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PubMed1996

Effectiveness of three different types of electric toothbrushes compared with a manual technique in orthodontic patients.

Patients undergoing orthodontic treatment with fixed appliances are at risk of developing carious white spot lesions and gingival inflammation because of the challenge of oral hygiene. The purpose of this study was to evaluate under home conditions the effectiveness of three different types of electric toothbrushes during active appliance therapy: Interplak (Bausch & Lomb, Berlin, Germany), Rota-dent (Rota-dent, Kusnacht, Switzerland), and Braun Oral-B Plaque Remover (Braun/Oral-B, Kronberg, Germany). A manual technique, which included normal toothbrush, interdental brush, and dental floss, served as reference. The study was structured as a single-blind "Latin square design" study. Thirty-eight orthodontic patients were randomly allocated to groups who, within the test period, alternately used the toothbrushes. Before getting a new toothbrush that was to be used for a period of 4 weeks, each patient received video and written instructions. For another 4 weeks, the patient returned to the usual oral hygiene procedures before receiving the next new toothbrush. Oral hygiene was evaluated at the start of a new test period and after 2 and 4 weeks. Clinical scores included a modified O'Leary Plaque Index and Ainamo Gingival Bleeding Index. Wilcoxon rank testing for aggregated surfaces revealed statistically significantly lower plaque scores for Rota-dent than for the manual technique (p < 0.01). For all other toothbrushes, no differences were found in comparison to the manual technique. For Plaque Indices of specific sites, statistical analysis revealed all electric toothbrushes to be equal to the manual technique. No differences in Gingival Bleeding Indices were found after 4 weeks with either toothbrush. Patients with poor oral hygiene who used Rota-dent and Braun Oral-B Plaque Remover OD5 had statistically significantly lower plaque scores compared with the manual technique (p < 0.01; p < 0.05); for patients with good oral hygiene, these differences were neutralized. It may be concluded that electric toothbrushes of the new generation are a real alternative to the often laborious manual tooth cleaning procedures used during active appliance therapy. Patients with poor oral hygiene may benefit from them especially because plaque removal can be achieved easier and faster.

Adolescent↗
PubMed1996

Effect of toothbrush wear on plaque control.

The purpose of this study was to investigate the effect of progressive toothbrush wear on plaque control. At baseline (week 0), each of 20 subjects was given a new toothbrush which they used for the 9-week period of the study. At weeks 0, 3 and 6, all plaque was professionally removed. The amount of plaque which accumulated in each of the 3 successive 3-week experimental periods was assessed at weeks 3, 6 and 9. Toothbrush wear was evaluated by measuring the increase in the brushing surface area of toothbrushes at weeks 3, 6 and 9 as compared with week 0. The brushing surface area was measured by computer analysis of tracings of the brushing surface outlines obtained from standardized photographs. Despite progressive toothbrush wear, the amount of plaque which accumulated in each successive 3-week period decreased. The decrease in plaque scores between weeks 3 and 6 and between weeks 3 and 9 were found to be highly significant (p < 0.001). Toothbrush wear varied widely amongst the subjects. When plaque scores were evaluated for the 10 subjects with highest toothbrush wear, and the 10 with lowest wear, no significant differences were found between the 2 subgroups. Under the experimental conditions of this study, progressive toothbrush wear did not lead to a decrease in plaque control. The improvement in plaque scores may have been due to motivational effects resulting from study participation and anticipation of oral examinations. It was concluded that the wear status of a toothbrush may not be critical in ensuring optimal plaque control.

Adult↗
PubMed1996

Toothbrushing force in relation to plaque removal.

This was a 2-part study. The purpose of the 1st part was to examine the relationship between brushing force and plaque removal efficacy comparing a regular manual toothbrush (M) with an electric toothbrush the Braun/Oral-B Plak Control (B). The study consisted of a single oral prophylaxis followed by 5 experiments which differed solely in respect to toothbrushing force. At baseline (after 24-h plaque accumulation), the amount of dental plaque was evaluated and subsequently, the subject's mouth was brushed by a dental hygienist. Brushing was carried out in a random split-mouth order. Either the 1st and 3rd quadrants or the 2nd and 4th quadrants were brushed with 1 toothbrush and the 2 remaining quadrants with the other. The available time for the brushing procedure was 2 min. After brushing, the amount of remaining dental plaque was assessed. The force used in experiment 1 through 5 was 100, 150, 200, 250, 300 g, respectively. The results show that when brushing force is increased, more plaque is removed with either of the two brushes. Except for the high brushing force (300 g), the electric toothbrush removed more plaque than the manual brush. The purpose of the 2nd part was to evaluate the habitual brushing force which individuals use with various toothbrushes. Besides a manual toothbrush (M), 3 electric toothbrushes were examined, the Rotadent (R), Interplak (I) and Braun (B). 20 subjects were selected on the basis of being 'good brushers' (plaque score at screening < 25%). At baseline, each subject randomly received 1 of the 4 brushes. They were allowed a training period of 3 weeks at the end of which they were asked to abstain from brushing for at least 24 h. The plaque (Turesky modification of the Quigley & Hein) was scored, after which the subjects brushed their teeth (2 min) with the assigned toothbrush equipped with a strain gauge. A computer set-up measured (100 Hz) and calculated the mean brushing force. After brushing, the amount of remaining plaque was assessed. The design of the study was a 4-way cross-over. The results show that with a manual brush, considerably more force is used than with the electric brushes (R = 96, I = 119, B = 146, M = 273). No significant relation between brushing force and plaque removal was demonstrated for any of the brushes.

Cross-Over Studies↗
PubMed1996

Comparative single-use plaque removal by toothbrushes of different designs.

Overall literature reviews have concluded that no one design of the manual toothbrush is superior for plaque removal. More recently, a toothbrush with filaments angled away from the head was shown to be more effective in several single-use studies than conventional designs. The aim of this study was to compare plaque removal by this new toothbrush and 3 other toothbrushes which had more conventional filament arrangements. 36 volunteers participated in this single-blind, randomised, 4-cell, crossover single use toothbrushing study. On day 1 of each period, volunteers brushed with a standard toothbrush and toothpaste for 60 s and then suspended oral hygiene for 48 h. On day 3, volunteers were scored for plaque by area and then brushed with the allocated test toothbrush with toothpaste for 60 s and plaque area was rescored. A washout of 4 days was allowed between test periods. The plaque areas were used to record the binary scores of the Rustogi et al. modification of the modified Navy plaque index but away from the clinic employing the Claydon and Addy procedural method for the index. Plaque removal scored by area and site were not significantly different between the brushes. This study is at variance with previous similar investigations which suggested that the new design of toothbrush head was superior for plaque removal. It is concluded again that there are no data which demonstrate unequivocally that any one manual toothbrush design is superior to any other for plaque removal.

Adult↗
PubMed2000

Australian dentists' views on toothbrush wear and renewal.

The purpose of this study was to survey the views of Australian dentists on toothbrush wear, toothbrush renewal periods and recommendations to patients and to investigate the relationship between dentists' views on patients' toothbrush renewal intervals and dentists' own renewal habits. Questionnaires were mailed to 5,596 Australian general dental practitioners and replies received from 3,406 (61 per cent response rate). The majority of respondents (85.7 per cent) felt patients should renew their toothbrushes more often. However, only 45.3 per cent usually made a recommendation to their patients as to when they should renew their toothbrush and only 41.7 per cent thought patients actually followed such recommendations. Most respondents (56.6 per cent) thought the average adult patient should renew a toothbrush every two-three months. A renewal period of one month or earlier was recommended by 23.8 per cent of dentists; four-five months by 8 per cent; and six months or longer by 11.5 per cent. A highly significant correlation was found between the renewal periods recommended for patients and the intervals selected by the dentists for their personal brushes (p < 0.001; chi-square test). Bending and splaying of bristles was the sign identified by the majority of dentists (70 per cent) as indicating the need for a new brush. The findings suggest dentists' recommendations concerning toothbrush renewal intervals may be based on their own toothbrush renewal habits. It is also concluded that dentists think patients comply poorly with their recommendations on toothbrush renewal.

Adult↗
PubMed1998

A comparison of two electric toothbrushes with respect to plaque removal and subject preference.

PURPOSE: To compare the safety and plaque removal efficacy, and subject preference of two electric toothbrushes in a single-blind, randomized, split-mouth study. MATERIALS AND METHODS: The devices studied were the Braun Oral-B 3D Plaque Remover and the sonicare electric toothbrush. The 3D toothbrush combines the clinically proven oscillating/rotating action of the D9 with a sonic frequency pulsating action in the direction of the long axis of the bristles, giving a three-dimensional cleaning action. At an initial visit, the subjects (n = 44) were given a baseline examination of the oral soft tissues and a full mouth prophylaxis and instructed in the use of the two products, which was followed by a 4-week training period. After 2 weeks of using each toothbrush on alternate days, brushing technique was checked. After a further 2 weeks, having abstained from oral hygiene for 48 hours, two contralateral quadrants of the mouth were randomly assigned to be cleaned by the subjects with each toothbrush. Plaque assessments and soft tissue examinations were made before and after brushing. Plaque was evaluated according to a refinement of the Modified Navy Plaque Index. At the end of the study, subjects completed a product evaluation questionnaire. RESULTS: Plaque levels were significantly reduced by both toothbrushes (P = 0.001), but the efficacy of the 3D electric toothbrush was significantly greater than that of the sonicare toothbrush (P = 0.001) for all comparisons. Plaque reduction was particularly marked in the interproximal areas, reaching 87% with the 3D product, compared with 68% for sonicare (P = 0.001). In the responses to the questionnaire, the majority of subjects stated that they preferred the 3D toothbrush (88% vs 12%), mainly because of the smaller size of the brush, ease of control and overall maneuverability.

Adult↗
PubMed2000

Clinical study of the effectiveness of two sonic toothbrushes.

The aim of this study was to determine the oral hygiene effects of two sonic toothbrushes, the Water Pik Sonic Speed (W) and Sonicare (S), compared to a manual toothbrush (Elmex Super 39, E). Thirty-six healthy volunteers between 13 and 69 years of age participated in this single-blind, crossover study. They were randomly assigned to three groups, with 12 participants each. Two weeks after a screening examination, a baseline examination was performed for each participant followed by professional tooth cleaning. Three indices were recorded to assess the oral hygiene status: a papillary bleeding index (PBI), a plaque index for smooth surfaces (PI) and a plaque index for approximal surfaces (API). After instructions on how to use the toothbrushes, each group started the experiment with a different type of toothbrush. After two weeks of application, the indices were recorded a second time. This was followed by two weeks of recess, where each participant used the same brand of manual toothbrush, and then before each group switched to the next toothbrush, participants had another baseline examination and professional tooth cleaning. The three types of brushes were used in the following order: S, E, W; recess; E, W, S; recess; W, S, E. The duration of the study was 12 weeks. A single investigator performed all examinations. The Friedman test and Wilcoxon signed rank test were used for statistical analysis. Compared to the manual toothbrush the Sonic Speed and the Sonicare were more effective in removing plaque and preventing gingivitis. The study indicated that the two sonic toothbrushes may be effective alternatives to a commonly used manual toothbrush.

Adolescent↗
PubMed2001

The comparative plaque removal efficacy of two advanced manual toothbrush designs in two independent clinical studies.

Two independent studies were conducted to evaluate and compare the clinical performance of two commercially available manual toothbrushes (Colgate Total Professional and the Oral-B Cross Action). Study I was a short-term, examiner-blind crossover clinical trial (N = 30) designed to measure the removal of 24-hour plaque build-up. All subjects refrained from brushing for 24 hours and were screened for dental plaque on the facial and lingual surfaces of all natural teeth using the Rustogi Modified Navy Plaque Index. Patients then received one of the two study toothbrushes and brushed their teeth for a timed one minute. They were then re-assessed for plaque. The data showed that the Colgate Total Professional toothbrush performed better than the Oral-B Cross Action toothbrush in reducing whole-mouth plaque scores (p < 0.001). Study II was a definitive six-week, single-blind clinical trial (N = 55), conducted in harmony with American Dental Association guidelines, to assess the ability of the two toothbrushes to reduce supragingival plaque and gingivitis. In this study, the subjects were stratified into two balanced groups based on their baseline plaque and gingivitis scores. Subjects were then instructed to continue with their normal brushing technique twice daily for one minute with their assigned toothbrush and a commercially available dentifrice. Examinations for plaque (Rustogi Modified Navy Plaque Index), and gingivitis (Loe-Silness Gingival Index) were conducted by the same examiner at baseline, after three weeks, and again after six weeks. The data from this long-term clinical trial showed that the Colgate Total Professional toothbrush exhibited statistically significantly lower plaque and gingivitis scores than did the Oral-B Cross Action toothbrush. The magnitudes of these differences were 29.5% for plaque and 31.1% for gingivitis. These reductions are adequate to support the claim that the Colgate Total Professional toothbrush provides clinically superior control of supragingival plaque and gingivitis, when studied in accordance with the criteria provided by the 1999 Guidelines of the American Dental Association for determining superiority.

Adolescent↗
PubMed2001

Clinical evaluation of the efficacy of a battery-powered toothbrush. results from two independent studies.

PURPOSE: To compare the clinical efficacy with respect to plaque removal of a battery-operated power toothbrush (Dr. Johns Spin Brush Classic) with two manual toothbrushes, a standard ADA flat trim reference brush and the Oral-B CrossAction toothbrush. MATERIALS AND METHODS: Efficacy was evaluated in two independent studies using a randomized, single-use, cross-over design. Healthy adult subjects from a general population brushed their teeth for a timed 1 min and plaque was scored before and after brushing was completed. In Study 1 (Spin Brush vs. ADA toothbrush), plaque was scored using the modified Quigley and Hein Plaque Index, while in Study 2 (Spin Brush vs. CrossAction) plaque was scored using the Modified Navy Plaque Index. In addition, a hard and soft tissue examination was carried out before and after brushing to allow evaluation of safety. RESULTS: In Study 1, both the ADA toothbrush and the Spin Brush significantly reduced levels of whole mouth and approximal plaque (P < 0.0005); however, the Spin Brush was not significantly more effective than the manual brush. Relative plaque reduction for the whole mouth was 35.6 +/- 16.0% for the Spin Brush compared to 38.9 +/- 14.9% for the manual toothbrush (P < 0.047), and, for the approximal surfaces, 32.7 +/- 14.6% and 36.3 +/- 13.7%, respectively (P = 0.024). In Study 2, both toothbrushes significantly reduced plaque levels (P < 0.0001), but, as for Study 1, the CrossAction manual toothbrush was more effective than the Spin Brush. For whole mouth, marginal and approximal sites, respectively, the Spin Brush reduced plaque by 54.3%, 43.5% and 62.0%, compared with 58.6%, 47.5% and 67.1% for the CrossAction toothbrush. The difference in favor of the CrossAction brush was statistically significant (P < 0.0005) for all areas.

Adolescent↗
PubMed2002

Dental plaque removal with a novel battery-powered toothbrush.

PURPOSE: To compare the plaque removal efficacy of a positive control power toothbrush (Oral-B Ultra Plaque Remover) to an experimental power toothbrush (Crest SpinBrush) following a single use. MATERIALS AND METHODS: This study was a randomized, controlled, examiner-blind, 2-period crossover design which examined plaque removal with the two toothbrushes following a single use in 38 completed subjects. Plaque was scored before and after brushing using the Turesky Modification of the Quigley-Hein Index. RESULTS: Baseline plaque scores were 1.89 and 1.91 for the experimental toothbrush and control toothbrush treatment groups, respectively. With respect to all surfaces examined, the experimental toothbrush delivered an adjusted (via analysis of covariance) mean difference between baseline and post-brushing plaque scores of 0.46 while the control toothbrush delivered an adjusted mean difference of 0.45. These results were not statistically significant (P=0.645). A 95% one-sided upper confidence limit on the Ultra Plaque Remover minus SpinBrush difference in amount of plaque removed was calculated as 9.4% of the Ultra Plaque Remover adjusted mean. A common criterion for what is known as an "at least as good as" test is that the 95% one-sided confidence limit on the product difference is below 10% of the control product mean. Using this criterion, the SpinBrush is at least as good as the Oral-B Ultra Plaque Remover. With respect to buccal and lingual surfaces, the experimental toothbrush delivered very similar results relative to the control toothbrush. These results were also not statistically significant (P> 0.564).

Adult↗
PubMed2002

The effectiveness of two different battery-powered toothbrushes on whitening through removal of stain.

Whitening dentifrices have recently become popular, achieving a whitening benefit by surface chemical action and/or abrasion that serve to remove extrinsic stains and/or prevent extrinsic stain buildup. Some powered toothbrushes have also been demonstrated to have whitening/stain-removal efficacy when used with standard dentifrice products. The objective of this study was to evaluate the effectiveness of an experimental prototype powered toothbrush (Crest SpinBrush Pro) and a commercially available powered toothbrush (Crest SpinBrush) on dental whitening through the removal of extrinsic stain. This study was a randomized, controlled, examiner-blind, parallel-group design, which examined extrinsic stain removal over four weeks of brushing by 70 subjects. Following a three-week period of stain induction using rinses of chlorhexidine and tea, subjects were randomized to use one of the two toothbrushes. Tooth stain was scored using the Lobene stain index at baseline, and after two and four weeks of toothbrush use. Prior to statistical analysis, the stain scores were averaged on a per-subject basis. The stain reductions (baseline minus post-treatment) in average scores were calculated and analyzed using an analysis of covariance, with baseline average score as the covariate. The experimental prototype powered toothbrush (Crest SpinBrush Pro) delivered statistically significant (p < 0.001) adjusted (via analysis of covariance) mean reductions from baseline in Lobene composite stain scores of 1.90 and 2.11 after 2 weeks and 4 weeks of use, respectively. These results represent 56-62% reductions in extrinsic stain compared to baseline. The commercially available powered toothbrush (Crest SpinBrush) also delivered statistically significant (p < 0.001) adjusted (via analysis of covariance) mean reductions from baseline in Lobene composite stain scores, with magnitudes of 1.95 and 2.22 after two and four weeks of use, respectively. These results represent 60-68% reductions in extrinsic stain compared to baseline. In conclusion, both the experimental prototype powered toothbrush and the commercially available powered toothbrush were effective in removing extrinsic tooth stain.

Adult↗
PubMed2002

Laboratory evaluations of elmex inter X toothbrushes for interproximal access efficacy and posterior tooth surface cleaning.

Laboratory methods have been developed to evaluate the ability of toothbrush bristles to remove artificial plaque deposits at interproximal sites (Interproximal Access Efficacy; IAE) and on distal tooth surfaces (Posterior Tooth Surface Cleaning; PTSC). In the testing performed for this study, six toothbrushes were evaluated. These were: elmex inter X Sensitive; elmex inter X Sensitive Short Head; elmex inter X medium; elmex inter X Medium Short Head; Oral-B Cross Action 40 medium; and the ADA reference standard toothbrush. Six toothbrushes of each design were tested four times under wet brushing conditions in all assays. In the IAE studies, toothbrushing was conducted using a vertical or horizontal brushing motion, simulated anterior or posterior teeth, and a brushing weight of 250 g. The bristles were placed at a 90 degree angle to the tooth surface, and brushing was performed for 15 seconds at two strokes per second with 50 mm strokes. IAE was recorded as the maximum width of simulated plaque deposit removed. For the PTSC evaluations, a horizontal brushing motion was used on posterior tooth shapes, with a 250 g brushing pressure for ten seconds. PTSC was determined as the maximum measurement of artificial plaque deposit removed from the mid-facial area to the maximum post-distal area of the most posterior simulated tooth shape. All data were assessed with ANOVA and the post hoc Tukey test. In the individual IAE tests, with vertical or horizontal brushing on anterior and posterior simulated teeth, and on overall IAE mean values, the four elmex inter X toothbrushes were significantly higher (p < 0.01-0.001) than the ADA reference standard and the Oral-B Cross Action 40 toothbrushes. The mean PTSC values for all toothbrushes were significantly higher (p < 0.01-0.001) compared to the ADA Reference Standard toothbrush mean PTSC. All elmex inter X brushes were statistically significantly higher (p < 0.01-0.001) compared to the Oral-B Cross Action 40 product. The elmex inter X Medium had a significantly higher (p < 0.05-0.001) PTSC compared to the PTSC mean values of the other elmex inter X products tested.

Analysis of Variance↗
PubMed2002

A practice based study of a children's power toothbrush: efficacy and acceptance.

Power toothbrushes can offer significant advantages over a manual toothbrush both with respect to plaque removal and compliance. Most studies have, however, been carried out with adult toothbrushes in adult populations. Less is known about the efficacy of children's power toothbrushes, although it is likely that similar advantages will be demonstrated. This practice based study used the Debris Index (DI) component of the Simplified Oral Hygiene Index to compare baseline oral hygiene with results after 2 months of using the Braun Oral-B Kids' Power Toothbrush (D10). The study involved 13 dental offices and a total of 154 children aged 4 to 9 years. For all sites (facial and lingual), using the D10 for 2 months resulted in an approximately 40% reduction in the DI. Questionnaires completed by the parents or guardians, the children, and the dentists indicated a very favorable response to the power toothbrush. Both parents and children preferred the D10 to a manual toothbrush and most said they would continue to use it. The fact that children found the D10 fun to use may well aid compliance. Dentists thought that the D10 was effective and, at the end of the study, most said that they would now recommend a power toothbrush. It is concluded from the results of this practice based study that the D10 can help to reduce plaque levels in a population of children who previously relied on a manual toothbrush. The fact that the D10 is appealing to children and fun to use should aid compliance with long-term oral hygiene.

Analysis of Variance↗
PubMed2003

The impact of bristle profile on plaque removal efficacy of a battery-powered toothbrush.

PURPOSE: To compare the plaque removal efficacy of a control powered toothbrush (original Crest SpinBrush, flat bristle profile) to a prototype powered toothbrush (new Crest SpinBrush, rippled bristle pattern). MATERIALS AND METHODS: This study was a randomized, controlled, examiner-blind, 4-period crossover design, which examined plaque removal following a single use. The 20 subjects repeated the single use in each of four periods, twice with each toothbrush. Plaque was scored before and after brushing using the Turesky Modification of the Quigley-Hein Index. RESULTS: Baseline plaque scores were 1.59 and 1.65 for the prototype powered toothbrush and control toothbrush treatment groups, respectively. With respect to all surfaces examined, the prototype powered toothbrush delivered an adjusted (via analysis of covariance) mean difference between baseline and post-brushing plaque scores of 0.54 while the control toothbrush delivered an adjusted mean difference of 0.48. The experimental toothbrush group, on average, had a 13.1% larger plaque removal score than the control toothbrush. These results were statistically significant (P= 0.031). Similar results were observed on buccal and lingual surfaces.

Adult↗
PubMed1989

[Toothbrush holder for a day-care center].

A recent investigation of the various oral hygiene activities in 23 day-care centers located in the district administered by the Verdun Community Health Department has highlighted the need for a standardized hygienic method of storing toothbrushes. The study proposed to identify the main criteria related to hygiene that must be observed in order to prevent the transmission of contagious diseases within a day-care center, through the use of toothbrushes or toothbrush holders. Furthermore, the toothbrush holder has to meet four requirements: (1) be inexpensive; (2) be easy to build or manufacture; (3) allow the storage of 15 toothbrushes at the same time; (4) permit easy identification of the toothbrush by the child or teacher. A review of the literature, together with an assessment of toothbrush holders presently used by day-care centers in the district administered by the Verdun Community Health Department, showed that there were none which completely satisfied the required criteria. Under these circumstances, the authors of the study propose a detailed plan for the construction of a toothbrush holder that will satisfy these requirements. The toothbrush holder can be used to promote dental health to the very young. A sponsor could present it as a gift to one or more day-care centers in order to demonstrate their interest in the prevention of dental disease among these children.

Child Day Care Centers↗
PubMed1989

[Effectiveness of power toothbrushes].

Three power toothbrushes with different mechanical principles (blend-a-dent master-vertical oscillating system, blend-a-dent medic electric elliptical oscillating system, interplak-contra-rotationsystem of the bristle-tuft) and a conventional hand toothbrush were investigated in 60 oral hygiene-motivated persons in a three-month-study. Efficiency was tested by two parameters (plaque index, papillary-bleeding index) under statistically identical conditions. The study showed no major differences in efficiency between the power toothbrushes and the manual toothbrush. --For the whole study the power toothbrush with an elliptical oscillating system showed the best results. --Power toothbrushes are not more effective in plaque removal than a manual toothbrush. The great statistical variation of the investigated parameters in each group shows that an optimal brushing technique was more important than the choice of a certain toothbrush. --The investigation of the interproximal areas showed that a toothbrush alone is not effective enough. The additional use of dental floss and/or interdental cleaners for optimal oral hygiene is essential.

Analysis of Variance↗
PubMed1994

Laboratory evaluations of toothbrush interproximal penetration ratios.

Access to interproximal tooth surfaces by toothbrush bristles has been associated with plaque removal. The ability of toothbrushes to assess the interproximal area was assessed with a new laboratory apparatus by measuring the extent of bristle-to-tooth contact in simulated toothbrushing with ink-coated toothbrush bristles. Toothbrush types evaluated were the bi-level trim Advanced Design Reach Soft, the ripple trim Crest Complete Large Soft, the flat trim Colgate Plus Full Head Adult Soft, and the flat trim Oral-B 35. Six replicates of each toothbrush were tested. Denture teeth in a Columbia Dentoform, mounted at 45 degrees, were brushed at a 300 g brushing weight for 15 horizontal strokes. Tooth #15 (upper left second molar) was then removed for measurement and the interproximal distance of ink deposition was determined under 10x magnification from the plane of the buccal contour, along the mesial side of the tooth in the lingual direction at the approximate vertical midpoint of the proximal surface. This was compared in ratio to the same measurement from the buccal contour to the midline. Mean penetration ratios were 0.84 for the Advanced Design Reach, 0.79 for Crest Complete, and 0.78 for both Colgate Plus and Oral-B 35 (overall standard error = 0.01). A one-way ANOVA showed a highly significant difference (p < 0.001) demonstrating that Advanced Design Reach penetrated significantly farther than the toothbrushes with flat or ripple trim bristle patterns. The data suggest the bi-level trim in the Advanced Design Reach toothbrush offers better penetration into the area between teeth, and may provide superior clinical or plaque removal compared to the other toothbrushes tested.

Analysis of Variance↗
PubMed1993

A clinical comparison of plaque removal performance of three manual toothbrushes.

A clinical study was performed to evaluate and compare the plaque-removal performance of a recently introduced, computer-designed manual toothbrush with that of two commercially available products; the Oral-B 40 and the Reach Full-Head soft toothbrushes. Seventy-five adult male and female subjects participated, each refraining from toothbrushing for twenty-four hours. Plaque was scored according to the Rustogi, et al. refinement of the Modified Navy Plaque Index. Following screening, the subjects were divided into three balanced groups on the basis of initial plaque scores. Each group, in an alternate weekly cross-over design, used each of the three toothbrushes. At Visit 1, each group, having refrained from toothbrushing for twenty-four hours, was evaluated for plaque before brushing for sixty seconds with the assigned toothbrush, after which plaque was again scored. At Visit 2 one week later, the same procedure was followed except for the assignment of a different toothbrush. The same procedure was employed for Visit 3. On completion of the study, the data were subjected to statistical analyses which indicated that the Colgate Precision Full Head soft toothbrush removed significantly more plaque than either of the other two toothbrushes.

Adult↗