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PubMed1995

One month evaluation of the manually rotating "Bio-Bright" toothbrush for clinical safety and efficiency.

A clinical trial, based on the guidelines of the American Dental Association, was conducted to evaluate the efficacy and safety of Bio-Bright, a new manually rotating toothbrush. The brush was used by 28 adults and compared to a group of 26 adults who used an ADA-accepted toothbrush (Oral-B 35). Examinations were recorded for safety, plaque level, gingival inflammation and gingival bleeding at baseline, 15 days and one month. Analysis of the data revealed no statistically significant differences between the two groups at any of the measurement periods. When calculating the cumulative longitudinal effect on plaque increase or decrease, a consistent and statically significant advantage was revealed for the Bio-Bright group, as compared to the control. No significant differences were demonstrated when comparing safety, gingival, and bleeding indices between the two groups.

Adult↗
PubMed1997

A six-month clinical comparison of the efficacy of the Sonicare and the Braun Oral-B electric toothbrushes on improving periodontal health in adult periodontitis patients.

A sonic electric toothbrush (Sonicare) and an oscillating/rotating electric brush (Braun Oral-B) were compared for efficacy in removing supragingival plaque, reducing gingival inflammation, reducing probing pocket depth (Pd) and improving probing attachment levels (PAL) in a 6-month, single-blind clinical trial. Sixty-six adults with early-moderate periodontitis (5-7 mm Pd in at least two quadrants) entered the study, and 54 completed the entire study. The Sonicare and Braun groups were equally matched for plaque scores, and balanced for age, race and gender. Plaque was scored using the Turesky, Gilmore and Glickman Index. Gingival inflammation was determined by the Papillary Bleeding Score (PBS) of Loesche. Probing depths and attachment levels were determined using a manual North Carolina probe. All measurements were recorded at baseline, 2, 4 and 6 months. The mean overall plaque scores improved in both the Sonicare and the Braun groups at each of the follow-up visits. Interproximal plaque scores also improved in both groups with time, and the mean differential Sonicare post-brushing score was significantly better than the Braun at the 6-month visit (t-test; p = 0.039). Gingival inflammation also decreased in both groups over the 6-month period, but the Sonicare group showed significantly superior PBS scores at 4 months (t-test; p = 0.002) and 6 months (p = 0.005). The percentage reduction in inflammation from baseline at 6 months was 31.9% for Sonicare and 18.1% for Braun. Probing depth scores followed a similar pattern, with the Sonicare showing a mean reduction of 0.84 mm (15.8%) from baseline at 6 months, and Braun showing a 0.39 mm (7.2%) reduction (p = 0.002). In the Sonicare group probing attachment levels improved by 8.6% (MANOVA; p = 0.01), but no PAL improvement was seen in the Braun group. Overall, this study demonstrates that long-term use of these two electric toothbrushes improves periodontal health in adult periodontitis patients, and that the Sonicare brush is superior to the Braun brush in reducing gingival inflammation and probing depth. Moreover, 6 months' use of Sonicare led to actual improvement in probing attachment levels of periodontal pockets.

Adult↗
PubMed1988

Toothbrush swallowing.

We encountered four cases of toothbrush swallowing and reviewed the literature on this subject. A total of 31 toothbrushes within the gastrointestinal tract have been reported. None have passed spontaneously. Several have caused significant complications related to pressure necrosis, including gastritis, mucosal tears, and perforation. The recommended treatment is endoscopic retrieval and postoperative monitoring for 24 hours in case of esophageal or gastric injury.

Adult↗
PubMed2002

The clinical efficacy of Colgate Total Plus Whitening Toothpaste containing a special grade of silica and Colgate Total Toothpaste for controlling breath odor twelve hours after toothbrushing: a single-use clinical study.

The objective of this double-blind clinical study, conducted in harmony with American Dental Association guidelines, was to compare a new dentifrice formulation variant of Colgate Total Toothpaste containing a special grade of silica (Colgate Total Plus Whitening Toothpaste) to the commercially available, ADA-Accepted and clinically proven Colgate Total Toothpaste for controlling breath odor twelve hours after brushing the teeth. Breath odor was evaluated by a panel of three examiners using a nine-point hedonic scale. Following a baseline evaluation of breath odor, prospective study subjects who scored above the threshold value for unpleasant breath odor were stratified by score and randomized into two treatment groups. Subjects were provided with a soft-bristled toothbrush, and brushed their teeth thoroughly in their regular and customary manner with their assigned dentifrice. Subjects refrained from dental hygiene, breath mints or mounthrinses for the next twelve hours, after which they were again evaluated for breath odor. Eighty-three (83) adult male and female subjects from the Mississauga, Ontario, Canada area participated in the study. At twelve hours after brushing their teeth, subjects in both dentifrice treatment groups presented mean breath odor scores which were statistically significantly lower than the mean scores observed at baseline. Importantly, there was no statistical difference between the two dentifrices of the mean twelve-hour breath odor scores. The mean twelve-hour breath scores for the Colgate Total Plus Whitening Toothpaste group and the Colgate Total Toothpaste group were 4.89 and 4.67, respectively, which are within the range of values corresponding to pleasant breath odor. Thus, the results of this double-blind clinical study, conducted according to a protocol which had been approved by the Council on Scientific Affairs of the American Dental Association, support the conclusion that Colgate Total Plus Whitening Toothpaste and Colgate Total Toothpaste provide effective control of breath odor at twelve hours after toothbrushing.

Adolescent↗
PubMed2002

[Endoscopic removal of a toothbrush from a 13-year-old girl's stomach].

A case of a 13-year-old girl is reported. She swallowed her toothbrush accidentally, the surgeon suggested the endoscopic examination. The teen-age, well-developed girl did not have complaints, there were five hours between the accident, and the starting of the examination. After the pharynx anaesthetization by Lidocaine spray, the endoscopy was performed by a video endoscope of GIF-130 type. The brush was found in the stomach, but its handle went through the pylorus. Injury was not found on the esophagus and stomach mucosa. The patient and her mother were fully informed, and for their request, the removal of the toothbrush was attempted by using grasping forceps and polypectomy snare. It lasted nearly forty minutes and was ensured by the intensive care. The procedure was successful, the patient who tolerated it well, left the hospital after observation, without complaints.

Adolescent↗
PubMed2002

A clinical trial comparing the effectiveness of a three-headed versus a conventional toothbrush for oral hygiene in children.

AIM: The study was designed to compare the efficacy of the Superbrush three-headed with a conventional brush for oral hygiene in children. MATERIALS AND METHODS: The study population was 78 children attending three primary schools in Leeds (UK). The clinical trial consisted of a single blind, randomized, four visits, crossover and single use toothbrush design. Subjects were randomized to one of two test groups (A and B). The 16-week trial consisted of four visits with a washout period of four weeks between the second and third visits. Both brushes were used with a horizontal mini-scrubbing strokes technique. Plaque scores were recorded at each visit using the Quigley and Hein Plaque Index as modified by Turesky et al. [1970]. RESULTS: Using a paired t-test the results from the outcome measures of the four visits indicated that buccally the conventional brush was superior in plaque removal to the three- headed brush, lingually there was no difference between brushes. Although over-all plaque removal was similar for both brushes, 85% of the children preferred the Superbrush. CONCLUSION: Significant improvements in plaque removal in children can be achieved following good tooth brushing instructions regardless of the design of toothbrush used.

Journal Article↗
PubMed1986

Toothbrush resistance and fluoride retention of sound, etched, fluoridated, and remineralized bovine enamel.

The wear resistance of tooth enamel that had undergone eight different treatments regarding the bonding procedure has been investigated. In comparison to sound enamel, the outer 3 microns of the etched-surface enamel show a decreased wear resistance against toothbrushing in vitro. Remineralization, either direct or preceded by acidified phosphated fluoride (APF) application, did not improve the wear resistance. The prophylactic effect of the APF treatment of etched enamel is considerable and is not lost after the soft, outer surface layer has worn off.

Acid Etching, Dental↗
PubMed1980

Toothbrush abrasion of color-corrective porcelain stains applied to porcelain-fused-to-metal restorations.

Normal toothbrushing with a common dentifrice has the ability to wear away color-corrective porcelain stains applied to the surface of porcelain-fused-to-metal restorations in as few as 10 to 12 years unless a protective layer of clear glaze is applied over the stain. The additional layer of clear glaze more than doubled the time required to abrade the stain from the surface.

Color↗
PubMed1991

The effect of toothbrushing on a hybrid composite resin.

This study observed the effect of various toothpastes on a hybrid composite resin to determine the difference in surface roughness as measured by a profilometer. Slurries (100 gm dentifrice/100 gm H2O) of eight toothpastes were tested by brushing composite resin samples 20,000 times and recording changes in surface smoothness with a profile meter. The surface topography of a hybrid composite resin was altered by routine toothbrushing; the effect of Colgate toothpaste was a statistically smoother surface than found with the other dentifrices; and the surface topography of acrylic resin was altered less by Colgate, Crest, Viadent, and Supersmile than the more abrasive Shane, Sensodyne, Rembrandt, and Topol dentifrices.

Acrylic Resins↗
PubMed1977

Chronic staphylococcal stomatitis resistant to penicillin and tetracycline, with evidence of local immune response. Report of a case apparently precipitated by toothbrushing trauma.

Described is a case of chronic staphylococcal stomatitis, apparently precipitated by toothbrushing, which persisted for almost 6 months. The implicated organism, Staphylococcus aureus, was resistant to penicillin and tetracycline but sensitive to erythromycin. Recovery finally occurred after antibiotic therapy combined with surgical excision of some small persistent ulcers. Ther sera from a paired set of blood specimens failed to show a significant agglutinating titer, but the samples of saliva collected at the same times gave evidence of specific secretory Iga and showed relatively high agglutinating titer.

Adult↗
PubMed2002

Do powered toothbrushes contaminate toothpaste with metals?

Replaceable brush units of powered toothbrushes (PTBs) can contain metal parts made of nickel and chromium bearing alloy. These alloy ingredients have allergenic potential, and may contaminate toothpaste and the mouth during use. Here I quantify metals abraded from PTBs. A leading brand of PTB was used in a simulated intraoral environment with three leading brand toothpastes, and post-brushing samples were analysed for iron, chromium, nickel, molybdenum, and manganese by certified laboratories using standard methods. Results showed tartar control toothpaste abraded most metal, and caused discolouration of toothpaste slurry. Discolouration of toothpaste slurry, as a useful indicator of metal abrasion, was limited to one toothpaste brand, and not useful across brands.

Color↗
PubMed1990

A mathematical model for predicting toothbrush stiffness.

Both cleaning efficiency and gingival damage depend on the access of toothbrush bristles to sheltered areas and their ability to deliver sufficient force to remove plaque as they travel over tooth surfaces. A mathematical expression was therefore developed which relates bristle properties and features of brush construction to overall brush stiffness, in order to provide a framework for the prediction and systematic investigation of brush performance: Brush stiffness = 0.125E(DBDT)2NTPf/L3. This shows that brush stiffness is predominantly affected by bristle modulus (E), bristle and tuft diameter (DB and DT), the number of tufts (NT), the number of bristles per unit area packed into a tuft hole (Pf = packing factor), and the trim length of bristles (L). Bristle composition and shape had no measurable effect. The 0.125 factor is empirically derived and probably depends on visco-elastic, frictional, and other dynamic effects which were not examined. Thus, this is a first-order approximation, and further work must be done to account for bristle interactions and brushing rate, and to correlate stiffness with a measure of cleaning efficiency.

Dental Stress Analysis↗
PubMed1991

Toothbrushing and transient bacteremia in patients undergoing orthodontic treatment.

This study was made to determine whether and to what extent bacteremia occurred after toothbrushing in patients undergoing orthodontic treatment with fixed appliances. Twenty patients were selected, all with negative history of heart or hematologic disorders. These patients had not taken antibiotics or had a history of a cold in the previous 30 days. Blood samples of 20 ml were drawn before and 5 minutes after brushing. The immune status of the patients was tested by measurement of isohemagglutins and immunoglobulin levels. Blood samples were incubated in paired culture bottles containing trypticase soy broth (TSB) with an agar paddle and Columbia broth. All samples taken before brushing were negative for bacteria. Five of the 20 patients (25% of the sample) had positive blood tests after brushing. Both anaerobic and aerobic bacteria were identified from the blood samples. Those patients who were found to have a bacteremia did not display poor oral hygiene.

Bacteriological Techniques↗
PubMed1999

Powered toothbrushes: a review of clinical trials.

There is now a vast range of powered toothbrushes (PTBs) available on the market and the efficacy of each product is usually determined in one, or a series of controlled clinical trials. This article reviews briefly the design of PTBs, some of the proposed indications for their use, and the principal observations from published studies of these products. The important issues regarding the regulation and design of trials involving PTBs are discussed and some recommendations are proposed with a view to developing a more structured approach to testing these products.

Benchmarking↗
PubMed2000

Testing the efficacy of plaque removal of a prototype brush head for a powered toothbrush.

BACKGROUND/AIMS: The principal aim of the study was to compare the efficacy of a powered toothbrush (PTB) prototype (B) brush head in removing dental plaque to the relative efficacy of a marketed model (A). METHOD: A 12-week, 2-group, 2-treatment, double-blind trial of 2, two-brush heads (with the same power unit) recruited 62 volunteers (18-25 years) who were non-clinical university students. After a screening visit, 31 subjects were allocated to each of groups A and B at baseline with stratification according to gender and plaque index. After 48 h of plaque growth, subjects underwent a timed and supervised brushing episode with the allocated PTB (visit 1). Subjects then used the PTBs at home for 12 days before being recalled (visit 2) and asked again to abstain from all oral hygiene measures for 48 h. Supervised brushing was repeated (visit 3) before the subjects were dismissed for a further 10-week, unsupervised period of home use of the PTBs. The sequence of visits (2 and 3) was then repeated at visits 4 and 5. RESULTS: The sole outcome variable was plaque which was scored at all visits using the modified Quigley & Hein Index (PI) at full mouth (FM), interproximal (IP) and smooth surfaces (S). At visits 1, 3 and 5, the PI was recorded both before and after supervised brushing. There were no significant differences in PI between the brushing groups at baseline, visit 1, visit 2 or visit 5 (2 sided t-test). At visit 3, the prototype achieved significantly lower PIs than the marketed PTB brush head for IP (and FM) surfaces, this difference was most apparent on posterior tooth surfaces. For within-group changes, PIs at visit 2 were significantly lower than those at baseline (paired t-test), an observation which may be attributable to the improved cleaning and 'novelty effect' of a PTB. The PIs at visit 5 were significantly higher than the baseline values (paired t test) and this may be accountable to an element of Hawthorne effect and/or, a fall off in compliance over the entire 12 weeks. CONCLUSION: We conclude that this in vivo model is appropriate for testing the efficacy of PTB prototypes but only over a 2-week period, as the inter-group differences were not maintained over the full 12 weeks of the trial.

Adolescent↗
PubMed2001

A clinical study to compare the efficacy of 2 electric toothbrushes in plaque removal.

OBJECTIVES: To compare the cleaning efficacy of a powered toothbrush with 3-dimensional brush head action (Braun Oral-B 3D Plaque Remover D15) and a high-speed "microtation" brush with an additional "microbrush-clip" (Rowenta Dentasonic MH921S). MATERIAL AND METHODS: 82 healthy subjects took part in the study. After a familiarization period of 8 days, the subjects abstained from all oral hygiene procedures for 48 h. After plaque was scored, the subjects brushed their teeth under supervision with the two brushes according to a split-mouth design. Immediately after brushing, subjects completed a questionnaire and plaque was scored again. RESULTS: The overall plaque scores were found to be significantly reduced from 3.05+/-0.60 to 1.96+/-0.63 by the D15 and from 3.02+/-0.58 to 2.24+/-0.64 by the Dentasonic (p<0.05). The proximal surface plaque scores were reduced from 3.20+/-0.63 to 2.17+/-0.69 by the D15 and from 3.17+/-0.60 to 2.44+/-0.69 by the Dentasonic. The relative plaque reduction was overall 36.6+/-12.2% for the D15 compared to 26.1+/-13.5% for the Dentasonic and at proximal surfaces, 33.1+/-12.3% and 23.2+/-13.0%, respectively. 75% of the subjects stated that they would prefer to keep the D15. CONCLUSIONS: Both brushes were able to remove a significant amount of plaque, but the D15 was significantly more effective compared to the Dentasonic. The additional "microbrush-clip" for the proximal embrasures failed to improve plaque removal from these tooth surfaces, compared to the D15 alone.

Adult↗
PubMed2002

Testing the efficacy of 2 prototype brush heads for a powered toothbrush: refining the model.

OBJECTIVES: To compare 2 prototype powered toothbrush (PTB) heads (A, B) to a marketed head (Sensiflex 2000) for plaque removing efficacy on the Philips/Jordan HX2550 PTB. MATERIALS AND METHODS: A 2-week, 3-group, single-blind trial recruited 78 volunteers (18-25). Plaque indices (PIs) were recorded at screening and 14 days later at baseline. Subjects were stratified (gender and PI) and then asked to abstain from oral hygiene measures for 48 h. A supervised episode of brushing with the allocated PTB head followed. Subjects then used the PTBs at home for the next 12 days before being asked to abstain from all oral hygiene measures for another 48 h prior to a second supervised brushing episode. Plaque was scored using a new modification of the Quigley & Hein Index (PI) at full mouth (FM), interproximal (IP) and smooth surfaces (SS). PIs were recorded before and after the supervised brushing episodes to enable the means of the within subject differences (pre- to post-brushing) to be compared between groups (ANOVA/t-tests). RESULTS: There were no significant differences in PI between groups at baseline or prior to the supervised brushings (p>0.05). Highly significant, mean reductions in PIs (approximately 1/2 of one PI unit) were observed for design B compared with the Sensiflex 2000 at FM and IP sites (p<0.0001) for both supervised brushing episodes. A significant reduction in PI at SS was seen only after the first brushing episode (p=0.0004). For design A, PI reductions were consistently greater than those for the Sensiflex 2000 but differences were only significant at the p<0.05 level. CONCLUSION: It is concluded that this model of clinical trial has sufficient power to demonstrate clinical superiority with respect to plaque removal for PTBs and can be used for testing one or more prototype designs of brush heads.

Adolescent↗
PubMed2001

Don't forget your toothbrush!

Patients with rectally inserted foreign bodies can present to accident and emergency departments or general medical practitioners. Rarely dentally related objects are inserted because of their ready availability in the domestic environment. There are many reasons given for their presence in the rectum, most commonly accidental insertion, assault, and psychosexual motives. This case is the first reported incident of a patient using a toothbrush to relieve his pruritus ani and subsequently losing it up into the rectum.

Aged↗