A study on the plaque removal efficiency of new and worn toothbrushes

Abstract

Increased plaque accumulation is associated with gingivitis1) and if not adequately removed may lead to periodontitis.2) Poor oral hygiene status usually increases the possibility of alveolar bone loss.3) It is now widely accepted that thorough plaque control will prevent the development and recurrence of periodontitis .4,5) Toothbrushing is the most widespread mechanical means of personal plaque control in the world6) and is considered to be an important factor in the long-term maintenance of periodontal health.7) The toothbrush is still the most common and often the only cleaning device people use. Therefore, its proper use is of importance in plaque control and prevention of periodontal disease. Many factors can influence the ability of an individual to remove plaque with a manual toothbrush. Brushing duration, brushing force and brushing technique will all either increase or decrease the amount of plaque removed and therefore, in the long term, influence gingival health. Another factor that is thought to affect brushing efficacy is toothbrush wear.8) Dental professionals and toothbrush manufacturers generally recommend that a toothbrush be replaced every three months. This is based on the supposition that a toothbrush is likely to be less effective than a new one. The American Dental Association also makes this recommendation, stating that worn brushes are not effective at removing plaque bacteria and broken bristles may injure gums.9) Evidence supporting the hypothesis that a brush is less effective at removing plaque than a new brush is, however, relatively scarce. Few studies have investigated the effect of toothbrush wear and those written on the subject have produced conflicting results. Studies by Kreifeldt et al.,10) Glaze and Wade11) and Warren et al.8) found that a toothbrush was significantly less effective at