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[Effect of different kinds of toothbrushes on toothbrushing pressure and plaque removal in the scrubbing method of toothbrushing (5). Toothbrushes with nylon bristles arranged in different lengths along the toothbrush shank and with different types of toothbrush bristle tip].

The purpose of this study (Report 5) was to investigate the effect of difference in the length of toothbrush shank and type of tip of toothbrush bristle on toothbrushing pressure and plaque removal in the scrubbing method. Four kinds of toothbrushes which were different in length of shank (30 mm, 40 mm) and type of bristle tip (round type, tapered type respectively) were used in this study. Referring to the results of our previous reports (1-4), the dimension of new toothbrushes were determined as follows, nylon bristles: 40 mm long and 0.20 mm in diameter, brushing surface: 30 mm long, bristles: 3 rows with 26 tufts, and a straight handle. Twelve subjects participated in this experiment. Plaque scores were measured before and after toothbrushing. Then plaque removal rates were calculated. Toothbrushing pressure was determined using Watanabe's method. The average toothbrushing pressure of the toothbrush with a 40 mm long shank (301.6 +/- 84.1 g/cm2) was higher than that with a 30 mm long shank (294.7 +/- 74.8 g/cm2), and that with a tapered bristle type (316.7 +/- 90.4 g/cm2) was higher than that with a round type bristle (279.6 +/- 61.7 g/cm2). However statistically significant differences were not found among the four toothbrushes in brushing pressure and in plaque removal on total teeth surfaces and on distal surfaces of the most posterior teeth (P less than 0.05; two-way ANOVA).

Dental Plaque↗

A comparative evaluation of the in vitro penetration performance of the improved Crest complete toothbrush versus the Current Crest complete toothbrush, the Colgate Precision toothbrush and the Oral-B P40 toothbrush.

Removal of plaque and debris from interproximal surfaces during toothbrushing has generally been difficult to achieve, in large part because traditional flat-bristled toothbrushes do not offer good interproximal penetration. As a result, a number of varying bristle designs have been developed, with the rippled-design brush shown to be particularly effective at removing interproximal plaque. Recently, an existing brush, the original Crest Complete, was modified to offer a more deeply rippled version. This study evaluated the interproximal penetration of four bristle designs: rippled pattern (original Crest Complete), deeper rippled pattern (improved Crest Complete), multi-level (Colgate Precision), and flat-tufted (Oral-B P40). The study used a previously reported in vitro model for determining interproximal penetration of manual toothbrushes (J Clin Dent 5:27-33, 1994). In order to effectively mimic the in-use characteristics of toothbrushing, this model is based on analysis of videotaped consumer brushing habits, tooth morphology, and in vivo plaque tenacity characteristics and uses the three most predominantly used brushing techniques (circular, up-and-down, and back-and-forth, with the brush held at both 45 and 90 degrees to the tooth surface). In addition, the model's brush stroke length, brush force, and brush speed are likewise based on analysis of consumer brushing patterns. The results of the study indicate that the new Crest Complete with deeper rippled bristles provided significantly superior (p < or = 0.05) interproximal penetration than the Colgate Precision and Oral-B brushes overall and for three of the four brush strokes tested. In addition, the new Crest Complete was found to provide significantly superior interproximal penetration to the original Crest Complete overall and in circular and up-and-down strokes, and the original Crest Complete provided superior overall interproximal penetration to the Colgate and Oral-B brushes.

Analysis of Variance↗

Comparison of an oscillating/rotating electric toothbrush and a 'sonic' toothbrush in plaque-removing ability. A professional toothbrushing and supervised brushing study.

The purpose of the present study was to compare the Braun/Oral-B Plak Control (D7) and Sonicare (S) in their plaque-removing efficacy. For this study, 35 university students (non-dental) were selected. This was a 2-part study. Prior to each appointment, all subjects were asked to abstain from all oral hygiene procedures for at least 24 h. In Part 1, the efficacy of the toothbrush was studied when one of the investigators brushed the teeth of the panellists. In Part 2, the efficacy of toothbrushing was studied after the students had received professional instruction. The available time for the brushing amounted to a total of 2 min per mouth. Dental plaque was evaluated by means of the Silness and Löe plaque index assessed at 6 sites per tooth. Results showed that both in Part 2 and Part 1 the D7 removed significantly more plaque than the S-electric toothbrush. The plaque reduction assessed according to Silness and Löe in Part 1 was for the D7, 1.28 and for the S, 1.12. In Part 2, the reductions were 0.90 and 0.80, respectively. The majority (n = 34) of subjects preferred the D7 over the S. In conclusion, the results of the present study show that the oscillating/rotating toothbrush (Braun/ Oral-B Plak Control) is more effective in plaque removal than the sonic electric toothbrush (Sonicare). In addition, given a choice, the panellists preferred the oscillating/rotating electric toothbrush.

Adult↗

Transient bacteremia induced by toothbrushing a comparison of the Sonicare toothbrush with a conventional toothbrush.

PURPOSE: Several investigations have demonstrated toothbrush-induced bacteremias. Transient bacteremias are well tolerated by healthy individuals but may increase endocarditis risk in patients with cardiac conditions. This study assessed bacteremia levels after brushing with either the Sonicare electric toothbrush or a manual toothbrush. METHODS: Fifty healthy children receiving dental treatment under general anesthesia with oral intubation were randomly assigned to a manual or Sonicare group. Plaque levels and gingival health were scored and a blood sample collected. Teeth were brushed for 1 minute and a postbrushing blood sample was drawn. Samples were analyzed for aerobic and anaerobic bacterial growth. RESULTS: Gingival health and plaque scores did not differ between groups. No correlation was detected between plaque and gingival scores and occurrence of bacteremia. The frequency of bacteremia was 46% with manual brushing: 18% aerobic, 9% anaerobic and 73% both. This differed significantly (P = .022) with 78% bacteremias in the Sonicare group: 22% aerobic, 22% anaerobic and 56% both. CONCLUSIONS: The Sonicare induced significantly more bacteremias than manual toothbrushing. These results show that vigorous brushing increased bacteremia from one brushing but does not answer whether bacteremia incidence would decrease with a program of vigorous daily brushing; this should be clarified before recommending brushing methods for patients with compromised cardiac conditions.

Bacteremia↗

A comparative evaluation of the in vitro penetration performance of the improved Crest Complete toothbrush versus the Colgate Total toothbrush and the Oral-B Advantage toothbrush.

Removal of plaque and debris from interproximal surfaces during toothbrushing has generally been difficult to achieve, in large part because traditional flat-bristled toothbrushes do not offer good interproximal penetration. As a result, a number of varying bristle designs have been developed, with the rippled-design brush shown to be particularly effective at removing interproximal plaque. Recently, an existing rippled brush, the original Crest Complete, was modified to offer longer rippled outer tufts to clean along the gumline more effectively. Therefore, this study evaluated the overall and gumline interproximal penetration of three bristle designs: rippled, raised pattern (Improved Crest Complete); and two multi-level patterns (Colgate Total and Oral-B Advantage). The study used a previously reported in vitro model for determining interproximal penetration of manual toothbrushes (J Clin Dent 5:27-33, 1994). In order to effectively mimic the in-use characteristics of toothbrushing, this model is based on analysis of videotaped consumer brushing habits, tooth morphology, and in vivo plaque tenacity characteristics, and uses the three most predominantly used brushing techniques (circular, up-and-down, and back-and-forth with the brush held at both 45 degrees and 90 degrees to the tooth surface). In addition, the model's brush stroke length, brush force, and brush speed are likewise based on an analysis of consumer brushing patterns. The results of this study indicate that the Improved Crest Complete with longer rippled outer bristles provided significantly superior (p < 0.05) interproximal penetration overall and at the gumline than the Colgate Total and Oral-B Advantage brushes.

Dental Plaque↗

Laboratory interproximal access efficacy comparison of a rippled bristles toothbrush and a flat manual toothbrush.

The Colgate Plus Rippled Bristles toothbrush and the Oral-B 40 toothbrush were compared using a laboratory device designed to stimulate clinical toothbrushing motions and pressures and measure interproximal access efficacy. The toothbrushing time was sixty seconds for each vertical or horizontal toothbrushing sequence and for each of the three brushing weights tested (250, 500 or 750 grams). Interproximal access efficacy was determined by measuring the maximum width of the brushing stroke on pressure-sensitive paper placed around simulated anterior or posterior teeth. Twenty-four toothbrushes of each design were evaluated for each toothbrushing motion, tooth shape and toothbrushing weight. With vertical toothbrushing motions, the Colgate Rippled toothbrush had significantly higher (p < 0.001) interproximal access efficacy means compared to the Oral-B 40 toothbrush, on anterior tooth shapes at the 250 and 500 grams of brushing weights and on posterior tooth shapes at all of the brushing weights tested. Using the horizontal toothbrushing motion on anterior teeth, the interproximal access efficacy for the Colgate Rippled toothbrush was significantly higher (p < 0.05) than the Oral-B 40 toothbrush at 250 and 500 grams of brushing weights. With horizontal toothbrushing across posterior-shaped teeth, interproximal access efficacy values for the Colgate Rippled toothbrush were significantly higher (p < 0.05-0.001) than the Oral-B 40 toothbrush at all of the brushing weights tested. When the various parameters tested were combined for all brushing weights, both brushing motions or both tooth shapes, interproximal access efficacy means for the Colgate Rippled toothbrush were higher (p < 0.05-0.001) than the combined means for the Oral-B toothbrush. When all factors tested were combined, total interproximal access efficacy for the Colgate Rippled toothbrush was significantly superior (p<0.001) to the Oral-B 40 toothbrush.

Analysis of Variance↗

Plaque removal efficacy of a prototype manual toothbrush versus an ADA reference manual toothbrush with and without dental floss.

OBJECTIVE: The objective of this study was to compare the plaque removal efficacy of a prototype manual Deep Clean toothbrush versus an American Dental Association (ADA) manual toothbrush and the ADA manual toothbrush in conjunction with floss. METHODS: This study was a randomized, examiner-blind, six-period cross-over, single-center study conducted in 60 adult subjects that examined plaque removal with a prototype Deep Clean manual toothbrush, an ADA reference manual toothbrush, and an ADA reference manual toothbrush followed by floss. During the course of this study, subjects used each treatment two times. Plaque was scored before and after brushing using the Rustogi Modification of the Navy Plaque Index. A mixed model analysis of covariance (ANCOVA) for a crossover design with baseline plaque score as the covariate was applied to the baseline minus one-minute post-brushing differences in average whole-mouth plaque scores. Supplemental analyses were also performed using the ANCOVA model separately for average gingival margin scores and for average interproximal scores, using the appropriate baseline score as the covariate. All comparisons were two-sided at the 0.05 level of significance. RESULTS: The prototype Deep Clean manual toothbrush delivered an adjusted (via ANCOVA) mean difference between baseline and post-brushing plaque scores of 0.245, while the ADA manual toothbrush plus floss delivered an adjusted mean difference of 0.207 versus 0.196 for the ADA manual toothbrush alone. The prototype Deep Clean manual toothbrush demonstrated a statistically significantly greater reduction in plaque than the ADA manual toothbrush plus floss (p<0.001), which in turn had a statistically significantly greater reduction in plaque than the ADA manual toothbrush alone (p<0.001). The prototype Deep Clean manual toothbrush group had, on average, 25.2% and 18.3% greater plaque removal scores than the ADA manual toothbrush alone and the ADA manual toothbrush plus floss groups, respectively. Results for the interproximal and gingival margin regions also demonstrated statistically significantly (p<0.001) greater plaque removal for the prototype Deep Clean manual toothbrush group relative to the other groups. CONCLUSIONS: The prototype manual Deep Clean toothbrush was found to deliver greater plaque removal by 25.2% and 18.3% compared to the control manual toothbrush group (ADA reference manual toothbrush) and ADA manual toothbrush plus floss group.

Adult↗

Plaque removal efficacy of a battery-operated power toothbrush compared to two control manual toothbrushes in single use studies.

PURPOSE: Recently, a power toothbrush (Crest SpinBrush) has been reported to remove plaque more effectively than a manual toothbrush (Colgate Navigator). The objective of these studies was to compare the plaque removal efficacy of two control manual toothbrushes (Colgate Wave and Colgate Plus) to an experimental power toothbrush (Crest SpinBrush). The Colgate Plus has an ordinary flat bristle trim design, while the Colgate Wave has an advanced design multilevel bristle trim for greater interproximal penetration. MATERIALS AND METHODS: Each of these two studies were randomized, controlled, examiner-blind, 4-period crossover designs which examined plaque removal with the experimental toothbrush relative to a control manual toothbrush following a single use in 37 and 35 subjects, respectively. Plaque was scored before and after brushing using the Turesky Modification of the Quigley-Hein Index. RESULTS: In the first study, average baseline plaque scores were 2.88 and 2.89 for the experimental toothbrush and advanced designed manual control toothbrush (Colgate Wave) treatment groups, respectively. With respect to all surfaces examined, the experimental toothbrush delivered an adjusted (via analysis of covariance) mean difference between baseline and post-brushing plaque scores of 0.70 while the control toothbrush delivered an adjusted mean difference of 0.59. The difference between the brushes was statistically significant (P < 0.001). The experimental toothbrush removed, on average, 19.9% more plaque than the control toothbrush. In the second study, baseline plaque scores averaged 3.07 and 3.04 for the experimental toothbrush and ordinary flat trim manual control toothbrush (Colgate Plus) treatment groups, respectively. With respect to all surfaces examined, the experimental toothbrush delivered an adjusted (via analysis of covariance) mean difference between baseline and post-brushing plaque scores of 0.87 while the control toothbrush delivered an adjusted mean difference of 0.62. The difference between brushes was statistically significant (P < 0.001). The experimental toothbrush removed, on average, 40.0% more plaque than the control toothbrush.

Adolescent↗

Plaque removal efficacy of a prototype power toothbrush compared to a positive control manual toothbrush.

PURPOSE: Recently, a new experimental battery-powered toothbrush was developed as a second generation to Crest SpinBrush. The brush head of this new prototype toothbrush (Crest SpinBrush Pro) incorporates a dual moving head design with one oscillating and the other translating back and forth. The objective of this study was to compare the plaque removal efficacy of a positive control manual toothbrush (Oral-B Cross Action) to this prototype power toothbrush following a repeated single use study design. In addition, this paper reports the results of a study examining the relative plaque removal efficacy of the positive control manual toothbrush to seven representative manual toothbrushes. METHODS: This study was a randomized, controlled, examiner-blind, four-period crossover design, which examined plaque removal with the two toothbrushes following a single use in 40 subjects. Plaque was scored before and after brushing using the Turesky Modification of the Quigley-Hein Index. RESULTS: Baseline plaque scores were 2.61 and 2.66 for the prototype power toothbrush and control toothbrush treatment groups, respectively. With respect to all surfaces examined, the prototype power toothbrush delivered an adjusted (via analysis of covariance) mean difference between baseline and post-brushing plaque scores of 0.98 while the control toothbrush delivered an adjusted mean difference of 0.74. The experimental toothbrush group, on average, had a 32.8% larger plaque removal score than the control toothbrush. These results were statistically significant (P < 0.001). Similar results were observed on buccal and lingual surfaces. In addition, results from the study comparing manual toothbrushes showed that the positive control manual toothbrush had higher plaque removal scores compared to seven representative manual toothbrushes. The plaque removal score differences reached statistical significance for five of the seven toothbrushes.

Adult↗

Plaque removal efficacy of a battery-operated toothbrush compared to a manual toothbrush.

PURPOSE: Recently, a new power toothbrush has been marketed with a design that fundamentally differs from other marketed power toothbrushes, in that it incorporates a round oscillating head, in conjunction with fixed bristles. The objective of this study was to compare the plaque removal efficacy of a control manual toothbrush (Colgate Navigator) to this experimental power toothbrush (Crest SpinBrush) following a single use. MATERIALS AND METHODS: This study was a randomized, controlled, examiner-blind, 4-period crossover design which examined plaque removal with the two toothbrushes following a single use in 40 completed subjects. Plaque was scored before and after brushing using the Turesky Modification of the Quigley-Hein Index. RESULTS: Baseline plaque scores were 1.77 for both the experimental toothbrush and control toothbrush treatment groups. With respect to all surfaces examined, the experimental toothbrush delivered an adjusted (via analysis of covariance) mean difference between baseline and post-brushing plaque scores of 0.48 while the control toothbrush delivered an adjusted mean difference of 0.35. The experimental toothbrush removed, on average, 37.6% more plaque than the control toothbrush. These results were statistically significant (P< 0.001). With respect to buccal surfaces, the experimental toothbrush delivered an adjusted mean difference between baseline and post-brushing plaque scores of 0.54 while the control toothbrush delivered an adjusted mean difference of 0.42. This represents 27.8% more plaque removal with the experimental toothbrush compared to the control toothbrush. These results were also statistically significant (P= 0.001). Results on lingual surfaces also demonstrated statistically significantly (P< 0.001) greater plaque removal for the experimental toothbrush with an average of 53.4% more plaque removal.

Adolescent↗

Plaque removal efficacy of a prototype power toothbrush compared to a control manual toothbrush.

PURPOSE: To compare the plaque removal efficacy of a control manual toothbrush (Lion Dentor Systema) to this prototype power toothbrush (Blend-a-Med Power) following a repeated single use study design. In addition, this paper reports the results of a study examining the relative plaque removal efficacy of the control manual toothbrush to nine representative manual toothbrushes. METHODS: This study was a randomized, controlled, examiner-blind, 6-period crossover design which examined plaque removal with the two toothbrushes following a single use in 86 completed subjects. Plaque was scored before and after brushing using the Turesky Modification of the Quigley-Hein Index. A second 10-period crossover study was conducted to index the relative plaque removal performance of the control manual toothbrush (Lion Dentor Systema) to nine representative manual toothbrushes. RESULTS: Baseline plaque scores were 2.322 and 2.305 for the prototype power toothbrush and control toothbrush treatment groups, respectively. With respect to all surfaces examined, the prototype power toothbrush delivered an adjusted (via analysis of covariance) mean difference between baseline and post-brushing plaque scores of 0.633 while the control toothbrush delivered an adjusted mean difference of 0.576. The experimental toothbrush group, on average, had a 9.9% larger plaque removal score than the control toothbrush. These results were statistically significant (P= 0.014). Similar results were observed on buccal and lingual surfaces. In addition, results from the study comparing manual toothbrushes showed that the control manual toothbrush had similar plaque removal scores, not statistically significantly different, relative to nine representative manual toothbrushes.

Adult↗

Dental plaque removal efficacy of a battery-powered toothbrush vs. a control Japanese manual toothbrush.

PURPOSE: Recently, a new powered toothbrush has been marketed with a design that fundamentally differs from other marketed powered toothbrushes, in that it incorporates a round oscillating head, in conjunction with fixed bristles. The objective of this study was to compare the plaque removal efficacy of a control manual toothbrush (Lion Dentor Systema) to this experimental powered toothbrush (Crest SpinBrush) following a single use. MATERIALS AND METHODS: This study was a randomized, controlled, examiner-blind, 4-period crossover design which examined plaque removal with the two toothbrushes following a single use in 36 subjects. Plaque was scored before and after brushing using the Turesky Modification of the Quigley-Hein Index. RESULTS: Baseline plaque scores were 2.90 for the experimental toothbrush and 2.95 for the control toothbrush treatment groups. With respect to all surfaces examined, the experimental toothbrush delivered an adjusted (via analysis of covariance) mean difference between baseline and post-brushing plaque scores of 0.70 while the control toothbrush delivered an adjusted mean difference of 0.54. The difference between treatment groups was statistically significant (P < 0.001). The experimental toothbrush removed, on average, 29.6% more plaque than the control toothbrush. With respect to buccal surfaces, the experimental toothbrush delivered an adjusted mean difference between baseline and post-brushing plaque scores of 1.09 while the control toothbrush delivered an adjusted mean difference of 0.90. This difference between treatment groups was also statistically significant (P = 0.001) and represents, on average, 21.1% more plaque removal with the experimental toothbrush. Results on lingual surfaces also demonstrated statistically significantly (P< 0.001) greater plaque removal for the experimental toothbrush with an average of 83.3% more plaque removal.

Adult↗

A comparison of a waterpik dual-motor powered toothbrush and a manual toothbrush in affecting interproximal bleeding reduction and dental biofilm accumulation.

OBJECTIVE: This single-blind, 21-day clinical study was designed to compare the effectiveness of a dual-motor powered toothbrush (SynchroSonic) and a manual toothbrush in affecting interproximal bleeding reduction and dental biofilm accumulation in a cohort of 70 subjects. METHODOLOGY: After baseline evaluations of soft tissue trauma, dental biofilm and interproximal bleeding, subjects were randomly assigned to one of the two experimental groups, given toothbrushing instructions and had their teeth cleaned. At 21 days, the clinical parameters were again evaluated. RESULTS: In the powered toothbrush group, there were 37 subjects at baseline and 36 subjects at follow-up. In the manual toothbrush group, there were 34 subjects at baseline and 33 subjects at follow-up. In the powered toothbrush group, the mean biofilm index fell from 3.46 to 3.12; a 9.7% reduction. In the manual toothbrush group, the mean biofilm index fell from 3.51 to 3.30; a 5.4% reduction. The powered toothbrush group showed significantly greater biofilm reduction (9.7% vs. 5.4%, p = 0.043). In the powered toothbrush group, the mean gingival bleeding index fell from 0.66 to 0.44; a 32% reduction. In the manual toothbrush group, the mean gingival bleeding index fell from 0.66 to 0.53; a 20% reduction. The powered toothbrush group showed significantly greater gingival bleeding reduction (32% vs. 20%, p = 0.02). CONCLUSION: The results demonstrated that both the manual toothbrush and the SynchroSonic powered toothbrush were safe, with no evidence of clinically significant hard or soft tissue abrasion observed. Additionally, the powered toothbrush was more effective in reducing biofilm and gingival bleeding than the manual toothbrush.

Adult↗

Three laboratory assessments of a new triple-head toothbrush and the Oral-B 40 toothbrush.

OBJECTIVE: The objective of this series of laboratory studies was to assess a new triple-head toothbrush, the DR BEST FreiKopf, compared to the Oral-B 40 toothbrush, for interproximal access efficacy (IAE), gingival margin cleaning (GMC), and subgingival access (SA) as measures of toothbrush efficacy. METHODOLOGY: In each procedure, six toothbrushes of each product were tested four times for a total of twenty-four tests on each toothbrush design. In the IAE assay, the tooth brushing technique involved independent evaluations of each toothbrush in a vertical or horizontal brushing motion, tooth shapes simulating anterior and posterior teeth, and a brushing weight of 250 g. The brushing apparatus was set to brush 15 seconds at two strokes per second with a 50 mm stroke. In the GMC assay, the tooth brushing technique involved independent evaluations of each toothbrush in a horizontal brushing motion, tooth shapes simulating posterior teeth, and a brushing weight of 500 g. Simulated gingivae were prepared from self-curing dental acrylic. The brushing apparatus was set to brush for 60 seconds at two strokes per second with a 15 mm stroke. In the SA evaluations, the tooth shapes simulating posterior teeth were used, as well as a brushing weight of 500 g for 60 seconds at two strokes per second with a 15 mm stroke. All readings were measured with 3x magnification by one investigator. RESULTS: The mean IAE value on anterior and posterior tooth shapes, with vertical and horizontal brushing, and overall, was significantly (p < 0.001) higher for the triple-head toothbrush than for the Oral-B 40 toothbrush. In the GMC assay, the triple-head toothbrush had a significantly (p < 0.001) superior mean value compared to the Oral-B 40 product tested. In the SA study, the triple-head toothbrush was significantly (p < 0.001) superior compared to the Oral-B 40 toothbrush product tested. CONCLUSIONS: The triple-head toothbrush has demonstrated superiority to a traditional flat-head toothbrush for access into interproximal areas, and for removing deposits from the gingival margin, as well as below the gumline, in these laboratory assays.

Analysis of Variance↗