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Comparative efficacy on supragingival plaque and gingivitis of a manual toothbrush (Colgate Plus) and a battery-powered toothbrush (Colgate Actibrush) over a 30-day period.

This clinical study compared the effect of Colgate Actibrush, a battery-powered toothbrush, and Colgate Plus Diamond Head, a full-head, soft-bristled manual toothbrush, on established supragingival plaque and gingivitis over a 30-day period. Sixty-two healthy adult men and women were entered in the study. The subjects were stratified into two balanced groups according to their mean baseline plaque and gingivitis scores. Each group was randomly assigned to the use of one of the two toothbrushes. Subjects were instructed to brush their teeth at home twice daily (morning and evening) for 1 minute with their assigned toothbrush and a commercially available tooth-paste for the 30-day duration of the study. Gingivitis and plaque examinations, as well as a soft-tissue evaluation, were conducted by the same dental examiner at baseline and after 15 and 30 days of toothbrush use. Plaque and gingivitis scores were reduced significantly from baseline after the use of both toothbrushes for 30 days. However, improvement in both supragingival plaque and gingivitis scores was significantly greater in the group using Colgate Actibrush. In conclusion, although both toothbrushes provided a significant plaque and gingivitis benefit when used as part of a normal oral hygiene regimen, the efficacy of the Colgate Actibrush was demonstrated to be superior to that of the Colgate Plus Toothbrush after 30 days of use.

Adolescent↗

Effect of rotary electric toothbrush versus manual toothbrush on periodontal status during orthodontic treatment.

Adolescents with fixed orthodontic appliances frequently have increased levels of plaque accumulation and gingivitis. The purpose of this study was to determine whether a rotary electric toothbrush would be more effective than conventional toothbrushing in maintaining periodontal health in these patients. Forty adolescent patients were divided into equal groups matched for sex and age. Before and during placement of orthodontic appliances, one group was instructed in use of the rotary electric toothbrush and the other in the use of a conventional toothbrush; these instructions were reinforced at monthly visits thereafter. Baseline clinical assessments of Plaque Index, Gingival Index, and bleeding tendency were made on six standard teeth before appliances were placed. assessments were repeated at 1, 3, 6, 9, 12, and 18 months after appliances were placed. Intragroup and intergroup differences were tested by a two-way analysis of variance. At baseline there were no significant differences between the two groups for any study variable. During the 18-month study period, however, plaque accumulation and gingivitis increased significantly over baseline levels in the control group (p less than 0.01) but remained stable in the group using the rotary electric toothbrush. In addition, the control group showed significantly greater plaque (p less than 0.01), gingival inflammation (p less than 0.001), and gingival bleeding on probing (p less than 0.001) than did the treatment group from the 1- to 18-month examinations. These data suggest that the rotary electric toothbrush is more effective than conventional toothbrushes for removing plaque and controlling gingivitis in adolescents during orthodontic treatment with fixed appliances.

Child↗

Laboratory evaluations of two battery-powered toothbrushes and a manual toothbrush for efficacy and safety.

Two laboratory testing procedures, predictive of clinical efficacy and safety, have been used to evaluate two battery-powered toothbrushes (a new prototype, Crest SpinBrush Pro and a commercially available product, Crest SpinBrush) and a standard manual toothbrush (Oral-B Indicator). Interproximal access efficacy (IAE) and depth of deposit removal (DDR) have been evaluated in laboratory methods using pressure-sensitive paper placed around simulated anterior and posterior teeth at a brushing pressure of 250 g with horizontal or vertical brushing motions. Twenty-four tests on each toothbrush design were conducted, and results were statistically analyzed using ANOVA and the post hoc Tukey test. Both of the battery-powered toothbrushes had a significantly (p < 0.001) higher mean overall IAE value compared to the Oral-B Indicator product. The Crest SpinBrush Pro was significantly statistically higher (p < 0.05) compared to the Crest SpinBrush for mean overall IAE (access to interproximal spaces). On overall DDR, both of the powered toothbrushes had a significantly (p < 0.05-0.001) lower mean overall value compared to the Oral-B Indicator toothbrush (higher mean indicates higher irritation potential). Based on these results, both the new prototype Crest SpinBrush Pro and the commercially available Crest SpinBrush are predicted to be more effective clinically for plaque removal, and at least as safe on hard and soft intraoral tissues as the standard manual toothbrush (Oral-B Indicator) tested. In addition, the results support that the new prototype Crest SpinBrush Pro is more effective than the Crest SpinBrush with respect to IAE and predicted plaque removal.

Analysis of Variance↗

The effect of toothbrushing frequency, toothbrushing hand, sex and social class on the incidence of plaque, gingivitis and pocketing in adolescents: a longitudinal cohort study.

Reported toothbrushing frequency and the effect of toothbrushing frequency, toothbrushing hand, sex and social class on the incidence of plaque and periodontal disease in a group of 720 adolescents examined at age 11-12 years and again at 15-16 years is presented. At 11-12 years, the mean toothbrushing frequency was 11.5 times per week. By age 15-16 years, it had risen to 13.3 times per week. Children from social class I were less likely to brush once per day or less and more likely to brush twice daily than those from social class V. At both examinations, consistently low negative correlations were seen between reported toothbrushing frequency and the mean scores for buccal and lingual plaque, buccal, mesial and total bleeding. Few significant differences were seen between left- and right-handed toothbrushers at age 11-12 years. These were almost entirely due to differences between the boys. By age 15-16 years, no significant differences existed between the two groups. At both examinations, the boys had higher plaque, bleeding and pocketing scores than did the girls. At 15-16 years of age, all social classes exhibited lower mean total pocketing scores than at age 11-12 years. At 11-12 years of age, the social class differences were mainly contributed by the girls, while at re-examination plaque and bleeding scores for both sexes showed an overall trend to increase from social class I through to social class V. At 11-12 years of age, the boys showed a trend for pocketing to increase from social class I through to social class V. This was absent at 15-16 years of age. The girls showed no such trend at 11-12, but it had emerged by age 15-16. The results again demonstrate the influence of social class and sex rather than toothbrushing frequency and handedness on oral hygiene and gingival health. However, in view of the high number of statistical tests employed, some caution must be exercised in the interpretation of differences significant at the 5 per cent level.

Adolescent↗

The effectiveness of a u-v toothbrush sanitizing device in reducing the number of bacteria, yeasts and viruses on toothbrushes.

Sixty-six sterile toothbrushes were exposed to one of the following microorganisms: Staphylococcus aureus, Pseudomonas aeruginosa, Escherichia coli, Bacillis subtilis, Serratia marcescens and Baker's yeast. The Pollenex DS60 Daily Dental Sanitizer was found to be effective in substantially reducing the number of retained bacteria and yeasts as compared to contaminated toothbrushes not treated with such a device. Different toothbrush types had different response rates. Seventy-two sterile toothbrushes were exposed to Herpes Simplex Virus, Type I and seventy-two sterile toothbrushes were exposed to Parainfluenza Virus, Type III. The Pollenex DS60 Daily Dental Sanitizer consistently killed both viruses on all of the toothbrushes treated. Both viruses were consistently retained on non-treated toothbrushes for at least 24 hours.

Bacillus subtilis↗

An oscillating/pulsating electric toothbrush versus a high-frequency electric toothbrush in the treatment of gingivitis.

OBJECTIVES: The objective of this study was to compare the effect of an oscillating/pulsating power toothbrush (Oral-B ProfessionalCare 7000; PC 7000) and a high-frequency power toothbrush (Philips Sonicare Elite; SE) on the reversal of experimental gingivitis. METHODS: The study had a randomised, examiner-blind, split-mouth design. After dental prophylaxis, subjects refrained from brushing mandibular teeth for 21 days to allow development of gingivitis. During a 4-week treatment phase, the right or left side of the mouth was brushed with either the PC 7000 or the SE toothbrush as randomly allocated. Plaque and gingivitis were assessed at baseline (Day 0), after 21 days of no oral hygiene, and after 1, 2 and 4 weeks of brushing twice daily. Gingival abrasion was assessed at Day 0 and after 1, 2 and 4 weeks of product use. RESULTS: Of 38 enrolled subjects, 35 provided evaluable data. The experimentally induced gingivitis (EIG) phase resulted in higher bleeding and plaque scores as compared to Day 0. During the treatment phase, plaque and bleeding scores were significantly lower with the PC 7000 than the SE toothbrush. After 4 weeks of use, the mean plaque scores changed from 2.78 (Day 21 of EIG phase) to 0.70 for the PC 7000 and from 2.67 (Day 21) to 0.88 for the SE. The mean bleeding scores changed from 1.86 (Day 21) to 1.24 for the PC 7000 and from 1.88 (Day 21) to 1.42 for the SE. No major differences were found between brushes with regard to gingival abrasion. CONCLUSIONS: The oscillating/pulsating power toothbrush (Oral-B ProfessionalCare 7000) was more effective than the high-frequency power toothbrush (Philips Sonicare Elite) at plaque removal and improvement of gingival condition, with no greater potential for causing gingival abrasion.

Adult↗

Comparison between electric toothbrushing and manual toothbrushing, with and without oral irrigation, for oral hygiene of orthodontic patients.

This study evaluated the effectiveness of one electric toothbrush and oral irrigation system in comparison with manual toothbrushing in 20 orthodontic patients. Twenty patients performed four oral hygiene routines for at least 4 weeks each. The routines included manual toothbrushing alone, electric toothbrushing alone, manual toothbrushing plus irrigation, and electric toothbrushing plus irrigation. Baseline plaque and gingival scores were recorded, and both indices were again recorded after each routine. The index used to evaluate gingival health was a slight modification of the Silness and Löe gingival index, while the plaque index was similar to the patient hygiene performance (PHP) index developed by Podshadley and Haley. The average overall scores for plaque and gingival condition for all patients who used each of the four oral hygiene routines were compared with a repeated-measures, analysis-of-variance statistical evaluation. The values obtained from the analysis showed that there were no significant differences between the means for plaque and gingival health in each group. The probabilities that these conclusions are incorrect are 18% for plaque and 2% for gingival health. Testing for validity of the data was done by more than one researcher, with consistent results.

Adolescent↗

Effect of rotary electric toothbrush versus manual toothbrush on decalcification during orthodontic treatment.

The purpose of this study was to determine whether daily use of a rotary electric toothbrush (Rota-dent, Prodentec Corp., Batesville, Ark.) and a 0.05% sodium fluoride (NaF) rinse would significantly reduce decalcification when compared with manual toothbrushing only (control group) or manual toothbrushing and daily use of a NaF rinse (rinse group). All three groups used a standard fluoride toothpaste. Ninety consecutive adolescent patients who were to receive orthodontic treatment were placed into one of three groups according to age and sex criteria. Decalcification was evaluated single blind by two calibrated examiners on the facial surfaces of all permanent teeth before appliances were placed (baseline) and 3 months after appliances were removed (posttreatment). Data were analyzed by analysis of covariance with the dependent variable derived by subtracting the baseline decalcification scores from the posttreatment scores and using the baseline scores as the covariate. The results showed that although there were no significant differences between the three groups at baseline, the Rota-dent group showed significantly (p < 0.05) less posttreatment decalcification than either the control or rinse groups. In a separate analysis of first molars, the Rota-dent group again showed the least decalcification and the control group showed the most. These data suggest that twice daily use of the Rota-dent electric toothbrush with a standard fluoride toothpaste and once daily use of a 0.05% NaF rinse is more effective for preventing decalcification in adolescents during orthodontic treatment with fixed appliances than either conventional toothbrushing with a fluoride toothpaste, or similar toothbrushing and toothpaste with a once daily NaF rinse.

Adolescent↗

Effect on periodontal status of rotary electric toothbrushes vs. manual toothbrushes during periodontal maintenance. I. Clinical results.

The purpose of this study was to compare the Rotadent rotary electric toothbrush with conventional toothbrushing for its effectiveness in controlling supragingival plaque and gingival inflammation in periodontal maintenance patients. Forty subjects who had received periodontal treatment, including periodontal surgery, for moderate to advanced periodontitis and were on a 3-month periodontal maintenance were divided into two equal groups matched for age and sex. One group used conventional toothbrushing, dental floss, and toothpicks and the other used only the rotary electric toothbrush for a 12-month study period. Single-blind clinical assessments (Plaque Index, Gingival Index, bleeding tendency, pocket depth, and loss of attachment) were made at baseline and at 3, 6, 9, and 12 months after baseline. Subgingival debridement was performed 1 week after the baseline assessment and the 6- and 12-month examinations. Plaque removal was reinforced at 3-month intervals. Both groups had significantly improved scores (P less than 0.01) for Gingival Index and bleeding tendency during the 12-month period, but no differences were found between the groups at any examination. These results indicate that the rotary electric toothbrush is as effective for plaque removal and control of gingival inflammation as a combination of conventional toothbrushing, flossing, and toothpicks for patients in periodontal maintenance.

Adult↗

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).

Dental Plaque↗

Can toothpaste or a toothbrush with antibacterial tufts prevent toothbrush contamination?

BACKGROUND: Periopathogens and cariogenic species survive more than 48 hours on toothbrushes even under dry storage. This study examined a decontamination of toothbrushes by means of the bactericidal effect of different toothpastes or a special coating of the tufts. METHODS: Eight untreated periodontitis patients were professionally brushed, using a new toothbrush per quadrant and 3 different toothpastes containing either amine/stannous fluoride (AmF/SnF2), amine fluoride (AmF), or a mild surfactant as major antibacterial component (excipient), or no paste (C). The brushes were rinsed and stored dry at room temperature. At different time intervals, 4 tufts per toothbrush were processed for selective and non-selective culturing procedures. The protocol was repeated comparing AmF/SnF2 and C with 2 toothbrushes with coated tufts (coat1 and coat2). RESULTS: At baseline, C brushes (n = 16) harbored 10(7), 10(8), and 10(6) colony forming units (CFU) of aerobic, anaerobic, and black pigmented species, respectively. After 24 hours 10(6) CFU of aerobic and anaerobic species could still be cultured from 14 of the 16 brushes. Black-pigmented species remained detectable up to 4 hours; detection frequencies for Fusobacterium nucleatum and Streptococcus mutans at 24 hours were 5/16. With AmF/SnF2 and AmF toothpaste the number of adhering bacteria was already 2 log lower at baseline (P<0.05), but not for the excipient (0.5 log, P = 0.7). With AmF/SnF2 no vital species could be detected after 8 hours. AmF reduced the bacterial survival rate significantly more than the excipient, but less than AmF/SnF2 (P<0.05). The bactericidal effect of coat1 and coat2 was negligible when compared to C (P>0.20), and clearly inferior to the AmF/SnF2 paste (P<0.0001). After 24 hours these brushes still harbored >10(5) CFU. CONCLUSIONS: Toothpastes can significantly reduce contamination of toothbrushes, but their bactericidal activity is dependent on their composition. Coated tufts failed to limit the bacterial contamination.

Adult↗

The attitudes of New Zealand dentists and dental hygienists towards toothbrushes and toothbrushing.

The purpose of this study was to survey the attitudes of dentists and dental hygienists who practise in New Zealand, with respect to their personal habits, and the recommendations they give to their patients about toothbrush use. A questionnaire was mailed to 800 dentists and 74 dental hygienists with a response rate of 58% and 66% respectively. The results indicate that 76.6% of dentists and 89.1% of dental hygienists recommend toothbrush replacement every two to three months to their patients and generally follow this recommendation themselves. Both groups feel patients should replace their toothbrushes more often than they currently do and the majority tell their patients when to replace brushes. Dentists and dental hygienists have identified bristles that "no longer remove plaque" and "bent, splayed bristles" as the two most important indicators of when a new toothbrush is needed. Soft, compact head brushes are most often recommended by both groups. Most offices give toothbrushing instruction and distribute complimentary brushes. Dentists most often assume this task, but when a hygienist is employed, this duty is typically their responsibility. Oral B and Colgate toothbrushes are the brands most often recommended by both dentist and dental hygienists.

Attitude of Health Personnel↗

Comparative efficacy of a new battery-powered toothbrush and an electric toothbrush on plaque removal.

This single-use, examiner-blind clinical study evaluated the plaque-removal efficacy of a new, battery-powered toothbrush (Colgate Actibrush) compared to a commercially available electric toothbrush (Braun Oral-B Plaque Remover) after 24 hours of no oral hygiene. Adult men and women reported to the clinical facility having refrained from oral hygiene procedures for 24 hours, and were stratified into 2 balanced groups according to plaque (prebrushing) scores. Participants then brushed their teeth for 1 minute, under supervision, with their assigned toothbrush and a commercially available toothpaste (Colgate Cavity Protection Great Regular Flavor Fluoride Toothpaste) and again were evaluated for supragingival plaque (postbrushing). The same dental examiner conducted the prebrushing and postbrushing plaque examinations. The study found no statistically significant difference in plaque removal between the group using the battery-powered toothbrush and the group using the electric toothbrush. Both power toothbrushes were found clinically to be equally effective with regard to the removal of 24-hour plaque accumulation.

Adolescent↗

Laboratory investigation of Colgate 360 degrees toothbrush and Oral-B indicator toothbrush for the removal of dental stains.

The objective of this in vitro study was to evaluate the stain-removal efficacy of a newly designed manual toothbrush, the Colgate 360 degrees, relative to a commercially available toothbrush, the Oral-B Indicator. A modification of Stookey et al was used to evaluate the stain-removal effects of toothbrushes instead of dentifrice on bovine teeth. A V.8 mechanical cross-brushing machine equipped with the test toothbrushes and adjusted to 500g to enamel surfaces evaluated stain removal using a dentifrice slurry and water after 800 double strokes. The overall results of this laboratory investigation indicate that the Colgate 360 degrees toothbrush is more effective, P < .05, than the commercial Oral-B Indicator toothbrush in removing dental stain and brightening teeth using a standard toothpaste or water.

Animals↗

[Clinical comparison of newly introduced toothbrush with two presently available toothbrushes].

The cleansing effect of a newly introduced toothbrush, which is characterized by a thin, permanently elastic neck for reduction of abrasion pressure and an especially flat brush head, was clinically compared with two tested toothbrushes. Under identical experimental conditions, 30 subjects tested all three toothbrushes. Plaque was determined by the plaque index for toothbrush studies. On the whole, no significant differences were demonstrable with regard to the cleansing effect among the toothbrushes. Reduction of abrasion pressure, therefore, does not have a negative effect on the cleansing effect of these toothbrushes.

Adolescent↗

A clinical trial to compare plaque removing efficiency of a prototype toothbrush with alternative toothbrushes.

Three alternative toothbrushes were investigated in a double blind Latin Square repeated measures design study for their relative efficiency at removing plaque 'in vivo'. A prototype filament suspension design toothbrush was tested, with the suspension mechanism both active and inactive, against a conventional toothbrush. Following an initial control plaque score, subjects were ordered by oral hygiene levels and randomly allocated to each of the three test groups. The trial was made up of three periods of 14 days consisting of four days of no brushing followed by 10 days of brushing with each of the three toothbrushes. All plaque scores were recorded using the Greene and Vermillion Index of Oral Hygiene and plaque scores were recorded for each patient at the start, four days later and at the end of each 14-day period. There were no significant differences in the quantity of plaque remaining after brushing with any of the brushes tested in this study. Ignoring the toothbrush used, the end brushing average plaque scores for period 1 were found to be higher than the control plaque scores. It is suggested that this resulted from the patients finding new toothbrushes less comfortable to use initially but following a period of accommodation and adjustment, end brushing plaque levels in subsequent periods returned to near the same level as the control plaque score.

Dental Plaque↗

The effect of an oscillating/rotating electric toothbrush and a sonic toothbrush on removal of stain from enamel surfaces.

This laboratory investigation compared the Sonicare toothbrush, the Braun Oral-B Plaque Remover and a manual brush, in terms of removal of stained pellicle from the surface of enamel specimens. Enamel specimens were stained over a period of 4 days to produce a stained pellicle film. Staining was assessed photometrically before and after brushing 16 specimens per group for 4.5 minutes with the three test toothbrushes and dentifrice slurry prepared from Crest toothpaste. The positive control consisted of the ADA reference abrasive and a manual toothbrush. Results were expressed as a cleaning ratio (CR), with higher values representing more efficient stain removal. Analysis of results revealed that removal of stain from the enamel surfaces was similar in the Braun Oral-B Plaque Remover group (CR 94) and the reference standard group (CR 100). There was no statistically significant difference between these 2 groups. In contrast, stain removal in the Sonicare toothbrush group and the manual toothbrush group was significantly less effective (p<0.01), with a mean CR of 66 and 76, respectively. There was no statistical difference between the cleaning ratio scores for these 2 groups. It is concluded that extrinsic stain removal with the Sonicare toothbrush is similar to that achieved with a manual brush, but that stain removal with the Braun Oral-B Plaque Remover is significantly more effective.

Analysis of Variance↗

A comparative clinical investigation of the safety and efficacy of an oscillating/rotating electric toothbrush and a sonic toothbrush.

This clinical study compared the ability of a sonic toothbrush to remove plaque and control gingivitis with that of an oscillating/rotating electric toothbrush. One-hundred and sixteen subjects from a general population were randomly allocated to either a sonic toothbrush group (Sonicare) or an electric toothbrush group (Braun Oral-B Plaque Remover). After 8 weeks use, there was found to be no statistically significant difference in either plaque removal or gingival index between the two groups. Both devices were found to be safe, but whereas 100% of volunteers in the Braun Oral-B Plaque Remover group expressed a wish to continue using the toothbrush, approximately 25% of the Sonicare group did not like the device and said that they would not continue to use it. The Sonicare device was found to offer no advantages in clinical terms over an established oscillating/rotating electric toothbrush (Braun Oral-B Plaque Remover) with respect to removal of supragingival plaque or improvement in gingival health.

Adult↗