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At least 1,747 records · Page 97Linked to original sources
PubMed2001

A cluster randomized controlled trial of a dental health education program for 10-year-old children.

OBJECTIVE: Using a cluster randomized trial, this study tested the effectiveness of a dental health education program designed to improve the oral hygiene and dental knowledge of 10-year-old children. METHODS: Thirty-two primary schools in the northwest of England participated. After a baseline assessment of plaque and the completion of a dental knowledge questionnaire by the children, the schools were allocated randomly to active or control groups. Children in schools allocated to the active group received the dental health program, which consisted of four one-hour lessons. After four months the children were examined clinically and scored for plaque, and a second questionnaire was administered. The schools in the control group were then allocated randomly to receive the program or not over the following three months, the program being withdrawn from the schools who initially received it. A further assessment of plaque was made and a questionnaire administered seven months after the baseline of the study. RESULTS: The active groups had 20 percent and 17 percent lower mean plaque scores than the control group at four and seven months (P < .001). The children's knowledge of which type of toothbrush should be used and the role of disclosing tablets improved in the initial test group when compared with the control group and this was retained over the second part of the study. CONCLUSION: The children receiving the program had significantly lower mean plaque scores and greater knowledge about toothbrushes and disclosing tablets than the control children who had not received the program.

Attitude to Health↗
PubMedDate not supplied

The lack of efficacy of a foam brush in maintaining gingival health: a controlled study.

Foam brushes have been used in the oral care of hospitalized patients for many years. However, no controlled study of their efficacy has been conducted. A randomized crossover study, comparing the effectiveness of a foam brush with that of a toothbrush, was carried out. The gingival condition and presence of plaque in the mouths of 29 volunteers were followed. It was shown that a toothbrush was more effective in controlling plaque levels and gingivitis.

Dental Plaque↗
PubMed2000

The surface effect of dentifrices.

The aim of this study was to evaluate clinically three commercially available dentifrices and to determine any surface effects on tooth or gingival surfaces. Sixty-four participants were included in this study and were allocated randomly to one of four treatment groups by an independent person to ensure the investigators were unaware of the brushing material used. All toothbrushes and dentifrices were distributed by this independent person. The treatment groups were: Group 1--brush with water; Group 2--brush with Colgate (Baking Soda and Peroxide); Group 3--brush with Macleans (Whitening); Group 4--brush with Colgate (Sensation Whitening). All participants were requested to brush both morning and evening in their customary fashion using only the designated toothpaste, or water, for four weeks. All participants were required to use the same toothbrush type. No other oral hygiene products such as mouth rinses or dental floss were used during the trial period. Prior to commencement of the brushing period, all participants received a full clinical examination recording the status of the soft and hard tissues including a gingival index (Löe and Silness) to record gingival condition. A polyvinyl siloxane impression was taken of the six anterior teeth and gingival tissues at the commencement of the trial. After four weeks, a second full clinical examination was made and further silicone impressions were taken of the anterior teeth. All impressions were cast in epoxy resin for investigation with light and electron microscopy. Participants were also asked to answer a questionnaire relating to the toothpaste used. The results of this study indicated that no significant clinical differences were recorded for any dentifrice or water and there was no significant difference in gingival index scores over the four week period. Patient responses to each dentifrice varied according to individual patient preferences and expectations and no consistent findings could be determined. Light and electron microscopy indicated that tooth and gingival surface changes that occurred over the four week period with any of the dentifrices were similar to, and not significantly different from, changes seen with the use of water alone. These results indicate that none of the dentifrices tested was harmful to teeth or soft tissues.

Adolescent↗
PubMed2003

Can tooth brushing damage your health? Effects on oral and dental tissues.

Circumstantial evidence based on anecdote, case reports, epidemiological data and studies in vitro and in situ implicate tooth brushing with toothpaste with tooth wear, gingival recession and dentine hypersensitivity. This review attempts to assess the clinical significance of the potential harm produced by this most common oral hygiene habit. The toothbrush alone appears to have no effect on enamel and very little on dentine. Most toothpaste also has very little effect on enamel and in normal use would not cause significant wear of dentine in a lifetime of use. Wear of enamel and dentine can be dramatically increased if tooth brushing follows an erosive challenge. Gingival recession has a multi-factorial aetiology and certain individuals and specific teeth may be predisposed to trauma from tooth brushing. Tooth brushing is known to cause gingival abrasions but how these relate to gingival recession is not known. The role of toothpaste in gingival abrasion and recession surprisingly has received little if any attention. Gingival recession most commonly exposes dentine and localises sites for dentine hypersensitivity. Some toothpaste products can expose dentinal tubules but erosion is probably the more dominant factor in dentine hypersensitivity. There is no evidence to indicate that electric and manual toothbrushes differ in effects on soft and hard tissues. It is only under, over or abusive use or when combined with erosion that significant harm may be thus caused. In normal use it must be concluded that the benefits of tooth brushing far out-way the potential harm.

Gingival Diseases↗
PubMed2003

Is there a link between tooth brushing and infective endocarditis?

Tooth brushing is known to cause bacteraemias, which could theoretically potentially lead to the development of infective endocarditis. It is therefore paradoxical that tooth brushing is not thought to cause infective endocarditis. The reasons for this lack of association are not clear, but may be related to the fact that most oral procedures do not have a high association with infective endocarditis. There is no definitive data on the relative risks of using manual or electric toothbrushes in patients predisposed to infective endocarditis. It may be prudent to advise patients predisposed to infective endocarditis to use adjunctive chlorhexidine when cleaning their teeth with either a manual or electric toothbrush. The use of adjunctive chlorhexidine reduces the magnitude of any bacteraemia caused by tooth brushing and may interfere with the bacteria that could potentially cause infective endocarditis. Prophylactic antibiotics are not warranted for tooth brushing in patients at risk of infective endocarditis.

Anti-Infective Agents, Local↗
PubMed2004

Oral health in Tunisia.

Current WHO methods were employed to estimate the prevalence of toothbrush possession, tea drinking, tobacco habits, fluorosis, dentofacial anomalies, periodontal diseases, dental caries as well as treatment needs in schoolchildren in Tunisia, the smallest country in North Africa. Fluorosis was endemic in some regions. Dentofacial anomalies were more frequent than in the other countries of the Eastern Mediterranean Region (EMR). The prevalence of periodontal disease was high despite the high percentage of toothbrush possession. Altogether 60% of 12-year-olds and 70% of 15-year-olds required oral hygiene instruction, 44% and 15% respectively required scaling. Dental caries was also relatively frequent, but indices were low and the dental therapeutic index was very low. Of the 6-12- and 15-year-olds, 52%, 44% and 52%, respectively needed restorative care. Moreover, 19% of 6-year-olds, 20% of 12-year-olds and 5% of 15-year-olds required extractions. None of 6-year-olds, 3% of 12-year-olds and 5% of 15-year-olds required other dental treatment such as pulpal treatment and prosthetics. A comparison with a survey carried out 13 years ago indicated that dental caries seemed to be decreasing. The DMF at age 12 was lower than WHO goals for the Year 2000 and of the Eastern Mediterranean Region countries. The findings showed an unequal distribution of oral health personnel, with the southern part of the country being particularly underserved.

Adolescent↗
PubMed1998

Brushing abrasion of eroded dentin after application of sodium fluoride solutions.

The aim of the present in vitro study was to evaluate the influence of sodium fluoride solutions on brushing abrasion of eroded dentin. Dentin specimens were prepared from 60 bovine incisors. The specimens were embedded in acrylic resin, ground flat, polished and subsequently covered with tape exposing an area of 1.8 mm x 10.0 mm in the center of the exposed dentin. The samples were alternatingly stored in a demineralizing solution (5 min) and a remineralizing solution (1 min) for 5 times. The erosive soft drink Sprite light(R) served as a demineralizing solution and artificial saliva was used as a remineralizing solution. Prior to storage in artificial saliva 15 specimens were each treated for 1 min with 250 and 2,000 ppm fluoride solution, respectively. Fifteen specimens were treated with distilled water instead of the fluoride solution (= eroded controls). The remaining samples were neither eroded with the soft drink nor fluoridated (= uneroded controls). After each immersion in artificial saliva the specimens were submitted to abrasion in a toothbrushing machine. After 5 demineralization-remineralization brushing cycles the total amount of tooth wear due to erosion and subsequent abrasion was profilometrically evaluated. Statistical analysis revealed the significantly lowest wear in the uneroded controls and the highest amount of abrasion in the eroded controls. Application of the fluoride solutions increased the wear resistance of the eroded dentin specimens, showing significantly better protection by the high-concentration compared to the low-concentration solution. The susceptibility to abrasion of the eroded dentin specimens treated with the high-concentration fluoride solution did not differ significantly from the uneroded dentin samples. It is concluded that application of 2,000 ppm sodium fluoride solutions immediately before toothbrushing significantly reduces abrasion of eroded dentin in vitro.

Animals↗
PubMedDate not supplied

In situ evaluation of different remineralization periods to decrease brushing abrasion of demineralized enamel.

The aim of the present in situ study was to evaluate the effect of different periods of intraoral remineralization to decrease the susceptibility of previously demineralized enamel against toothbrushing abrasion. Six human enamel specimens (A-F) were recessed in the buccal aspects of each of eight intraoral appliances which were worn for 21 days by 8 panelists. Demineralization of the samples was performed twice a day extraorally in the acidic beverage Sprite Light for 90 s. Subsequently, the enamel specimens were brushed at different times. Specimen A was brushed immediately after the demineralization. The remaining samples B-E were brushed after the intraoral appliances had been worn for various periods of remineralization: specimen B, 10 min; C, 20 min; D, 30 min and E, 60 min, respectively. Specimen F was only demineralized and remineralized, but not brushed. After 21 days, enamel wear was measured with a laser profilometer. The following values (mean +/- standard deviation) were obtained: specimen A, 6.78+/-2.71 microm; B, 5.47+/-3.39 microm; C, 6.06+/-3.18 microm; D, 5.43+/-2.58 microm; E 4.78+/-2.57 microm, and F 0.66+/-1.11 micro;m. Analysis of variance revealed a significant influence of remineralization period on abrasive wear. However, even after a remineralization period of 60 min the wear was significantly increased as compared to the demineralized, but not brushed control. It is concluded that (1) abrasion resistance of softened enamel increases with remineralization period and (2) at least 60 min should elapse before toothbrushing after an erosive attack.

Amines↗
PubMedDate not supplied

Fluoride, beverages and dental caries in the primary dentition.

Knowledge concerning risk factors for primary dentition caries in young children is incomplete. Models are presented for caries development using longitudinally gathered fluoride exposure and dietary intake data in the Iowa Fluoride Study. Primary tooth caries examinations were conducted at age 5. Dietary (beverage) and fluoride exposure data were gathered longitudinally from age 6 weeks through 4 years (n = 291); 23% had decayed or filled surfaces. Logistic regression revealed that beverage components and toothbrushing made unique contributions to caries experience. Water consumption (36-48 months), milk consumption (24-36 months), and fluoridated toothpaste brushings (36-48 months) were negatively associated with caries; sugared beverages and milk (6 weeks to 12 months) were positively associated. Although fluoride exposure is important, sugared beverages contribute substantially to caries risk, while water and milk consumption and frequent toothbrushing early can have protective effects.

Animals↗
PubMedDate not supplied

Comparative study of wear of enamel induced by alternating and simultaneous combinations of abrasion and erosion in vitro.

Two types of interaction of erosive and abrasive forces with human enamel were analysed in an in vitro study. To simulate toothbrushing or chewing after an acidic challenge, enamel specimens were eroded in 0.3% citric acid (pH 3.2), then brushed with or without silica abrasive. To simulate simultaneous erosion and abrasion, as would occur during chewing of abrasive acidic food, enamel specimens were abraded in a toothbrushing machine, with and without silica abrasive, while immersed in citric acid. Enamel wear was measured by profilometry. In both experiments the combination of erosion and abrasion resulted in significantly greater wear than erosion alone, but no significant differences in wear after brushing with or without abrasive were found. Simultaneous erosion and abrasion resulted in about 50% more wear than alternating erosion and abrasion. It is concluded that softened enamel is highly unstable and potentially easily removed by short and relatively gentle physical action. Chewing of acidic foods with some abrasive properties might cause enhanced tooth wear.

Citric Acid↗
PubMedDate not supplied

Brushing abrasion of softened and remineralised dentin: an in situ study.

The aim of the present in situ study was to evaluate the effect of different periods of intra-oral remineralisation on the susceptibility of softened dentin to toothbrushing abrasion. Groups of 6 human dentin specimens (A-F) were recessed in the buccal aspects of intra-oral appliances which were worn for 21 days by 11 volunteers. The samples were demineralised twice a day extra-orally in the acidic beverage Sprite Light (pH 2.9) for 90 s. Subsequently, the dentin specimens were brushed at different times. Specimen A was brushed immediately after demineralisation. Specimens B-E were brushed after the intra-oral appliances had been worn for various periods in the mouth: specimen B for 10 min, C for 20 min, D for 30 min and E for 60 min. Specimen F was not brushed (control). After 21 days, dentin wear was measured with a profilometer. The following values (means +/- standard deviation) were recorded (microm): A, 23.6 +/- 16.7; B, 37.9 +/- 29.7; C, 31.8 +/- 26.5; D, 18.5 +/- 10.5; E, 15.3 +/- 11.6; F, 12.6 +/- 6.7. There was a statistically significantly increased dentin loss for groups A, B and C as compared to the controls (U test: p < 0.05). However, after intra-oral periods of 30 and 60 min, wear was not significantly higher than in unbrushed controls. It is concluded that for protection of dentin surfaces at least 30 min should elapse before toothbrushing after an erosive attack.

Carbonated Beverages↗
PubMed2007

Self-reported oral hygiene habits and oral health problems of Kuwaiti adults.

OBJECTIVE: The aims of this study were to examine self-reported oral hygiene habits and oral health problems of a sample of adult Kuwaitis. MATERIALS AND METHODS: A self-administered, anonymous, structured questionnaire was distributed to 2,400 adult Kuwaiti nationals from all 6 governates of Kuwait assessing socio-demographic variables, oral hygiene habits, and oral health problems. RESULTS: Of the 2,400 questionnaires, 1,925 (80.25%) responded. Of these, 62% reported brushing their teeth at least twice daily, while daily use of dental floss was uncommon (11.8%). Adequate toothbrushing habits were significantly associated with female gender, educational level, non-smoking status, and history of recent preventive dental visits (p = 0.001). The majority of subjects reported multiple oral health problems (64.7% with 2 or more and 41.8% with 3 or more). Factors associated with multiple oral health complaints included younger age, smoking, not having a recent preventive dental visit, and brushing the teeth less than twice daily. CONCLUSIONS: Less than two-thirds of the sampled adult Kuwaitis followed the recommended toothbrushing frequency of twice daily or more, and the majority of subjects have not had a preventive dental visit in the previous 6 months. Furthermore, most subjects reported multiple oral health problems that are mostly preventable through adequate oral hygiene habits and regular preventive dental visits.

Adolescent↗
PubMed1992

Effect of oral care habits on caries in adolescents.

Data on toothbrushing habits were collected during a 3-year caries clinical trial of sodium monofluorophosphate toothpastes in Lanarkshire, Scotland, involving 3,005 schoolchildren of mean age 12.5 years at baseline. Stated normal brushing frequency and oral rinsing method after brushing were recorded. Half the panel indicated they rinsed their mouths after toothbrushing using a beaker. The proportion of the panel brushing once per day or more increased during the trial. Differences in oral habits were observed between the sexes, with 42% of girls and 52% of boys being non-beaker rinsers and 73% of girls, but only 44% of boys, brushing their teeth at least twice per day. Twice-a-day brushers had a consistently lower caries increment than less frequent brushers. This was also seen in the baseline prevalence data, but did not account for all incremental differences noted. Subjects using beakers had consistently higher increments than non-beaker rinsers. Again, this difference could not be explained by variations in baseline prevalence. Differences in the caries increment were also observed between boys and girls, these appearing to be linked both to the cumulative effect of male/female habit variations plus a difference in the baseline caries prevalence. A dose response to the three fluoride levels, i.e 1,000, 1,500, and 2,500 ppm F, was seen for the different habit combinations which again could not be explained by differences in the baseline caries prevalence.

Adolescent↗
PubMed1993

Microstructural changes of human enamel surfaces by brushing with and without dentifrice containing abrasive.

Toothbrushing with and without dentifrice containing abrasive was performed on human enamel pieces attached to resin plates exposed to the oral cavities of 3 human subjects for 8 weeks. The effects on the ground enamel surfaces with engraved scratches were examined by scanning electron and scanning laser microscopy. Brushing with such a dentifrice caused smaller scratches to disappear, large scratches to expand and new microwear to appear; in some samples, prism structures were exposed. Under brushing without dentifrice, these scratches were protected by an organic pellicle with mineral deposits, and also the experimental surface was entirely covered with these membranous deposits. The results indicate that toothbrushing with no dentifrice but saliva induces an organic-mineral protective membrane on the enamel surface. The membrane may increase the enamel resistance to caries. On the other hand, the use of abrasive-containing dentifrice causes slight abrasion with microwear. This roughness may contribute to the formation of dental plaque.

Adult↗
PubMed1993

Role of fluoride toothpastes in a caries-preventive strategy.

While the clinical relevance of fluoride toothpastes per se is firmly established, the multifactorial processes involved in causation and prevention of caries render it difficult to define their exact role in an overall caries-preventive strategy. Therefore, an indirect pragmatic approach was chosen: the interpretation of secular trends in caries prevalence and other parameters is used to estimate the relative importance of this method of topical fluoride administration and to compare it with the contributions by other methods of prevention. All methods of caries prevention, with the exception of population-administered measures such as fluoridation of drinking water or domestic salt, can only work when applied regularly and conscientiously. For this reason behavioural aspects such as compliance and the chances for widespread (if not universal) application have to be considered. There is indirect evidence that toothbrushing with fluoride toothpastes is a highly probable explanation for the decline of caries prevalence in developed countries since the 70s; moreover, toothbrushing, and the use of therapeutic dentifrices, is considered to meet spreading compliance because a 'healthy mouth' becomes more and more socially desirable in growing numbers of subpopulations.

Attitude to Health↗
PubMed1985

Properties of microfilled composite resins as influenced by filler content.

Two series of composite resins were prepared with a light-cured urethane dimethacrylate matrix to which varying amounts of two types of silanated silica particles were added. One series contained volume fractions ranging from 15.8 to 28.8% silica particles of 20 nm in diameter (Type I filler) and the other series volume fractions of from 24 to 49.4% of an agglomerated silica particle of 40 nm in diameter (Type II filler). Tests were conducted to determine the effect of filler level on: depth of cure as determined by hardness measurements; color stability in both UV light and water; water sorption with time; hardness; compressive strength; strain behavior in slow compression; and resistance to toothbrush abrasion and wear by hydroxyapatite. Analysis of the data obtained for these two microfilled series indicate that increased filler levels result in trends for increased depth of cure, color stability, hardness, compressive strength, and stiffness, while water sorption and resistance to both toothbrush abrasion and wear by hydroxyapatite were reduced. These trends were more pronounced for the Type II filler series than for the Type I filler series. However, there was a greater differential in filler levels within the Type II series than within the Type I series.

Acrylates↗
PubMed1988

The effects of experimental variations in dietary sugar intake and oral hygiene on the biochemical composition and pH of free smooth-surface and approximal plaque.

The biochemical compositions of free smooth-surface and approximal plaque were compared after 48 hours in the presence and absence of twice-daily toothbrushing and during ingestion of either high- or low-sugar diets in ten young adults. In addition, the effect of a single sugar intake on the pH of both types of plaque was investigated. The results confirmed previously reported differences in biochemical composition between free smooth-surface and approximal plaque, the concentrations of inorganic ions and carbohydrate fractions being generally lower in the approximal sample after all experimental regimens. The concentrations of calcium and phosphorus were doubled on the low-sugar diet compared with the high-sugar diet in both types of plaque. A significant decrease in carbohydrate concentrations was observed in free smooth-surface plaque in subjects on the low-sugar diet, but not in approximal plaque. Little variation was observed in the biochemical composition which could be attributed to the presence or absence of toothbrushing. The pH in free smooth-surface plaque was lower than that in approximal plaque five minutes after a sugar intake, but the situation was reversed two hours later. The results indicate that differences in composition and pH between free smooth-surface and approximal plaque are associated with reduced access to salivary and dietary influences due to diffusion limitation in the deeper layers of plaque.

Carbohydrates↗
PubMed1997

A three-year clinical trial of a combination of trimetaphosphate and sodium fluoride in silica toothpastes.

The relative efficacy of NaF silica toothpastes containing 1000 ppm fluoride and 1500 ppm fluoride in the control of dental caries is not clear-cut. Also, it has not been established that incorporation of trimetaphosphate (TMP) improves the anticaries activity of NaF toothpastes. A three-year clinical trial was conducted to test the hypotheses that: (i) the anticaries activity of NaF toothpastes containing 1500 ppm F was greater than that of NaF toothpastes containing 1000 ppm F, and (ii) inclusion of TMP improved the efficacy of NaF silica pastes. Subsidiary aims included determination of whether frequency of toothbrushing and method of rinsing after brushing were correlated with caries increments. The study involved 4196 children aged 11 to 12 years at outset. These participants had been selected from a pool of 7374 potential subjects on the basis of caries experience and dental eruption pattern. They were stratified by sex, examiner, and presence of calculus and caries, and were allocated at random to one of the four toothpastes under study. Using mirror and probe and also FOTI, we carried out clinical examinations at baseline and annually thereafter for 3 yrs. Bitewing radiographs of a subset of children were taken at baseline and at the end of the study. The outcome measure for the study, DMFS increment, was defined as the increase in caries over 3 yrs, taking into account changes occurring on individual tooth surfaces. Data for 3467 subjects were available for analyses at both baseline and year 3 examinations. Radiographs were taken for 1942 subjects at both baseline and year 3 examinations. The mean three-year clinical-only DMFS increment for the subjects using 1500-ppm-NaF pastes was 3.93, which was 6% lower than the corresponding mean of 4.19 for the 1000-ppm-NaF pastes. There was no significant difference between the mean DMFS increment for those using paste with or without TMP. Subjects who claimed to brush more frequently or who claimed not to use a tumbler to rinse after toothbrushing had lower three-year DFMS increments.

Analysis of Variance↗