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An unusual complication of toothbrushing in a 20-month-old girl is presented. This occurred as an accident while the child was brushing her teeth. It would appear that such incidents are not uncommon. However, no report of such an injury has been found in the literature.
Fifty patients took part in a single blind study to test the plaque-removing efficacy of a new double-headed brush (Duodent 2000), compared with a conventional brush (Oral B 32). Twenty-seven patients were attending for an initial course of hygiene treatment, and 23 were recall patients with persistently inadequate plaque control. Plaque was assessed at baseline and at the end of the 2-week study period using the Turesky modification of the Quigley and Hine index for all buccal and lingual surfaces. All patients had plaque scores of more than 1 at baseline (maximum = 5). The reductions in mean plaque scores for combined lingual and palatal surfaces for subjects using the double-headed brush were significantly better than the corresponding reductions for the control groups. There were no significant differences between mean buccal plaque scores at the final examination for patients using either brush. The double-headed toothbrush helped to achieve better lingual and palatal plaque control, not only in the new patient group, but also in the group of patients who had not previously responded well to oral hygiene advice.
The lingual aspect of mandibular anterior implant-supported prostheses is often difficult to reach for adequate hygiene. The following technique describes modification of an end-tufted toothbrush to allow for improved access into to difficult-to-reach areas.
A new toothbrush design, the Snakebrush, was clinically evaluated along with the Flexible and Precision brushes. In this parallel, random-allocation investigation, the plaque removing qualities of the 3 brushes were evaluated over a period of 30 days. 60 patients of good dental health between the ages of 20 and 30 years formed the basis of the clinical trial. Mean plaque area scores were evaluated and recorded after a 1-min brush at baseline, day 15 and day 30. Gingivitis indices and bleeding on probing indices were also recorded at the same time intervals. Both uni- and multivariate analyses of our data suggested that the Snakebrush removed significantly more plaque than the 2 controls. For both lingual and buccal surfaces, subjects who had used the Snakebrush showed a significant decline in bleeding on probing and qinqivitis indices.
A single blind 30 day study compared the reduction of plaque and gingivitis for the Hapika Powerbrush to the Interplak ultra 10 tuft. A longitudinal parallel group design was utilized and screening evaluation was performed to determine patient eligibility prior to study enrollment, 66 subjects were entered into the study and assigned to 1 of 2 groups, each using one of the toothbrushes. At baseline, subjects received an oral soft tissue exam, a dental hard tissue exam, and were scored by the Lobene modification of the Löe and Silness gingival index (GI). Plaque was then disclosed and scored both pre and post brushing using the modified Turesky plaque/debris examination and an interproximal bleeding examination was performed post-brushing. On days 15 and 30, after an oral soft tissue and GI examination, plaque was graded by the Modified Turesky plaque/debris exam. Subjects then brushed and were graded by the Modified Turesky plaque/debris examination and an interproximal bleeding index examination. The results showed that both brushes provided a similar change in clinical indices. All produced a statistically significant reduction from baseline to day 30 for the gingival index (26.5-29.1%), the bleeding index (13.8-24.1%), and the plaque index (16.9-19.4%). A comparison of pre and post brushing scores for the plaque index at 30 showed that both brushes reduced plaque similarly with a statistically significant reduction (P < 0.05) from their pre-brushing plaque index scores at all time periods.
OBJECTIVES: This parallel examiner blind study was designed to compare the results of professional brushing with an electric toothbrush (ETB, Braun Oral-B 3D Excel) to a professional polish session. MATERIAL AND METHODS: For this study, 90 non-dental students were selected. All received a single oral prophylaxis where plaque and calculus were removed and the teeth were polished so that all subjects started with equally clean teeth. Approximately 4 weeks later the subjects received a new appointment prior to which they were asked to abstain from oral hygiene procedures for at least 48 h. At baseline the examiner (M.P.) evaluated the amount of dental plaque (Sillness & Löe) at six surfaces of each tooth. Subsequently, in the absence of this examiner, the subject's teeth were brushed or polished by a dental hygienist (Y.I.J.). Three groups were formed; the subjects in Group 1 received 10 min of polishing with a rubber cup/point using dentifrice as abrasive paste, in Group 2 subjects were brushed for 2 min with an ETB and dentifrice by the hygienist and in Group 3 brushing for 10 min was performed with an ETB and dentifrice. Care was taken to call upon the examiner always >10 min after her leaving the room so that she was unaware of the treatment. Electric brushing was carried out carefully following the contour of the teeth and turning the brush head separately in the direction of the mesial and distal aspect of each tooth in each approximal space. After finishing with the brushing/polishing, the examiner re-evaluated the amount of remaining dental plaque. RESULTS: The baseline plaque levels in Groups 1-3 were 1.54, 1.62 and 1.55, respectively. The reduction in plaque scores in Group 1 was 94.8% (+/-4.0), for Group 2 94.2% (+/-4.7) and for Group 3 99.4% (+/-0.5). The results in Group 3 were significantly better than in Groups 1 and 2. Explorative analysis revealed that these differences were due to a higher plaque removal from the approximal surfaces and molars. CONCLUSION: Two minutes of professional brushing with an ETB was as effective as 10 min of professional polishing. Whereas 10 min with an ETB was even more effective.
OBJECTIVES: A good quality of filament tips is desirable to protect both gingiva and dental hard tissues. The aim of the present study was to compare the end-rounding quality of the filaments in 15 electric toothbrushes (Rowenta dentaclip ZH-07, dentaclip ZH 010, rotaclip ZH-11; Blend-a-dent Wellenprofil 2000 hart, Wellenprofil 2000 mittel-weich, Medic for kids; Broxo; UltraSonex; Krups 548, Waterpik BH-4U; Butler Gum; Dr. Best e-Flex3; Oral-B (EB3, EB 17-8, Plak Control Kids)). MATERIAL AND METHODS: From each brand five brushes were chosen randomly. Five tufts were selected from each brush and studied with a scanning electron microscope (x 45) at a viewing angle of 45 degrees. The filament tips were numbered from top left to bottom right and selected filaments were judged by a well-trained, blinded second examiner according to the Silverstone & Featherstone method. RESULTS: Nine of the 15 brands examined showed a high ("acceptable": >89%), four products a medium (76-84%) and two a bad (34-38%) end-rounding quality. CONCLUSION: A good quality of filament tips is claimed by the dental profession to protect both gingiva and dental hard tissues from abrasion. This could be observed for 13 of the 15 brands examined.
Clinical caries examinations, supplemented by bite-wing radiographs, were conducted on 290 schoolchildren. The children ranged from 12 to 15 years of age and were residents of a fluoride-deficient community in New York State. The children were divided into two groups based upon their stated daily toothbrushing frequency, namely, those brushing once or less/day and those brushing twice or more/day. Mean DMFS and DMFT scores were recorded for children in both categories. A trend was noted that more frequent brushing was associated with less caries activity. For females and male-females combined the differences in mean DMFS and DMFT scores between those children brushing once a day or less. The caries scores for males in these two brushing groups were marginally significant (P less than .05). Ninety percent of the children used fluoride-containing dentifrices. The inverse relationship between brushing frequency and caries activity may be related to the more frequent fluoride contact when the children brush.
Oral hygiene behavior was surveyed in June 1971 by interviews with a sample comprising 1063 persons drawn to cover the total Finnish population aged 15 years and over. The interview revealed that the frequency of brushing as reported by dentulous interviewees was distributed as follows: less than once a day (32%), once a day (25%) and more than once a day (43%). Six percent of the interviewees stated that they did not brush their teeth. Most commonly the brushing was performed either as the last thing before retiring for the night (67%) or immediately after waking up in the morning (47%). There was a strong positive correlation between high socioeconomic status and high frequency of toothbrushing. Freshening of the breath and mouth was the most common (55%) reason for brushing the teeth and forgetfulness was the most frequent reason for neglecting it (56%). The investigation showed tha the dental health behavior of the Finnish people with respect to brushing of the teeth has much room for improvement.
A method measuring plaque by area has been developed which can be used to evaluate the antiplaque effect of agents such as dentifrices when used in combination with toothbrushing. The extent of disclosed plaque 24 hours after treatment on tooth surfaces previously cleaned of all observable plaque was drawn by the examiner onto accurate enlarged scale drawings of the outline of the labial surfaces of all incisors, canines, premolars and 1st molars. Areas were then measured by an electronically recording planimeter. Three separate blind crossover trials were performed using this plaque area measurement in which a minimum of 15 subjects brushed normally on one occasion only, with either a calcium carbonate dentifrice or water. Compared with when subjects brushed with water, a statistically significant reduction of 45%-52% in plaque was observed in subjects 24 hours after brushing with the dentifrice in each of the three trials. In a study with 27 subjects, the periodontal condition of the papillae was found to be related to plaque present on labial surfaces on adjacent teeth as measured by this method. The teeth adjacent to papillae which bled on probing had 77% greater plaque area than teeth adjacent to papillae which did not bleed. Plaque area measured by this method on a continuous scale has a sensitivity advantage over the commonly used four-point plaque indices, especially when comparing effective antiplaque treatments or combination of treatments.
The ability of a powered rotary toothbrush to remove 3- and 4-day-old microbial plaque deposits was evaluated in 10 young adults with healthy gingivae. Using a split mouth technique and a cross-over experimental design, the powered brush was compared with a conventional hand brush over a 14-day period. Statistical analysis of the results showed no significant differences between either method of brushing when the whole mouth, maxillary or mandibular arches were compared. Further analysis of the proximal scores again showed no significant differences between the powered brush or handbrush. The majority of the subjects preferred the conventional handbrush to the powered brush.
Video recordings were obtained of 50 men aged 18-20 yr (25 smokers, 25 non-smokers) brushing their teeth. From repeated viewing of the films the total brushing time and the number of strokes used in each of 16 areas of the mouth were obtained for each subject. Comparisons between smokers and non-smokers of time spent brushing, and number of brushing strokes used overall and in each area of the mouth, showed no significant differences. However, the distribution of brushing strokes around the mouth was more uniform in the non-smokers than in the smokers, which may indicate a tendency towards less favourable toothbrushing performance in smokers.
This study was conducted to evaluate the effect of dental prophylaxis prior to the topical application of acidulated phosphate fluoride solution applied twice a year in schoolchildren. Experimental groups were: Group I--control group, had no treatment. Group II--twice yearly topical application of acidulated phosphate fluoride solution with prior professional prophylaxis with rubber cup and non fluoride paste. Group III--twice yearly topical application of acidulated phosphate fluoride solution with prior toothbrushing with a non-fluoridated prophy paste. After 18 months analysis of 160 children in each study group led to the following conclusions: 1. Acidulated phosphate fluoride topical applications are effective in the prevention of dental caries. 2. The omission of a professional prophylaxis prior to topical fluoride application does not affect significantly the caries preventive effect.
Randomly selected groups of 486 Southern Chinese and 129 non-Chinese 12-yr-old Hong Kong children were examined for calculus and oral debris. The non-Chinese children had less plaque and calculus than the Chinese children (P less than 0.001). The girls had lower plaque scores than the boys in both ethnic groups. The higher frequency of toothbrushing by the girls possibly reflects their greater awareness of personal appearance. There is a need to increase the standard of oral hygiene and the level of dental awareness amongst Chinese children living in Hong Kong.
In our previous report we found that the dental health of Finnish 13-15-yr-old children had significantly improved from 1973 to 1982. The aim of this study was to assess whether the improved dental health was associated with frequency of toothbrushing and associated use of fluoride dentifrice. In both 1973 and 1982 some 360 children were scored for the DFS index. In each of three towns with 0.2 ppm, 1.0 ppm, and 2.5 ppm fluoride in the drinking water, samples of about 40 children were randomly picked from each age cohort of 13, 14, and 15 yr. The children were grouped into "infrequent", "daily", or "frequent" brushers. Overall, from 1973 to 1982 the proportion of "daily" and "frequent" brushers had increased from 56% to 75% (P less than 0.001). The overall DFST (T = total) and DFSA (A = approximal) scores had declined significantly in all brushing frequency groups. Looking at separate fluoride areas, the actual decline was found to have occurred in the low fluoride area where in 1982 the DFS scores were 50% or less of the 1973 scores (P less than 0.05). In the low fluoride area in 1973, no association was found between brushing frequency and DFS scores whereas in 1982, high brushing frequency was found to be associated with low DFS scores (P less than 0.05). The decrease in DFS scores was suggested at least partly to be associated with the increased frequency of brushing the teeth with fluoride dentifrice.
Prevention and control of common dental diseases highly depends on individual behavior, and during the last decades, individuals have increasingly been required to take responsibility for their own oral health. In Finland the rate of toothbrushing and dental visits were first surveyed nationwide in 1971 by interviews with a sample of 1063 individuals, drawn to represent the total population aged 15 yr and over. At the time, 68% of the 829 dentulous interviewees claimed to brush at least once a day. Using another sample of 1006 interviewees, drawn in the same manner, in 1990 the brushing rate was found to have increased to 91% in 853 dentulous subjects. Daily brushing was more frequent among women (98%) than men (83%). The most distinct positive change regarding brushing frequency was found among men and those with only elementary education. In 1971 the interval between the two most recent dental visits was 1 yr or less for 44% of all the interviewees and for 25% it was more than 5 yr. In 1990, 53% of the interviewees had visited a dentist within a year and the visiting interval was more than 5 yr for 16%. The youngest subjects were the most frequent visitors: 60% of them in 1971 and 74% in 1990. The results indicate a clear trend toward more frequent brushing in Finland. However, this trend regarding dental visits does not seem to be equally remarkable.
OBJECTIVES: To explore factors contributing to dental service use and toothbrushing among Mäori, Pacific and New Zealand European or Other (NZEO) children in New Zealand. METHODS: Data were obtained from the 2002 National Child Nutrition Survey. Models representing demographic, socio-economic status (SES), lifestyle, dietary, food security and oral health paradigms were tested using logistic regression. RESULTS: Mäori and Pacific children were more likely to not attend for dental care (OR: 1.99 and 2.05 respectively) than NZEO children when age, sex and time lived in New Zealand were accounted for. The addition of household (OR: 1.93 and 2.05 respectively) or lifestyle (OR: 1.95 and 1.81 respectively) factors resulted in minimal OR changes for Mäori or Pacific child dental attendance, whereas addition of dietary (OR: 1.44 and 1.23 respectively) and food security (OR: 1.43 and 1.32 respectively) items reduced the ORs of Mäori and Pacific child dental attendance so they no longer differed significantly to NZEO children. Addition of dental factors increased the ORs of Mäori and Pacific children not utilizing dental services compared with NZEO children (OR: 2.30 and 2.13 respectively). Mäori and Pacific children were more likely to not brush teeth (OR: 3.86 and 1.49 respectively) than NZEO children when age, sex and time lived in New Zealand were accounted for. Addition of dietary factors resulted in a 36% OR reduction of Mäori children not brushing (OR: 2.57), while addition of household SES (OR: 1.06), lifestyle (OR: 1.14), dietary (OR: 0.71) or food security factors (OR: 1.19) reduced the ORs of Pacific children so they were no longer significantly different to NZEO children. CONCLUSIONS: Mäori and Pacific children were more likely to have not received dental care (variance largely explained by dietary and food security factors) and Mäori children were more likely to not brush their teeth (variance largely explained by dietary items) than NZEO children.
The maxillary canine and premolar areas of a beagle dog were brushed according to the roll and the scrub toothbrushing techniques. Characteristic, reproducible soft tissue lesions could be associated with the brushing.