The effectiveness of a counter-rotary action powered toothbrush and conventional toothbrush on plaque removal and gingival bleeding. A short term study

Initial investigations have demonstrated the effectiveness of a new contra-rotary powered electric toothbrush in removing plaque supragingivally, subgingivally, and interproximally following a single use. The purpose of this study was to evaluate the effectiveness of a counter-rotary toothbrush following 1) one time instruction, 2) reinstruction and 1 week practice; and 3) a third instruction and 3 weeks of practice and home use. Twenty-four patients were studied; 12 using the counter-rotary toothbrush and 12 using a conventional toothbrush. Using O'Leary and Turesky plaque indices, both brushes significantly reduced supragingival plaque from baseline at all intervals. The counter-rotary brush, however, was more efficient than the conventional brush at all intervals (P less than 0.01). Using a Surface Area Plaque Index, both brushes significantly reduced supragingival plaque from baseline at all intervals but there were no significant differences between brushes. A timed bleeding index showed significant reduction in gingival bleeding following 28 days of brushing with both brushes. Again, the counter-rotary toothbrush was superior to the conventional toothbrush (P less than 0.01).     

Plaque removal efficacy of power and manual toothbrushes: a comparative study

The aim of this study was to compare the plaque removal efficacy of a new oscillating/rotating/pulsating toothbrush [Oral-B® Professional Care® 8500 (PC 8500)] with two manual toothbrushes [Oral-B® CrossAction? Vitalizer (CAV) and Oral-B® Indicator? (IND), respectively]. The safety of the PC 8500 was also assessed. The study was a single-use, observer-masked, randomised 3?×?3 Latin square crossover design balanced for carryover effects. The enrolled subjects (n?=?66) refrained from brushing for 23–25 h before each clinical examination. Plaque scores were recorded before and after brushing with the allocated toothbrush using the Turesky et al. modification of the Quigley and Hein plaque index. The safety was assessed evaluating the soft tissue conditions present after 30 days of the use of the PC 8500. The PC 8500 toothbrush was better in plaque removal efficacy compared with the CAV and IND brushes for full mouth and approximal surfaces (P?<?0.01). When marginal surfaces were considered, the PC 8500 was significantly more effective than the IND (P?<?0.01). No significant differences were found between PC 8500 and CAV (P?>?0.05). The latter was shown to be significantly more effective than the IND at all tooth surfaces (P?<?0.01). Safety examinations revealed the onset of only two small gingival abrasions after the 30-day use of the PC 8500. The PC 8500 toothbrush demonstrated to be more effective in plaque control than the CAV and IND in the full mouth and approximal surfaces and similar to the CAV in the marginal surfaces. The PC 8500 was safe to oral tissues in long-term use.     

Comparison of a sonic and a manual toothbrush for efficacy in supragingival plaque removal and reduction of gingivitis

Abstract A new sonic electric toothbrush (Sonicare®) and a traditional manual toothbrush were compared for efficacy in removing supragingival plaque and reducing gingival inflammation in a 12-week, single-blind clinical trial. 60 subjects with a gingival index (GI) of >1.5 and no probing depths >5 mm were randomly assigned to use either the manual or sonic brush, instructed in its use, and asked to brush each morning and evening for 2 minutes. Plaque scores were taken at baseline and at 1.2, 4. and 12 weeks using the Turesky modification of the Quigley-Hein plaque index. Gingival inflammation was assessed by the GI. bleeding tendency score, presence or absence of bleeding on probing, volumetric measurements of gingival crevicular fluid (GCF). and aspartate aminotransferase (AST) levels in GCF. Repeated measures multivariate analyses of variance were used to delect time- and device-dependent differences for all clinical assessments between the 2 groups over the 5 visits. Both types of brush were effective in removing supragingival plaque. The sonic brush was statistically superior, on a percentage reduction basis, in removing supragingival plaque from the dentition taken as a whole (F-statistic; p=0.012) and was particularly better in hard-to-reach areas such as posterior teeth (F-statistic; p=0.003) and interproximal sites (F-statistic; p=0.004). Both devices were equally effective in reducing gingival inflammation. The sonic brush exhibited less tendency to cause gingival abrasion than the manual brush (1 incident with sonic, 5 incidents with manual), confirming the safely of this product as an oral hygiene device.     

Why pick on teeth?

In the evolution of oral hygiene practices, the toothpick is the progenitor device. Although modern variations are used interdentally, with the current emphasis on plaque control rather than gingival massage and stimulation, the toothpick has been largely superseded by floss, interproximal brushes, and other supplementary aids. The natural hard bristle toothbrush and vigorous scrub brushing popular a generation ago have been replaced by soft bristle nylon brushes and gentler, more defined brushing procedures for plaque removal in the crevicular areas. Quantitative studies support the superiority of the current techniques in maintaining periodontal health with less trauma to the oral tissues.     

Clinical evaluation of an ionic tooth brush on oral hygiene status, gingival status, and microbial parameter.

It has long been recognised that the presence of dental plaque leads to gingivitis and periodontal disease, as well as dental caries. Today tooth brushing is the most widely accepted method of removing plaque. Hence this present clinical study was undertaken to evaluate the effectiveness of an ionic toothbrush on oral hygiene status. For this study, 20 dental students in the age group of 18-20 years were included. All the subjects after undergoing dental prophylaxis were then provided with ionic toothbrushes, either active (equipped with lithium battery) or inactive (without lithium battery). Plaque index and gingival bleeding index were examined at 7th, 14th, and 21st day. Microbial assessment was done for detection of colony forming units (CFU) from the plaque samples which were collected on 0 day and 21st day, both before brushing and after brushing. Results shown a significant reduction in all the parameters and the reduction was more significant in active and inactive ionic toothbrush users. It was concluded that both active and inactive ionic toothbrushes reduced the plaque index and gingival bleeding index scores significantly and active ionic tooth brushes were more effective as compared to inactive ionic toothbrushes. There was no soft tissue trauma following the use of both type of toothbrushes, which showed that ionic toothbrushes were equally safe for regular long-term use.     

A comparative study of electric toothbrushes for the effectiveness of plaque removal in relation to toothbrushing duration

Abstract The purpose of the present study was to test the plaque-removing efficacy of 4 different toothbrushes in relation to duration of toothbrushing. The brushes studied were a manual toothbrush (M), a conventional electric toothbrush – the Blend-a-Dent® (BPC), the Interplak® (IP) and the Braun Plak Control® (BPC). For this study, 20 subjects were selected. The study was divided into 5 experiments which differed only in respect to the brushing time. The available time in experiment 1 through 5 was 7.5, 15, 30, 45, 90 s per quadrant respectively. Prior to each experiment, all subjects were asked to abstain from oral hygiene procedures for at least 24 h. The efficacy of toothbrushing in each experiment was studied while one investigator (MAL) brushed the teeth of the subjects. In each subject, all 4 brushes were tested. Each brush was assigned to a quadrant in a random order. No toothpaste was used throughout this study. The amount of dental plaque was evaluated before and after brushing by means of the Silness & Löe plaque index at 6 sites around each tooth investigated. The results show an increase in efficacy for all brushes varying from 7.5 s per quadrant to 90 s per quadrant (mean plaque reduction in terms of percentage 7.5 s-90 s: M =40%-75%, BL = 45%-82%, BPC = 51%-94%. IP=64%-92%). The IP removed significantly more plaque than the other 3 after 7.5 s of brushing. From 15 s through 90 s, the IP and BPC were equally effective. Both were, at all times, significantly more effective than the M and BL. This difference was mainly caused by a greater plaque removal from the interproximal areas, since brushing for 30 s or more with all 4 brushes removed about 90% of the plaque from the vestibular and lingual surfaces. Evaluation of the efficacy in relation to brushing time showed for all brushes that the greater part of the effect is reached after 30 s of brushing per quadrant. The brushing time appears to be an important variable in the evaluation of plaque removing effectiveness since the efficacy increases with time and differs per toothbrush.     

Clinical trial of a novel interdental brush cleaning system

OBJECTIVE: This single-blind, five parallel-arm, four-week randomized clinical trial was designed to compare the efficacy of a 0.05% cetylpyridinium chloride gel-releasing interdental brush (IDB) with standard interproximal cleaning devices for plaque and gingivitis reduction, and decreased frequency in interproximal gingival bleeding. METHODOLOGY: After consenting, participants meeting inclusion criteria brushed their teeth, received a baseline examination and a professional cleaning, and were then block-randomized into five groups, with the plaque level serving as the blocking variable. All five groups performed standard tooth brushing as a background regimen. Three of the groups were respectively assigned to one of three interdental brush regimens, the fourth group was assigned to a standard flossing regimen (positive control), and the fifth group was assigned to a standard tooth brushing only regimen (control). Clinical outcome data were collected at two and four weeks. RESULTS: Of a total of 162 starting participants, 152 completed the study. There were no baseline differences among the five groups with respect to age, interproximal plaque score, interproximal gingivitis score, or percent of interproximal bleeding on probing. After two and four weeks, the 3 IDB groups exhibited 30-40 percent lower plaque levels than the control (p < 0.05). With respect to interproximal gingival scores, the active agent IDB group exhibited a statistically significant effect after two weeks, and all three IDB groups demonstrated significantly better outcomes after four weeks (p < 0.05). At two and four weeks, the three IDB groups demonstrated a greater reduction in interproximal bleeding points upon probing compared to the two control groups (p < 0.05). The group using the 0.05% cetylpyridinium gel-releasing IDB system did not demonstrate superior clinical results when compared to the two other IDB groups. CONCLUSION: When compared to control and positive control interdental cleaning procedures, daily use of IDBs was effective in reducing interproximal plaque and gingivitis scores, as well as interproximal bleeding on probing. The benefits were evident at two weeks, but were more consistent after four weeks. The 0.05% cetylpyridinium gel-releasing IDB system did not appear to confer a consistently independent incremental benefit.     

A comparative study of the Philips HP 735, Braun/Oral B D7 and the Oral B 35 Advantage toothbrushes

Abstract. The aim of this 3-group, 3-treatment, single-blind, parallel group study was to evaluate and compare the efficacies of the Philips/Jordan HP 735 powered toothbrush, the Braun/Oral B D7 powered toothbrush and the Oral B Advantage B35 manual toothbrush in a cohort of 75 young adults (18–25 years). Following an appointment for screening, full mouth mean (±sd) modified Turesky plaque index (PI) and Löe & Silness gingival index (GI) were recorded at baseline. After 24 h abstinence from all oral hygiene measures, PI was recorded and each subject was given one of the test brushes with detailed instructions for use. The subject then brushed under supervision for 90 s, during which time mean (±sd) toothbrushing forces (TBF) were recorded. PI were recorded immediately after supervised brushing and the subjects were then discharged for 6 weeks to use the allocated toothbrush at home. After 6 weeks, PI, GI and TBF were again recorded. Comparisons between the brushing groups for all parameters, at baseline, 24 h and 6 weeks were tested using ANCOVA. There were no significant differences for PI and GI between groups at baseline, or for PI following supervised brushing at 24 h. After 6 weeks subjects using the powered brushes had lower mean PI (±sd) scores than those using manual brushes but the differences were significant only at interproximal sites; HP 735 1.44 (0.52), D7 1.44 (0.53), B35 1.75 (0.51) (p=0.05). At 6 weeks, mean (±sd) GI were; HP 735 1.49 (0.21), D7 1.61 (0.21), B35 1.64 (0.22) (p=0.033). Mean GI scores for the HP 735 group were similar at baseline and at 6 weeks although for the other brushes, the GI scores actually increased over this period. Mean (±sd) TBF (grammes/force) at baseline and 6 weeks respectively for the brushes were; HP 735 233 (205), D7 159 (58), B35 279 (122) (p=0.026): HP 735 194 (86), D7 141 (57), B35 297 (113) (p=0.0001). The within-group variability for the HP 735 TBF reduced considerably over 6 weeks, a likely consequence of the click-force threshold feature of this brush.     

A randomized, parallel design study to evaluate the effects of a Sonicare and a manual toothbrush on plaque and gingivitis

OBJECTIVE: This study was designed to determine the effects of twice daily tooth brushing with the Sonicare Elite (Elite) and the Oral-B P40 manual toothbrush (MTB) on plaque accumulation and plaque-induced gingival inflammation. METHODS: One-hundred and eighty (180) subjects, with moderate gingival inflammation and a Silness and L?e Plaque Index (PI) of > or = 0.8 after refraining from oral hygiene for three to six hours, were randomly assigned to receive the Elite or MTB in this single-blinded, controlled clinical trial. At baseline and after two and four weeks of using the product at home twice daily for two minutes, efficacy was assessed with the PI and the L?e and Silness Gingival Index (GI) after brushing three to six hours prior to assessment The primary efficacy variable was reduction of baseline plaque scores over the four weeks for Elite compared to MTB. Secondary outcomes included a change in GI and number of bleeding sites. Safety was appraised using adverse event reports and soft tissue examinations. RESULTS: One-hundred and sixty-eight subjects (81 Elite, 87 MTB) completed the study. The four-week study period resulted in significant reductions of PI and GI from baseline at weeks two and four for both brushes. Reduction in mean PI from baseline to week four for Elite was 0.84 (95% CI: 0.80, 0.88), and 0.72 (0.68, 0.76) for MTB, p < 0.0001. Reduction in mean GI from baseline to four weeks for Elite was 0.56 (0.53, 0.59), and 0.47 (0.45, 0.50) for MTB, p = 0.0001. Both treatment groups demonstrated a significant reduction in number of bleeding sites relative to baseline (p < 0.0001); however, a significant difference in percent reduction in favor of Elite relative to MTB was found at week four: 82.5% vs. 75.8% (p = 0.026). Both toothbrushes were safe on oral tissues. CONCLUSION: Elite was significantly more effective than MTB in the reduction of plaque after two and four weeks of product use, and significantly more effective in the reduction of gingivitis and bleeding sites than MTB after four weeks.     

Comparative plaque removal efficacy of a dual-action power toothbrush and a manual tooth: effects by tooth type

PURPOSE: To evaluate the plaque removal efficacy of a dual action power toothbrush (Crest SpinBrush Pro Clean) relative to an ADA reference manual toothbrush. In addition to overall plaque removal, emphasis was put on plaque reduction around the gingival margin, interproximal areas of the tooth and in the posterior segment of the dentition. METHODS: The study was a randomized, examiner-blind, two-treatment, four-period, crossover design. After an informed consent, 50 healthy volunteers were randomized to four treatment sequences and used each toothbrush twice according to their assigned treatment sequence. At every visit, plaque removal was assessed at baseline and after a single brushing using the Rustogi-modified Navy Plaque Index that allows estimation of interproximal plaque and plaque at the gingival margin. Self-reported and examiner-observed adverse events were collected at every visit. Mean Plaque Index (MPI) scores were calculated for the whole mouth, gingival region, interproximal region and different areas of the dentition using an analysis of covariance for crossover design with baseline plaque score as the covariate. RESULTS: 49 subjects provided complete data and were included in the analysis. Baseline MPI scores were not significantly different between the groups for any investigated tooth region or dentition area. Following a single brushing, the power toothbrush provided a reduction of 43% (P< 0.001) for the whole mouth MPI, 43% (P< 0.001) for the gingival margin MPI and 65% (P< 0.001) for the interproximal MPI relative to a manual brush. Use of the power toothbrush resulted in a significant reduction of whole-mouth and gingival margin MPI across all areas of the dentition compared to a manual toothbrush (P< 0.001). The power toothbrush also had superior interproximal plaque removal efficacy compared to the manual toothbrush for molars (P< 0.001, with 118% greater removal score). Both brushes were well tolerated.     

Home oral hygiene revisited. Options and evidence

In regard to the limited literature on the subject, and the contradictions observed, we can not conclude that the types of manual brushes produce clinically important effects on the patients' gingival health, or that these effects can be detected consistently. However, the best results have been obtained with new brush designs, and future studies are necessary to clarify the existing contradictions. There is a clear need of long-term studies which comparatively evaluate the ability to reduce gingivitis and plaque with the newly designed brushes. On the other hand, there is evidence that supports the use of powered toothbrushes in the general population, especially those of the oscillating-rotating and counter-rotational type, as they have shown their ability to reduce gingival bleeding or inflammation, and dental plaque with greater efficacy than manual brushes. There is a clear need of long-term trials on the efficacy of powered brushes in orthodontic patients. With the existing studies we can conclude that there is limited evidence that orthodontic patients using a powered toothbrush show a slight, but significant, reduction of bleeding, compared with users of manual brushes. No conclusion can be made concerning the type of brush to be used. The techniques of interproximal oral hygiene, fundamentally the use of dental floss and interproximal brushes, appear to add additional benefits, in terms of plaque reduction, when they are associated with conventional manual brushes. Further long-term studies are necessary to confirm their efficacy in the reduction of gingival bleeding or inflammation. The choice of the type of technique must be made in relation to the characteristics of the patient: dental floss could be indicated in individuals with closed interdental spaces, and inter-proximal brushes in periodontal patients, or in those with open embrasures.     

Interproximal gingival inflammation related to the conversion of a bleeding to a nonbleeding state

Elimination of gingival bleeding has been related to a reduction in inflammation; however, histologic data are not available to support this association. The purpose of this study was to characterize the histology of interproximal gingiva that was converted from a bleeding to a nonbleeding state. An interproximal gingival biopsy was obtained from each of 32 patients, 15 of whom bled upon stimulation with a soft wooden interdental cleaner. The remaining 17 biopsies were obtained from sites which initially bled, but were converted to nonbleeding by scaling and interproximal plaque control. Specimens were processed for light microscopic evaluation and subjected to a morphometric analysis for various tissue components. Data from bleeding and "stopped bleeding" specimens were compared using analysis of covariance. The results indicated that "stopped bleeding" specimens had significantly less inflamed connective tissue. It was concluded that the conversion of a bleeding to a nonbleeding state corresponds with a histological reduction in the magnitude of the interproximal inflammatory lesion and provides a rationale, therefore, for the use of bleeding to monitor the effects of therapeutic methods.     

Comparison between manual and mechanical methods of interproximal hygiene.

OBJECTIVE: The aim of this study was to compare the effectiveness of the automated Interclean Interdental Plaque Remover with that of interdental brushes and Ultrafloss. METHOD AND MATERIALS: The interdental hygiene effectiveness of 35 healthy patients suffering from gingivitis was studied by an examiner daily over a period of 1 week. The sizes of the interdental spaces were classified and corresponding-sized interdental brushes or floss was selected. In a random, split-mouth design both interdental cleaning methods, mechanical and manual, were applied while the patients continued to use standard brushing techniques. Disclosed proximal plaque, the papillary bleeding index, and interdental bleeding tendency on stimulation were evaluated. RESULTS: The papillary bleeding index was reduced from an average value of 40% to 25%. Only 5% of interproximal plaque remained after manual interdental cleaning, whereas 40% of plaque was still present after use of the Interclean device. Cleaning efficiency of manual and mechanical methods was comparable in only 1 interproximal space size. At the end of the study, the interdental bleeding on stimulation was significantly higher in the automatically cleaned interspaces than in the manually cleaned spaces. CONCLUSION: Manual interproximal cleaning was more effective than the automated device.     

Plaque removal efficacy and safety of the next generation of manual toothbrush with angled bristle technology: results from three comparative clinical studies

PURPOSE: To investigate the safety and efficacy of a novel angled-bristled toothbrush in comparison with three established brushes. METHODS: The Oral-B CrossAction Vitalizer toothbrush was compared with two manual toothbrushes, the Oral-B CrossAction and Oral-B Advantage, and the battery-operated Crest SpinBrush Pro brush in three independent single-use, examiner-blind, crossover studies. In each study, over 50 healthy subjects from a normal population brushed with their randomly assigned toothbrush for 1 minute without instruction. Subjects returned after a 1-week washout period and brushed with the alternate toothbrush. At each visit, oral hard and soft tissues and plaque were examined before and after brushing. Plaque was evaluated using the Rustogi Modified Navy Plaque Index. RESULTS: Each tested toothbrush significantly (P=0.0001) reduced plaque levels after a single brushing. However, in all three studies, the CrossAction Vitalizer was significantly (P=0.0001) more effective than the comparator brushes in plaque removal from the whole mouth, the gingival margin and approximal surfaces. All toothbrushes were found to be safe with no evidence of oral hard or soft tissue trauma.     

The effectiveness of a musical toothbrush for dental plaque removal: A comparative study

Background and Objectives: the purpose of this study was to clinically evaluate and compare the efficacy of "Brush Buddies" musical tooth brush and Colgate Smile tooth brush in the reduction of established plaque and gingivitis. Materials and Methods: for this study, 120 healthy kids (73 boys and 47 Girls) were selected. The subjects were randomly assigned into two groups by a second examiner; one group used Colgate Smile brush and the other group used "Brush Buddies" musical tooth brush. Plaque index (Quigley and Hein), Modified Gingival Index (Lobene and Associates) and Gingival Bleeding Index (Ainamo and Bay) were assessed at baseline, 30th day, 60th day, and 90th day. Results: all the baseline indices appeared to be well balanced. At the end of the study, reduction in plaque index, modified gingival index and gingival bleeding index were statistically highly significant during each interval for both the toothbrushes. For "Brush Buddies" musical tooth brush, the reduction in all clinical parameters were statistically significant for 30 days and 60 days interval, while nonsignificant at 90 days interval. Interpretation and Conclusion: both the tooth brushes used in this study were clinically effective in removing plaque, improving gingival health. Musical tooth brush is more effective initially but as the time period increases both tooth brushes give almost similar results.     

Comparison of the clinical effects and gingival abrasion aspects of manual and electric toothbrushes

AIMS: The clinical effects and gingival abrasion aspects of 2 electrical tooth-brushes (Braun Oral-B Plak Control Ultra and the novel development Braun Oral-B Plak Control 3D) were to be compared with conventional manual tooth-brushing. MATERIAL AND METHODS: In a cross-over study, 26 dental student volunteers participated and were assigned to 1 of 3 groups. Following instruction in the use of the electric as well as manual toothbrushes, the volunteers were timed for 2 min each day to apply one electric or the manual toothbrush, respectively, during 3 experimental phases of 2 weeks. No other methods of tooth cleaning were to be performed except the one specified for the respective test period. When brushing manually, the Bass toothbrushing technique was applied. Between each test period, a recovery period of 1 week was allowed during which no oral hygiene was performed at all. At the start and the end of each of the experimental periods, the extension of plaque deposits from the gingival margin in coronal direction was assessed using the Turesky et al. modification of the Quigley and Hein plaque index. Presence or absence of gingival inflammation was evaluated by bleeding and probing (BOP). The extent and severity of gingival abrasions were assessed by use of a modified method of Breitenmoser et al. and adapted by Danser et al. RESULTS: The plaque-reducing effect was similar in all groups with the same cleaning regime. For that reason, the result of the different experimental phases with the respective cleaning modalities were collapsed. Cleaning with the Braun Oral-B Plak Control Ultra electric toothbrush resulted consistently in the lowest plaque scores when compared to both the Braun Oral-B Plak Control 3D and the manual toothbrush. Although the differences in plaque reduction were statistically significant between cleaning with Braun Oral-B Plak Control Ultra and 3D, they were small and of questionable clinical relevance. No significant differences in plaque reductions were found between manual brushing and any of the 2 electric brushes. Gingival abrasions were least pronounced following brushing with the Braun Oral-B Plak Control 3D electric toothbrush. However, no significant differences in gingival abrasion were encountered following brushing with the Braun Oral-B Plak Control Ultra electric in comparison with the manual toothbrush. CONCLUSIONS: The results of the present study have shown that in a group of dental students trained in manual brushing technique, where efficacy was similar with the 3 toothbrushes tested, there is no evidence of greater gingival abrasion with either Braun Oral-B Plak Control Ultra or 3D when compared with a manual brush.     

Toothbrushing force in relation to plaque removal

Abstract 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. 1 = 119. B= 146, M=273). No significant relation between brushing force and plaque removal was demonstrated for any of the brushes.     

A comparison of the efficacy of 2 powered toothbrushes in affecting plaque accumulation, gingivitis, and gingival bleeding.

BACKGROUND: The purpose of this 30-day blinded, parallel-design study was to compare the effect of 2 powered toothbrushes, the Rowenta MH700 and the Braun Plak Control Ultra, on reducing plaque accumulation, gingivitis, and gingival bleeding in a cohort of 60 healthy adults. METHODS: After baseline evaluation of plaque, gingivitis, and gingival bleeding, subjects were randomly assigned to one of the experimental groups, provided written and verbal toothbrushing instructions, and had their teeth polished. At 2 weeks (follow-up 1) and 4 weeks (follow-up 2), all clinical parameters were again evaluated. RESULTS: The Braun group demonstrated a nearly significant reduction in gingival index (GI) and a significant reduction in GI at follow-up 2. The Rowenta group demonstrated significant reductions in GI, plaque index (PI), and bleeding index (GBI) at both follow-up 1 and 2 examinations. At follow-up 1, the Braun group demonstrated a nearly significant reduction in GI, a significant reduction in PI, and a non-significant reduction in GBI. At follow-up 2, the Braun group demonstrated a significant reduction in GBI, but not a significant reduction in PI. The reduction in GI for the Rowenta group was significantly greater (P values of 0.0001 and 0.0001, respectively) than that demonstrated in the Braun group. However, the Rowenta group did not demonstrate a significantly greater reduction in PI (P values of 0.7135 and 0.3184 for follow-up 1 and follow-up 2, respectively) or GBI than the Braun group at either examination (P values of 0.0663 and 0.3397 for follow-up 1 and 2, respectively). CONCLUSIONS: The results of this study support the findings of numerous other studies that powered toothbrushes have great potential to remove plaque and improve gingival health and that the improvement can be demonstrated in a relatively short period of time.     

Toothbrush age and wear as it relates to plaque control

An investigation was conducted to test the hypothesis that age and wear of toothbrushes do not affect plaque removal. 40 preclinical dental students between the ages of 19 and 26 years were assigned randomly to 2 groups. 1 group of 19 subjects used a toothbrush for 10 weeks while the 21 subjects in the other group were given new toothbrushes every 2 weeks for 10 weeks. A baseline of zero plaque and calculus was obtained on the first visit. On subsequent visits, 2 weeks apart, the gingival status of each group was evaluated using the gingival index, and plaque levels were scored using the patient hygiene performance index. The brushing surface area of the toothbrushes was measured with a caliper as well as being graded subjectively according to their condition (good, fair or poor). Results were statistically analysed at the end of the 10-week period. It was found that after 10 weeks, the subjects using the same toothbrush for the whole period had significantly more plaque than those who replaced their brushes every 2 weeks. As brushes deteriorated, they became less effective. No differences in gingival state were detected. There was appreciable variation in toothbrush wear among subjects, some reducing their brush to a poor state in 2 weeks whereas with others the brush was rated as "good" after 10 weeks.     

The effectiveness of a counterrotational-action power toothbrush on plaque control in orthodontic patients

This study compared counterrotational-action power toothbrushing with manual toothbrushing in effectiveness on plaque control and gingival health in 20 randomly selected orthodontic patients at the University of Missouri-Kansas City. A blind two-group crossover design was used. Gingival and plaque scores were recorded, and a prophylaxis was given to bring the plaque score to zero. Ten subjects received counterrotational power brushes, and ten subjects received manual brushes. Instructions appropriate to each brushing method were given by a hygienist. At 30 and 60 days, plaque and gingival scores were recorded and a prophylaxis was given. At 60 days the subjects who were using power brushes were switched to manual brushes, and the subjects who were using manual brushes were switched to power brushes. At 30 and 60 days, plaque and gingival scores were recorded and a prophylaxis was given. Plaque and gingival scores were significantly less (p less than 0.01) after brushing 2 months with the counterrotational power brush than with the manual brush. This finding was irrespective of the sequence in which the brushes were used.