[Toothbrushing instruction for children--use of a chart for toothbrushing].
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A new toothbrush from the Colgate-Palmolive Company, called the Colgate Precision toothbrush, was compared to the Oral-B 40 toothbrush and Reach Full-Head soft toothbrush using a laboratory device designed to simulate clinical toothbrushing motions and pressures. The toothbrushing time was sixty seconds for each vertical or horizontal brushing motion and for each of the three brushing weights tested, 250, 500 or 750 grams. Interproximal access efficacy was determined by measuring the maximum width of the brushing stroke measured on pressure sensitive paper placed around the simulated anterior or posterior teeth. Twenty-four toothbrushes of each design were evaluated for each toothbrushing motion, tooth shape and toothbrushing weight for a total of 864 measurements. In all studies conducted, the Colgate Precision toothbrush had statistically superior total interproximal access efficacy scores compared to the Oral-B and Reach toothbrushes. In several assessments the Reach toothbrush was superior to the Oral-B 40 toothbrush.
In a clinical study, the relative incidence of gingival injuries after standardized tooth brushing was tested by 22 volunteer dental assistants whose teeth were brushed with a soft multi-tufted toothbrush, a manual V-form toothbrush, and an electric toothbrush. At the beginning of the study, a dental hygienist cleaned the right or left side of the jaw of each subject with a manual V-form toothbrush or an electric toothbrush; the other side was manually cleaned with a multi-tufted toothbrush. At the second cleansing one week later, the same dental hygienist cleaned the side contralateral to that brushed in the first test week with the multi-tufted brush; the manual V-form brush was used instead of the electric toothbrush and vice versa. The number of new gingival lesions was recorded after each brushing. The cleansing effect was established by determining the amount of residual plaque. The subjects did not know which type of toothbrush was used to cleanse the evaluated side of the jaw. The results showed that the manual V-form toothbrush abraded the gingiva more than the electric toothbrush (p less than 0.005). A similar difference was found between the manual multi-tufted and the electric toothbrush (p less than 0.05). No significant differences could be established with respect to the plaque-removing properties of the three types of toothbrush tested.
The purpose of the present investigation was to determine bacterial contamination of chlorhexidine coated and uncoated (normal) nylon filaments of toothbrushes. Ten healthy subjects were employed in this study and the test toothbrush of four lines and thirty-eight tufts were used twice a day. Test periods were 1, 8, and 20 days for each filaments of toothbrush and after they brushed the used toothbrush was kept at the constant condition (20 degrees C, 65% RH). After each test period, those toothbrushes were immediately collected and kept at the same condition for drying. After 0, 3, 6, 9, and 24 hours of drying, two tufts of filaments were pulled out from the toothbrush and cutted into two parts (end- and root-side of tufts) by sterile scissors. Each cutted part of filaments was washed with PBS and the aliquots was incubated on Brucella blood agar plate at 37 degrees C for 48 hours. The number of bacteria attached to filaments was enumerated. The results were as follows: 1. The number of bacteria attached to both end- and root-sides of chlorhexidine coated filaments decreased with the time of drying. 2. At the root-side of the normal filaments, the number of contaminated bacteria increased with the test periods. 3. The isolated bacteria from tested toothbrushes were mainly gram positive at shorter period, however, gram negative rods were also found at longer period. 4. The anti-bacterial activity of the end-side of chlorhexidine coated filaments diminished at eight days of the use, however, their activity at the root-side still remained even at twenty days. From these results, it was clear that the bacterial contamination of toothbrush was affected by several factors such as the condition of drying, the site of tufts, the using period of toothbrush and so on. To prevent this problem, it is important to keep it at good storage condition and to change it periodically. The developed chlorhexidine coated filaments of the toothbrush also indicates to be one of the useful way for prevention of bacterial contamination of toothbrush.
Two independent cross-over design studies were performed to compare two toothbrushes for their ability to remove plaque. In Study I, the Colgate Precision toothbrush was compared to the Oral-B 40 toothbrush; in Study II, the Colgate Precision toothbrush was compared to the Reach Full-Head soft toothbrush. A total of 54 and 72 adult male and female subjects who met the inclusion/exclusion criteria completed Study I and Study II, respectively. In each study, subjects refrained from brushing for 24 hours, and were screened for dental plaque on the facial and lingual surfaces of all natural teeth, using the Rustogi, et al. index. Based on mean scores and number of teeth, qualifying subjects were randomly assigned to one of two groups. Subjects were then scheduled to return one week later, having again abstained from all oral hygiene procedures for a 24-hour period. At this visit, each subject was evaluated for plaque, then brushed with his/her assigned toothbrush for sixty seconds, and was again scored for plaque after brushing. Subjects were instructed to resume their normal routine and return to the clinical site one week later. At this visit, a different test toothbrush was assigned to each group in a cross-over design. Plaque evaluations and toothbrushing procedures were again performed. In both studies, the Colgate Precision toothbrush was significantly more effective (p < 0.01) than either the Oral-B 40 toothbrush or the Reach Full-Head soft toothbrush in reducing whole mouth plaque scores, plaque scores at the gumline, and plaque scores at interproximal areas.
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.
A recent investigation of the various oral hygiene activities in 23 day-care centers located in the district administered by the Verdun Community Health Department has highlighted the need for a standardized hygienic method of storing toothbrushes. The study proposed to identify the main criteria related to hygiene that must be observed in order to prevent the transmission of contagious diseases within a day-care center, through the use of toothbrushes or toothbrush holders. Furthermore, the toothbrush holder has to meet four requirements: (1) be inexpensive; (2) be easy to build or manufacture; (3) allow the storage of 15 toothbrushes at the same time; (4) permit easy identification of the toothbrush by the child or teacher. A review of the literature, together with an assessment of toothbrush holders presently used by day-care centers in the district administered by the Verdun Community Health Department, showed that there were none which completely satisfied the required criteria. Under these circumstances, the authors of the study propose a detailed plan for the construction of a toothbrush holder that will satisfy these requirements. The toothbrush holder can be used to promote dental health to the very young. A sponsor could present it as a gift to one or more day-care centers in order to demonstrate their interest in the prevention of dental disease among these children.
Three power toothbrushes with different mechanical principles (blend-a-dent master-vertical oscillating system, blend-a-dent medic electric elliptical oscillating system, interplak-contra-rotationsystem of the bristle-tuft) and a conventional hand toothbrush were investigated in 60 oral hygiene-motivated persons in a three-month-study. Efficiency was tested by two parameters (plaque index, papillary-bleeding index) under statistically identical conditions. The study showed no major differences in efficiency between the power toothbrushes and the manual toothbrush. --For the whole study the power toothbrush with an elliptical oscillating system showed the best results. --Power toothbrushes are not more effective in plaque removal than a manual toothbrush. The great statistical variation of the investigated parameters in each group shows that an optimal brushing technique was more important than the choice of a certain toothbrush. --The investigation of the interproximal areas showed that a toothbrush alone is not effective enough. The additional use of dental floss and/or interdental cleaners for optimal oral hygiene is essential.
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.
Dentine hypersensitivity occurs when dentinal tubules are open on the dentine surface and patent to a vital pulp. There has been limited interest in the aetiology of dentine hypersensitivity. In particular, little is known about agents that remove the dentine smear layer to expose tubules. Toothbrushing certainly may expose dentine, but whether a toothbrush per se has the effect of opening tubules has not been established. The aim of this study in vitro was to determine whether a toothbrush could remove or create a smear layer. In addition, the combined effects of toothbrushing with dietary fluids on dentine was assessed. Toothbrushing was observed, by scanning electron microscopy, both to remove and to recreate a smear layer on dentine specimens. However, the processes took a considerable time, and under conditions of normal toothbrushing it is unlikely that the latter plays a direct aetiological role in opening tubules. Indeed, together with toothpaste it is more likely that brushing has a therapeutic action by mechanically forming a smear layer. Conversely, and importantly, toothbrushing in the presence of dietary acids enhanced smear layer removal. This finding raises the question of whether the dental profession should be advising that teeth be brushed before meals rather than after, as is often the case.
Abrasion lesions were recorded in 818 individuals representing the adult population of 430,000 residents of the Stockholm region, Sweden. The subjects were asked about toothbrushing habits, toothbrush quality and dentifrice usage; these factors were related to abrasion criteria. Abrasion was prevalent in 30% and wedge-like or deep depressions were observed in 12%. The relationship between abrasion and toothbrushing was evident, the prevalence and severity of abrasion being correlated to toothbrushing consumption. The importance of the toothbrushing technique for the development of abrasion lesions was elucidated. Horizontal brushing technique was strongly correlated to abrasion. It was demonstrated by treating the data with the statistical AID analysis that toothbrushing factors related to the individual (brushing frequency and brushing technique) exert a greater influence than material-oriented toothbrushing factor such as dentifrice abrasivity and bristle stiffness.