Toothbrush abrasivity in a long-term simulation on human dentin depends on brushing mode and bristle arrangement.

Mozhgan Bizhang,Wolfgang H Arnold,Ilka Schmidt,Stefan Zimmer,Yong-Hee Patricia Chun,Luigi F Rodella

doi:10.1371/journal.pone.0172060

Mozhgan Bizhang, Wolfgang H Arnold + Show 4 more

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https://doi.org/10.1371/journal.pone.0172060

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Abstract

ObjectiveThe aim of this study was to evaluate the susceptibility of dentin to brushing abrasion using four different toothbrushes (rotating-oscillating, sonic and two types of manual toothbrushes) with the same brushing forces.MethodsDentin samples (n = 72) were selected from 72 impacted third molars. Half of the surface of dentin samples was covered with an adhesive tape, creating a protected and a freely exposed area in the same specimen. Brushing was performed with either a: sonic (Sonicare PowerUp, Philips GmbH, Hamburg, Germany), b: oscillating-rotating (Oral B Vitality Precisions Clean, Procter & Gamble, Schwalbach am Taunus, Germany) or two different manual toothbrushes c: flat trim brush head toothbrush (Dr. Best: Original, Glaxo-Smith-Kline, Bühl, Germany) and d: rippled-shaped brush head toothbrush (Blend-a-Dent, Complete V-Interdental, Blend-a-med, Schwalbach, Germany) in a custom made automatic brushing machine. The brushing force was set to 2 N and a whitening toothpaste (RDA = 150) was used. The simulation period was performed over a calculated period to mimic a brushing behavior of two times a day brushing for eight years and six months. Dentin loss was quantitatively determined by profilometry and statistically analyzed by Wilcoxon and Mann-Whitney-U Test (p < 0.05).ResultsThe mean (standard deviation) surface loss was 21.03 (±1.26) μm for the sonic toothbrush, 15.71 (±0.85) μm for the oscillating-rotating toothbrush, 6.13 (±1.24) μm for the manual toothbrush with flat trim brush head and 2.50 (±0.43) μm for the manual toothbrush with rippled-shaped brush head. Differences between all groups were statistically significant at p<0.05.ConclusionUsing the same brushing force and a highly abrasive toothpaste, manual toothbrushes are significantly less abrasive compared to power toothbrushes for an 8.5—year simulation.

Highlights

The increasing elderly population in many developed countries is expected to retain their teeth into old age [1]
Using the same brushing force and a highly abrasive toothpaste, manual toothbrushes are significantly less abrasive compared to power toothbrushes for an 8.5—year simulation
Non-carious cervical lesions often are the result of substance loss that results from mechanical interaction between toothbrush, toothpaste and tooth

Summary

Introduction

The increasing elderly population in many developed countries is expected to retain their teeth into old age [1]. The number of exposed root surfaces and non-carious cervical lesions in elderly people is steadily increasing[2]. The need for adequate prevention and treatment of this condition is of high relevance. The treatment options for non-carious cervical lesion include either to watch and wait or to intervene early with restorations [3,4,5]. Non-carious cervical lesions often are the result of substance loss that results from mechanical interaction between toothbrush, toothpaste and tooth. Frictional forces are increased by small particles contained in toothpaste [6, 7]. The abrasivity is modified by the type of toothbrush and the applied brushing force [8]

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Conclusion