of 0.66 while the control toothbrush delivered an adjusted mean difference of 0.43. This represents an increase of 55% plaque removal relative to the control power toothbrush. The difference between brushes was statistically significant (P < 0.001). With respect to buccal and lingual surfaces, the experimental toothbrush delivered very consistent results relative to the control toothbrush. The differences between brushes were also statistically significant (P < 0.001).

Adolescent↗
PubMed2002

A study to assess the safety and tolerability of three toothbrushes.

This study evaluated the oral soft tissue safety and tolerability of an experimental powered toothbrush (Crest SpinBrush Pro) compared to two leading manual toothbrushes: an advanced-design manual toothbrush (Oral-B CrossAction) and a flat-trimmed toothbrush (Oral-B 40 Indicator). Manual brushes are generally viewed as safe for use, and as such are appropriate controls. A total of 140 subjects was enrolled in this single-center, randomized, examiner-blind parallel study over a four-week test period. Subjects were instructed to brush in their normal manner, twice per day for 60 seconds per use. An oral soft tissue interview and examination were conducted by a trained dentist examiner at baseline, as well as three days and four weeks after baseline to assess clinical signs and symptoms of oral irritation associated with use of the toothbrushes. Overall, there were 19 adverse events reported for 18 subjects (13% of the population). The adverse events were distributed across test groups with five subjects in the experimental powered brush group, eight in the advanced design manual toothbrush group and five in the flat-trimmed toothbrush group experiencing at least one adverse event. The most frequently reported adverse event was localized irritation/inflammation of the gingiva. All adverse events were mild in severity except for one report of severe hyperesthesia (tooth sensitivity) in the advanced-design manual toothbrush group. There were no statistically significant differences between the groups for the proportion of subjects reporting adverse events at either three days or four weeks of product use. The results of this study indicate that daily use with the Crest SpinBrush Pro powered toothbrush is at least as safe as two leading manual toothbrushes.

Adult↗
PubMed2003

Comparative clinical study in plaque removal efficacy of a new sonic toothbrush (Float-Brush) with floating bristle action.

OBJECTIVE: Floating action toothbrush bristles have been incorporated into a V-shaped sonic toothbrush. The base of the bristles moves down or up according to the pressure of the toothbrush being applied to a tooth surface. It was thought that this floating action with sonic vibration may generate new motion for increased plaque removal efficacy through increased contact between bristles and tooth surfaces. The objective of this investigation was to compare the plaque removal efficacy of a sonic toothbrush with floating bristle action (Float-Brush) to either a conventional V-shaped sonic toothbrush (Techno-Brush) or a manual toothbrush. MATERIALS AND METHODS: A single-blind, three-treatment cross-over study was performed on 42 subjects. Each subject refrained from brushing for 24 hours, followed by assessment for dental plaque on the Ramfjord teeth employing the Rustogi Modified Navy Plaque Index. Plaque removal efficacy was determined by the percentage of plaque score reduction in a single-use toothbrushing under supervision for two minutes. RESULTS: Forty participants completed this study. No significant difference in pre-brushing plaque scores was detected among the three toothbrushes. In the comparison of whole mouth mean scores, plaque removal efficacy of the Float-Brush (65.0%) was significantly higher than that of the Techno-Brush (59.1%, p = 0.0487) and the manual toothbrush (50.9%, p < 0.0001). Superiority of the Float-Brush was similar to whole mouth scores, when comparing the gumline and interproximal tooth area scores. CONCLUSION: These findings indicate the superiority of the Float-Brush for plaque removal compared to the Techno-Brush and the manual toothbrush.

Adult↗
PubMed2004

Tooth whitening effects of an experimental power whitening toothbrush relative to an 8.7% hydrogen peroxide paint-on gel control.

PURPOSE: To assess the whitening efficacy of a new whitening power toothbrush, designed specifically for the removal of extrinsic stains, relative to an 8.7% hydrogen peroxide paint-on gel control. METHODS: This study was a randomized, single center, two-treatment, parallel design, 4-week, controlled study (n = 27) conducted to measure the whitening ability of an experimental power toothbrush relative to a peroxide paint-on gel control used in conjunction with a manual toothbrush. Subjects were randomized to the experimental battery-powered toothbrush group (twice a day brushing with Crest Cavity Protection dentifrice for 2 minutes each time) or the peroxide paint-on gel control group who applied Colgate Simply White Night per manufacturer's instructions once a day prior to bedtime for the first 14 days of the study as well as brushed twice a day with Crest Cavity Protection dentifrice for 2 minutes using the ADA manual reference toothbrush over the 4-week study period. Study evaluations included objective digital image analysis (L* a* b*) and oral soft tissue examinations at baseline, Week 2 and Week 4. In addition, a pilot, single center, 1-week study (n = 9) was conducted to measure the absolute whitening ability of the experimental power toothbrush as measured by digital imaging analysis in a high stain population, induced by 1 week of rinsing with tea. Study evaluations included digital image analysis (L*a*b*) and oral soft tissue examinations at baseline and Week 1 following brushing with the experimental power toothbrush. RESULTS: In the comparative study, the average baseline L*, b*, and W* values were well-balanced across treatment groups. At the Week 2 visit, adjusted (via ANCOVA) mean deltaL*, delta(a)*, delta(b)* and deltaW* values of 0.08, -0.41, -0.08, and -0.28, respectively, were observed in the peroxide paint-on control group, relative to adjusted mean deltaL*, delta(a)*, delta(b)* and deltaW* values of 0.16, -0.19, -0.38, and -0.33, respectively, in the experimental power toothbrush group. No statistically significant differences were observed between the two treatment groups for any of the endpoints. However, delta(b)* and deltaW* values for the experimental power toothbrush group were statistically significantly improved relative to baseline. At the Week 4 visit, adjusted (via ANCOVA) mean deltaL*, delta(a)*, delta(b)* and deltaW* values of -0.15, -0.24, -0.14, and -0.04, respectively, were observed in the peroxide paint-on control group, relative to adjusted mean deltaL*, delta(a)*, delta(b)* and deltaW* values of 0.02, -0.12, -0.22, and -0.15, respectively, in the experimental power toothbrush group. No statistically significant differences were observed between the two treatments groups for any color endpoints of deltaL*, delta(a)*, delta(b)*, or deltaW*. In the induced stain study, the average baseline L*, a*, b*, and W* values were 71.21, 8.28, 19.01, and 35.52, respectively. At the Week 1 visit, the mean deltaL*, delta(a)*, delta(b)*, and deltaW* values were 0.55, -0.27, 0.00, and -0.51 respectively. The deltaL* and deltaW* were statistically significantly improved (P < 0.05) relative to baseline.

Adult↗
PubMedDate not supplied

Comparison of powered and manual toothbrushes for plaque removal by 4- to 5-year-old children.

PURPOSE: This study compared the small head Oralgiene 60 Second Time Machine powered toothbrush, used for 60 seconds, with the Braun Oral-B Mickey Mouse powered toothbrush and a manual toothbrush (Oral-B Rugrats 20), each used for 2 minutes, for efficacy in plaque removal and reduction of gingival inflammation in young children. METHODS: Fifty-eight children, ages 4 to 5 years old, were randomly assigned to one of the 3 toothbrush groups. At visit 1, plaque and gingival indices were recorded for all subjects. Then, the children did not brush for 24 hours. At visit 2, 24 hours later, plaque indices were recorded, the children brushed with their assigned toothbrush, and plaque indices were recorded again. Six weeks later, plaque and gingival indices were recorded again. The data was analyzed to detect plaque reduction after a one-time use (visit 2, prebrushing and postbrushing) as well as plaque and gingival inflammation reduction after 6 weeks of use. RESULTS: The Oralgiene toothbrush removed significantly more plaque during the one-time trial and reduced significantly more gingival inflammation during the 6-week trial. The Braun Oral B powered toothbrush removed significantly more plaque than the other toothbrushes during the 6-week trial. However, no clinically meaningful differences were found between any of the toothbrushes with regard to plaque removal or gingival scores. CONCLUSIONS: There were no clinically meaningful differences found between any of the toothbrushes tested during either of the trials with regard to plaque removal or improvement in gingival health.

Analysis of Variance↗
PubMed2004

Clinical efficacy of Colgate 360 degrees and three commercially available toothbrushes on the removal of desquamated epithelial cells.

A clinical study was done to evaluate the performance of four toothbrushes on the removal of desquamated epithelial cells after brushing according to the manufacturers' instructions for use. This randomized, crossover-design clinical study compared a new manual toothbrush (Colgate 360 degrees) to two commercially available manual toothbrushes (Oral-B CrossAction and Oral-B Indicator) and a commercially available battery-powered toothbrush (Crest SpinBrush PRO). Adult men and women subjects reported to the clinical facility after a 1-week "washout" period of brushing with a regular fluoride dentifrice and a soft-bristled toothbrush. Participants reported having refrained from oral hygiene procedures, eating, and drinking that morning. After providing a baseline rinse sample, subjects brushed their teeth for 1 minute with their assigned toothbrush and a commercially available fluoride toothpaste, then returned 30 minutes later to provide postuse rinse samples. Subjects refrained from dental hygiene, eating, and drinking during the 30-minute evaluation period. To provide the samples, subjects rinsed with 10 mL of sterile phosphate-buffered saline solution for 10 seconds. Each collected sample was centrifuged, resuspended, and run in a colorimetric assay to determine the level of desquamated epithelial cells found in the rinse as measured by the absorbance at 570 nm. Twenty adults completed the study. At baseline, the mean levels of desquamated epithelial cells for the 4 treatments were 0.70+/-0.27, 0.63+/-0.20, 0.69+/-0.30, and 0.62+/-0.31 for the Colgate 360 degrees, Oral-B Indicator, Crest SpinBrush PRO, and Oral-B CrossAction, respectively. Posttreatment, the mean levels of epithelial cells were 0.19, 0.38, 0.42, and 0.34, respectively. All of the treatments provided a statistically significant reduction compared to their respective baseline. In addition, the Colgate 360 degrees toothbrush was statistically significantly better than the other three toothbrushes in reducing desquamated epithelial cells. Therefore, the results of this randomized, crossover clinical study indicate that the newly designed Colgate 360 degrees manual toothbrush, with a tongue-cleaning implement on the back of the brush head, was statistically significantly more effective than the Oral-B Indicator, Crest SpinBrush PRO, and Oral-B CrossAction toothbrushes in removing desquamated epithelial cells.

Adult↗
PubMed2004

Comparison of the clinical efficacy of a new manual toothbrush on gingivitis reduction and plaque removal.

The objective of this controlled, examiner blind, 4-week clinical study was to evaluate and compare the safety and efficacy of a newly designed manual toothbrush, the Colgate 360 degrees toothbrush, to the Oral-B Indicator toothbrush for the control of supragingival plaque and gingivitis. A total of 82 subjects from the northern New Jersey area reported to the clinical facility for a baseline plaque and gingivitis examination after having refrained from all oral hygiene procedures for 12 hours and from eating, drinking, or smoking for 4 hours. The population was comprised of healthy adult men and women 30 to 68 years of age. After the baseline examinations, qualifying subjects were randomized into two groups and assigned to one of the two test toothbrushes. All subjects were instructed to brush their teeth for 1 minute under supervision, after which they were again examined for supragingival plaque. They were then instructed to brush their teeth twice a day for 1 minute with their assigned toothbrush and a commercially available toothpaste (Colgate Cavity Protection Great Regular Flavor Fluoride Toothpaste) for the next 4 weeks. After 4 weeks, subjects returned to the clinical facility for a final gingivitis and plaque examination. Eighty-one subjects complied with the protocol and completed the 4-week clinical study. The results of the study indicated that the new manual toothbrush was statistically significantly effective in reducing gingivitis after 4 weeks and in removing plaque after a single toothbrushing and after 4 weeks of use. Also, the new manual toothbrush exhibited a statistically significant greater reduction in gingivitis and in gingivitis-related bleeding sites after 4 weeks of use as well as statistically significant greater plaque removal after a single toothbrushing and after 4 weeks of use, as compared to the Oral B Indicator toothbrush. This superior plaque-removal performance was found in separate analyses of the whole mouth, at interproximal surfaces, and at the gumline.

Adult↗
PubMed2006

The Oral-B CrossAction manual toothbrush: a 5-year literature review.

The design of the modern conventional manual toothbrush can be attributed to Dr. Robert Hutson, a Californian periodontist, who in the early 1950s developed the multitufted, flattrimmed, end-rounded nylon filament brush that became known as the Oral-B manual toothbrush. The trademark Oral-B emphasized that this was an oral brush, designed to clean all parts of the oral cavity, not merely a toothbrush. Flat-trimmed conventional toothbrushes based on the original Oral-B design have good plaque-removing capability when used carefully. However, limitations in terms of patients" brushing technique and brushing time necessitated a radical change in bristle pattern to improve performance, especially at approximal sites and along the gumline. RATIONALE FOR PRODUCT DEVELOPMENT: Detailed studies of the tooth-brushing process, using advanced scientific and ergonomic research methods, led to new toothbrush designs intended to maximize the efficacy of brushing efforts. These studies showed that the point of greatest interproximal penetration occurs when the direction of brushing changes; bristles angle back into the interproximal space, moving down and back up the adjoining approximal surface. These mechanics were further optimized on the basis of standardized evaluations of brush-design characteristics, including combinations of tuft lengths, insertion angles and tuft layout. With conventional vertical bristles these improvements yield limited benefits because only a few bristles are correctly positioned at the interproximal junction when the brush changes direction. Ultimately, a design with bristle tufts arranged at 16 masculine from vertical along the horizontal brush head axis was identified, in which the maximum number of bristles operated at the optimum angle throughout the brushing cycle. This design was significantly more effective (p < 0.001) than others in terms of penetration (by 9.6%) and cleaning effectiveness per brush stroke (by 15.5%). EFFECTIVENESS: This discovery paved the way for a new toothbrush design with a unique patented array of tufts, which became known as the Oral-B CrossAction brush. This design was selected for extensive independent studies designed to evaluate plaque removal at the gingival margins and in the approximal areas and longer-term control of gingivitis, relative to current standard designs. In a series of studies (published in 2000), 14 single-brushing comparisons and 2 longer-term studies demonstrated the consistent superiority of the Oral-B CrossAction brush over the equivalent commercial standards. Since then, several additional studies have contributed further positive performance data for the CrossAction brush. Two of the studies demonstrated that plaque removal by this brush was superior to that of 15 other manual toothbrushes, and further investigations contributed similarly positive data. Longer-term data have confirmed superior CrossAction performance and the long-term benefits of improved efficacy, particularly for gingivitis. DISCUSSION: Novel approaches to toothbrush design have produced a toothbrush that, when tested in a large number of clinical studies, has consistently met or exceeded established standards of efficacy. The literature contains a wealth of performance data on various toothbrush designs, but none of these designs shows the year-on-year consistency and reproducibility of the Oral-B CrossAction.

Dental Devices, Home Care↗
PubMed1990

Comparative analysis of the plaque removal ability of .007 and .008 toothbrush bristles.

A two-phase study was conducted to compare the plaque-removal effectiveness of a .007 toothbrush and a .008 toothbrush when used in an unsupervised home-care program. In the first phase of the study, two children's toothbrushes, a .007 toothbrush (POH Junior #8) and a .008 toothbrush (Allie-Croc), were compared in a population of third through sixth grade children. The .007 group had a greater reduction of plaque from pretest to post-test than the .008 group in all grades, with statistically significant differences favoring the .007 toothbrush for fourth and sixth grades. In phase two a .007 adult toothbrush (POH #4) was compared to a .008 adult toothbrush (Oral B 40) in a population of nursing and dental hygiene students. Both toothbrushes performed equally well with a significant decrease in plaque and gingival inflammation observed from pretest to post-test regardless of toothbrush used. Any changes in soft-tissue abrasion were negligible and not statistically significant. Based on the results of this study, both brushes appear to be safe and effective and can be recommended with confidence.

Adult↗
PubMed1996

The clinical effect of a newly designed electric toothbrush on supragingival plaque, gingivitis and gingival bleeding.

A clinical study was carried out in an attempt to assess the efficacy of a newly designed electric toothbrush compared to a conventional manual toothbrush using the American Dental Association's protocol for evaluating toothbrushes. An Oral-B 35 manual toothbrush, which served as the control, was compared to the Plaq & White125 electric toothbrush. Examinations were performed by two calibrated examiners at baseline, day 15 and day 30. Examinations included the gingival index, plaque index and bleeding index. Mean indices were calculated and compared between the two brushes using the repeated measures multiple analysis of variance. No statistically significant differences between the mean indices on the three examination days were observed following the use of the manual or the electric toothbrushes. The results of this study demonstrate that the electric toothbrush was numerically more effective than the manual toothbrush in reducing supragingival plaque levels, either before or after brushing, at each examination date compared to baseline plaque values. However, this difference was not statistically significant. This and other findings concluded that the Plaq & White toothbrush is comparable to the control ADA-accepted toothbrush.

Adult↗