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PubMed2005

Efficacy of a high bioavailable cetylpyridinium chloride mouthrinse over a 24-hour period: a plaque imaging study.

PURPOSE: To evaluate the antiplaque benefits of a 0.07% high bioavailable, alcohol-free cetylpyridium chloride (CPC) rinse used after toothbrushing versus toothbrushing alone. METHODS: A digital plaque image analysis technique was used to quantify in situ plaque formation in a subject population carrying out modified hygiene using standard fluoridated dentifrice or standard dentifrice augmented with 30 seconds mouthrinsing with an alcohol-free mouthrinse containing 700 ppm CPC. RESULTS: Comparison of plaque formation 24 hours following "last hygiene" revealed that brushing followed by CPC mouthrinse use provided a statistically significant decrease in plaque coverage on teeth averaging 42% as compared with brushing only. Moreover, toothbrushing with a standard dentifrice in the morning resulted in 34% less plaque when subjects used the CPC mouthrinse 24 hours prior to examination. CLINICAL SIGNIFICANCE: These results support the strong retention and lasting antiplaque efficacy of high bioavailable CPC mouthrinse and suggest that the plaque biofilms formed during CPC use are susceptible to more efficient debridement.

Anti-Infective Agents, Local↗

PubMed2005

Self-efficacy perspective on oral health among Turkish pre-adolescents.

OBJECTIVE: To assess the association between toothbrushing and dietary self-efficacy and oral health status and behaviour related to it among Turkish pre-adolescents. MATERIALS AND METHODS: A cross-sectional study of Turkish school pre-adolescents aged 10 to 12 (n = 611) by oral health examinations (OHE) and self-administered health behaviour questionnaire (PHBQ). The PHBQ, including new Toothbrushing (TBSES), and modified Dietary Self-Efficacy (DSES), was designed to survey pre-adolescents' oral, dietary and general hygiene behaviour by psychosocial factors. An OHE based on World Health Organization criteria was implemented. The participation rate was 97% (n = 591), and 95% (n = 584) for PHBQ and OHE. Multiple linear regression analysis, descriptive statistics, factor and item analysis, Pearson correlation coefficient, chi-square test, and Student t-test were applied. RESULTS: Pre-adolescents, mostly with regular toothbrushing habits (69% at least once a day) and high levels of irregular dental visits (79%) had as their mean DMFS figure 3.77 +/- 3.37. Principal component analysis for TBSES and DSES revealed that four factors met the Kaiser Criteria, accounting for 50.2% of total variance. Scales with good internal consistency and test-retest stability were associated with professionally (DMFS) and self-assessed dental health (p < 0.05). A similar tendency appeared between self-assessed gingival health and DSES (p < 0.05). CONCLUSION: Self-efficacy beliefs were associated with oral health and related behaviour among pre-adolescents. Further research is needed for implementation of scales to enhance oral health.

Attitude to Health↗

PubMed2006

Antibacterial effect of electrolyzed water on oral bacteria.

This study investigated the antibacterial effect of electrolyzed water on oral bacteria both in vitro and in vivo. Tap water was electrolyzed in a water vessel using platinum cell technology. The electrolyzed tap water (called Puri-water) was put in contact with five major periodontopathogens or toothbrushes contaminated with these bacteria for 30 sec. In addition, Puri-water was used as a mouthwash for 30 sec in 16 subjects and the antibacterial effect on salivary bacteria was evaluated. Puri-water significantly reduced the growth of all periodontopathogens in culture and on toothbrushes, and that of aerobic and anaerobic bacteria in saliva, when compared to the effect of tap water. It also significantly reduced mutans streptococci growing on mitis salivarius-bacitracin agar. Our results demonstrate that the electrolyzed tap water is effective as a mouthwash and for toothbrush disinfection.

Adult↗

PubMed2006

Oral health status of children with syndromic craniosynostosis.

OBJECTIVE: To gain more information on the oral health status of subjects with syndromic craniosynostosis. DESIGN: A cross-sectional study. MATERIALS AND METHODS: The present study took place at the Hospital for Rehabilitation of Craniofacial Anomalies of University of São Paulo (HRAC-USP). The sample was 19 patients with syndromic craniosynostosis (10 Apert, 5 Crouzon, 2 Pfeiffer and 2 Saethre-Chotzen), aged 5 to 15 years. An assessment of plaque, caries and gingival indices, and evaluation of the efficacy of toothbrushing was carried out. The measurements included PHP index, dmft and DMFT indices, gingival index, comparison of PHP before and after non-supervised toothbrushing and between individuals with and without severe syndactyly. RESULTS: The patients displayed high plaque index and poor efficacy of toothbrushing, regardless of the presence of severe syndactyly; despite the plaque accumulation, the gingival index was not proportionally high. There was predominance of the D component for the DMFT index, which combined with the need for restorative treatment in 42.1% of the patients indicates poor access to dental care by these patients. CONCLUSIONS: The results show the need for a dental follow-up programme for these patients. Carers should be informed of the importance in aiding these patients during accomplishment of oral hygiene at home.

Acrocephalosyndactylia↗

PubMed1991

Background factors of enamel focal demineralization in groups of Finnish and Russian children.

The aim of this study was to analyze the occurrence of EFD lesions in relation to some background factors in Finnish and Soviet children. Children aged 7, 9 and 12 years (n = 1187) were examined clinically in Helsinki, Kuopio (Finland), Moscow and Leningrad (USSR). A questionnaire sent to the parents was used to collect data on toothbrushing frequency, use of sweets, cakes, soft drinks, sugar-sweetened tea/coffee and mother's education. In addition to bivariate analysis, log-linear regression models were used for comparing the simultaneous association in two ethnic groups. In general, the Finnish children had more EFD lesions than the Soviet children did. Among the Finns no consistent associations were found between the number of EFD lesions and the use of different sugar products or differences in toothbrushing habits. The number of EFD lesions decreased consistently according to mother's education with the Finnish children, but not with the Soviet children. The final multivariate model for Finnish children included age, toothbrushing frequency, place of residence (Kuopio) and use of soft drinks. The respective model for the Soviet children included age and place of residence (Leningrad). Evidently, the demineralization process or tooth resistance differs in these two ethnic groups.

Carbonated Beverages↗

PubMed1990

[Oral hygiene habits of periodontal patients in relation to age].

The relationship between age and oral hygiene habits as it was defined by the answers in a special questionnaire was studied and evaluated in a group of adult periodontal patients. The answers of 185 patients were evaluated from a total of 987 questionnaires from patients presented for periodontal treatment in the private offices of the authors during the last ten years, consisting a representative sample. The questions related to the personal habits of the patient in relation with the frequency of brushing, the method of brushing, the hardness of the toothbrush, the possibility "of brushing their gums" and the possibility of using additional mechanical aids of oral hygiene. The results showed that the frequency of the everyday brushing is decreasing steadily and progressively from the younger to the older patients. The method of brushing as well as the choice regarding the hardness of the toothbrush that the periodontal patients are using is not influenced by age. However the knowledge of patients regarding brushing the use of additional mechanical aids of oral hygiene except the toothbrush and the value of the toothpaste are statistically significant influenced by the age of the patients. The results of this study confirm that the younger age groups of periodontal patients are more informed about oral hygiene. The greater awareness which is higher in younger patients is possible explanation for these results.

Adult↗

PubMed1990

[Influences of composition on brush wear of composite resins. Influences of particle size and content of filler].

The influences of the composition on abrasion resistance of composite resins were examined using various experimental composite resins which had various matrix resin, filler size and content. The abrasion test was conducted by the experimental toothbrush abrasion testing machine developed in our laboratory. Three series of heat-curing composite resins were tested. One series was made from a Bis-MPEPP or UDMA monomer, and a silica filler with an average particle size of 0.04, 1.9, 3.8, 4.3, 7.5, 13.8 and 14.1 microns. The filler content of this series was constant at 45 wt%. The second series contained a silica filler of 4.3 microns in a content ranging from 35 to 75 wt%. The third series contained a microfiller (0.04 microns) and macrofiller (4.3 microns) in total content of 45 wt%. In this series, the microfiller was gradually replaced by 5, 15, 25 and 45 wt% of the macrofiller. The results obtained for these three series indicated that the abrasion resistance of composite resins was controlled by the inorganic filler, mainly filler size and content. The abrasion loss did not vary with the difference of matrix resin. When the particle size of the filler was below about 5 microns, the abrasion resistance decreased markedly with the decrease in filler size. The composite resin which contained a 0.04 or 1.9 micron filler was less resistant to toothbrush wear than the unfilled matrix resin. However, the microfiller also contributed to abrasion resistance when used in combination with the macrofiller, although abrasion resistance decreased with the increase in the microfiller concentration. The increase of filler content clearly improved the abrasion resistance when used the macrofiller. The analysis of these results and SEM observations of the brushed surfaces of samples suggested that the toothbrush abrasion was three-body abrasion caused by the abrasive in the toothpaste, and affected by the difference in the particle size between abrasive and filler, and between the abrasive size and the interparticle distance of the filler.

Absorption↗

PubMed1989

[The significance of the contamination of dental care articles. The results of a field study].

Permissible conclusions both from recent available literature and our own field-study results concerning the problematic nature of microbial contamination of dental hygiene articles and the resulting possible health hazard for the consumer can be summarized as follows: Manufacturing practices as are given in the basic instructions for production sites of the cosmetic industry, render a possible degree of microbial contamination. This largely rules out the danger of infection of the consumer upon acquisition of the dental hygiene product. Secondary contamination of these products, as inevitably is the case during use of dental hygiene articles, leads to microbial colonization especially of toothbrush bristles. The extent of this colonization depends at least partially upon the utilization age of the toothbrush. Also for this reason a toothbrush should be replaced by a new one after period of three months, six months at the latest and in all cases of inflammatory changes of the mouth and throat region. The contamination of both the glass or plastic container used for rinsing the teeth after brushing or for gargling can be held within certain limits by dry storage. Only in exceptional cases do mouthwashes show a small degree of contamination. Provided they contain antimicrobial substances, no therapeutically serviceable possibilities worth mentioning follow for the reduction of oropharyngeal flora. Microbial colonization of toothpastes as a result of secondary contamination following use is observed only in exceptional cases due to their preservative content. Significant germination of stagnated residual water in waterpicks often occurs, achieving germ counts up to more than 10(7) cfu per ml. Moreover, waterpicks can represent a biotope for Pseudomonas aeruginosa, and should be used neither by patients with open wounds or mucous membrane lesions in the oropharyngeal area, nor by patients with reduced immune resistance. Manufacturers of waterpicks are urged to impede or prevent the stagnation of residual water more effectively by introducing constructive improvements. Denture and retainer cleansing agents presently on the market display a sufficient antimicrobial effect within the frame of their application, however do not meet the standards set for disinfectants. Dental hygiene products are without relevance for the epidemiology of Legionnaires' disease.

Bacteria↗

PubMed1978

Oral hygiene and dental caries--a review.

Numerous studies have related dental caries experience of children with the frequency of their toothbrushing or with their oral cleanliness at the time of examination. Conflicting results were obtained and, therefore, no conclusions may be drawn from these studies. In other studies, the incidence of new carious lesions over a number of years was related to oral cleanliness during the same period of time. These studies showed that children with good oral hygiene had a lower caries incidence than those with poor oral hygiene, but the differences were small. Toothbrushing with a fluoridated toothpaste, which is now the usual practice, is effective in reducing caries incidence. Flossing can remove plaque from approximal tooth surfaces, and there is some evidence that it can reduce caries incidence. Dental caries can be largely prevented by highly efficient removal of plaque by toothbrushing and flossing. However, the available evidence suggests that regular prophylaxis by dental personnel is essential to maintain the necessary high level of efficiency. It is not known to what extent individuals are capable of removing their own plaque to the same high level of efficiency. It is probable that only highly-motivated individuals can maintain such a high standard of plaque control.

Adolescent↗

PubMed1985

Lustre changes on teeth. The use of laser light for reflexion measurements on the tooth surface--in vivo.

Lustre changes on teeth in vivo were studied with the use of equipment based on a helium-neon gas laser. Variations of the intensity of laser light reflected from the tooth surface were measured under different conditions of accumulation and removal of deposits, which were assumed to consist mainly of the pellicle. The possibility of using fluoride varnish as an artificial surface layer in this kind of investigation was also tested but rejected. Measurements were made after toothbrushing with water alone and with two toothpastes possessing different degrees of abrasivity. Teeth that had been left without toothbrushing for 24 hours showed statistically significant (p less than 0.05) lower light reflexion values than those recorded immediately after the teeth had been brushed with a toothpaste. During a period of seven months, persons brushing their teeth with water alone generated lower intensity values than did those brushing with the two toothpastes. The more abrasive paste yielded the highest intensity values, indicating a more polished or cleaner surface. The results suggest that the use of a toothpaste containing abrasives contributes to the cleaning effect of toothbrushing.

Adult↗

PubMed1995

Toothpaste technique. Studies on fluoride delivery and caries prevention.

The aim of the investigations was to evaluate the cariostatic effects of a modified toothpaste technique using fluoride (F) toothpaste. The modification consisted of an active mouthrinse with the toothpaste slurry and a sip of water for one minute after brushing. Toothpaste technique and salivary F concentration after toothbrushing were recorded in a caries active and a caries inactive group. The level of F in whole saliva, the concentration of F in plasma, the effect on demineralised enamel and dentine samples, and the accumulation of F in interdental plaque when using the modified toothpaste technique were studied. In a 3-year clinical trial, 4-year old children were trained in the toothpaste technique. The results showed that in the caries active group, the water rinsing was more thorough and more water was used compared to a caries inactive group. Rinsing with water and eating immediately after toothbrushing decreased the F level in whole saliva. Mouthrinsing with either a NaF solution or a slurry of toothpaste foam and water increased the F concentration in saliva compared to when a single or double water rinse was performed. The degree of F absorption in plasma, the accumulation of F in approximal plaque and the interdental clearance after toothbrushing were strongly related to the mode of water rinsing. The degree of demineralisation of enamel and dentine at approximal sites was also related to the mode of water rinsing. The clinical study showed that the cariostatic effect of the modified toothpaste technique resulted in 26% less approximal caries in the test group. It is concluded that a toothpaste technique where a slurry rinse was carried out after brushing increased the efficacy of F toothpaste.

Absorption↗

PubMed1993

The relationship between tooth brushing frequency and personal hygiene habits in teenagers.

A survey of 904, 14-17 year old school children from secondary schools around Nairobi was done to find out if there was any relationship between toothbrushing frequency and personal hygiene habits. The students completed a questionnaire anonymously in class. Female students brushed their teeth more often than the male students. 62.2% of the females and 50.1% of the males brushed their teeth more than once a day. Of those students who brushed their teeth more than once a day, 52% bathed daily, 22% used perfumes/deodorants daily and 50.1% always washed their hands after visiting the lavatory. No relationship was found between washing of hair and toothbrushing frequency. 69.7% males and 53.2% females gave toothache and tooth decay as the main reasons for mouth care. Those who brushed their teeth more frequently also visited the medical doctor regularly for routine check-ups. These findings indicated that toothbrushing was closely related to personal hygiene habits.

Adolescent↗

PubMed1993

Analysis of several risks factors involved in dental caries through multiple logistic regression.

Through multiple logistic regression an epidemiological study was undertaken of the following factors: age, gender, socio-economic status, dental care, toothbrushing, chewing gum, snacking, fluoride, and of their influence on the development of tooth decay. The factors are analysed individually and globally (global model). An initial model was constructed, establishing the interactions, and developing a final model. Risk factors shown to be involved were: low social class status, lack of dental care in the previous 12 months, absence of toothbrushing, and belonging to the age group 9-12 years old. An interaction was established between the following variables: socio-economic status and toothbrushing, and dental care and age.

Adolescent↗

PubMed1996

The development of the Braun Oral-B Ultra Plaque Remover: an in vitro robot study.

PURPOSE: To assess the efficacy of a new brush head design and brushing action using a novel robot system which simulates normal clinical toothbrush use. The system allows developments in toothbrush design to be assessed prior to embarking on expensive and time consuming clinical trials. MATERIALS AND METHODS: Using this system, the efficacy of a new brush head design combined with a modified brushing speed, was compared with the clinically established Braun Oral-B Plaque Remover (D7 handle and EB5 brush head). RESULTS: A combination of a new brush head (EB9) with longer tufts of bristles designed to improve interdental penetration, and an increased frequency of bristle movement (63Hz, 3,800 strokes per minute - D9 handle) was associated with significantly greater removal of artificial plaque. Visual observation of typodonts suggested that this increased efficacy is related to greater removal of plaque from interdental surfaces and occlusal fissures. These results suggest that the D9/EB9 prototype electric toothbrush is suitable for further investigation and clinical evaluation.

Dental Plaque↗

PubMed1997

Dentin desensitizing agents: SEM and X-ray microanalysis assessment.

PURPOSE: To evaluate the effect of four proprietary dentin desensitizing agents on dentin tubular occlusion, chemical composition changes on the dentin surface, and the effect of saliva and toothbrushing on these agents. MATERIALS AND METHODS: Fifty dentin discs, obtained from 50 freshly extracted human premolar and molar teeth were used in this study. These were divided into five groups of 10 discs each. Five discs from each group were treated with the desensitizing agents, viewed under the SEM and subjected to energy dispersive X-ray analysis. The other five discs were treated with the desensitizing agents, immersed in artificial saliva, subjected to simulated toothbrushing equivalent to 3 weeks of normal brushing and viewed under the SEM. The agents studied were Sensodyne Dentin Desensitizer, Therma-Trol Desensitizer Gel, Gluma Desensitizer and All-Bond DS. RESULTS: The Kruskal-Wallis test followed by the Wilcoxon signed-rank test showed that Sensodyne Dentin Desensitizer exhibited the greatest amount of tubular occlusion among the unbrushed samples, followed by Therma-Trol Desensitizer Gel, Gluma Desensitizer and All-Bond DS (P < 0.05) in that order. Toothbrushing increased tubular occlusion in all cases except the Sensodyne Dentin Desensitizer treated samples.

Chi-Square Distribution↗

PubMed1993

Effect of crosslinking agent content, monomer functionality, and repeat unit chemistry on properties of unfilled resins.

Seven mechanical/physical properties were used to evaluate 10 unfilled resins: eight aromatic dimethacrylates and two urethane dimethacrylates. Physical property tests included compressive strength, Young's modulus in compression, uniaxial tensile strength, intrinsic yield point, toothbrush abrasion, Knoop hardness, and water sorption. Controlled changes were made in the following four material parameters: amount of crosslinking diluent present in the uncured monomer, functionality of the monomer, repeat unit chemistry of the monomer (urethane vs. aromatic structure) and mode of activation (chemical vs. visible light). Polymers containing a high concentration of crosslinking agent (50 wt%) were found to be tougher and to possess lower hardness than materials containing lesser amounts of crosslinking agent. This was attributed to the flexible nature of the triethylene glycol dimethacrylate crosslinking molecule. Exposure to water plasticized the highly crosslinked materials to the degree that the yield point and elastic modulus were effectively lowered. Most of the tested properties were unaffected by differences in functionality except resistance to toothbrush abrasion, which was enhanced for polymers derived from high functionality monomers. The urethane-based polymers sorbed substantially more water than the aromatic-based materials, which presumably resulted in lower values for surface hardness. However, the urethane resins were very tough, and excellent resistance to toothbrush abrasion was observed. Property differences caused by differences in activation mode were small, although the visible light materials did sorb more water.

Absorption↗

PubMed2001

Effect of filler size on wear resistance of resin cement.

The purpose of this study was to evaluate the effect of filler size on the wear of resin cements. Materials tested included four experimental dual-cure resin cements (Kuraray) consisting of different-sized filler particles. A rectangular box cavity was prepared on the flattened occlusal surface of extracted human molars. Ceramic inlays for the cavities were fabricated using the Cerec 2 system. The Cerec inlays were cemented with the respective cements and adhesive systems according to the manufacturer's directions. The restored surface was finished by wet-grinding with an 800-grit silicon carbide paper. Six specimens were prepared for each resin cement. Half of the specimens were subjected to a three-body wear test for 200,000 cycles, and the others were subjected to a toothbrush abrasion test for 30,000 cycles. The worn surface of each restoration was scanned by a profilometer (Surfcom 475 A) at eight different points for each restoration. The wear value was determined by measuring the vertical gap depth on the profilometric tracings. The data were statistically analyzed by one-way analysis of variance (ANOVA) and Scheffe's test. The results showed that, with increase of filler size, the wear value decreased in the toothbrush test and increased in the three-body wear test. The cement with 0.04-microm filler exhibited the lowest wear value among the materials in the three-body wear test, and the same wear value as the cement with 0.97-microm filler in the toothbrush test. Based upon the results of this study, it is concluded that the wear of resin cements was affected by the filler size as well as the mode of wear test.

Journal Article↗

PubMed1997

Effect of abdominal vibroacoustic stimulation on sound and acceleration levels at the head of the fetal sheep.

OBJECTIVE: To measure the vibratory response of the fetal head and abdominal wall in sheep during vibroacoustic stimulation. METHODS: A piezoresistive accelerometer was attached to the skulls of seven sheep fetuses (128-134 days' gestational age), and a miniature hydrophone was attached to the skin overlying the fetal temporal bone. During fetal preparation and vibroacoustic stimulation procedures, ewes were anesthetized and supine. Vibroacoustic stimulation of the maternal abdomen was produced by each of two clinical devices that differed in spectral content, and an electric toothbrush. RESULTS: The approximate fundamental frequencies (f0) and first overtones (f1), as determined by both recordings of intrauterine sound pressure level and fetal head acceleration, were as follows: fetal acoustic stimulator, 75 and 150 Hz; electronic larynx, 150 and 300 Hz; and electric toothbrush, 25 and 50 Hz, respectively. At fundamental frequencies and first overtones, the ranges of fetal head accelerations (expressed in 1/12-octave bands) were as follows: fetal acoustic stimulator, 10-53 and 25-224 mm/sec2; electronic larynx, 10-53 and 18-114 mm/sec2; and electric toothbrush, 33-792 and 8-116 mm/sec2, respectively. Sound pressure levels exceeded 110 dB in all cases. High sound pressure levels in the uterus were proportional to fetal head vibration levels. CONCLUSION: Vibroacoustic stimulation of the surface of the abdomen of pregnant sheep is accompanied by both acoustic and vibratory exposure of the fetus.

Abdominal Muscles↗