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PubMed2004

Sustained oral health improvement and use of toothbrushes and dentifrice by previous users of traditional materials in a rural population in Andhra Pradesh, India.

AIM: To follow-up, one year later, a double-blind, randomised study, which investigated the effect of regular brushing with dentifrices on the oral health of an economically disadvantaged rural population in Andhra Pradesh, India who were primarily users of traditional materials. SUBJECTS: 150 of the original study population. METHOD: Examination to determine whether the improvements in oral health status and oral health behaviour (use of toothbrush and dentifrice), being unsupported, had been sustained since completion of the original study. RESULTS: Data analysis showed sustained, statistically significant improvements in gingival health as measured by gingival bleeding and plaque indices (GBI and PI) comparing users and non-users of toothbrushes and dentifrice in the original study (PI: p = 0.04; GBI: p = 0.03) and sustained use of toothbrushes and dentifrice by 60% of the subjects at follow-up one year later. CONCLUSIONS: This study shows a beneficial effect on oral hygiene indices following the introduction of toothbrushes and dentifrices to a community using traditional oral hygiene materials and sustainability of use of these materials with motivation and support. It may therefore be concluded that it is feasible to achieve significant use of conventional toothbrushes and toothpastes, with consequent major and sustained improvements in plaque control and gingival health in a disadvantaged population hitherto often considered as not amenable to conventional oral hygiene for cultural or economic reasons.

Adolescent↗

PubMed2003

Toothbrushing as part of the adolescent lifestyle predicts education level.

Socio-economic differences in health and health behavior are well-known. Our hypothesis was that toothbrushing frequency in adolescents predicts their education level in adulthood. The aim was also to study the role of toothbrushing in adolescents' health-related lifestyle. Data from nationally representative samples of 12- to 16-year-olds (N = 11,149) were linked with register data on the highest level of education attained at age 27-33 years. Adolescents with a low toothbrushing frequency reached only the lowest education levels. School achievement or sociodemographic background only partly accounted for the association. Exploratory factor analysis found four dimensions of health behaviors. At age 12, a low toothbrushing frequency was loaded highly with "street-oriented" behaviors, concentrated around smoking and alcohol use. At ages 14 and 16, it was associated with a "traditional" lifestyle of the less-well-educated. Altogether, a low toothbrushing frequency indicated selection into the less-well-educated stratum of society. This is likely to be reflected in socio-economic health differences in adulthood.

Adolescent↗

PubMed2002

Models for assessing powered toothbrushes.

The continued development of the power toothbrush over the last 25 years has led to some present-day models that demonstrate increased efficacy in plaque removal compared with a manual brush. The wealth of clinical data that supports these claims has a reference to both in vitro and in vivo models. An overview of performance evidence compared with manual toothbrushes must also be considered from a research model view. The issue of power toothbrush safety in relation to soft tissue abrasion will offer an opportunity for the review of the scientific facts behind any fictitious "hype". Specific studies will provide clinical evidence on power toothbrush safety and performance. This paper will consider implications of the evidence for the use of powered toothbrushes in clinical practice and will emphasize the current consensus of clinical opinion in the light of scientific evidence.

Clinical Trials as Topic↗

PubMed1985

The therapeutic effect of toothbrushing on naturally occurring gingivitis.

A majority of previous toothbrushing studies have examined proposed virtues of particular brushing techniques or the relative cleaning ability of various toothbrushes. A smaller number were concerned with their role in prevention of gingivitis. Whether toothbrushing could be therapeutic in naturally occurring gingivitis was tested in 40 teenagers aged 12 to 14 years. Groups from two public schools were examined for gingivitis and plaque. Students from both groups were given a soft multi-tufted toothbrush and nonfluoridated toothpaste to be used daily. Students at one school were given a single intensive oral hygiene session. All students were reexamined 42 days later and given a thorough prophylaxis. Final readings were obtained 84 days after baseline and the results analyzed statistically. Sign test analysis disclosed a significant (P less than .01) improvement in plaque and gingivitis scores for both groups. Wilcoxon tests of patient means revealed a significant improvement in plaque scores, whereas gingivitis means were more variable. Chi square analysis between groups showed that the groups receiving oral hygiene instructions had significantly better (P less than .01) plaque and gingivitis scores at session 2. Gingivitis differences were generally significant at session 3. Toothbrushing has a therapeutic effect on naturally occurring gingivitis, enhanced by oral hygiene instruction.

Adolescent↗

PubMed2003

Effectiveness of low cost toothbrushes, with or without dentifrice, in the removal of bacterial plaque in deciduous teeth.

The main objective of this study was to compare the effectiveness of a low cost toothbrush ("monoblock") to that of a conventional toothbrush with and without addition of dentifrice with respect to the removal of dental plaque. Thirty-two 4- to 6-year-old children took part in this study: they were evaluated under four experimental conditions defined by the combinations of the values of two factors, toothbrush (conventional or monoblock) and use of dentifrice (with or without). The effectiveness of the treatments was defined in terms of the reduction of a bacterial plaque index evaluated before and after toothbrushing. No statistically significant differences were detected between the two types of toothbrushes with respect to the reduction of the bacterial plaque index. Similarly, there were no statistical evidences that the use of dentifrice improves the mechanical control of dental plaque. These results are important from a public health point of view, specially in developing countries, where the dissemination of educational and preventive techniques of low cost are fundamental.

Brazil↗

PubMedDate not supplied

Influence of toothbrushing on enamel softening and abrasive wear of eroded bovine enamel: an in situ study.

This study assessed the surface softening and abrasive wear of eroded bovine enamel with or without the influence of toothbrushing. Five volunteers took part in this in situ study of 5 days. They wore acrylic palatal appliances containing 6 bovine enamel blocks divided in two rows with 3 blocks, which corresponded to the studied groups: erosion without toothbrushing (GI) and erosion with toothbrushing (GII). The blocks were subjected to erosion by immersion of the appliances in a cola drink for 10 minutes, 4 times a day. After that, no treatment was performed in one row (GI), whereas the other row was brushed (GII). The appliance was then replaced into the mouth. Enamel alterations were determined using profilometry and microhardness tests. Data were tested using paired Students t test (p < 0.05). The mean wear values (microm) and percentage of superficial microhardness change (%SMHC) were respectively: GI--2.77 +/- 1.21/91.61 +/- 3.68 and GII--3.80 +/- 0.91/58.77 +/- 11.47. There was a significant difference in wear (p = 0.001) and %SMHC (p = 0.001) between the groups. It was concluded that the wear was more pronounced when associated to toothbrushing abrasion. However, toothbrushing promoted less %SMHC due to the removal of the altered superficial enamel layer.

Adult↗

PubMed2000

An evaluation of the efficacy of a curved bristle and conventional toothbrush. A comparative clinical study.

BACKGROUND: The aim of this study was to determine the plaque-removing ability of a curved bristle toothbrush compared to a conventional, straight bristle, manual toothbrush. METHODS: The study group consisted of 100 volunteers 16 to 24 years of age from a professional engineering college. A four-week post-prophylaxis, parallel, longitudinal, double-blind clinical study was conducted; all volunteers were instructed in specific oral hygiene techniques. Plaque was assessed at baseline and at the end of 1, 2, 3, and 4 weeks using the Quigley-Hein plaque index after disclosing with erythrosin red. Gingival status was assessed at baseline and at the end of 1, 2, 3 and 4 weeks by using the gingival index of Löe and Silness. RESULTS: Comparative assessment showed a mean of 2.11 +/- 0.086 mm for group 1 and 2.37 +/- 0.216 mm for group 2, indicating a significant difference between the plaque-removing efficacy of the curved bristle and straight bristle toothbrush. CONCLUSIONS: The curved bristle toothbrush was significantly more effective in removing plaque overall than the conventional toothbrush.

Adolescent↗

PubMed2005

Sense of coherence as a determinant of toothbrushing frequency and level of oral hygiene.

BACKGROUND: Antonovsky's salutogenic theory seeks to find general health-promoting factors in individuals as distinct from characteristics that function as risks for specific diseases. A central construct of the theory is sense of coherence (SOC). Individuals with a strong SOC have the ability to define events as less stressful (because of comprehensibility); to mobilize resources to deal with encountered stressors (manageability); and to possess the motivation, desire, and commitment to cope (meaningfulness). Our aim is to investigate whether SOC, self-reported toothbrushing frequency, and objectively assessed levels of oral hygiene are related. METHODS: The sample of the present study consisted of 4,131 30- to 64-year-old dentate Finns belonging to a large nationally representative sample. The questionnaire and home interview included information about socioeconomic and demographic factors, behavioral variables, such as oral health behaviors (toothbrushing frequency), and a 12-item SOC scale, used here as a unidimensional measure categorized into quintiles. The level of oral hygiene was measured during clinical oral examination. Chi-square test, ordinal, and ordinary logistic regression analyses were used. RESULTS: Subjects belonging to the strongest SOC quintile were found to be significantly more often two, or more, times a day brushers compared to those with less strong SOC. After controlling for toothbrushing frequency, sociodemographic and socioeconomic factors, smoking habits, and number of teeth, both strong and moderate levels of SOCs were also found to be related to a good level of oral hygiene compared with moderate and poor levels of oral hygiene. Furthermore, subjects within the weakest SOC quintile were found to have significantly more often than others poor levels of oral hygiene. CONCLUSIONS: Our results suggest that a weak sense of coherence increases both the probability of having a poor level of oral hygiene and a frequency of toothbrushing of less than once a day. This and the theory concerning the development of SOC suggest that sense of coherence may be taken as a determinant of both the frequency and the quality of toothbrushing.

Adult↗

PubMed1982

Plaque and gingivitis in a group of Swedish schoolchildren with special reference to toothbrushing habits.

The plaque and gingival condition in 232 Swedish schoolchildren aged 13-14 years has been related to the following predictors; plaque, toothbrushing frequency and technique, bristle stiffness of the toothbrush, smoking habits, use of snuff, social class and sex. Multiple regression analyses have been performed in order to explain the variation of plaque index and of gingival index employing these predictors. Significant predictors of plaque index were toothbrushing frequency, sex (boys), number of cigarettes and social class. The predictors which significantly aggravated gingival inflammation were: plaque, use of snuff and the toothbrushing method "modified Bass". The slight gingival inflammation due to toothbrushing with the modified Bass' method was not due to inferior plaque removal.

Adolescent↗

PubMed1998

Electric toothbrush use. Attitudes and experience among dental practitioners in Germany.

PURPOSE: To evaluate the attitudes and experience of electric toothbrush use among dental practitioners in Germany. MATERIALS AND METHODS: A telephone survey of 399 dentists was conducted. RESULTS: Many dentists in Germany (41%) thought that between half and 70% of their patients do not clean their teeth correctly, and that this is the result of either poor brushing technique or insufficient brushing time coupled with insufficient visits to the dentist. Most dentists surveyed (61%) would recommend an electric toothbrush to their patients in order to improve oral hygiene control, and of these, 82% would recommend the Braun Oral-B Plaque Remover. When these dentists were asked if there had been any change in tooth and gum condition among those patients who switched from using a manual toothbrush to the Braun Oral-B Plaque Remover, 73% said that they had observed an improvement. None of the dentists interviewed had noted any deterioration. These views of German dentists are in agreement with laboratory and clinical studies that have shown an advantage for the Braun Oral-B Plaque Remover over a manual toothbrush. The results indicate that clinical trial results are a relevant way of assessing toothbrush performance, and that results may be extrapolated to normal home use.

Adult↗

PubMed1998

Cleaning efficacy of a new electric toothbrush.

PURPOSE: To evaluate the cleaning efficacy of a new electric toothbrush and new brush head design, using a robot system to simulate normal clinical toothbrush use. MATERIALS AND METHODS: The study compared the new oscillating/rotating/pulsating electric toothbrush (Braun Oral-B 3D Plaque Remover) comprised of the D15 handle and new EB15 brush head, with the clinically established oscillating/rotating electric toothbrush (Braun Oral-B Ultra Plaque Remover-D9) and brush head (EB9). Plaque substitute was applied to the artificial teeth of typodonts, which were cleaned by the robot system for 2 minutes. The remaining plaque substitute was measured for buccal + lingual/palatal and occlusal surfaces, as well as gumline and interproximal sites using a computerized vision system. RESULTS: The new D15/EB15 combination was found to be significantly more effective than the D9/EB9 combination in removing plaque substitute at all surfaces combined and all specific sites (P < 0.001). These results show that the new toothbrush which features an additional pulsating motion (D15), combined with the new brush head design (EB15), offer improved efficacy in comparison with the established oscillating/rotating combination (D9/EB9).

Dental Plaque↗

PubMed2000

Fluoride release from a toothbrush.

The purpose of the present study was to evaluate the fluoride concentration in unstimulated saliva after using a toothbrush with 9,048 ppm fluoride as sodium fluoride incorporated in the bristles. A toothpaste with 1,500 ppm fluoride served as the positive control. Twelve volunteers took part in the single-blind crossover study. In a pre-test phase of 14 days, the subjects refrained from eating fluoride-rich foods and did not use any fluoride-containing products for oral hygiene measures. This was followed by a test period of four weeks. At day one and after 14 and 28 days, unstimulated saliva was collected and analyzed for its fluoride content. Saliva was collected immediately after toothbrushing and after 15, 30, 60, 90, 120 150, and 180 minutes. On day one, the fluoride toothbrush released significant amounts of fluoride immediately after the brushing, and after 15 and 30 minutes (p < 0.01). After 14 days of use, this could be found immediately after brushing and after 15 minutes (p < 0.01 or p < 0.05, respectively). After 28 days, a significant fluoride release was only found immediately after brushing (p < 0.05). On all days, compared to the positive control, the fluoride release from the fluoride toothbrush was generally lower immediately after brushing and after 15 minutes (p < 0.001, p < 0.01 or p < 0.05, respectively). It may be concluded that a toothbrush with incorporated sodium fluoride could act as a fluoride-releasing. device.

Cariostatic Agents↗

PubMed2002

The effect of two power toothbrushes on calculus and stain formation.

PURPOSE: To compare the safety and efficacy with respect to the control of calculus and stain of two power toothbrushes. MATERIALS AND METHODS: This was a cross-over study involving a total of 81 subjects from a general population who used, in a randomized sequence, the Braun Oral-B 3D Excel (D17) and the Sonicare toothbrush with a conventional dentifrice, and a manual brush with a tartar control dentifrice. The manual toothbrush with tartar control dentifrice served as a positive control with respect to control of calculus. Following 9 weeks of manual brush use with a conventional, non-abrasive dentifrice, each test brush was used for a period of 9 weeks, after which subjects switched to the next brush in the sequence. Calculus was scored using the Volpe-Manhold Calculus Index and stain using the Lobene Stain Index. RESULTS: All three brushes were found to be safe as used in the study. All three toothbrushes significantly reduced the levels of calculus as compared to the control period. Reduction from baseline in the rate of calculus formation was greatest in the D17 group (63%), followed by the manual brush with tartar control dentifrice (60%) and Sonicare (44%). Both the D17 and the manual brush were significantly more effective than Sonicare (P< 0.001). The D17 was also more effective at controlling stain formation than either Sonicare or the manual brush with tartar control dentifrice at the gingival margin, the difference from Sonicare being statistically significant for all analyses (P< 0.0001). It is concluded that the D17 is significantly more effective in reducing both the rate of calculus and stain formation than the Sonicare toothbrush.

Adult↗

PubMed2002

Effects of the sonicare toothbrush for specific indications.

The sonicare toothbrush has been shown to reduce plaque and gingivitis better than a manual toothbrush among orthodontic patients. The sonicare toothbrush has also been shown to reduce pocket depths in patients with periodontitis. Use of the sonicare toothbrush reduced hypersensitivity after 8 weeks of use and removed 82% of the extrinsic stain from coffee, tea, and tobacco after 4 weeks of use. It has also been shown to be as effective as or better than a manual toothbrush for reducing plaque and gingivitis around dental implants and to increase salivary flow in xerostomia patients.

Dental Implants↗

PubMed2003

Bristle end rounding of manual toothbrushes and reproducibility of end rounding classification.

PURPOSE: To evaluate the bristle end rounding quality of the toothbrushes selected. Furthermore the reproducibility of the bristle tip classification method was assessed. METHODS: Fifteen different manual toothbrushes were examined by taking into account the traumatic potential of toothbrushing caused by sharp and edged bristle end geometry. Three brushes for young children (0-4 years of age), eight brushes for children of 5-14 years of age and four brushes for juveniles and adults were included. The macroscopic criteria to which the selected brushes had to conform were: a compact toothbrush handle, a small brush head with rounded contours and a medium or soft bristle stiffness. Bristle tip geometry was investigated under SEM according to a modified scale by Silverstone & Featherstone. End rounding was examined in five regions equally distributed over the brush head. Two brushes of each brand were included in the SEM investigation. For evaluation of reproducibility , end roundings of 119 bristle tips were assessed twice by one experienced examiner and once by two additional unexperienced examiners. RESULTS: The proportion of acceptably rounded bristle tips varied widely from 65.2 - 99%. Half of the products examined achieved a level of at least 90% acceptable bristle end rounding. Five of the toothbrushes examined had between 70 and 90% acceptable bristle end geometries, while two products had less than 70%. Intraindividual reproducibility regarding acceptable and unacceptable end rounding was 99.16%, interindividual reproducibility varied between 90.76% and 94.96%.

Adolescent↗

PubMed2003

[Clinical effect of Sonicare electric toothbrush in treating gingivitis].

OBJECTIVE: To observe the clinical effect of Sonicare toothbrush in treating gingivitis by means of using Sonicare toothbrush in both healthy group and gingivitis group. METHODS: 50 medical students aged 18 to 25 years old were selected. At first,The gingival Index(GI) was examined and they were divided into 2 different groups. The students were instructed to use the Sonicare toothbrush, demanding them to brush teeth 2 times one day and 2 minutes each time. One month later,the GI were reexamined. RESULTS: After one-month period of using Sonicare toothbrush, the GI decreased significantly in both groups and the difference was statistically significant. CONCLUSION: Sonicare toothbrush can remove debris and improve gingival health. It is effective tool for family oral care.

Adolescent↗

PubMed2004

Comparison of plaque removing ability of one standard and two flexible-head toothbrushes.

PURPOSE: This pilot study compared the plaque removing ability of two flexible-head toothbrushes and one nonflexible-head toothbrush. METHODS: Twenty individuals meeting specific criteria participated. Three quadrants on each subject were disclosed and scored using the Turesky modification of the Quigley-Hein plaque index. For consistency, one dental hygienist performed all brushing and another performed all indices. Pre- and post-brushing scores were compared using t-tests and analysis of variance (ANOVA) to determine differences. RESULTS: Differences between pre- and post-brushing scores of all groups were significant (p > 0.005). However, no significant differences were detected between mean scores of the test toothbrush groups and the control group of the two test toothbrush groups, or among the means of all groups. CONCLUSION: No differences in plaque removing ability were found between or among the toothbrushes tested.

Adult↗

PubMed1992

A comparison of the end-rounding of nylon bristles in commercial toothbrushes: Crest Complete and Oral-B.

Nylon bristle end-rounding provides important soft tissue benefits to modern toothbrushes. In these studies, the proportion of acceptably end-rounded bristles have been compared for a new rippled bristle design toothbrush (Crest Complete) and a flat bristle control toothbrush (Oral-B). Toothbrush bristles were examined using a stereomicroscope by a grader blind to brush type and assigned empirical grades of acceptable/unacceptable based upon the Silverstone and Featherstone scale used previously in the literature (1988). Thirty brushes of each type (soft and medium texture brushes obtained from commercial sources) were selected and ten random bristles from five randomly selected tufts were isolated for grading. In both soft and medium texture brushes, bristles in Crest Complete demonstrated 89% acceptable end-rounding. These results were significantly different (p less than 0.0001) from those found for the control toothbrush, where 53 and 51% acceptable end-rounding was observed. These results demonstrate the newly designed rippled bristle brush (Crest Complete) exhibits excellent end-rounding.

Analysis of Variance↗