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PubMed1996

Efficacy of a sonic toothbrush on inflammation and probing depth in adult periodontitis.

This single-blind, 8-week study compared the efficacy of a sonic toothbrush and a manual brush in 40 patients with adult periodontitis. Qualitative clinical indices and quantitative laboratory methods were used to monitor the periodontal status of 3 pockets 5 to 7 mm deep in each subject. Patients were randomly assigned either a sonic or manual toothbrush. The two groups were comparable with respect to age, gender, and anatomical location of the test sites. Data were collected from all sites at baseline and at 2, 4, and 8 weeks. Over the 8-week period, both groups showed significant improvements in the clinical indices used. Descriptive statistics indicated the sonic brush group had greater improvement than the manual group in the clinical parameters (gingival index, bleeding index, probing depth, and clinical attachment level). Gingival crevicular fluid (GCF) flow was significantly lower in the sonic brush group (P = 0.018). Considerable variation was present in the levels detected for both inflammatory cytokines tested, however, concentration of interleukin-1 beta was significantly lower in the GCF of sonic group patients (P = 0.05), while concentration of interleukin-6 was significantly reduced in both groups (P < or = 0.05) (t tests). Under these conditions, there is some evidence to suggest that the sonic toothbrush is more beneficial in resolving inflammation in patients with moderate periodontal disease.

Adolescent↗
PubMed1999

A comparison of the efficacy of 2 powered toothbrushes in affecting plaque accumulation, gingivitis, and gingival bleeding.

BACKGROUND: The purpose of this 30-day blinded, parallel-design study was to compare the effect of 2 powered toothbrushes, the Rowenta MH700 and the Braun Plak Control Ultra, on reducing plaque accumulation, gingivitis, and gingival bleeding in a cohort of 60 healthy adults. METHODS: After baseline evaluation of plaque, gingivitis, and gingival bleeding, subjects were randomly assigned to one of the experimental groups, provided written and verbal toothbrushing instructions, and had their teeth polished. At 2 weeks (follow-up 1) and 4 weeks (follow-up 2), all clinical parameters were again evaluated. RESULTS: The Braun group demonstrated a nearly significant reduction in gingival index (GI) and a significant reduction in GI at follow-up 2. The Rowenta group demonstrated significant reductions in GI, plaque index (PI), and bleeding index (GBI) at both follow-up 1 and 2 examinations. At follow-up 1, the Braun group demonstrated a nearly significant reduction in GI, a significant reduction in PI, and a non-significant reduction in GBI. At follow-up 2, the Braun group demonstrated a significant reduction in GBI, but not a significant reduction in PI. The reduction in GI for the Rowenta group was significantly greater (P values of 0.0001 and 0.0001, respectively) than that demonstrated in the Braun group. However, the Rowenta group did not demonstrate a significantly greater reduction in PI (P values of 0.7135 and 0.3184 for follow-up 1 and follow-up 2, respectively) or GBI than the Braun group at either examination (P values of 0.0663 and 0.3397 for follow-up 1 and 2, respectively). CONCLUSIONS: The results of this study support the findings of numerous other studies that powered toothbrushes have great potential to remove plaque and improve gingival health and that the improvement can be demonstrated in a relatively short period of time.

Adolescent↗
PubMed2003

Spatial extent of gingival cell activation due to mechanical stimulation by toothbrushing.

BACKGROUND: Mechanical stimulation by toothbrushing enhances gingival fibroblast proliferation and collagen synthesis, and reduces inflammatory cell infiltration. The aim of this study was to investigate the spatial extent of proliferation of fibroblasts and endothelial cells in dog gingiva in response to mechanical stimulation by toothbrushing. METHODS: All maxillary fourth premolars and mandibular first molars of 6 mongrel dogs were used. Dental plaque was removed with a curet. One of each pair of bilateral teeth (in the same jaw) was assigned to the brushing group, and the corresponding tooth (opposite side) was assigned to the control group. The Bass method was used to brush the limited mesial half of the tooth at 1.96 N for 20 seconds with a fitted plastic stent. Immediately before fixation of tissue, the surface of brushed gingiva was notched to indicate the borderline between the brushed and non-brushed areas. Histometrical analyses of the sections were performed using assays for proliferating cell nuclear antigen (PCNA) and von Willebrand factor. RESULTS: The numbers of fibroblasts and PCNA-positive fibroblasts in the subepithelial connective tissue adjacent to oral sulcular epithelium significantly increased in brushed gingiva, not only in the brushed area but also in the non-brushed area 0 to 0.5 mm from the notch. Increased numbers of vascular endothelial cells were observed only in the brushed area. CONCLUSION: The effect of mechanical stimulation by toothbrushing on gingival cell proliferation was not observed more than 0.5 mm from the brushed area. These results indicate that effective activation of gingival cell proliferation requires mechanical stimulation of gingiva in all areas.

Animals↗
PubMed1983

Appearance of finished and unfinished composite surfaces after toothbrushing. A scanning electron microscopy study.

The effect of toothbrushing, using tap water, pumice, or dentifrice, on five resins--two microfiller resins, one composite resin with both large and microfiller particles, one composite resin introduced as a filling material for posterior teeth, and one conventional composite resin--was studied by scanning electron microscopy. Brushing with water had almost no effect on the unfinished specimens. When the unfinished and finished specimens of the large filler-containing materials were brushed with toothpaste or pumice, rough surface characteristics were obtained. After the finishing and toothbrushing procedures only one of the microfiller materials showed very smooth surface characteristics. The microfiller materials may be finished with successively finer devices to smooth surfaces that will stay smooth after toothbrushing, whereas finishing the large filler-containing resin materials does not lead to a lasting smooth surface.

Composite Resins↗
PubMed1994

Microorganisms on toothbrushes at day-care centers.

The microflora on 44 toothbrushes at 4 day-care centers in the city of Göteborg have been investigated as a presumptive risk factor for transmission of microorganisms by children. Non-supervised toothbrushing without the use of toothpaste was performed at the day-care centers twice a day. Streptococci, predominantly S. salivarius, S. sanguis, and S. mitis, were the most frequently recorded group of microorganisms and generally constituted the greatest part of the flora (on average, 50%). Beta-hemolytic streptococci were not found in any sample. Haemophilus species were noted in 82% of the samples. H. parainfluenzae being the most frequent, and H. influenzae being identified in only one sample. Anaerobes constituted on average a third of the microflora. Staphylococci were identified in 86% of the samples, S. epidermidis dominating. Fungi including molds were found in 50% of the samples, and from one day-care center large numbers of enteric organisms were identified. Thus this study shows that unsupervised toothbrushing at day-care centers can be questioned, more from a general hygienic point of view than from the risk of transmitting serious pathogens.

Bacteria↗
PubMed1999

[Effectiveness of portable toothbrush use on reducing cigarette consumption and improving oral health].

There have been many studies on the influence of smoking on health, and in recent years, there have also been studies examining the relationship between smoking and oral health, concluding that smoking has a considerable detrimental effect on oral health. We introduced in a number of companies the idea of "Non smoking through the use of a portable toothbrush" as a means of giving up smoking while at the same time promoting oral health. The results demonstrated that consumption of cigarettes was reduced in about 50 percent of cases, while some improvement in mouth freshness was seen in about 90 percent. The study also showed that the success rate in reducing cigarette consumption through the use of a portable toothbrush was higher in highly motivated subjects, leading us to conclude that motivation is a major factor in reducing cigarette consumption. The study impressed on us the importance of educating people on the effect of smoking on oral health and the possibility of using a portable toothbrush as a means of reducing smoking.

Adult↗
PubMed2000

Clinical comparison of plaque removal and gingival bleeding reduction by two different brush heads on a sonic toothbrush.

Previous clinical studies have demonstrated the efficacy of a sonic toothbrush (Sonicare) in plaque removal and reduction of gingival inflammation. Currently, several different brush heads are available for this sonic toothbrush. The purpose of this clinical study was to compare two different brush heads (nine row and eight row) with respect to their ability to remove dental plaque and reduce gingival bleeding. One-hundred twenty-one young adults, in good general and periodontal health, volunteered as subjects in this five-week, single-blind, crossover study. All subjects used one brush for a two-week period, brushing twice daily for two minutes. Subjects used a manual toothbrush during a one-week washout period, and then used the other head for two weeks. At the beginning and end of each two-week trial period, subjects were scored for plaque and bleeding by means of the Turesky modification of the Quigley-Hein Plaque Index and the Mombelli et al. modification of the Sulcus Bleeding Index of Mühlemann and Son. Findings of reductions were limited to "before vs. after" assessments. The nine-row brush demonstrated a significant reduction (p < 0.05) in plaque removal on the smooth surfaces (p = 0.02) as well as significant reductions in bleeding at interproximal (p = 0.04) and posterior sites (p = 0.031). Overall, both brushes appeared to be effective in reducing dental plaque and bleeding. A questionnaire administered to all subjects at the end of the five-week study revealed a preference for the smaller of the brush heads.

Adolescent↗
PubMed2001

Influence of a controlled pressure system on toothbrushing behavior.

The use of excessive brushing force has been shown to be a major cause of gingival abrasion. To aid in preventing over-vigorous brushing, the Philips/Jordan electric toothbrush incorporates a Controlled Pressure system (CPS) that causes the brush head to flex back when a toothbrushing force (TBF) in excess of a pre-determined threshold is exerted against the teeth or soft tissues. Two studies (I/II) were conducted to determine whether this mechanical feedback system is sufficiently sensitive to enable users to control their brushing behavior. In Study I, the learning pattern of brushing behavior as a response to the feedback system was evaluated. Seventeen subjects were asked to brush their teeth under observation at least twice a day for a two-week period. During these observations, the number of clicks, as well as the time the brush was pushed "through the click" were recorded. Ten of seventeen volunteers demonstrated a clear learning behavior; the mean number of clicks/minute (for all subjects) was reduced from 10 to 4 after 10 sessions of brushing, and then to 2 or 3 clicks at the end of two weeks. In Study II, 46 subjects used the electric toothbrush with the CPS click force set at various levels between 150-420 g (at 30 g intervals). After a 4-week learning period, the mean TBF was determined in each subject. TBF was most strongly influenced at pre-set click forces between 180 and 270 g. The mean TBF was lowest (about 80 g) when the threshold was set at 210 or 240 g; it then increased (to about 130-140 g TBF) both for smaller and larger values of the threshold setting. Hence, both studies indicate that the Controlled Pressure system is a functional feature that can be used to control the habitual brushing force in a learning period of less than 2 weeks.

Adult↗
PubMed2001

Comparison of the mechanical effects of a toothbrush and standard abrasive on human and bovine dentine in vitro.

Dentine abrasion is an important possible side effect of individually used mechanical oral hygiene products. Since human teeth are sometimes not available in sufficient numbers for research purposes, bovine teeth are often used as a substitute for in vitro tests of dentine abrasion. The aim of the present comparative study was to determine the mechanical effects of a manual toothbrush and a standard abrasive on human and bovine dentine under standardized conditions. Roots of human and bovine teeth were radioactivated and subjected to standardized machine brushing using a manual toothbrush and a standard abrasive slurry. Dentine abrasion was assessed by measuring radioactive phosphorus contained in the slurry after brushing. Non-radioactive human and bovine roots were brushed in the same machine, and the generated surface roughness was assessed using profilometry. Artificially stained human and bovine roots were brushed as described, and the cleaning effect was expressed as the extent of stain-free surfaces after different brushing times. The results for abrasion and surface roughening found with bovine and human dentine suggest that if standardized methods are used, roots of bovine mandibular front teeth can be used in place of human roots for in vitro studies of the mechanical effects of toothbrushes and toothpastes on dentine. The use of bovine dentine for measuring the cleaning effects of these products is, however, not recommended.

Animals↗
PubMed2001

Safety, efficacy and acceptability of a new power toothbrush: a 3-month comparative clinical investigation.

PURPOSE: To compare the safety and efficacy of a new power toothbrush (Braun Oral-B D17) with an ADA reference manual toothbrush. MATERIALS AND METHODS: 110 healthy subjects, 18-65 yrs of age, with a mean plaque index of > or = 1.80 and a gingival index of > or = 1.00, were enrolled in this 3-month, randomized, parallel-group, examiner-blind study. Oral soft and hard tissues were examined for safety, and plaque, gingivitis and bleeding were measured to evaluate efficacy. Measurements were made at baseline and after 1 and 3 months of product use. Following the baseline visit and randomization, subjects were instructed to brush twice daily for 2 mins with their assigned brush. RESULTS: 101 subjects completed the study with evaluable data for all time periods, 52 in the D17 group and 49 in the manual group. None of the nine withdrawals from the study were related to product use and no product-related adverse effects were reported. There was no clinically significant soft or hard tissue abrasion observed at any time point in either group. After 1 and 3 months, significant reductions from baseline in whole mouth and interproximal plaque, gingivitis and bleeding were observed in both groups. A comparison of the two groups revealed that the whole mouth and approximal plaque indices were reduced to a significantly greater extent in the D17 group after both 1 and 3 months. The whole mouth gingival index was also reduced to a greater extent in the D17 group at 1 and 3 months, but a difference in the approximal gingival index was only apparent after 3 months. With respect to the bleeding index, there was a significant difference between the two groups for the whole mouth at both 1 and 3 months, but the differences in favor of the D17 for approximal values did not achieve statistical significance. In conclusion, the D17 was found to be safe and had increased efficacy with respect to reduction of plaque and gingivitis, compared with a manual toothbrush.

Adolescent↗
PubMed2001

An evaluation of a commercial chewing gum in combination with normal toothbrushing for reducing dental plaque and gingivitis.

New evidence suggests a beneficial outcome to chewing a sugarless gum as an added component to a regular, twice-daily toothbrushing regimen. Results of a 4-week study performed on 78 adults with preexisting gingivitis showed a significant reduction of dental plaque and gingivitis when the test group of 39 adults chewed 2 pieces of ARM & HAMMER Dental Care The Baking Soda Gum (AHDC)--a sugar-free chewing gum containing sorbitol, malitol, xylitol, and sodium bicarbonate--for 20 minutes twice a day in conjunction with once-daily toothbrushing for 60 seconds. The control group, also comprised of 39 adults, used breath mints (the study placebo) twice a day in conjunction with the same toothbrushing regimen. There were no statistically significant differences in plaque and gingivitis scores at the baseline examination. Using the Quigley-Hein Plaque Index, the test group experienced a 17% reduction in plaque over 4 weeks, while the control group reduced their plaque amounts by approximately 9% over the same period. Lobene's Mean Gingivitis Index scores were equally significant: a nearly 10% decline for the test group compared to almost 2% for the control group. This article describes the 4-week study and its promising results.

Adolescent↗
PubMed2001

An evaluation of sodium bicarbonate chewing gum in reducing dental plaque and gingivitis in conjunction with regular toothbrushing.

The purpose of the present study was to determine the ability of a chewing gum containing 5% sodium bicarbonate to remove dental plaque and reduce gingivitis when used as a supplement to daily toothbrushing. The study group consisted of 88 adults with moderate gingivitis. Participants were divided into 4 groups and instructed to chew the study gum 0 (control), 1, 2, or 3 times daily for 1 month in addition to regular daily toothbrushing. Chewing sodium bicarbonate-containing gum significantly (P < .05) reduced plaque after 1 week, with progressively greater reductions occurring after 2 and 4 weeks of gum chewing. No correlation was observed between plaque reduction and the number of times per day that the gum was chewed. By week 4, plaque reduction of approximately 16% was achieved in all groups using the gum as compared with the control group. Reductions in gingivitis were observed in all participants who chewed the gum, and these reductions achieved statistical significance by week 4. Slightly greater improvements in gingivitis were achieved in participants who chewed the gum 2 or 3 times daily as compared with the control group and those who chewed the gum once daily. No adverse effects on the oral tissues were observed in any of the participants for the duration of the study. In conclusion, regular use of a chewing gum containing 5% sodium bicarbonate appears safe and effective for the removal of dental plaque and reduction of gingivitis when used in conjunction with daily toothbrushing.

Adult↗
PubMed2002

Comparison of the Sonicare Elite and a manual toothbrush in the evaluation of plaque reduction.

PURPOSE: To compare the clinical efficacy and safety of a new oral hygiene device, the Sonicare Elite toothbrush, with a soft-bristled manual toothbrush (Oral-B 35). MATERIALS AND METHODS: This study was designed as a single-blind crossover with two arms. A sample of 25 subjects who met the entrance criteria was divided into two sequences at random: manual-Sonicare Elite, or Sonicare Elite-manual. Within each treatment arm, subjects were given a dental cleaning and polish, and written brushing instructions, and were allowed to use the assigned brush for at least 10 days at home before reporting for two plaque reduction evaluations. Upon completion of the first treatment arm, subjects were assigned the remaining brush and repeated the same protocol as before. Pre- and post-brushing scores were recorded at all visits after 12-18 hours of overnight plaque accumulation and were used to calculate a plaque reduction score at each evaluation. The scores were then averaged over the repeated visits with the same brush and the averages from the two brushes were paired within subjects. ANOVA was performed to determine if a difference existed between the two groups in terms of overall plaque reduction. RESULTS: The Sonicare Elite achieved a significantly greater reduction in plaque than the manual toothbrush (36.0% compared to 25.7%; P < 0.05). No adverse events related to either brush were reported during the study.

Adolescent↗
PubMed2002

Evaluation of tapered-end toothbrush bristles regarding efficacy of access to occlusal fissures.

The purpose of this in vitro study was to determine how two toothbrushes, with a combination of a tapered-end and round-end bristle design (Group A), compared to a conventional toothbrush with only rounded-end bristles (Group B) for cleaning in simulated occlusal fissures on a brushing machine. The fissure width at the surface was 200 microns, and then tapered down to the fissure base depths of 230 and 400 microns. The toothbrushes were positioned 90 or 180 degrees to the fissure groove surface on the model, and a 200 g force was applied to the brush head. The fissure model received 190 strokes over one minute by the brushing machine. The removal of an artificial plaque substance in the fissure model was measured by a two-dimensional analyzing system. For each combination of the fissure depth versus bristle angle versus brush head configuration variables, five specimens were measured and means were determined. The results were statistically analyzed using a three-way ANOVA followed by Scheffe's test (alpha = 0.05). The results demonstrated that the combination of tapered and round-end bristles (Group A brush) was statistically significantly (p < 0.01) more effective in removing the artificial plaque material on the fissure area than the Group B brush for specific types and brush stroke directions.

Analysis of Variance↗
PubMed2003

Comparative efficacy of two battery-powered toothbrushes on overnight plaque removal: a single-use clinical study in New Jersey.

OBJECTIVE: The objective of this single-use, examiner-blind clinical study, was to evaluate the efficacy of a newly designed Colgate Actibrush (battery-powered toothbrush) relative to the Crest SpinBrush (battery-powered toothbrush) for the removal of supragingival plaque. METHODOLOGY: This study included the assessment of plaque removal via the comparison of pre- and post-brushing plaque levels. A total of 80 adult male and female subjects from the central New Jersey area reported to the clinical facility for a baseline (pre-brushing) plaque examination after having refrained from all oral hygiene procedures and chewing gum for 24 hours, and from eating, drinking, or smoking for four hours. Subjects were entered into the study and stratified into two balanced groups based on their baseline plaque scores. Subjects were instructed to brush their teeth for one minute under supervision with their assigned toothbrush and a commercially available toothpaste (Colgate Cavity Protection Great Regular Flavor Fluoride Toothpaste), after which they were once again evaluated for supragingival plaque (post-brushing). RESULTS: All 80 subjects complied with the protocol, and completed the single-use clinical study. The subjects assigned to the Colgate Actibrush group exhibited a statistically significant 44.5% greater whole-mouth plaque reduction after a single brushing than did those subjects assigned to the Crest SpinBrush group. Relative to the pre-brushing baseline scores, the Colgate Actibrush group exhibited a statistically significant 63.7% reduction in whole-mouth plaque removal. CONCLUSION: The results of this single-use, examiner-blind, clinical study support the conclusion that the newly designed Colgate Actibrush provides significantly greater efficacy for the removal of supragingival plaque than does the Crest SpinBrush.

Adult↗
PubMed2003

The effect of frequency of toothbrushing on oral health of 14-16 year olds.

The aim of the present study was to evaluate the impact of toothbrushing frequency on dental plaque, caries and periodontal condition in 14-16 year old students. A total of 2083 students selected from 20 schools enrolling 8th and 9th grades were investigated by a questionnaire and a clinical examination. All participants were examined for oral hygiene, dental caries and periodontal condition using Silness & Löe plaque index (Pl.l), decayed, missing and filled teeth/surfaces (DMFT/S) indices and Community Periodontal Index of Treatment Needs (CPITN), respectively. It was revealed that about 49 per cent of males and 89 per cent of the females reported to brush their teeth on a regular basis. Such differences in toothbrushing frequency between the sexes were statistically significant (P = 0.0001). The mean (Pl.l) scores were lower in those who brushed than those who did not brush their teeth, with a significantly lower scores in females than in males (P = 0.0001). There were slight but nonsignificant differences in caries experience (MFT/S) amongst males and females as related to toothbrushing frequency (P = 0.121, 0.208 respectively). While bleeding on probing (43.0 per cent) was most prevalent in students who did not brush. Calculus scores were similar in all groups. The occurrence of shallow and deep pockets in students who brushed or didn't brush their teeth were minimal (6.6-8.4 per cent). The oral health status among those who did not brush or brushed their teeth on regular or irregular basis was found to be poor and slightly varied. Therefore, more emphasis should be placed on proper oral hygiene. Also, implementation of school based oral health promotion and prevention programs is urgently needed.

Adolescent↗
PubMed2003

History of the toothbrush.

Civilized people have always used some type of instrument to clean and preserve their teeth. The first known instrument was a toothstick, referred to as a toothpick, woodmop, twigbrush, miswak, or siwak. Ancient Roman patricians employed special slaves to clean their teeth. The Chinese probably invented the bristle brush. French dentists, who were the most advanced in Europe, advocated the use of toothbrushes in the 17th and early 18th centuries. Still the toothbrush is a relative modern invention. Today, toothbrushes come in a variety of shapes and sizes with more choices than ever.

China↗
PubMed2004

The immediate antimicrobial effect of a toothbrush and miswak on cariogenic bacteria: a clinical study.

The aim of this study was to assess the antimicrobial activity of the miswak chewing stick (Salvadora persica) in vivo, especially on streptococcus mutans and lactobacilli. The study was conducted clinically using patients' saliva and measuring the effect of miswak (chewing stick), miswak extract, toothbrush, and normal saline on mutans and lactobacilli. Forty male subjects aged 20-45 years were included in the study; there were four groups of ten subjects each. For the study, 50% of miswak extract (solution) was used. The levels of mutans streptococci and lactobacilli were measured using commercially available Vivacare line CRT (Caries Risk Test) bacteria 2 in 1 kit. The results showed there was a marked reduction of streptococcus mutans among all groups. When the groups were compared, the reduction of streptococcus mutans was significantly greater using miswak in comparison to toothbrushing (p = 0.013), and there was no significant difference for lactobacilli reduction (p = 0.147). It may be concluded miswak has an immediate antimicrobial effect. Streptococcus mutans were more susceptible to miswak antimicrobial activity than lactobacilli. Dietary intake of sugar and oral health status may be considered for controlled clinical trials with special emphasis on the antibacterial activity of miswak on cariogenic bacteria for a longer period of time. A toothbrush with and without toothpaste should be compared with miswak alone. Further research is needed with a larger sample size.

Adult↗