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PubMed2001

Comparative study of 2 electric and 2 manual toothbrushes in patients with fixed orthodontic appliances.

The objective of this prospective single-blind crossover clinical trial was to evaluate the efficacy of 4 toothbrushes in 33 children undergoing fixed appliance orthodontic therapy. The toothbrushes included in this study were the Braun Oral-B 3D Plaque Remover (Kronberg, Germany), the Philips-Jordan HP 510 (Philips Domestic Appliances, Groningen, The Netherlands), the Lactona orthodontic toothbrush (Bergen op Zoom, The Netherlands), and the Oral-B Advantage Control Grip (Braun); the first 2 are electric, and the last 2 are manual. Every patient tested each type of toothbrush in a randomly designed sequence. Plaque and gingival scores were recorded at baseline and after every 4-week test period. All patients received professional prophylaxis after each clinical evaluation. The data were analyzed with the Friedman test, which showed no significant differences among the 4 brushes for any of the parameters measured. The Wilcoxon signed rank test, comparing the plaque and the gingival scores between the upper and lower jaw for each brush, indicated that plaque removal was more efficient in the lower jaw than in the upper.

Adolescent↗
PubMed2003

Subgingival microbiota levels and their associations with periodontal status at the sampled sites in an adult Sudanese population using miswak or toothbrush regularly.

Little information is available on the effect of miswak use on gingival microbiota. We assessed levels of 28 oral bacteria in subgingival plaque of adult Sudanese miswak (n = 38) and toothbrush users (n = 36) age range 20-53 years (mean 34.6 years) to study associations between these bacteria, oral hygiene method, and periodontal status at the sampled sites. A pooled subgingival plaque sample from 6 probing sites of 1 selected tooth in each jaw was obtained from each subject. Whole genomic DNA probes and the checkerboard DNA-DNA hybridization were used in assessing 74 pooled samples. Using 10(5) bacterial cells threshold, between 2.6% and 47.4% of miswak users and between 2.8% and 36.1% of toothbrush users harbored the investigated species. The percentages of subjects with the investigated species at 10(6) bacterial cells varied between 2.6% and 39.5% in miswak and between 2.8% and 36.1% in toothbrush users. Miswak users harbored significantly higher Streptococcus intermedius, Actinobacillus actinomycetemcomitans, Veillonella parvula, Actinomyces israelii, and Capnocytophaga gingivalis, and significantly lower Selenomonas sputigena, Streptococcus salivarius, Actinomyces naeslundii, and Streptococcus oralis than did toothbrush users. Probing pocket depth > or = 6 mm showed significantly (P < 0.05) higher levels of Porphyromonas gingivalis, Treponema denticola, Bacteroides forsythus, Fusobacterium nucleatum, and V. parvula than those 4-5 mm. Our results indicate that the type of oral hygiene had a significant effect on levels of 11 out of 28 bacterial species, and that the type of effect was also dependent on type of bacteria and probing pocket depth.

Actinomyces↗
PubMed2005

Association between sharing of toothbrushes, eating and drinking habits and the presence of Actinobacillus actinomycetemcomitans in Moroccan adolescents.

BACKGROUND/AIMS: Actinobacillus actinomycetemcomitans is frequently detected in dental plaque collected from Moroccan adolescents, and has been shown to be associated with clinical attachment loss in this population. The aim of this study was to assess whether behaviors such as the sharing of toothbrushes, and eating and drinking habits were associated with the presence of A. actinomycetemcomitans in Moroccan adolescents. MATERIALS AND METHODS: A total of 121 adolescents were clinically examined. Interviews regarding sharing of toothbrushes, eating and drinking habits were performed, and plaque samples were collected and analyzed for A. actinomycetemcomitans with different leukotoxin promoter types by polymerase chain reaction. Based on eating and drinking habits, the study population was divided in a low risk behavior group (LRB) and a high risk behavior group (HRB). RESULTS: No association was found between the sharing of toothbrushes and the presence of A. actinomycetemcomitans. The odds ratios between the HRB and LRB group for being positive for the JP2 type, for non-JP2 types, and for any type of A. actinomycetemcomitans were 4.74 (95% CI 0.55; 40.71), 2.49 (95% CI 1.03; 5.97), and 2.97 (95% CI 1.28; 6.91), respectively. The difference in the mean number of teeth with a clinical attachment loss of > or = 3 mm between the HRB and the LRB group was 0.91(95% CI 0.09; 1.72). CONCLUSION: Sharing of toothbrushes does not seem to be associated with the presence of A. actinomycetemcomitans in young Moroccans. Eating and drinking habits conducive to exchange of saliva are positively associated with presence of A. actinomycetemcomitans, and with a higher level of clinical attachment loss.

Actinobacillus Infections↗
PubMed1999

Effect of toothbrushing on elemental release from dental casting alloys.

PURPOSE: This study assessed the effect of toothbrushing on the elemental release from common dental casting alloys. MATERIALS AND METHODS: A Au-Pt high-noble alloy, a Au-Pd high-noble alloy, a Pd-Cu-Ga noble alloy, and a Ni-Cr base-metal alloy were placed into a biological medium for 1 week to allow equilibration of elemental release, then brushed for 30 minutes at 90 strokes/min under 200 g of force with a soft toothbrush. The brushing was performed in neutral saline or lactic acid at pH 4 with or without toothpaste. The alloys were then transferred back into a biological medium for 1 week. Atomic absorption spectroscopy was used to measure the mass lost from each alloy during and in the week after brushing. Mass loss was expressed as micrograms per square centimeter of alloy surface, and the various brushing conditions were compared by analysis of variance and Tukey multiple comparison intervals (alpha = 0.05). RESULTS: During brushing, element release increased significantly over nonbrushed controls for all alloys except the Ni-Cr. Toothpastes, acidic solutions, or combinations of these conditions with toothbrushing further enhanced elemental release, but Ni release from the Ni-Cr alloy increased the most (30-fold). In the week after brushing, brushing alone increased elemental release only from the Ni-Cr alloy. However, toothpastes and acidic solutions increased elemental release for all alloys significantly, except for the Au-Pd alloy. In general, elemental release during brushing was far greater than in the week after brushing. CONCLUSIONS: Under the conditions of this study, toothbrushing increased the elemental release from dental casting alloys.

Analysis of Variance↗
PubMed1982

Scanning electron microscopy of unused and used manual toothbrushes.

A scanning electron microscopic study of the brushing surface of 17 different types of commercial toothbrushes with natural and nylon bristles was conducted on new unused brushes as well as on 65 brushes used from 1 month up to 1 year, once, twice or three times a day, with various brushing techniques. Natural swine or wild boar toothbrushes, even when new, had filaments of irregular length and diameter with deficient and irregular ends. These defective surface conditions became worse with used. Unused soft and hard nylon toothbrushes were made of tufts with bristles of the same length and diameter with cut or rounded ends. The surface of the bristle ends was generally flat but various surface defects were observed. The contours of the bristle ends of both types of nylon toothbrushes improved with use, becoming smooth and rounded. Deteriorations of the brushing surfaces of both soft and hard nylon brushes were observed at time intervals varying from one subject to another, but hard nylon bristles wore best. Soft nylon brushes wore out more rapidly.

Animals↗
PubMed1984

Comparison of the clinical effectiveness of a single and a double headed toothbrush.

A 3-way, blind, cross-over study was done to compare the plaque removing effects of a double headed toothbrush with a popular single headed flat toothbrush in 39 patients instructed in specific oral hygiene techniques. Both brushes were used with the modified Bass technique for 1 week each, whilst for an additional consecutive week, the single headed brush was used with the modified Bass and roll techniques combined. The results of this study indicated that, lingually, the double headed brush was superior to the flat single headed brush, whilst buccally no difference was found. With single headed toothbrushes the combined toothbrushing action of the modified Bass and roll techniques was less efficient than the modified Bass technique alone in the removal of dental plaque.

Adolescent↗
PubMed1986

Gingival abrasion and plaque removal with manual versus electric toothbrushing.

A clinical trial was designed to test the relative numbers of gingival lesions caused during standardized brushing of the teeth of 22 volunteer dental nurse students with a manual soft multitufted, a manual soft V-shaped, and an electric toothbrush. First, the left or the right side of the jaws of each subject was brushed by a dental hygienist using the manual V-shaped or the electric brush, and the other side using the manual multitufted brush. At the 2nd brushing 1 week later, the same hygienist used the multitufted brush for brushing the side contralateral to the one in which it was used the 1st week and the V-shaped manual brush instead of the electric and vice versa. After each brushing, the number of new gingival lesions was recorded and the cleansing effect evaluated by assessment of the amount of remaining plaque. This examiner was unaware of the type of brush used. The V-shaped manual toothbrush was found to have caused more gingival abrasion than the electric toothbrush (P less than 0.005) and a similar difference was found between the multitufted manual and the electric toothbrush (P less than 0.05). There was no clinically significant difference between the plaque removing effects of the 3 brushes tested.

Dental Plaque↗
PubMed1992

Clinical evaluation of a light energy conversion toothbrush.

A blind, two-way crossover clinical trial was carried out to compare the effectiveness of plaque removal between a new, light energy conversion toothbrush incorporated with a semiconductor of TiO2 (test) and a similar toothbrush without the semiconductor (control). The study was completed by 73 school children aged 13-15 years. Each toothbrush was used for a period of 3 weeks. The mean differences between baseline plaque scores and after subjects used the test and control brushes were analyzed by the paired t-test. The Soladey 2 toothbrush showed significantly more reduction of plaque on the buccal surfaces of all teeth than the control brush. There was no significant difference in the plaque removing ability of the two brushes on the lingual aspects of the mandible and on the lingual surfaces of the maxillary posterior sextant. As the buccal surfaces are more likely to allow light to reach the semiconductor during brushing than the lingual areas, it is possible that the reported photocatalytic property of the semiconductor may be involved in some way in the observed reduction of plaque.

Adolescent↗
PubMed1995

Temperature dependence of toothbrush bristle morphology. An ultrastructural study.

In this study, it was demonstrated that the original forms of toothbrush bristle ends undergo morphological changes during the preparatory procedures required prior to their examination by scanning electron microscopy (SEM). In particular, the distance of the specimens from the cathode of a traditional sputter-coater and the time of gold-palladium coating influence the temperature inside the vacuum compartment. Moreover, the temperature influences the original morphology of toothbrush bristles. 2 segments of each toothbrush head with nylon or ultralon bristles were cut off the brush: one was mounted vertically and one horizontally on stubs for SEM analysis. Different temperatures were measured inside the sputter-coater at the level of the bristle ends, during coating with gold-palladium alloy. The temperature at the level of the bristles that were placed horizontally was about 38 degrees C, and 59 degrees C when they were placed vertically. SEM analysis of the specimens showed that the same toothbrush has end-rounded bristles at about 59 degrees C and non-acceptable irregular bristles at about 38 degrees C. Retraction of bristles (which appeared shortened and with increased diameters) and superficial cracks were particularly present in the vertically placed ultralon bristles.

Alloys↗
PubMed1998

Evaluation of the incidence of gingival abrasion as a result of toothbrushing.

The aims of the present study were: (1) to establish the incidence of gingival abrasion as a result of toothbrushing, using a manual and electric toothbrush; (2) to establish the influence of filament end-rounding on the incidence of gingival abrasion and the efficacy of toothbrushing; (3) to assess whether the speed of the electric brush has a feedback-effect on the brushing force used and to correlate the incidence of gingival abrasion with force. 2 experiments were carried out. In the first experiment, 50 subjects brushed for 3 weeks every other day with either a manual (Butler 411) or an electric toothbrush (Braun/Oral-B Ultra Plaque Remover-D9). All received brief instructions and were asked to abstain from oral hygiene 24 hrs before their appointment. After disclosing the teeth and gums with Mira-2-Tone solution, plaque and gingival abrasion were assessed. Next, the panelists brushed in a random split-mouth order. After brushing and a second disclosing, plaque and abrasion were re-assessed. The results showed that the incidence of gingival abrasion was comparable for the manual and the D9. Using a similar design as in experiment no. 1, in experiment no. 2 a new group of 47 subjects brushed for 3 weeks alternating between the Braun/Oral-B Plaque Remover-D7 and D9. At the appointment, the subjects first brushed in a split-mouth order with the D9 with 2 different types of endrounding. Plaque and abrasion were assessed. Immediately following this brushing exercise, the subjects re-brushed with the D7 (2800 rot/min) and the D9 (3600 rot/min) during which brushing force was measured. The results of this experiment showed that endrounding has no effect on plaque removal but does effect the incidence of gingival abrasion. Brushing force is not influenced by the speed of the brushhead and no correlation with the incidence of gingival abrasion was observed. In conclusion, the results of this study show that gingival abrasion is not influenced by brushing force, but is affected by filament endrounding.

Coloring Agents↗
PubMed2005

Efficacy of the Cybersonic in comparison with the Braun 3D Excel and a manual toothbrush.

OBJECTIVES: To evaluate the efficacy of two power toothbrushes (Cybersonic and Braun 3D Excel) and one manual brush (Elmex super 29). MATERIAL AND METHODS: After professional toothcleaning 120 subjects were randomly assigned to three groups. Four weeks later, at baseline, the Quigley-Hein plaque index (QHI), the modified approximal plaque index (API), and the papillary bleeding index (PBI) were recorded. Thereafter the subjects used the assigned toothbrushes for 8 weeks. Improvements of the indices after 4 and 8 weeks were calculated as medians. Kruskal-Wallis- and Mann-Whitney U-test served for statistical analysis. RESULTS: All indices showed statistically significant reductions for both power toothbrushes which were superior to the manual brush (4 weeks: Cybersonic: API, 0.21; PBI, 0.25; QHI, 0.23; Braun: API, 0.20; PBI, 0.39; QHI, 0.22; Elmex: API, 0.04; PBI, 0.02; QHI, 0.07; 8 weeks: Cybersonic: API, 0.28; PBI, 0.36; QHI, 0.41; Braun: API, 0.36; PBI, 0.61; QHI, 0.35; Elmex: API, 0.03; PBI, 0.10; QHI, 0.08; p<0.001). The Braun was superior to the Cybersonic with respect to API after 8 weeks (p<0.05) and PBI after 4 and 8 weeks (p<0.01). CONCLUSION: Cybersonic and Braun 3D Excel may be more efficacious than a manual toothbrush in removing plaque and reducing gingivitis.

Adolescent↗
PubMed1975

Oral hygiene instruction and motivation in children using manual and electric toothbrushes.

The effect of individual chairside instruction and motivation on children using either manual or electric toothbrushes was investigated. From 123 children aged 9-15 years attending the Children's Department, Eastman Dental Hospital, four groups were constructed. Group 1 acted as the control, Groups 2 and 3 used manual toothbrushes and received instruction and motivation, and Group 4 used electric toothbrushes (Touch Tronic, Teledyne Aqua Tec) and also received instruction and motivation. For all children, modified Löe and Silness' Gingival and Plaque Indices were scored, a disclosing agent applied and a prophylaxis completed. Children in Groups 2, 3 and 4 were additionally shown the disclosed plaque, and its importance was discussed. Their attempts to "get the stain off" were checked and their own brushing techniques modified. Re-examinations took place after 1 and 3 months. To estimate the reliability of the diagnosis, 172 of the 344 examinations were repeated by a second operator. The overall coefficient of correlation (between operators) was 0.8. In the control group no detectable improvement in the gingival health or oral cleanliness occurred over the 3-month study period. However, both gingival and plaque scores decreased significantly, by 35-50%, in all instructed and motivated groups within 1 month and this improvement was still observable 2 months later. There were no significant differences in improvement between motivated children using manual or electric toothbrushes.

Adolescent↗
PubMed1998

The influence of toothbrushing frequency and post-brushing rinsing on caries experience in a caries clinical trial.

OBJECTIVE: To examine the effect of reported toothbrushing frequency and method of rinsing after brushing on caries experience and increment. METHODS: Data are presented from 2621 adolescents (mean age 12.5 years at outset) participating in a 3-year double-blind caries clinical trial. At baseline, examiners questioned each participant about their toothbrushing habits, and at subsequent examinations, this information was obtained using a self-administered computer-based questionnaire. Participants used a fluoride-containing dentifrice throughout and clinical examinations were conducted using a mirror, CPITN probe and fibre-optic transillumination. RESULTS: The reported brushing frequency increased throughout the trial. Caries experience at baseline was inversely related to toothbrushing frequency with mean DMFS=9.66, 8.12 and 7.63 respectively for <1/day, 1/day and >1/day brushers (P<0.001). Mean 3-year DMFS increments of 8.90, 6.63 and 5.48 (P<0.01) were observed in those reporting to brush <1/day, 1/day or >1/day, on not less than two of the three clinical examinations during the trial. Caries increment was also significantly related to the claimed method used to rinse post-brushing. Overall frequency of brushing and rinsing method accounted for over 50% of the explained variance in the ANOVA model used to analyse the DMFS increments. CONCLUSIONS: Stated toothbrushing frequency and rinsing method after brushing were found to be strongly correlated with caries experience and caries increment. These factors should be reflected in the design of oral health education material and taken into account in the design and analysis of caries clinical trials.

Adolescent↗
PubMed2001

Toothbrushing competency among high-risk grade one students: an evaluation of two methods of dental health education.

OBJECTIVE: To evaluate the effectiveness of two methods of dental health education (DHE) for improving toothbrushing competency among grade one students at high risk for dental diseases. METHODS: Fifty elementary schools in the former city of North York, Ontario, Canada, were assigned to one of two groups. In one group, students received a classroom-based DHE lesson that was reinforced by two small group sessions (n = 243). In the other group, students received only a single classroom-based DHE lesson (n = 206). Trained examiners assessed 11 toothbrushing skills at pre- and postintervention. RESULTS: At the preintervention test, few significant differences were found between the groups and many students did not display competency in fundamental oral health skills, such as placing a toothbrush at the gum line. Following DHE interventions, students in both groups demonstrated improvements in most skills. A significantly higher proportion of students who received both classroom and small group sessions displayed gains in competency in three skills, compared to students receiving only a classroom lesson. These skills were brushing anterior lingual surfaces, brushing posterior lingual surfaces, and brushing all areas in a routine fashion. Students receiving only a classroom session did not display greater improvements in any skill areas compared to "classroom plus small group" students. Some students in both groups still lacked fundamental skills at the end of the DHE program. CONCLUSIONS: While one must exercise caution in interpreting the results due to several methodologic limitations, findings suggest that for high-risk grade one students, a classroom-based lesson combined with small group sessions is a more effective method of improving toothbrushing skills compared to a single classroom-based lesson.

Child↗
PubMed1999

Dental caries in pre-school children: associations with social class, toothbrushing habit and consumption of sugars and sugar-containing foods. Further analysis of data from the National Diet and Nutrition Survey of children aged 1.5-4.5 years.

This project examined the relative significance of dietary sugars, toothbrushing frequency and social class as predictors of caries experience (caries vs. no caries) among 1,450 British pre-school children who took part in the National Diet and Nutrition Survey. This cross-sectional survey was based on a representative sample of children aged 1.5-4.5 years studied in 1992/3. Children were classified into four groups according to social class and toothbrushing habit. Diet/caries associations were examined for biscuits and cakes, sugar confectionery, chocolate confectionery and soft drinks, and the percentage of energy from non-milk extrinsic sugars, using data on amount and frequency of consumption from 4-day weighed dietary records. In stepwise logistic regressions, the strength of the association between social class and caries experience was twice that between toothbrushing and caries, and nearly three times that between sugar confectionery and caries (other dietary variables were not significant). The association of caries with sugar confectionery (both in amount and frequency) was only present among children whose teeth were brushed less than twice a day. Toothbrushing frequency appeared to have a stronger impact on caries prevention in non-manual compared with manual children. Household expenditure on confectionery was associated with caries only among children from the manual group. The findings suggest the hypothesis that regular brushing (twice a day) with a fluoride toothpaste may have greater impact on caries in young children than restricting sugary foods.

Age Factors↗
PubMedDate not supplied

Effect of amine/sodium fluoride rinsing on toothbrush abrasion of softened enamel in situ.

The aim of this study was to test the effect of fluoride rinsing on the prevention of toothbrush abrasion of softened enamel in situ. For softening, the samples were immersed in 0.1 M citric acid (pH 3.5) for 3 min. Eight test subjects had to make 5 runs in which 4 slabs per run were attached to intraoral appliances. They were as follows: (1) no softening, no fluoride rinsing (control 1); (2) softening, no fluoride rinsing (control 2); (3) softening, rinsing in situ with a sodium/amine fluoride rinsing solution (250 ppm F) for 30 s; (4) rinsing in situ with the sodium/amine fluoride rinsing solution (250 ppm F) for 30 s, softening; (5) softening, rinsing in situ with an experimental amine fluoride-containing rinsing solution (250 ppm F) for 30 s. After exposure for 60 min to the oral milieu, the volunteers brushed the samples for 30 s with toothpaste and the loss of tooth substance was determined. For each test person, the secretion rate of resting and paraffin-stimulated saliva, buffering capacity and pH were measured. Toothbrush abrasion in situ was not significantly lower using the fluoride rinsing solutions before or after softening the enamel compared to no rinsing (p > 0.05). Multiple linear regression analyses revealed that 57% of the variation in toothbrush abrasion could be attributed to the severity of softening (p < 0.001) and the pH of stimulated saliva (p < 0.001). It was concluded that a single rinse for 30 s had no statistically significant effect on the prevention of toothbrush abrasion of softened enamel.

Adult↗
PubMed1994

Effect of water rinsing after toothbrushing on fluoride ingestion and absorption.

This investigation was done to determine the bioavailability of fluoride (F) after toothbrushing associated with different water rinsing procedures. Eight adult subjects participated in four experiments, conducted with a randomised, crossover design: (A) 2 min brushing with an F dentifrice, followed by three quick (3 x 2 s) rinses, each with 10 ml of water; (B) brushing as in A followed by one long-lasting (1 min) rinse with 5 ml of water combined with the toothpaste-saliva mixture; (C) brushing as in A followed by expectoration but without any water rinse afterwards; and (D) ingestion of the toothpaste as a slurry with 100 ml of de-ionized water. Blood samples were collected before and frequently for 6 h after each experiment and analyzed for F content. The area under the plasma F concentration vs. time curves (AUC) was calculated and the degree of F absorption estimated. AUC values obtained in experiment D were assumed to represent 100% F bioavailability. The plasma values recorded during experiment A were not significantly greater than the baseline values, indicating almost no F absorption when 3 quick water rinses were performed after toothbrushing. The degrees of F absorption after one long-lasting water rinse (B) were 7.6 +/- 4.2% and with no water rinse after toothbrushing (C) 23.8 +/- 13.5%, respectively. The results showed that the degree of F absorption after toothbrushing using an F toothpaste is strongly related to the mode of water rinsing.

Absorption↗
PubMed1980

A systematic study of the plaque removal efficiency of worn toothbrushes.

This study described a new in vivo methodology for measuring and comparing plaque removal efficiencies of different toothbrush designs and used it to quantify the loss of plaque removal efficiency of worn toothbrushes, as well as to elucidate the causes. Worn toothbrushes produce statistically significant and large decreases in plaque removal ability depending upon their state of wear. While both bristle matting and bristle tapering contribute to this loss, the former appears to be the more potent. Thus brush designs that are resistant to bristle matting should show markedly superior durability. An indirect conclusion from the bristle tapering results is that the softer a brush, the less plaque it will remove. As a practical conclusion, it is recommended that a standard toothbrush be discarded when it shows signs of matting, regardless of age.

Adolescent↗