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PubMed2004

Clinical comparison of a new manual toothbrush on the level of hydrogen-sulfide-forming bacteria on the tongue.

The objective of this randomized, crossover study was to compare the effectiveness of a newly designed manual toothbrush (Colgate 360 degrees) to two commercially available manual toothbrushes (Oral-B Indicator and Oral-B CrossAction) and a battery-powered toothbrush (Crest SpinBrush PRO) for their ability to reduce hydrogen-sulfide-forming bacteria on the tongue. After a washout period, subjects arrived at the clinical site for baseline sampling without performing dental hygiene, eating, or drinking. Subjects sampled the left side of their tongue with a cotton swab. Subjects brushed for 1 minute with the assigned test toothbrush and regular fluoride toothpaste. Those using the Colgate 360 degrees toothbrush were instructed to clean their tongue with the implement on the back of the brush head for 10 seconds. After 2 hours, the subjects returned to the clinical site having refrained from dental hygiene, eating, and drinking for posttreatment sampling, this time sampling the right side of their tongue. After a minimum 2-day washout period, subjects repeated the same regimen using the other toothbrushes. Collected tongue samples were dispersed in sterile water, serially diluted in sterile phosphate-buffered saline, and plated in duplicate onto lead acetate agar. When plated on this medium, bacteria that produce hydrogen sulfide appear as dark-pigmented colonies. After 72 hours of incubation, the dark colonies were counted, expressed as log colony-forming units/mL, and reduction from baseline was calculated. Thirty-one adult men and women completed the clinical study. There was no significant difference between baseline hydrogen-sulfide-forming bacteria levels. Posttreatment, the log reduction of bacteria was 0.80, 0.41, 0.33, and 0.44 for the Colgate 360 degrees, Oral-B Indicator, Crest SpinBrush PRO, and Oral-B CrossAction, respectively. Statistical analysis indicated that the Colgate 360 toothbrush was statistically significantly better (P < .05) than the 3 commercial toothbrushes in reducing the levels of hydrogen-sulfide-forming bacteria on the tongue.

Adult↗
PubMed2006

Evaluation of the plaque removal efficacy of three power toothbrushes.

INTRODUCTION: The objective of this randomized, single use, single blind, single center, 4-group parallel clinical study was to evaluate the plaque removal efficacy of three power toothbrushes and a manual toothbrush. METHODS: One hundred forty-four (144) subjects completed the study. Subjects were randomly assigned to one of four toothbrush groups: Sonicare Elite, Oral-B Sonic Complete, Waterpik Sensonic or Oral-B Indicator (manual). Subjects abstained from brushing 23-25 hours prior to the pre-brushing data collection. Pre-brushing scores were obtained using the Rustogi modified navy plaque index (RMNPI). Post-brushing RMNPI scores were obtained after a supervised uninstructed two-minute brushing with the assigned toothbrush. Scores were recorded for whole mouth, marginal region, and approximal region for each subject. RESULTS: Pre-brush comparability of whole mouth, marginal and approximal regions indicated no statistical differences among the four groups for any of the three measurement regions. All four toothbrushes showed statistically significant change from pre-brush to post-brush scores for whole mouth, marginal region, and approximal region. The Waterpik Sensonic provided significantly greater reduction in plaque as measured by the RMNPI compared to the other three brushes for whole mouth (89%), marginal area (81%) and approximal area (97%). The only exception was for adjusted p-values for the approximal area compared to the Oral-B Sonic Complete (p = 0.12). CONCLUSION: All groups demonstrated a significant reduction in plaque. The single use plaque removal efficacy of the Waterpik Sensonic toothbrush compared favorably to the other two power toothbrushes, the Sonicare Elite and the Oral-B Sonic Complete, and compared favorably to the manual toothbrush, the Oral-B Indicator.

Adult↗
PubMed2006

Comparative plaque removal efficacy of a dual-action power toothbrush and a manual tooth: effects by tooth type.

PURPOSE: To evaluate the plaque removal efficacy of a dual action power toothbrush (Crest SpinBrush Pro Clean) relative to an ADA reference manual toothbrush. In addition to overall plaque removal, emphasis was put on plaque reduction around the gingival margin, interproximal areas of the tooth and in the posterior segment of the dentition. METHODS: The study was a randomized, examiner-blind, two-treatment, four-period, crossover design. After an informed consent, 50 healthy volunteers were randomized to four treatment sequences and used each toothbrush twice according to their assigned treatment sequence. At every visit, plaque removal was assessed at baseline and after a single brushing using the Rustogi-modified Navy Plaque Index that allows estimation of interproximal plaque and plaque at the gingival margin. Self-reported and examiner-observed adverse events were collected at every visit. Mean Plaque Index (MPI) scores were calculated for the whole mouth, gingival region, interproximal region and different areas of the dentition using an analysis of covariance for crossover design with baseline plaque score as the covariate. RESULTS: 49 subjects provided complete data and were included in the analysis. Baseline MPI scores were not significantly different between the groups for any investigated tooth region or dentition area. Following a single brushing, the power toothbrush provided a reduction of 43% (P< 0.001) for the whole mouth MPI, 43% (P< 0.001) for the gingival margin MPI and 65% (P< 0.001) for the interproximal MPI relative to a manual brush. Use of the power toothbrush resulted in a significant reduction of whole-mouth and gingival margin MPI across all areas of the dentition compared to a manual toothbrush (P< 0.001). The power toothbrush also had superior interproximal plaque removal efficacy compared to the manual toothbrush for molars (P< 0.001, with 118% greater removal score). Both brushes were well tolerated.

Adult↗
PubMedDate not supplied

Meswak chewing stick versus conventional toothbrush as an oral hygiene aid.

This study consisted of two trials. Trial 1 compared the meswak with the toothbrush when used twice and five times a day. Trial 2 compared habitual meswak users with toothbrush users. Under experimental conditions, a significant reduction in gingivitis was found both buccally (p less than 0.01) and lingually (p less than 0.05) after using a meswak five times a day compared with a conventional toothbrush. Twice a day brushing with a meswak produced a significant reduction in gingivitis buccally (p less than 0.005) compared with toothbrushing, but lingually the difference was insignificant. There were no significant differences in plaque scores between a meswak and a conventional toothbrush when brushing was continued five times a day. Plaque scores became significantly higher when a meswak was used only twice a day compared with toothbrushing, specifically on the lingual surfaces of the teeth (p less than 0.01). Habitual meswak users showed a significant reduction in gingival bleeding (p less than 0.05) and interproximal bone height (p less than 0.02) compared with toothbrush users. The differences in plaque scores and pocket depth measurements between the two groups were insignificant. The results imply that a meswak, used five times a day, may offer a suitable alternative to a toothbrush for reducing plaque and gingivitis. However, meswak may not be sufficient for maintaining interproximal dental health when used without the support of other oral hygiene aids.

Adult↗
PubMed1985

Toothbrushing effectiveness of a group of six-year-old uninstructed schoolchildren.

The main purpose of this study was to evaluate the effectiveness of toothbrushing in 124 six year-old uninstructed schoolchildren. The toothbrushing conditions were made to closely simulate the toothbrushing procedure carried out at home. The amount of plaque before and after toothbrushing was assessed using the Modified Personal Hygiene Performance Index. An overall reduction of 54.0 per cent in plaque score was observed following toothbrushing. This reduction was much more favourable than other reported studies using subjects of similar age group. However most of the plaque that remained following brushing were accumulated in the gingival areas. The highest prebrushing score and the least effective toothbrushing ability was observed among the Malay schoolchildren. The pre and postbrushing scores among the Chinese and Indians were comparable. There was no statistically significant difference in toothbrushing ability between boys and girls at this age. The children brushed their anterior teeth better than their posterior and the facial surfaces better than the lingual. The greatest percentage reduction in plaque score was observed in the occlusal/incisal areas with the gingival areas being the least accessible. The conclusions of this study points to the lack of manual dexterity of children of this age group to effectively brush their teeth and the need for proper parental supervision in assisting them to carry out the toothbrushing procedure.

Child↗
PubMed1993

Laboratory evaluations of interproximal access of two differently bristled manual toothbrushes.

The Colgate Rippled Bristles toothbrush was compared to the Oral-B 40 toothbrush using a laboratory device which simulates horizontal and vertical brushing movements under pressures of 250, 500 and 750 grams. Interproximal access was determined by measuring the width of the brushing stroke on pressure-sensitive paper surrounding anterior or posterior tooth shapes. The Colgate Rippled toothbrush was consistently superior to the Oral-B 40 toothbrush in accomplishing interproximal access in the laboratory tests performed here. On anterior-shaped teeth, the superiority (p < 0.05-0.01) was evident at all pressures tested, with both horizontal and vertical brushing movements. On posterior tooth shapes the Colgate Rippled toothbrush was superior (p < 0.01) to the Oral-B 40 toothbrush at all brushing weights and with both vertical and horizontal motions. When total interproximal access efficacy means were calculated for all brushing weights, the Colgate Rippled toothbrush was superior (p < 0.05-0.01) to the Oral-B 40 toothbrush on both anterior and posterior tooth shapes in the vertical and horizontal brushing motions.

Analysis of Variance↗
PubMed1993

Dental plaque removal in adults using a newly developed, 'Concept 45 degrees' toothbrush.

A two by two factorial designed study was conducted to compare the effectiveness of the newly designed 'Concept 45 degrees' toothbrush on removal of dental plaque, to a standard conventional toothbrush using either the roll technique or the Bass technique of toothbrushing. One hundred male soldiers, aged 21-22 years were stratified into four balanced groups according to baseline plaque scores obtained from a pretest period. They received oral prophylaxis and were randomly assigned into one of the four experimental groups: (a) standard conventional toothbrush with the roll technique, (b) standard conventional toothbrush with the Bass technique, (c) the 'Concept 45 degrees' toothbrush with the roll technique, and (d) the 'Concept 45 degrees' with the Bass technique. The results showed that the 'Concept 45 degrees' toothbrush using the Bass technique removed dental plaque more effectively than the standard conventional toothbrush with either technique.

Adult↗
PubMed1995

Effect of a clamp on toothbrush bristle deterioration.

The purpose of this study was to evaluate, in vitro, the effectiveness of a device to prevent toothbrush deterioration. Ten toothbrushes from each of four brands, Oral-B 40, Py-co-pay Softex 12.0 row, Butler #330, and Oral-B 20, were divided into control and experimental groups. Toothbrushes were fixed into a machine that simulated toothbrushing by producing a reciprocating motion 41.5 mm in length at a rate of 380 strokes/min. Bristles slid over a ceramic disc that had a hardness similar to dental enamel. Pressure (450 g) was applied at a right angle to the toothbrush while it moved back and forth in a slurry of toothpaste. The pressure was calibrated with load cells. Toothbrushes were run for 15 minutes followed by a drying cycle for a total of four hours, or approximately equivalent to brushing twice daily for six months. During the drying cycle the bristles of the toothbrushes in the experimental group were compressed 3/4 their length from the brush head with a clamp (Gregory Patent #4884311). Bristle deterioration was evaluated based on Wear Index (WI), a quantitative means of ranking brushes in various stages of deterioration. Data on WI and WR showed that toothbrushes in the experimental group had significantly (< or = 0.005) less deterioration. Improvement in wear resistance was dependent on size and configuration of the bristles. Compressing the bristles between brushings retains the non-matted shape of the bristles and reduces their deterioration.

Analysis of Variance↗
PubMed1995

Clinical evaluation of the plaque removal efficacy of three toothbrushes.

A single-blind, randomized triple crossover study was conducted to compare the plaque removal effectiveness of three toothbrushes: Sunstar Do New Type, Reach Compact Head, and New Dental-H. Thirty-three female students were recruited from a dental school and a dental hygiene school. All subjects brushed with a control toothbrush for the first week and with each one of the three test toothbrushes in each subsequent one-week period. Plaque removal efficacy was determined by subtracting the plaque score for the test toothbrush from that of the control toothbrush. The Sunstar Do New Type toothbrush had a significantly (p<0.05) higher plaque removal efficacy than the other two toothbrushes. The differences were prominent on the distal line angle of the second molars. Differences in plaque removal efficacy between the Reach Compact Head and the New Dental-H toothbrushes were not statistically significant (p<0.05) in this study.

Adult↗
PubMed1997

Trends in toothbrushing frequency among Finnish adolescents between 1977 and 1995.

OBJECTIVE: To analyse trends in development of the toothbrushing frequency of Finnish adolescents and the socio-economic factors associated with these trends between 1977 and 1995. DESIGN: The data were collected as part of a nation-wide research programme, the Adolescent Health and Lifestyle Survey, which started in 1977. Since then a 12-page questionnaire has been sent every other year. Dental health behaviour was studied from the outset. SUBJECTS: The sample represented 12-, 14-, 16- and 18-year-old children and adolescents in Finland. The sample size varied between 3,205-10,626, making a total of 66,687 participants. OUTCOME MEASURES: The recommended toothbrushing frequency, twice-a-day, was studied. The socio-economic factors included age, gender, self-assessed school performance, level of education, socio-economic status of the householder, and socio-economic category of the residential area. RESULTS: Among boys, daily toothbrushing increased from 1977 to 1995, but among girls it remained stable. Among boys, the prevalence of twice-a-day toothbrushing frequency varied from 13 per cent to 25 per cent between the ages of 12 and 18 years, and among girls from 32 per cent to 60 per cent, respectively. Among 12- to 14-year-old boys, the socio-economic differences almost disappeared. There were no changes among 12- to 14-year-old girls but there was an unexpected declining trend in toothbrushing among 16- to 18-year-old girls. Apparently further improvement in the toothbrushing frequency of girls had stopped. CONCLUSIONS: Although there was a clear trend towards improvement of toothbrushing frequency among boys, their toothbrushing frequency still lagged far behind that of girls.

Achievement↗
PubMed1996

A thirty-day evaluation of the Rowenta Dentiphant powered toothbrush in children for safety and efficacy.

A thirty-day clinical trial was undertaken with second grade school children to assess the safety and efficacy of a new battery-powered toothbrush (Rowenta Dentiphant) compared to the manual Oral-B 20 toothbrush. The children from four class rooms were individually and randomly assigned to use either product for the thirty days. The children reported to school having not brushed the morning of each assessment at baseline, 15 days and 30 days. Following the gingivitis assessment and given a pre-brushing plaque assessment, the children were instructed on the use of the toothbrush as they then brushed their teeth for a timed 1 minute out of sight of the examiners. The children were then reassessed for plaque removal. The results demonstrated that the children using the Rowenta powered toothbrush became used to the brush and improved their cleaning efficiency during the study. By week two, the buccal plaque scores for the Rowenta brush were significantly lower (p < 0.05) compared to the Oral-B 20 group. By week four the Rowenta subjects had significantly lower buccal and lingual plaque scores after brushing, while the Oral-B 20 subjects had significantly lower buccal scores after toothbrushing, but no significant difference was found after brushing on lingual surfaces for plaque removal. On total plaque area scores, the Rowenta group was significantly lower (p < 0.01) than the Oral-B 20 group at both two and four weeks. The Rowenta group had a 10% reduction in plaque area after brushing comparing baseline to four weeks. The Oral-B group demonstrated no percentage difference in after brushing plaque scores from baseline to four weeks. On gingivitis, the Rowenta group had significantly lower buccal and lingual mean scores compared to the Oral-B 20 group at week two, and lingual mean scores compared to the Oral-B 20 group at week four. The Rowenta group demonstrated a 27% decrease in lingual gingivitis scores compared to baseline, while the Oral-B group had an 11% decrease in lingual gingivitis scores from baseline to four weeks. Total gingivitis scores for the Rowenta group were significantly lower (p < 0.01-0.001) at both weeks two and four compared to the Oral-B 20 group, with percentage declines from baseline to four weeks being 22% and 12%, respectively. The Rowenta Dentiphant toothbrush was found to be safe to use. On total plaque and gingivitis reduction, the Rowenta Dentiphant toothbrush was found to be significantly superior to the Oral-B 20 manual toothbrush by two weeks of use and this continued to the conclusion of the study.

Analysis of Variance↗
PubMed1997

Plaque removal efficacy of a newly developed powered toothbrush in the primary dentition of pre-school children.

A cross-over, single-blind clinical study was performed to compare a powered and a manual toothbrush for their ability to remove plaque from the teeth of pre-school children. Seventy-three randomly selected 4- to 6-year-old children from two kindergarten classes in Erfurt, Germany participated in the study. A new powered children's toothbrush (Rowenta) and a currently marketed manual children's toothbrush (Elmex) were used for an assessment period of two weeks each. Then the groups were crossed over to use the alternate toothbrush for another two weeks. Whole mouth, gingival margin and interproximal plaque area levels were determined using the Rustogi et al. plaque index. Statistical analysis of the data showed significantly effective (p < 0.05) plaque removal with both toothbrushes, immediately after toothbrushing and at one and two weeks, compared to the respective baseline scores. The statistical analysis also demonstrated that the powered toothbrush was significantly (p < 0.05) better on percent plaque reduction on all tooth areas compared to the manual toothbrush, except at two weeks with the interproximal assessment.

Child↗
PubMed2003

Manual versus powered toothbrushing for oral health.

BACKGROUND: Specific oral bacteria, generically known as "dental plaque" are the primary cause of gingivitis (gum disease) and caries. The removal of dental plaque is thought to play a key role in the maintenance of oral health. There is conflicting evidence for the relative merits of manual and powered toothbrushing in achieving this. OBJECTIVES: To compare manual and powered toothbrushes in relation to the removal of plaque, the health of the gingivae, staining and calculus, dependability, adverse effects and cost. SEARCH STRATEGY: We searched the Cochrane Oral Health Group's Trials Register (to 22/8/02); Cochrane Central Register of Controlled Trials (The Cochrane Library Issue 3, 2002); MEDLINE (January 1966 to week 5 2002); EMBASE (January 1980 to week 3 July 2002) and CINAHL (January 1982 to June 2002). Manufacturers of powered toothbrushes were contacted for additional published and unpublished trials. SELECTION CRITERIA: Trials were selected if they met the following criteria: design-random allocation of participants; participants-general public with uncompromised manual dexterity; intervention- supervised manual and powered toothbrushing for at least four weeks; primary outcomes-the change in plaque and gingivitis over that period. DATA COLLECTION AND ANALYSIS: Six reviewers independently extracted information in duplicate. Indices for plaque and gingivitis were expressed as standardised values for each study. The effect measure for each meta-analysis was the standardised mean difference (SMD) with the appropriate 95% confidence intervals (CI) using random effect models. Potential sources of heterogeneity were examined, along with sensitivity analyses for the items assessed for quality and publication bias. MAIN RESULTS: Twenty-nine trials, involving 2,547 participants, provided data for the meta-analysis. Brushes that worked with a rotation oscillation action removed more plaque and reduced gingivitis more effectively than manual brushes in the short and long term. For plaque at one to three months the SMD was -0.44 (95% CI: -0.66 to -0.21), for gingivitis SMD -0.44 (95% CI: -0.72, -0.15). These represented an 11% reduction on the Quigley Hein plaque index and a 6% reduction on the Löe and Silness gingival index. At over three months the effects were SMD for plaque -1.15 (95% CI: -2.02,-0.29) and SMD for gingivitis -0.51 (95% CI: -0.76, -0.25). These represented a 7% reduction on the Quigley Hein Plaque Index and a 17% reduction on the Ainamo Bay Bleeding on Probing Gingival Index. The heterogeneity found in these meta-analyses for short term trials was caused by one trial that had exceptionally low standard deviations. Sensitivity analyses revealed the results to be robust when selecting trials of high quality. There was no evidence of any publication bias. No other powered brush designs were consistently superior to manual toothbrushes. In these trials, data on cost, reliability and side effects were inconsistently reported. Those side effects that were reported on in the trials were localised and temporary. REVIEWER'S CONCLUSIONS: Powered toothbrushes with a rotation oscillation action achieve a modest reduction in plaque and gingivitis compared to manual toothbrushing. Observation of methodological guidelines and greater standardisation of design would benefit both future trials and meta-analyses.

Dental Devices, Home Care↗
PubMed2005

Plaque and gingivitis reduction in patients undergoing orthodontic treatment with fixed appliances-comparison of toothbrushes and interdental cleaning aids. A 6-month clinical single-blind trial.

AIM: Comparison of the efficacy of different oral cleaning devices to improve dental hygiene in patients with multibracket appliances. SUBJECTS AND METHODS: In a single-blind four-way crossover clinical trial, the following toothbrushes and cleaning aids were tested over 6 months to determine their efficacy in removing plaque and preventing gingivitis: the (A) manual interX short brush-head toothbrush (elmex), the (B) Sonic Speed SR-100E sonic toothbrush (Water Pik), the (C) Sonic Speed toothbrush in conjunction with the electric interdental cleaning device Flosser FL-110 (Water Pik), and (D) the Sonic Speed sonic toothbrush in conjunction with multi-floss 3-phase dental floss (elmex). Forty patients were randomly split up into four groups. Each group brushed their teeth for 4 weeks using cleaning aids/combinations A, B, C or D in different orders. The trial organization was controlled by a computer system that also assisted in recording the modified Quigley Hein Index (mQHI) and Papillary Bleeding Index (PBI) every two weeks using voice control. RESULTS: Initial improvement was observed with all cleaning aids/combinations, but after 4 weeks of application, conditions deteriorated again--except one. After 4 weeks of application, only cleaning involving the combined use of the sonic toothbrush and the Flosser FL-110 (C) was found to be significantly more effective than cleaning with the manual toothbrush (A), and that was mainly attributed to the flosser. In patients with good oral hygiene (mQHI(initial) < or = 1.4), no improvement was observed with any of the cleaning aids (A-D). CONCLUSIONS: Plaque and gingivitis can be reduced--especially in patients with poor oral hygiene (mQHI(initial) > or = 1.5)-by using an interdental cleaning aid. In the long run, the Flosser FL-110 is more effective than multi-floss 3-phase dental floss.

Adolescent↗
PubMed2000

Plaque removal by worn toothbrush.

BACKGROUND/AIMS: Assessment of the influence of toothbrush wear on plaque (PI) and gingival (GI) indexes. METHOD: 20 university students were recruited. PI and GI were recorded at the starting point (T0). Each subject received a toothbrush and toothpaste. 5 measurements of toothbrush were recorded to establish the initial size. The subjects were instructed to brush 3 x a day and to refrain from using other plaque removal aids. After 1 month (T1), the subjects were randomly divided into 2 groups: group no. 1 substituted the toothbrush at each monthly visit; group no. 2 brushed only with the toothbrush provided at T0. Recalls were scheduled after 1 (T1), 2 (T2) and 3 months (T3). PI, GI and an index of wear (WI) were calculated using 5 measurements of the toothbrush head and were recorded at recalls. RESULTS: From T0 to T3, a significant increase of PI was found within both groups. Non-significant differences, but very close to the significant level (p= 0.063), in group no. 1 and significant differences in group no. 2 of GI were found. No significant differences of PI and GI were found between groups. Increase of the WI was registered from T0 to T3 (p<0.001). CONCLUSION: Each individual is capable of maintaining low PI, even if using a toothbrush that shows evidence of wear.

Adult↗
PubMed2001

Toothbrush filaments end-rounding: stereomicroscope analysis.

BACKGROUND, AIMS: Toothbrush filaments with rounded ends allow for efficient removal of bacterial plaque and are less harmful to periodontal tissues than non-rounded bristles. The aim of this research was to evaluate the % of rounded filaments considered to be of acceptable quality in different toothbrush brands and to determine whether there is a standardization of quality, as manufacturers claim. METHOD: Brushes tested included 2 samples of medium-hard nylon or tynex toothbrushes from 31 various types found on the retail market in Italy. Tufts from the same position on the toothbrush head were removed and examined under a stereomicroscope, utilizing methods which did not alter the physical properties of the filaments. In 4 of the 31 toothbrush brands tested, more than 50% of the filaments appeared rounded, in 19 of them, between 11.9% and 40.5% and in 8 brands between 0% and 7%. RESULTS: Differences were found in the number and disposition of filaments among different brands and even within the same toothbrush brand. CONCLUSION: The results appear to indicate that a large % of toothbrushes on the retail market do not meet acceptable quality criteria.

Dental Plaque↗
PubMed2001

Plaque removal characteristics of electric toothbrushes using an in vitro plaque model.

BACKGROUND/AIM: The purpose of the study was to investigate and quantify the efficacy of plaque removal by commercially available electric toothbrushes using an in vitro system based on artificial plaque grown on glass slides. MATERIAL AND METHODS: Artificial plaque based on Streptococcus sanguis and Streptococcus mutans was cultured in a series of phosphate buffer solution, sucrose solution and brain heart infusion on sterile glass slides, for a period of 5 weeks. 7 different electric toothbrushes of current designs were operated in contact with the glass slides under loads of 1 or 2N for 10 s after which image analysis of the brushed slides was undertaken to calculate the absolute and relative areas of removal. RESULTS: The electric toothbrushes showed a larger area of plaque removal as loading force increased from 1 to 2N. The area of biofilm removed also depended on the head design and ranged from 258 mm(2) (1N, Interplak) and 314 mm(2) (2N, Interplak), to 30 mm(2) (1N, Braun 3D), and 148 mm(2) (2N, Blend-a-Dent). The area of biofilm removal was significantly different among all electric toothbrushes at p<0.01 (ANOVA). All electric toothbrushes removed more biofilm than the actual contacting tufted area of the head. CONCLUSION: The artificial plaque model system under different loading conditions showed differences in the absolute area of removal per electric toothbrush and also differences in the relative removal per unit contact bristle area. These differences on operating variables should be considered when evaluating new electric toothbrushes.

Algorithms↗
PubMed2002

A controlled trial to compare the ability of foam swabs and toothbrushes to remove dental plaque.

AIMS OF THE STUDY: To measure how effective foam swabs are at removing dental plaque when compared with using a toothbrush and to quantify any difference in ability. BACKGROUND: Few nursing studies have aimed to determine the effectiveness of different mouth care tools to remove plaque which is associated with the tooth/gingival margin and, therefore, with gingivitis and chronic inflammatory periodontal disease. Findings from a previous case study of two people that compared the ability of foam swabs and toothbrushes to remove plaque at the gum/tooth margin (gingival crevice) and plaque from between teeth (approximal plaque) suggested that the success of a toothbrush is affected by user technique and that foam swabs are not able to remove plaque from some 'sheltered' areas of teeth. METHODS: A time-series, cross-over controlled trial with 34 volunteers was used to determine the ability of foam swabs and toothbrushes to remove dental plaque which had been allowed to accumulate overnight. Plaque accumulations were scored at each approximal and crevice site for the buccal surfaces of the eight upper and eight lower teeth after each treatment of either toothbrushing or swabbing. RESULTS: Plaque frequency distributions in the form of boxplots, together with results from summary statistics demonstrate that toothbrushes performed substantially better than foam swabs in the ability to remove plaque from the sites studied in this larger sample of people. CONCLUSIONS: The trial verified the findings from the previous study. The conclusions can be generalized to a wider population because of the magnitude and direction of the differences measured. The implications for nurse education and the development of nursing in practice settings include the need to teach effective toothbrushing skills to nurses, and to support clinical staff in developing mouthcare practice, particularly in relation to the use of assessment strategies that include the choice of effective tools.

Clinical Nursing Research↗