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Effect of mouth rinsing and toothbrushing with fluoride solutions on caries among Norwegian schoolchildren.

The caries experience and the plaque and gingival conditions of 14-year-old children participating in fortnightly fluoride (0.2 % NaF) mouth rinsing (88 subjects) were compared with observations in children performing supervised toothbrushing with a fluoride (0.5 % NaF) solution 4-5 times per year (n = 90). Most of the children, 84 and 90% respectively, had participated in these programs for the previous 6 years. Caries was assessed only on radiographs. The mean number of decayed surfaces was 5.8 (s.d. = 4.1, n = 88) and 5.4 (s.d. = 4.1, n = 90). The mean numbers of decayed and filled surfaces were 19.3 +/- 9.2 and 27.9 +/- 10.2 for subjects with rinsing or brushing. This significant difference could not be ascribed to sex, social class, years of residence in the towns, number of dentists performing the previous treatments, toothbrushing habits, use of fluorides at home, or amount of plaque. All children had gingivitis. There were no differences in the mean number of Plaque Index score 2 or the number of Gingival Index score 2 between the children with the different preventive programs. The girls' oral hygiene was better than the boys', but the gingival conditions were the same. Sex, social class, and toothbrushing techniques tended to have a slight influence on the amount of plaque.

Adolescent

Influence of social norms on toothbrushing behavior of preschool children.

Two hundred and eighty mothers of preschool children were interviewed in order to determine first, their children's toothbrushing habits and secondly, their expectations concerning the brushing behavior of preschool children in general. The influence of social and demographic factors on children's brushing behavior was also investigated. The results showed that the practice of toothbrushing is widespread and mothers play the central role in teaching the brushing routine. However, the social norms concerning oral hygiene were imprecise, indicating that mothers had no social support for teaching their children to brush and no information on how brushing should be carried out. Dental health educators should encourage mothers of young children to develop positive attitudes towards toothbrushing and teach them the correct technique.

Age Factors

Using a "lifestyle" perspective to understand toothbrushing behaviour in Scottish schoolchildren.

Using data from a wider survey of health related behaviour in 4,935 Lothian schoolchildren, 11, 13, and 15 yr old, this paper analysed toothbrushing frequency and its relation to "lifestyle" factors. Analysis of the results showed that girls brush more frequently than boys and that children with higher social class background brushed more frequently than children with low social class background. Further toothbrushing frequency was significantly related to the subjects' health perception, smoking and drinking habits, eating habits, bedtimes, and video-watching. Moreover, all these lifestyle factors were inter-related. The paper reinforced the concept of lifestyle as a meaningful descriptive term. The results demonstrated that the bivariate associations are pieces in a more complex mosaic. Toothbrushing thus seems to be an integrated part of a child's lifestyle and should be regarded as such in future health promotion efforts.

Adolescent

Choice of toothbrush: a survey of dentists' personal preferences and recommendations for patients.

Data on dentists' choice of toothbrush brand/type for personal use and their recommendations for patients were obtained by means of a questionnaire. Seventy-nine per cent of dentists surveyed received free samples, with Oral-B comprising 33 per cent of all such samples, followed by Colgate (16 per cent) and Tek (13 per cent). Fifty-three per cent of dentists surveyed indicated they used all free samples received. Sixty-two per cent of dentists do not consider that different brushes differ significantly in their plaque-removing ability. Therefore, while an effective toothbrushing technique is important, selection of the 'correct toothbrush' from the wide range available may not be critical. The results of the present investigation provide information that is relevant to dental health education and can be applied at the chairside as well as at the broader community level.

Adolescent

An epidemiological study of the influence of sweets intake and toothbrushing on dental caries among children in Japan.

The study was designed to determine the influence of confectionery and beverages intake and of toothbrushing on infant dental caries. The participants were 700 three year old Japanese children from an urban area near Tokyo. The prevalence of caries in those who frequently consumed confectionery and beverages was higher than the prevalence in those who did not take them. However, the prevalence in children with a habit of toothbrushing did not differ from that of those without the habit. This study shows that restricting consumption of confectionery and beverages may be effective in preventing dental caries; however, encouragement of toothbrushing may not be effective in limiting dental caries progression.

Beverages

Damaging effects of toothbrush bristle end form on gingiva.

The ability of two different toothbrush bristle ends to produce traumatic gingival abrasion was assessed in a double blind study of 15 male and 15 female young adults. Brushing was performed in a circular fashion using a modified Bass Technique. An apparatus allowing continuous visual feedback of the average brushing force permitted a degree of standardization of the system. The upper left canine and bicuspid area had to be brushed for 30 seconds with cut toothbrush bristles (CP) and with round ended toothbrush bristles (RP) respectively. A two week interval separated the two brushing sessions. Traumatic lesions of the attached gingiva were stained with a disclosing solution, photographed and evaluated planimetrically. The "cut bristles" caused gingival abrasions 30% greater in extent than the round end bristles. The difference was not due to single brushing strokes accidentally greater for the "cut bristles". The size of the lesions was not sex dependent. To prevent gingival damage it is desirable to either round the bristles in production or to rid the bristle ends at least of sharp edges.

Adolescent

Condition of toothbrushes in use: correlation with behavioral and socio-economic factors.

Toothbrushes and questionnaires from 94 adult dentate individuals were analyzed. More than 97% of respondents said they brushed their teeth at least once a day, while 48% used more than one toothbrush (such as one at home and another at work). Only 47% said they preferred a soft nylon bristle, while 41% preferred medium and 10% a hard nylon bristle. More than 73% of subjects said they used their brushes for 3 months or longer. Examination of collected brushes by both objective and subjective criteria revealed a wide variation in wear; however, the majority of brushes did not appear to be 'worn-out'. No significant correlation was found between objective wear-index and the educational level of the user, annual household income of the user, or reported time in use of the brush. A significant (p less than 0.01) correlation was found between brush wear-index and the ability of the user to judge toothbrush wear.

Adult

A comparative study of plaque removing efficiency using rotary electric and manual toothbrushes.

Plaque removing efficiency was compared between rotary electric and manual toothbrushes. The first part of the study included 19 dental hygiene students randomly assigned to a "rotary" or a "manual" brushing group. The subjects were instructed to brush their teeth three minutes twice a day for three weeks either with rotary electric or with manual brushes. Then for another period of three weeks brushing techniques were reversed. The results showed that the median plaque index for all sites and for buccal and lingual sites was significantly lower in the rotary brushing group (28% vs 39% and 3% vs 6%, p less than 0.05). During the second part of the study 10 of the students refrained from all oral hygiene procedures for four weeks in the anterior mandibular region, i.e. from 33 to 43. They were then randomly assigned to a "rotary" or a "manual" brushing group. Registrations of accumulated plaque were made from photographs at baseline and after 15, 30 and 60 seconds of brushing. ANOVA analysis of the plaque scores showed a significant difference in reduction of plaque in favour of the rotary electric brush (p less than 0.01). The results suggest that the rotary electric toothbrush removes plaque more efficiently than the conventional manual toothbrush.

Adult

[The effect of toothbrushing on approximal dental surfaces].

Altogether 52 teeth (20 anteriors, 13 premolars and 19 molars) scheduled for extraction were used for study. Before extraction the teeth were brushed with a medium textured toothbrush applying the modified Bass method with five strokes of proximal cleaning. The lack of professional and proximal cleaning aids makes planimetrically. The following conclusions were drawn: 1. The usual five strokes with a toothbrush are not able to remove old plaque, therefore professional tooth cleaning is necessary. 2. After toothbrushing twice as much plaque remains on the proximal than on the buccal and lingual surfaces. This implies the necessity of proximal cleaning. The lack of professional and proximal cleaning aids makes the establishment of good oral hygiene illusorical.

Dental Caries

[Denta-Solar--comparison with a traditional toothbrush].

This paper reports on the clinical efficacy of a toothbrush (Denta-Solar) with an integrated TiO2 semiconductor element as compared to a conventional toothbrush. A significant reduction in the papilla bleeding index and the plaque indices was recorded in subjects using the Denta-Solar brush; the tartar situation near the gingivae was seen to deteriorate in those using conventional toothbrushes. This supports the assumption that the plaque reduction is due to the special construction features of the Denta-Solar.

Humans

Learning efficiency of a toothbrush for mastering scrubbing method.

Toothbrushing with long horizontal strokes often causes traumatization of sound enamel and gingival tissues. Also, dental plaque on cervical and adjacent surfaces of teeth can hardly be removed because toothbrush tips cannot reach these regions adequately. A toothbrushing device which indicates overstroke was tested to determine the efficacy with which it makes subjects master brushing with short horizontal strokes following an initial period of instruction. The degree of learning measured in the testing group was superior to that of the control group immediately after the first instruction. Moreover after one week and 12 weeks, its efficacy persisted. The plaque elimination ratio, however, showed no significant difference between the testing group and the control.

Adult

[The effect of toothbrushes on human dental enamel and dentin wear].

The authors compare the effects of natural (porcine) and synthetic (Toinex, USA, and Eschalon, France) bristle and rough toothbrushes on the tooth enamel and dentin in the course of toothbrushing. No abrasive effects were detected when brushing normal teeth in clear water. The rate of enamel and dentin abrasion in tooth powder or tooth paste suspension depended on the shape of bristle cut and particularly on the toothbrush roughness.

Adult

[Bristle end rounding and anchoring in children's toothbrushes].

This scanning electron microscopic study of eight toothbrushes for children has shown differences in quality and quantity of the rounding of bristle ends. While four products which were examined for the first time were partially deficient, the preparation of the other toothbrushes had clearly improved in comparison to previous products. Quotas of acceptable end rounding of the bristles varied considerably between 14.3% and 90.2%. Welding of bristle bundles at their base into the head of the toothbrush offers hygienic advantages.

Child

[Plaque reduction by means of "multi-tuft" brushes connected to electric toothbrushes].

In 20 patients the plaque-removing properties of two toothbrushes were tested which work on the principle of an electric swing toothbrush. Brush A was of space-tufted type, brush B of multi-tufted type. The test ran for 14 days for each toothbrush. The study showed that the multi-tufted brush achieved a 30 to 50% better plaque reduction, measured on all tooth surfaces. When considering individual tooth surfaces it was shown that approximal surfaces were less well cleaned than the facial or oral surfaces. After a fortnight the cleaning power of both brushes was reduced. In spite of better plaque reduction by the multi-tufted type of brush the hand tooth brush by instructed patients is to be preferred.

Dental Devices, Home Care

[Gingival injuries from toothbrush bristles].

The ability of two different toothbrush bristle ends to produce traumatic gingival abrasion was assessed in a double blind study on 15 male and 15 female young adults. Brushing was performed in a circular fashion using a modified Bass technique. An apparatus allowing continuous visual feedback of the average brushing force permitted a degree of standardisation of the system. The upper left canine and bicuspid area had to be brushed for 30 seconds with cut toothbrush bristles (CP) and with round ended toothbrush bristles (RP) respectively. A two-week interval separated the two brushing sessions. Traumatic lesions of the attached gingiva were stained with a disclosing solution, photographed and evaluated planimetrically. The "cut bristles" caused gingival abrasions 30% greater in extent than the round end bristles. The difference was not due to single brushing strokes accidentally greater for the "cut bristles". The size of the lesions was not sex-dependent.

Adult

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.

Adolescent

Contamination of toothpaste and toothbrush by Streptococcus mutans.

Toothbrushes and toothpaste tubes used by persons infected with S. mutans were examined for the presence of this microorganism. Fifteen minutes after brushing greater than 10(6) S. mutans were isolated from the toothbrushes and after ordinary storage for 24 h 10(4) were recovered. From two out of 10 toothpaste tubes S. mutans was isolated from the orifice of the tube. The implications of these findings for the spread of the microorganism are discussed.

Dentifrices

Effect of toothbrushing with a fluoride-free and fluoride-containing dentifrice on oral hygiene and number of leukocytes in the gingival fluid.

The number of leukocytes in the gingival exudate and the oral hygiene index during toothbrushing with a fluoride-free and fluoride-containing dentifrice was investigated in humans during a 3-month period. Significant correlations existed between the average number of leukocytes in the gingival exudate and the oral hygiene indices. The number of leukocytes increased significantly during the period of toothbrushing with the Fluoride dentifrice, whereas in the OHI no change was evident.

Dentifrices