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Some patients suffer from conditions that make holding toothbrushes difficult, if not impossible. This article describes a quick, simple and flexible method of adapting toothbrush handles to allow patients the best possible chance of performing adequate oral care.
Toothbrushing is a widely practiced oral healthcare habit which, in conjunction with fluoride toothpaste, can help to prevent dental caries and periodontal disease. The effectiveness of toothbrushing is dependent on many different factors including frequency and duration of brushing, rinsing habits and brush type. Knowledge of how these factors influence effectiveness will allow the dental professional to give appropriate advice.
Two of the newer composite resins, Miradapt and Visar-Fil, have resistance to toothbrush abrasion similar to that of Concise. After abrasion, the surface of these two resins appeared to be as rough as that of Concise. Prisma-Fil, Finesse, and Silar were abraded approximately six times as much as Concise. The abraded surface of Prisma-Fil was slightly granular, but the surface of Finesse and Silar was quite smooth. Surface characteristics after abrasion are attributable to the size of the largest particles used to make the composite resin. The blending of large and submicron particles may produce a composite that can initially be finished to an enamel-like smoothness, but eventually, toothbrush abrasion will produce a surface similar to that of a large particle resin, with the same potential for trapping stains and causing gingival irritation.
This study evaluates the effectiveness of the Collis-Curve toothbrush which has curved bristles in comparison with a control usage of a straight bristle toothbrush in removing oral accumulations of plaque and debris and preventing gingivitis.
Three different methods of instruction and motivation were used to assess the learning process and ability of preschool children in performing toothbrushing. Forty children from a private nursery of Brasília, DF, Brazil, were divided into 2 groups according to age (3-4 years old and 5-6 years old). The following methods of instruction and reinforcement were applied: I--audiovisual; II--child as a model; III--individual instruction. Professional prophylaxis was then performed and the children remained 48 hours without any kind of oral hygiene. Plaque disclosing and plaque index were carried out and recorded. The children subsequently brushed their teeth according to each method of instruction and a new plaque index was recorded. The data were analyzed statistically using the Student t-test and the comparison of two proportions. The results showed that the children of both groups reduced plaque index and that the individual instruction method was superior (p<0.05) to the others at all ages. Children older than 5 years of age were able to learn and accomplish toothbrushing better than younger children.
The aim of this study was to investigate, in vitro, the morphological characteristics of demineralized primary enamel subjected to brushing with a dentifrice with or without fluoride. In order to do so, 32 enamel blocks were divided in 4 different groups containing 8 blocks each. They were separately immersed in artificial saliva for 15 days. The experimental groups were: C - control; E - submitted to etching with 37% phosphoric acid gel (30 s); EB - submitted to etching and brushing 3 times a day with a non-fluoridated dentifrice; EBF = submitted to etching and brushing 3 times a day with a fluoridated dentifrice. The toothbrushing force was standardized at 0.2 kgf and 15 double strokes were performed on each block. After the experimental period, the samples were prepared and examined under SEM. The control group (C) showed a smooth surface, presenting scratches caused by habitual toothbrushing. The etched samples (E) exhibited different degrees of surface disintegration, but the pattern of acid etching was predominantly the type II dissolution. The brushed surfaces were smooth, with elevations which corresponded to the exposure of Tomes' process pits and depressions which corresponded to interrod enamel. Particles resembling calcium carbonate were found in the most protected parts of the grooves. No morphological differences were observed between brushing with fluoridated (EBF) and non-fluoridated (EB) dentifrice. The results suggest that the mechanical abrasion caused by brushing demineralized enamel with dentifrice smoothes the rough etched surface, and the presence of fluoride does not cause morphological modifications in this pattern.
The purpose of this study was to evaluate, in vitro, the properties (wear and roughness) of glass ionomer cements that could influence their indication as pit and fissure sealants. The utilized materials were Fuji Plus, Ketac-Molar and Vitremer (in two different proportions: 1:1 and :1). The resin-based sealant Delton was used as control. By means of an electronic balance (precision of 10-4 g), wear was measured in function of weight loss after simulated toothbrushing. Superficial roughness was determined by means of a surface roughness-measuring apparatus. The results revealed that diluted Vitremer and Fuji Plus were less resistant to toothbrushing abrasion and had the greatest increase in superficial roughness. Although in clinical situations luting or diluted ionomer cements are often utilized as alternatives to resin-based sealants, the resultsof this study revealed that the properties of those cements are worse than those of restorative ionomers, whichpresented results similar to those of the evaluated resin sealant.
This study examined the effects of an intensive training program on the toothbrushing skills of three preschool children, using both performance measures and outcome (plaque level) indicators. Toothbrushing was broken into 16 steps that involved actual manipulation of the brush in the mouth. Correct brushing included four criteria: (a) appropriate angle of bristles, (b) appropriate motion of brush, (c) appropriate tooth surface, and (d) minimum duration of brushing. Training included instructions, a three-phase modeling procedure, physical guidance, and reinforcement. Results of a multiple baseline design across subjects showed that the children completed an average of 8.6% of the steps prior to training, as compared with an average of 95.8% of the steps following training. Plaque levels decreased from an average of 58% during baseline to 24.6% after training. Follow-up measures revealed that 86.6% of the steps were maintained. The study demonstrated that the effectiveness of the procedures in teaching very young children a complex motor skill that is essential to their future health.
The number of leukocytes in the gingival exudate and the oral hygiene index during toothbrushing with a fluoride-free and fluoride-containing dentifrice was investigated in humans during a 3-month period. Significant correlations existed between the average number of leukocytes in the gingival exudate and the oral hygiene indices. The number of leukocytes increased significantly during the period of toothbrushing with the Fluoride dentifrice, whereas in the OHI no change was evident.
This paper explores, by means of clinical observation, toothbrush misuse and its relationship to gingival recession/clefting. The morphology of the lesions created is correlated with the vigor, duration, frequency and direction of the toothbrush abuse. In addition, histologic observations of biopsied tissue from different types of clefts and recessions are used as a basis for discussion of the possible pathogenesis of this type of lesion.
This study tested the effectiveness of a rechargeable electric toothbrush, Interplak, in removing supragingival plaque and resolving gingivitis. Forty adults with gingivitis were randomly assigned to either a "manual" or "electric" group. Detailed oral hygiene instructions were given and a blind examiner assessed plaque scores before and after brushing, toothbrush abrasion, and gingival inflammation at baseline, 1, 2, and 4 weeks. Subjects using the electric brush had significantly lower (P less than 0.05) mean plaque and gingival inflammation scores. The electric group's plaque scores fell from 77% at baseline to 28% (before brushing) and 14% (after brushing) at 4 weeks; the manual group's dropped from 75% to 50% and 30% (before and after brushing, respectively). The mean G.I. for the electric group fell from 1.65 at baseline to 1.28 at 4 weeks, while the manual group's scores decreased from 1.65 to 1.43. The results suggest that the electric brush removed supragingival plaque and resolved gingivitis better than the manual brush over a 28-day period. However, a telephone survey conducted 6 months later indicated that most subjects were not using the device twice a day as they had during the study.
This single (examiner) blind, randomized, 4-week study compared the safety and efficacy of a new electric toothbrush (experimental) regarding plaque removal and reducing gingivitis with two other brushes, an electric brush (control electric) and a manual toothbrush (control hand). Ninety-six subjects with 1) a minimum of 15 suitable teeth in acceptable occlusion; 2) a minimum gingivitis score of 0.9; and 3) a minimum plaque score of 1.8 were entered into the study. The subjects were randomly assigned to one of 3 groups: a control hand group (31 subjects), an experimental group (32 subjects), and a control electric group (33 subjects). Device use instructions were given according to the manufacturer's recommendations. Two examiners separately determined either gingival scores or plaque scores at baseline and 4 weeks. In regard to gingivitis, use of all 3 brushes for the study period showed statistically significant improvements in gingivitis scores (P values less than 0.01) within each of the 3 groups. Between group analyses of covariance showed that of the 3 groups, the control hand group improvement was better than both the experimental and the control electric groups (P less than 0.05). When interproximal gingivitis scores were analyzed separately, similar improvements were noted. Regarding effectiveness of plaque removal during a single brushing event at the initial and final visits, each of the 3 brushes was effective in reducing plaque for every tooth surface scored (P values less than 0.01). However, between group analyses of covariances showed that the experimental group was better than the other two (P less than 0.01).(ABSTRACT TRUNCATED AT 250 WORDS)
The Scrub and Bass Methods of toothbrushing with flossing as an adjunct were evaluated to determine which is most effective in eliminating or reducing plaque and gingivitis in 5th and 6th grade school children. Three hundred and eleven children were randomly selected and placed in five groups (Scrub, Scrub-Floss, Bass, Bass-Floss, Comparison). Four Method groups went through four weeks of daily supervised toothbrushing with four dental hygienists, while the Comparison group received no supervised instructions. There was a marked effect on oral hygiene and gingival conditions at the end of the experimental period in all four groups with no one method superior to another. Peer group intercommunication probably accounts for the improvement in the comparison group.
The surface characteristics of eight posterior and two anterior composite resins were studied by SEM and profilometric tracings. The materials included both chemically cured and light-cured resin systems. Two posterior materials were microfilled composites; the others were conventional or hybrid types. The anterior composites were of conventional and hybrid types. At various steps in the procedures the following polishing/brushing treatments were evaluated: 1) dry polishing with Sof-lex discs followed by brushing with toothpaste; and 2) wet polishing with diamond pastes of increasing fineness, followed by brushing with toothpaste. The base line before the polishing/brushing procedures was obtained by wet polishing on silicon-carbide paper (4000 grit). All materials could be polished to a comparable smoothness by the Sof-lex discs, but this polishing procedure was associated with the development of an amorphous surface layer. Polishing with diamond pastes gave various results, with a 20-fold difference in surface roughness values from the smoothest to the roughest material. Toothbrushing after polishing with the Sof-lex system increased the surface roughness for all materials, but to various degrees. The two microfilled and four of the conventional posterior composites showed comparable surface roughness values, whereas two remaining posterior and the two anterior materials showed two to three times higher surface roughness values after toothbrushing.
The purpose of the study was to investigate which factors in the child's environment are associated with poor toothbrushing behavior in 3-year-old children. Mothers' attitudes towards dental education at well-baby clinics and the relation of this attitude to children's toothbrushing frequency were also studied. The population sample was obtained by means of stratified cluster sampling of all primigravid women in the study area. The data were collected from the women by structured questionnaires and patient cards from dental well-baby clinics. The present study led to the following conclusions: a) new approaches are needed to make rural populations appreciate the benefits of oral hygiene; b) young mothers need support in their personal and in their children's dental health care; c) each family expecting their first child needs a basic amount of counseling. Health-conscious parents must be supported in the maintenance of their health habits; and d) the provider of the basic counseling has no significant role in the formation of health habits.
This study investigates the frequency of use of electric toothbrushes in relation to time of possession and social background variables. A questionnaire was sent to 129 patients who had acquired an electric toothbrush within 36 months. They were patients at the Department of Clinical Periodontology and at general dental clinics in Orebro. Response rate was 96%. The brush was used daily by 62%, whereas 3% had ceased to use them. Frequency of use and encountered problems were related only for those who had had the brush for 3 years or more. Logistic regression on the frequency of use with the variables age, gender, marital status, education, time of possession, and received instruction showed no associations except in two cases. For patients at general dental clinics, only brush type, and for patients at the department, only encountered problems had explanatory value. The conclusion is that compliance level was high and unrelated to social factors.
Although foreign body ingestion is relatively common, toothbrush swallowing is rare. We report a case of a swallowed toothbrush which passed through the ileocecal valve and perforated the proximal transverse colon, then the liver. To our knowledge, this is the first case to be reported.
In order to investigate the clinical application of paint-on resins, the effect of water absorption on toothbrush abrasion and light transmittance of ten crown resins including three paint-on resins was examined. Water absorption into each material ranged from 0.29 to 0.89 mg/cm2 after storage in distilled-water for 6 weeks and their hardnesses decreased by 3.5-22.3%. Maximum surface roughness (Rmax) of the materials stored in distilled water for 6 weeks increased with an increasing number of toothbrush abrasion cycles and ranged from 1.9 to 10.5 microm after 100,000 cycles. Also, Maximum depth and weight loss as an indicator of the amount of each material lost by abrasion showed similar behaviors similar to Rmax. These results indicated that the abrasion resistance of paint-on resins was located in the middle among all materials examined.