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PubMed1990

Using a "lifestyle" perspective to understand toothbrushing behaviour in Scottish schoolchildren.

Using data from a wider survey of health related behaviour in 4,935 Lothian schoolchildren, 11, 13, and 15 yr old, this paper analysed toothbrushing frequency and its relation to "lifestyle" factors. Analysis of the results showed that girls brush more frequently than boys and that children with higher social class background brushed more frequently than children with low social class background. Further toothbrushing frequency was significantly related to the subjects' health perception, smoking and drinking habits, eating habits, bedtimes, and video-watching. Moreover, all these lifestyle factors were inter-related. The paper reinforced the concept of lifestyle as a meaningful descriptive term. The results demonstrated that the bivariate associations are pieces in a more complex mosaic. Toothbrushing thus seems to be an integrated part of a child's lifestyle and should be regarded as such in future health promotion efforts.

Adolescent↗
PubMed1984

Role of brushing technique and toothbrush design in plaque removal.

Twenty-four adults participated in an intraindividual crossover experimental study to compare the plaque removing ability of straight multitufted and V-shaped brushes. Twelve of the participants had loss of periodontal tissue resulting in open but healthy interdental areas while the other 12 displayed no periodontal breakdown. In part 1 the participants were asked to brush their teeth using their own brushing technique and length over two 12-day periods during which time they, at random, used one brush for the first and the other brush for the second period. In part 2 the participants were professionally brushed by two dental assistants using four brushing techniques (The Bass, The Roll, The Circular Scrub and The Horizontal Scrub) randomly assigned to the four quadrants of the mouth. Cleaning was performed once a day for two 5-day periods, during which time the participants refrained from brushing and interdental cleaning. Initial toothbrush assignment was randomized. At the beginning of the study and each test period no plaque or gingival inflammation was visible. At the end of each period the accumulated plaque was registered. The results showed that there was no difference between the two brushes tested in the unsupervised part. The plaque removing ability when using either of the brushes varied between participants. When professionally used the straight multitufted and V-shaped toothbrushes did not show any difference in plaque removal on buccal and lingual surfaces. Interproximally the V-shaped toothbrush was better at plaque removal than the straight one.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed2005

In vitro toothbrush-dentifrice abrasion of two restorative composites.

BACKGROUND: Surface wear can be a problem with directly placed composites. PURPOSE: This study evaluated the in vitro wear and surface roughness of two composites at different cycle intervals after being subjected to toothbrush-dentifrice abrasion. MATERIALS AND METHODS: Twenty specimens of a microhybrid, Filtek Z250 (3M ESPE, St. Paul, MN, USA), and a nanofill composite, Filtek Supreme (3M ESPE), were prepared according to the manufacturer's directions. Each specimen was subjected to toothbrush-dentifrice abrasion (250 g vertical load) using a deionized water-dentifrice slurry (Close-Up, Lever Ponds Ltd., La Lucia, ZA) and toothbrush heads (Oral-B 40, Oral-B Laboratories, Delmont, CA, USA). A brushing sequence of 10,000, 20,000, 50,000, and 100,000 strokes was performed for all samples at a rate of 1.5 Hz. At baseline and each cycle interval, a surface profilometer was used to determine average surface roughness, Ra. At the same intervals, vertical loss of material was measured with a precision micrometer. Data were analyzed using repeated-measures analysis of variance at p value .05. Analyses with atomic force microscopy (AFM) and scanning electron microscopy (SEM) were also performed. RESULTS: After 20,000, 50,000, and 100,000 cycles, Filtek Supreme showed less significant wear than Z250. Filtek Supreme demonstrated higher surface roughness than Z250 after 50,000 and 100,000 cycles. However, AFM and SEM images indicated a more uniform surface topography for Filtek Supreme than for Z250. Abrasion wear and surface roughness increased with each cycle interval for both materials. CONCLUSIONS: Although the initial performance of both materials was similar, a greater number of brushing cycles revealed differences between the wear resistance and generated surface roughness of the materials. CLINICAL SIGNIFICANCE: The wear resistance and roughness results of Filtek Supreme suggest that it is suitable for clinical use, mainly in areas that are more subject to abrasive wear, such as Class V restorations.

Acrylic Resins↗
PubMed2005

Toothbrushing patterns over time in at-risk metropolitan African-American 5th- 8th graders.

OBJECTIVES: A large study of risky pre-teen behavior provided an opportunity to examine self-reported toothbrushing frequency for stability over time and adequacy. METHODS: 1115 metropolitan African-American children at risk for violence and drug use self-reported toothbrushing frequency in at least one of five measurement points from 5th to 8th grade as part of a larger study. Longitudinal data were available for 815 students. RESULTS: 81% reported mainly twice daily, 8% reported mainly once daily, 10% changed over time, and 1% were consistently less than once daily. CONCLUSIONS: Overall, the children reported once or twice daily toothbrushing frequency, stable between 5th and 8th grades. A minority of children showed low or inconsistent frequencies and these results may indicate an opportunity for intervention to improve habits.

Adolescent↗
PubMedDate not supplied

Comparison of the Interplak and manual toothbrushes in a population with mental retardation/developmental disabilities (MR/DD).

A major dental problem confronting persons with mental retardation/developmental disabilities (MR/DD) is poor dental hygiene, which can result in an increased incidence of gingivitis and periodontal disease. Studies indicate that the most obvious reason for the poor oral hygiene of such persons is their inability to clean the oral cavity adequately. The objective of this study was to determine whether there was a difference in the oral health between a group of residents with MR/DD using the Interplak and a group using manual toothbrushes. Fifty-six residents from four Franklin County group homes completed the study. Each group home was divided into two study groups, one using the Interplak and the second using manual toothbrushes. Each subject was seen for initial recording based on the Gingival Index (Löe) and Simplified Oral Hygiene Index (Greene and Vermillion), followed by a thorough prophylaxis. These measurements were recorded again at three, six, and nine months, with a final recording at 12 months. At the conclusion of the study, analysis of the data indicated significant improvement in the Gingival Index over a 12-month period for the residents using the Interplak compared with a manual toothbrush.

Adult↗
PubMed2003

Supervised toothbrushing and oral health education program in Kuwait for children and young adults with Down syndrome.

The authors report on the effectiveness of a school-based, supervised toothbrushing program among a group of 112 children with Down syndrome in Kuwait. The study involved 45 boys and 67 girls, who ranged in age from 11-22 years (mean, 14.8 years). The participants had moderate mental retardation and attended one of two special needs schools. Plaque was scored according to the Silness and Löe plaque index and gingivitis according to the Löe and Silness gingival index. Supervised toothbrushing and dental health education sessions were conducted twice a week. The program was evaluated at the end of three months. The mean plaque score decreased from 1.93 to 0.95 (p < 0.001), and the mean gingival score from 2.00 to 0.83 (p < 0.001). This three-month supervised toothbrushing program was effective in reducing plaque and gingivitis scores, but the key to long-term success of the program is sustaining the children's motivation to make oral hygiene a part of their daily life.

Adolescent↗
PubMed1992

Choice of toothbrush: a survey of dentists' personal preferences and recommendations for patients.

Data on dentists' choice of toothbrush brand/type for personal use and their recommendations for patients were obtained by means of a questionnaire. Seventy-nine per cent of dentists surveyed received free samples, with Oral-B comprising 33 per cent of all such samples, followed by Colgate (16 per cent) and Tek (13 per cent). Fifty-three per cent of dentists surveyed indicated they used all free samples received. Sixty-two per cent of dentists do not consider that different brushes differ significantly in their plaque-removing ability. Therefore, while an effective toothbrushing technique is important, selection of the 'correct toothbrush' from the wide range available may not be critical. The results of the present investigation provide information that is relevant to dental health education and can be applied at the chairside as well as at the broader community level.

Adolescent↗
PubMedDate not supplied

A randomised controlled trial of the efficacy of supervised toothbrushing in high-caries-risk children.

Scottish children have one of the highest levels of caries experience in Europe. Only 33% of 5-year-old children in Dundee who developed caries in their first permanent molars by 7 brushed their teeth twice a day. High-caries-risk children should benefit if they brush more often with fluoridated toothpaste. The aim of this clinical trial was to determine the reduction in 2-year caries increment that can be achieved by daily supervised toothbrushing on school-days with a toothpaste containing 1,000 ppm fluoride (as sodium monofluorophosphate) and 0.13% calcium glycerophosphate, combined with recommended daily home use, compared to a control group involving no intervention other than 6-monthly clinical examinations. Five hundred and thirty-four children, mean age 5.3, in schools in deprived areas of Tayside were recruited. Each school had two parallel classes, one randomly selected to be the brushing class and the other, the control. Local mothers were trained as toothbrushing supervisors. Children brushed on school-days and received home supplies. A single examiner undertook 6-monthly examinations recording plaque, caries (D(1) level), and used FOTI to supplement the visual caries examination. For children in the brushing classes, the 2-year mean caries increment on first permanent molars was 0.81 at D(1) and 0.21 at D(3) compared to 1.19 and 0.48 for children in the control classes (significant reductions of 32% at D(1) and 56% at D(3)). In conclusion, high-caries-risk children have been shown to have significantly less caries after participating in a supervised toothbrushing programme with a fluoridated toothpaste.

Cariostatic Agents↗
PubMedDate not supplied

The effects of a supervised toothbrushing programme on the caries increment of primary school children, initially aged 5-6 years.

Children in the London Boroughs of Kensington, Chelsea and Westminster have one of the highest levels of caries in England and Wales. In 1997/98, the mean dmft for 5-year-old children was 2.83 with only 45.9% of the children being caries free. The aim of this study was to determine whether teacher-supervised toothbrushing, once a day, at school, during term time, with commercial toothpaste containing 1,450 ppm fluoride, could reduce dental caries in primary school children when compared with children from the same community who did not receive this intervention. A total of 517 children (mean age 5.63 years) were recruited for the study. Class teachers were trained individually by the same dental hygienist in an appropriate toothbrushing technique for young children. Children in the intervention group brushed once a day at school. All examinations were by visual assessment only. All teeth present were assessed using the BASCD criteria. For children in the intervention group, the overall caries increment (2.60) was significantly less (10.9%; p < 0.001) than for children in the non-intervention group (2.92). Among different tooth surfaces, the difference in caries increment between the intervention group (0.78) and the non-intervention group (1.03) was greatest for the proximal surfaces (21.4%; p < 0.01). In conclusion, this study suggests that a programme of daily teacher-supervised toothbrushing with fluoride toothpaste can be effectively targeted into socially deprived communities and a significant reduction in dental caries can thereby be achieved especially among caries-susceptible children.

Cariostatic Agents↗
PubMed2007

Susceptibility of acid-softened enamel to mechanical wear--ultrasonication versus toothbrushing abrasion.

The study aimed to compare the amounts of softened enamel removable by ultrasonication and by toothbrushing abrasion of briefly eroded samples. Thirty bovine enamel samples were demineralized in hydrochloric acid (pH 2.1) for 60 s and were then either brushed with 350 brushing strokes in toothpaste slurry (group A) or distilled water (group B) or were ultrasonicated for 120 s (group C). Enamel loss was measured after 10, 20, 50 and then after every 50 brushing strokes or after 5, 30, 60 and 120 s ultrasonication. Samples were indented with a Knoop diamond after erosion, and enamel loss due to abrasion or wear was calculated from the change in indentation depth after mechanical treatment. Within- and between-group comparisons were performed by ANOVA or t test. Initially, enamel loss increased with increasing brushing treatment or ultrasonication time. Enamel loss did not increase after 300 brushing strokes in group A (534 +/- 169 nm) or 250 brushing strokes in group B (423 +/- 80 nm), or after 60 s ultrasonication (231 +/- 72 nm). Enamel loss was significantly higher in groups A and B than in group C. The results confirm that ultrasonication removes only the outer, more highly demineralized part of the softened enamel layer. Results also indicate that toothbrushing abrasion removes more softened enamel from briefly eroded enamel than ultrasonication, and therefore probably removes partly demineralized enamel from the deeper part of the softened layer. In vivo, excessive toothbrushing might remove the softened enamel layer almost completely.

Animals↗
PubMed1995

Toothbrushing and the occurrence of salivary mutans streptococci children at day care centers.

Risk factors for the occurrence of salivary mutans streptococci (MS) were surveyed in 677 children aged 1-8 years (4.9 +/- 1.2; mean +/- SD) at 20 municipal day care centers in Oulu. As a part of an intervention program to reduce the spread of infectious diseases, toothbrushing was discontinued in 10 centers, the other 10 serving as controls. The test for MS was performed on 506 children before the 8-month intervention, on 358 at the end and on 345 on both occasions. Past caries experience was recorded from the children's dental health cards (dmf). Dental health habits were evaluated by means of questionnaires filled in by the parents. The occurrence of MS varied from 43.4 to 48.0%. Although those children who cleaned their teeth regularly at home carried less MS than those who did so irregularly (46.4 vs. 64.9%, p < 0.001), the withdrawal of toothbrushing at the day care center did not increase the incidence of MS. The occurrence of MS was increased by consumption of sweets containing sucrose (p < 0.01) and reduced by the regular use of fluoride tablets (p < 0.02). Logistic modeling showed a positive MS test to be associated significantly with older age (p < 0.01) and female sex (p < 0.05) in addition to toothbrushing at home (p < 0.001). The children with positive tests had significantly higher mean (+/- SD) dmf than those with negative ones (1.6 +/- 2.7 vs. 0.3 +/- 1.2, p < 0.001).(ABSTRACT TRUNCATED AT 250 WORDS)

Age Factors↗
PubMed1990

An epidemiological study of the influence of sweets intake and toothbrushing on dental caries among children in Japan.

The study was designed to determine the influence of confectionery and beverages intake and of toothbrushing on infant dental caries. The participants were 700 three year old Japanese children from an urban area near Tokyo. The prevalence of caries in those who frequently consumed confectionery and beverages was higher than the prevalence in those who did not take them. However, the prevalence in children with a habit of toothbrushing did not differ from that of those without the habit. This study shows that restricting consumption of confectionery and beverages may be effective in preventing dental caries; however, encouragement of toothbrushing may not be effective in limiting dental caries progression.

Beverages↗
PubMed2000

The efficacy of a counter-rotational powered toothbrush in the maintenance of endosseous dental implants.

BACKGROUND: Although most patients with implants have lost their natural teeth because of poor oral hygiene, limited data exist to guide practitioners in their recommendations of home-care regimens for their patients' endosseous dental implants and maintenance of peri-implant soft-tissue health. The authors conducted a study to compare the home-care effectiveness of a counter-rotational powered tooth-brush with that of conventional home-care regimens. METHODS: Before starting the six-year study, the authors trained 85 clinical investigators at 32 dental research centers across the United States in gathering periodontal data. Data for 2,966 implants were entered into a centralized database. Outcomes were derived from 24-month observations of a subset of the implants studied. RESULTS: Repeated-measures analysis of the toothbrushing methods used on 2,966 implants showed that the counter-rotational powered toothbrush removed plaque significantly better than manual methods (P < .0001 Wald statistic) from all implant surfaces and at all recall intervals up to 24 months. Similar results were demonstrated for the gingival index. CONCLUSIONS: The counter-rotational powered brush appears to be well-suited for home-care regimens aimed at maintaining optimal peri-implant soft-tissue health in patients with dental implants. CLINICAL IMPLICATIONS: The importance of maintaining the health of the peri-implant tissues is well-recognized by the dental profession. The counter-rotational powered toothbrush is an effective tool in meeting the oral hygiene challenges associated with implant prosthesis maintenance.

Anti-Infective Agents, Local↗
PubMed2004

Evaluation of the roughness and mass loss of the flowable composites after simulated toothbrushing abrasion.

The purpose of this study was to measure mass loss and surface roughness changes of different brands of flowable resin composites after a simulated toothbrushing test. The null hypotheses were that there would be no differences in mass loss and no significant changes in surface roughness after this test and that there would be no correlation between the two variables. The tested materials were Aeliteflo (Bisco), Flow-It (Pentron), Flow-It LF (Pentron), Natural Flow (DFL) and Wave (SDI). Z100 (3M/ESPE) microhybrid and Silux Plus (3M/ESPE) microfilled resin composites were used as control materials. Twelve specimens (5 mm in diameter, 3 mm thick) of each material were prepared according to manufacturers' instructions. Toothbrushing abrasion was performed on all specimens from each of the materials using a simulator. The percentage mass loss and surface roughness were assessed before and after 100,000 brushstrokes, using a Sartorius analytical balance of 0.0001 g accuracy and a Hommel Tester T1000, respectively. The measurements of both properties were statistically compared by paired t-test and Tukey's test (p < 0.05). All materials presented a statistically significant mass loss comparing initial and final values, with the exception of Flow-It LF. However, no difference was revealed when comparing the mass loss of the different tested materials. All materials became rougher and Wave presented statistically higher roughness compared to the other resin composites. Flowable resin composites did not seem to be superior to the control groups, and they can be expected to wear by mass loss and to have an increased roughness of surface after toothbrushing action. The anticipated null hypotheses were partially accepted.

Composite Resins↗
PubMed2002

A study of manual toothbrushing skills in children aged 3 to 11 years.

The aim of the study was to evaluate toothbrushing management and ability of children in relation to age and gender. The study population consisted of 75 children and were divided into three equal groups as 3-5, 6-8 and 9-11 years of age. The grip type during toothbrushing was recorded on videotape, The most preferred grip types were distal (73%) followed by power (43%) and oblique grips (29%). There were a statistically significant differences between age groups and the grip types (p < 0.0041) but no significant difference was seen between boys and girls in grip preferences (p > 0.05). The mean duration of toothbrushing was shorter in 3-5 years of age group (28 seconds) than the 6-8 and 9-11 age groups (35 and 47 seconds respectively).

Age Factors↗
PubMed1979

Damaging effects of toothbrush bristle end form on gingiva.

The ability of two different toothbrush bristle ends to produce traumatic gingival abrasion was assessed in a double blind study of 15 male and 15 female young adults. Brushing was performed in a circular fashion using a modified Bass Technique. An apparatus allowing continuous visual feedback of the average brushing force permitted a degree of standardization of the system. The upper left canine and bicuspid area had to be brushed for 30 seconds with cut toothbrush bristles (CP) and with round ended toothbrush bristles (RP) respectively. A two week interval separated the two brushing sessions. Traumatic lesions of the attached gingiva were stained with a disclosing solution, photographed and evaluated planimetrically. The "cut bristles" caused gingival abrasions 30% greater in extent than the round end bristles. The difference was not due to single brushing strokes accidentally greater for the "cut bristles". The size of the lesions was not sex dependent. To prevent gingival damage it is desirable to either round the bristles in production or to rid the bristle ends at least of sharp edges.

Adolescent↗
PubMed1981

Effect of toothbrushing on subgingival plaque formation.

The purpose of the present study was to find out to what extent subgingival plaque formation may be prevented by toothbrushing. The experiment was carried out on a total of 28 molars in four monkeys. On day 0 all supra- and subgingival deposits were removed, and during the following year, the teeth on the left side were carefully brushed three times a week, employing the Bass' method. The right side was kept as unbrushed control. The histologic sections, which were cut in a bucco-lingual direction, showed that subgingival plaque almost invariably had developed on the unbrushed teeth. Although all of the brushed teeth were free of subgingival plaque, a mild to moderate cellular infiltration prevailed for some distance below the gingival margin. These inflammatory reactions were assumed to have been induced by the bristles of the toothbrush, which were shown to penetrate as far as 0.9 mm below the gingival margin, when employing the Bass method. It was concluded that subgingival plaque formation can be prevented in areas accessible to the toothbrush.

Animals↗
PubMed1993

Safety testing of a new electronic toothbrush.

While there have been major advances in understanding the causes and treatments of the inflammatory periodontal diseases in the past decade, there is still high reliance on the patient to prevent progression of disease through daily oral hygiene, primarily toothbrushing and flossing. A new electronic toothbrush, which produces mild fluid cavitation as well as rapid fluid streaming, has been developed and has shown promise in the ease and efficacy with which it removes plaque. In order to determine the safety of frequent and prolonged use of this device, the gingival tissues of 6 mongrel dogs were exposed to excessively long daily exposures to this toothbrush for up to 2 months. Each quadrant of each dog's mouth was randomly assigned a different treatment: no brushing, manual brush 1.0 minute, electronic brush 1.0 minute, or electronic brush 7.5 minutes. The dogs were examined weekly by a periodontist who was blinded to the treatments. Plaque scores and bleeding on probing scores were calculated, and possible gingival irritation was monitored carefully. At the end of the trial gingival biopsies taken from all the test areas. These were processed for conventional histopathologic evaluation and examined by an oral pathologist who was also blinded as to the treatments. The results showed that brushing a single posterior segment of teeth for 7.5 minutes daily for 2 months with the electronic brush did not result in any clinically or histologically evident damage to the gingiva. Rather, the areas so treated showed excellent health as determined by both clinical and histologic criteria.(ABSTRACT TRUNCATED AT 250 WORDS)

Analysis of Variance↗