Manual Toothbrush Research Articles

Plaque Removal Efficiency of Chewable Toothbrushes among 10-12-yearold Children: A Randomized Control Trial.

ABSTRACTAim and Objectives:Toothbrushing is one of the most important factors in controlling plaque accumulation and dental caries. There are vast varieties of toothbrushes available in the market. This study was designed to evaluate the effectiveness of novel chewable toothbrushes as compared to manual toothbrushes in plaque removal among 10–12-year-old children.Materials and Methods:This randomized controlled trial was conducted on 40 healthy children aged between 10 and 12 years of age who were randomly assigned to either of the groups: Group I––Chewable Toothbrushes and Group II––Manual Toothbrushes. Following oral prophylaxis, baseline records of oral hygiene indices (Simplified oral hygiene index (OHI-S) in indexed teeth and Turesky modification of Quigley Hein plaque index (TMQHI) were taken. Baseline Saliva samples were collected and sent for Streptococcus mutans counts. Children were then instructed to use their respective toothbrush twice daily for a week. Oral hygiene indices and S. mutans counts were repeated after 1 week.Results:Differences in pre-brushing and post-brushing plaque scores and salivary S. mutans counts were statistically significant when compared using paired-sample t test and independent-sample t test. There was a significant reduction in salivary S. mutans counts after using both chewable and manual toothbrushes. However, there was no statistically significant difference between the two groups (P = 0.08).Conclusion:Chewable toothbrushes are equally effective in plaque control when compared to manual toothbrushes. These can be a reliable alternative for children who lack manual dexterity.

Knowledge, attitude and oral care practices for preventing ventilator-associated pneumonia among critical care nurses - A questionnaire study.

A cross-sectional study was conducted among intensive care unit (ICU) nurses in private hospitals in India to identify knowledge and practice of ICU nurses in the prevention of ventilator-associated pneumonia (VAP). Knowledge of 135 nurses working in ICU was tested using a questionnaire consisting of 18 questions. Fourteen forms were excluded from the statistical analysis due to incomplete data entry by the participants. The data of 121 filled questionnaires were analyzed. The information letters, consent forms, and questionnaires were handed to ICU nurses by Research assistant. Data were coded and entered into SPSS version for descriptive and inferential statistics. A majority of the participants perceived oral care as a necessity in all critically ill patients. Nurses were generally aware of the most likely mechanism of acquiring pneumonia. The type and frequency of oral care varied widely. Many of them stated that they had adequate supplies to provide oral care. Although a majority of nurses had some formal training in oral care, they would appreciate an opportunity to enhance and improve their knowledge and skills. The methods of oral care provided vary widely. In summary, randomized controlled trial to date has demonstrated that tooth brushing is associated with a trend toward lower rates of VAP in intubated mechanically ventilated critically ill patients. But it is also to be noted that there was no clear difference between electric and manual tooth brushing. In-house training and workshop can provide required skills needed for the betterment of the treatment provided.

A comparative evaluation of manual and powered brushing on oral health and microbial status of mentally challenged individuals.

Background:Tooth brushing is a very simple and effective method for removing daily dental deposits and for preventing dental and periodontal diseases. In physically or mentally challenged person, there arises difficulty in oral hygiene maintenance so that oral hygiene methods may need to be simplified or modified to suit the individual situation.Methodology:Thirty individuals of age group 15–30 years with mild to moderate degree of mental retardation were selected. A randomized double-blind split-mouth design with Clinical Phase-i (aided brushing) and Clinical Phase-ii (unaided brushing) with a washout period of 3 days was conducted. The study duration was for 0–45 days. Two types of brushing that is manual and powered brushing were done. The recording of all clinical and microbial parameters were done on 0th day and 21st day while the clinical parameters were recorded up to 45th day.Results:On intragroup comparison, throughout the study phases, both manual and powered brushing significantly reduced the Quigley–Hein plaque index (48%), gingival bleeding index (GBI) (44%), and modified gingival index (52%). The Pearson correlation between GBI and periodontal pathogens like Prevotella internedia, Porphyromonas gingivalis, and Fusobacterium nucleatum showed statistically significant relation (P < 0.05) in powered brushing group.Conclusion:Powered toothbrush was more effective than manual toothbrush in reducing plaque levels and microbial count in the mentally challenged individuals. The Colgate 360 tooth brush is advisable to mentally challenged individuals.

Electric toothbrush for biofilm control in individuals with Down syndrome: a crossover randomized clinical trial.

Poor oral hygiene seems to be the norm in children and teenagers with Down Syndrome (DS). Advances in design and types of toothbrushes may improve biofilm control. This randomized, single-blind, crossover clinical trial evaluated the effectiveness of electric toothbrushes regarding mechanical control of biofilm in children and teenagers with DS and their cooperation. Twenty-nine participants with DS, aged 6 to 14 years, used both types of toothbrushes: electric (ET) and manual (MT). The order of use of the different types of toothbrushes was randomly defined, including a 7-day period with each type with 7-day washout period in between. The Turesky-Quigley-Hein biofilm index was used before and after brushing to assess the effectiveness of the technique. Frankl's behavioral scale was used during toothbrushing to assess the participants' cooperation. Paired T-test, Mann Whitney, Chi-square, and Fisher's Exact tests were applied, with a significance level of 5%. The quantity of dental biofilm was significantly reduced after both brushing techniques (p < 0.001). However, no significant difference was found in total biofilm (ET: 0.73 ± 0.36; MT: 0.73 ± 0.34; p = 0.985) or % biofilm reduction (ET: 72.22%; MT: 70.96%; p = 0.762) after brushing between techniques or in % biofilm reduction between toothbrushes of age groups (6 -9 years, p = 0.919; 10-14 years, p = 0.671). Participants showed similar cooperation level with the two types of toothbrush (p = 1.000). The use of electric or manual toothbrush had no effect on the quantity of dental biofilm removed in children and teenagers with DS, nor did it influence their cooperation during the procedure.

Influence of different type of toothbrushes on gingival fluid proteolytic potential during orthodontic treatment

To study the effect of toothbrushes of various types on the accumulation of plaque and the proteolytic potential of gingival fluid as a pathogenic factors in long-term orthodontic treatment of patients with a distal permanent bite. We examined 63 patients of both sexes aged 11-18 years. Orthodontic treatment was carried out for the close position of the teeth with a distal permanent bite (K07.2) and cleft palate and lips (Q37.1). Patients were divided into three groups depending on the type of toothbrush used for individual oral hygiene: group 1 (n=21) - an orthodontic manual toothbrush (Professor Persin, «Spazzolificio Piave», Italy); Group 2 (n=22) - an ultrasonic toothbrush (Emmi-dent, EMAG AG, Germany) and group 3 (n=20) - an electric toothbrush ("Oral-B Pro-Expert, «Procter & Gamble», USA). The amount of soft plaque was assessed by the Silness-Loe hygiene index in the subgingival region. The activity of proteolytic enzymes - elastase, collagenase, and a α-inhibitor of proteinases was determined by the enzymatic method using a XL 200 biochemical analyzer («Erba Lachema», Czech Republic). The accumulation of plaque in the gingival region on both jaws during the entire period of orthodontic treatment is most pronounced when using a manual brush compared to ultrasonic and electric brushes. An increase in proteolytic activity in the gingival fluid with a simultaneous decrease in antiprotease potential with long-term orthodontic treatment of patients was observed when using a manual orthodontic brush, which can be regarded as an increase in the activity of the pathogenic factors for the development of local inflammatory and destructive changes. To prevent inflammatory and destructive changes during prolonged orthodontic treatment of patients, the use of ultrasonic and electric toothbrushes in daily oral hygiene is justified.

Influence of different type of toothbrushes on the incidence of enamel demineralization and gingivitis in the course of orthodontic treatment

The aim of the study was to determine the likelihood and frequency of complications, the impact of the use of various types of toothbrushes in the dynamics of orthodontic treatment with fixed appliances in patients with a distal permanent bite. The clinical study was conducted on 63 patients of both sexes, aged 11-18 years. Patients received long-term orthodontic treatment for a close tooth position with a distal permanent bite (K07.2) and cleft palate and lip (Q37.1). Three groups were conditionally distinguished depending on the type of toothbrush used for individual oral hygiene: group 1 (n=21) - an orthodontic manual toothbrush (Professor Persin, Spazzolificio Piave S.p.A, Italy); Group 2 (n=22) - an ultrasonic toothbrush (Emmi-dent, EMAG AG, Germany) and group 3 (n=20) - an electric toothbrush (Oral-B Pro-Expert, Procter & Gamble, USA). According to the Kaplan-Meier method, the probability of developing complications of orthodontic treatment was calculated as patients wear braces, and the impact on the effectiveness of orthodontic treatment of using toothbrushes of various types was evaluated. A frequency analysis of the complications of orthodontic treatment for the entire period of wearing fixed orthodontic structures revealed a difference only in respect to enamel demineralization. In group 1, enamel demineralization was more common (42.9%) compared with 2 (9.1%) and 3 (25%) groups (p=0.039). The likelihood of developing gingivitis was higher in group 1, the timing of the development of inflammatory processes in periodontium was also shortened in group 1 compared with groups 2 and 3. The frequency and timing of the development of gingivitis and enamel demineralization depended on the type of toothbrush used in daily oral hygiene. A marked deterioration in the oral hygiene during orthodontic treatment using a manual brush was accompanied by a more frequent development of gingivitis and enamel demineralization.

Properties of manual toothbrush that influence on plaque removal of interproximal surface in vitro

Background/purposeFew papers were available on the interproximal cleaning efficiency by manual toothbrushes when used alone. The aim was to investigate the efficiency of commercially available toothbrushes on interproximal cleaning and determine the key properties that would make the differences. Materials and methodsArtificial-teeth were coated with manicure type experimental dental plaque covering mainly the interproximal surface and fixed in the jaw model of a dental simulator. A modified scrubbing technique was employed to brush out the plaque conducted by one trained dentist using 26 different toothbrushes from the equal number of separate interproximal conditions. The rate of the plaque removal (%) was calculated by measuring the plaque free areas on the post-brush images. ResultsThe data analysis using mixed effect modelling showed that stiffness, number of tufts and total length have effect on the rate of the plaque removable from the interproximal surfaces. ConclusionThis study indicated consideration should be given to toothbrush properties to enhance plaque removal from the interproximal surfaces.

Optimization of the supporting periodontal therapy at patients of risk group with dental implants

Relevance. Against the background of an increase in the number of established dental implants, there is an increase in the number of cases of inflammation of the surrounding tissues – mucositis and periimplantitis, which occupy the first place among all complications of dental implantation. Materials and methods . To assess the effectiveness of supportive periodontal therapy (SPT), depending on the method individual hygiene of an oral cavity (IHOC) and professional hygiene of an oral cavity (PHOC), 85 patients aged 24-52 with primary and moderate generalized periodontitis in remission with dental implants examined. SPT for patients in the first and third groups was conducted under the Guided Biofilm Therapy (GBT) protocol, the II group – according to the “classic” protocol. In the first group, patients brushed their teeth with a manual toothbrush (TB) in the II group – power toothbrush with oscillating-rotating movements (Oral-B Vitality), in the III group – power toothbrush with technology of rotational-return movements with pulsation and feedback by means of a mobile application (Oral-B Genius). Indices were evaluated: Silness-Loe (S-L), API, PBI, PMA, pain by visual analogue scale (VAS), duration of ongoing manipulations, two questionnaires of patients in the dynamics. Results. With comparable baseline data, there was no negative dynamics in the second group, and in the first and third – positive dynamics throughout the observation period, with statistically significant superiority in the third group. Lower time costs of the doctor, a more comfortable perception of the patient of the procedure itself and the absence of hyperesthesia after it are noted in GBT groups. Conclusion. The SPT complex, which includes GBT and the use of a power toothbrush with the technology of rotationalreturn movements with pulsation and feedback, shows high clinical efficacy in patients at risk with dental implants.

Comparison of the effectiveness between power toothbrushes and manual toothbrushes for oral health: a systematic review and meta-analysis

Objective: Power toothbrushes is considered an effective tool for maintaining oral health; however, its efficacy as compared to manual toothbrushes is still not completely clarified. This article aims to evaluate the efficacy of power toothbrushes compared with the manual toothbrushes in terms of plaque, gingivitis and bleeding reduction.Methods: An electronic search was performed on PUBMED, Web of Science, Wiley and Research Gate. Studies comparing the effectiveness of plaque, gingivitis and bleeding reduction between power and manual toothbrushes were included. Results and effect sizes analysis are presented as standard mean difference (SMD), and subgroup analysis stratified by mode of action of the power toothbrush was performed. Study quality and risk of bias were assessed using the Cochrane assessment tool.Results: A total of 21 randomized clinical studies were included. Power toothbrushes were significantly more effective in reducing plaque index (26 trials: SMD = 0.86, 95% CI: 0.58 to 1.14, I2 = 91.5%, p < .0001), gingival index (14 trials: SMD = 0.47, 95% CI: 0.12 to 0.82, I2 = 88.7%, p < .0001), and bleeding index (11 trials: SMD = 0.92, 95% CI: 0.43 to 1.40, I2 = 91.8%, p < .0001) compared with the manual toothbrushes, except that there was no significant differences between the oscillating-rotating toothbrushes and manual toothbrushes regarding gingivitis reduction (7 trials: SMD = 0.07, 95% CI: −0.20 to 0.33, I2 = 57.2%, p = .03).Conclusions: Power toothbrushes is more effective in reducing dental plaque, gingivitis and bleeding compared with the manual toothbrush.

A COMPARATIVE STUDY ON SURFACE CHANGES BETWEEN COMPOSITE VENEER AND ACRYLIC RESIN USING BATTERY- OPERATED TOOTHBRUSH AND MANUAL TOOTHBRUSH

Early forms of toothbrush have been in existence since 3000 BC. Several changes have happened since then, it has evolved from a‘chew stick’, into a bristle toothbrush, then a battery-operated toothbrush. Tooth brushing has been our primary way of cleaning theoral cavity and its structures to maintain good oral hygiene. However, prolonged brushing can be abrasive to one’s existing restorationand prosthesis increasing the surface roughness, leaving the resins vulnerable to damage and plaque accumulation. This study aims toevaluate the effect of tooth brushing using a manual toothbrush and a battery-operated toothbrush to the surface roughness ofcomposite resin restorations and denture base acrylic resin. Composite specimens and denture base acrylic specimens showed varyingwear and surface roughness with several variables taken into consideration such as brushing force, brushing stroke, dentifrice, type ofbristle, and type of toothbrush used. The expected result is that the specimens brushed using the battery-operated toothbrush withapplied toothpaste will have greater wear and surface roughness.

JUUL and Pod e-Cigarette Flavors Impose Oxidative Stress and Inflammatory Responses in Lung Epithelial Cells and Macrophages

Purpose: To compare a novel oscillating-rotating (O-R) electric rechargeable toothbrush with micro-vibrations (Oral-B iO) to a manual brush for gingivitis and plaque reduction. Methods: Adult subjects with gingivitis and plaque were randomized to use either the O-R or the manual toothbrush with standard fluoride dentifrice twice daily. Efficacy was assessed at baseline, week 1, and week 8 using the Rustogi Modification of the Navy Plaque Index (RMNPI), Modified Gingival Index (MGI), and Gingival Bleeding Index (GBI). Gingivitis status (‘healthy’/‘not healthy’) was also assessed, per the American Academy of Periodontology/European Federation of Periodontology criteria. Results: One hundred and ten subjects were enrolled and completed the randomized controlled trial. The baseline mean number (SD) of bleeding sites for all subjects was 32.11 (16.703). At week 8, 82% of subjects using the O-R toothbrush were categorized as ‘healthy’ (<10% bleeding sites), versus 24% of subjects using the manual brush (P < 0.001). Subjects using the O-R toothbrush showed statistically significantly greater reductions (P < 0.001) in the number of bleeding sites, GBI scores and MGI scores versus those using a manual toothbrush as early as 1 week and throughout the 8-week study. The O-R toothbrush also provided statistically significantly greater reductions (P < 0.001) in all plaque measures, including sub-regions, versus the manual toothbrush after a single brushing and at weeks 1 and 8. Conclusions: The novel O-R electric toothbrush with micro-vibrations provided statistically significantly greater plaque and gingivitis reductions versus a manual toothbrush, with performance benefits demonstrated after a single brushing and continuing throughout the 8-week study.

Influence of teeth anatomical characteristics on the efficacy of manual toothbrushing manoeuvres

PurposeThe aim of the study was to investigate the efficacy of two toothbrushing techniques on the amount of plaque accumulation and to evaluate how the changes were correlated to the anatomical characteristics of the anterior maxillary arch. MethodsThirty subjects of both genders were included, they were asked not to brush for 12 h. Afterwards, they were asked to manually brush the left side of their maxillary arch with the modified Bass technique and the right side adopting the roll technique. The comparison of photographs taken before and after the manoeuvres, using a plaque disclosing agent, allowed the researchers to measure the changes in plaque accumulation measured using the Quigley and Hein plaque scoring classification. Linear regression analysis was used to evaluate the correlation between such changes and the teeth and arch anatomical characteristics. ResultsA mean reduction of 9.6 ± 5.2% considering both arches after brushing was observed. The changes in plaque accumulation were not different between the two techniques. The length of the line obtained joining the contact point between the central incisors and the contact point between the second premolar and the first molar on the left side and the distance between that line and the lateral incisor on the same side positively correlated to the decrease in the plaque scores (P = 0.046 and P = 0.044, respectively). ConclusionBoth tested techniques were effective in plaque removal in the anterior maxillary arches. However, the research for the anatomical factors influencing the amount of efficacy of the toothbrushing manoeuvres was inconclusive. We can hypothesise that the adoption of one adequate technique could be more important than the teeth characteristics.

Effect of daily manual toothbrushing with 0.2% chlorhexidine gel on pneumonia-associated pathogens in adults living with profound neuro-disability.

Purpose. To investigate the effect of daily toothbrushing with 0.2 % chlorhexidine digluconate (CHX) on the colonization of dental plaque by pathogens associated with pneumonia amongst non-ventilated adults with a neuro-disability.Methodology. Forty-nine patients living in long-term care were recruited. Daily toothbrushing with 0.2 % CHX gel was conducted for 48 weeks. Plaque accumulation was assessed and microbiological sampling was undertaken every 6 weeks.Results. At any one time point at least 65 % (n=32) of subjects were found to harbour respiratory pathogens. Although there were significant changes in the proportion of individuals colonized over time with Gram-negative bacilli and Pseudomonas aeruginosa, the changes were not sustained. By week 48 there was no significant difference from the levels that had been recorded at baseline.Conclusions. Bacteria known to be causal in pneumonia are present and colonize the dental plaque of non-ventilated adults with a neuro-disability. Daily toothbrushing with 0.2 % CHX gel did not produce a sustained reduction in intra-oral respiratory pathogen counts after 48 weeks.

Very small differences in caries, periodontal parameters, and tooth loss between powered and manual toothbrushing after 11 years

Very small differences in caries, periodontal parameters, and tooth loss between powered and manual toothbrushing after 11 years

Should five to eleven-year-olds use manual or electric toothbrushes to clean their teeth?

Design A cohort study design was used. 120 healthy children were randomly assigned to a manual group and an electric tooth brushing group. Plaque scores plus a post-brushing questionnaire examining executive function/motor skills using indices from the occupational and developmental sciences (e.g. shoelace tying), was completed by the parents .Sample selection 120 subjects were recruited from a single site, the Nationwide Children's Hospital in Columbus, Ohio. The entire research project was carried out in the dental department there.All children were fit and healthy and presented with:• No caries• No disability that would affect the task completion• No injury to the dominant hand• Adequate parental literacy to complete a questionnaire• Teeth present to score.All ages were evenly represented in the final sample.Data analysis Two hygienists and one dentist were calibrated and trained in the use of the OHI-S plaque scoring system. Reliability was determined using the Cohen's kappa. Teeth were disclosed and pre-brushing plaque scores were obtained. A set of brief brushing instructions were delivered orally to the patient. The children were given a brush and were asked to brush at a sink with no toothpaste or mirror. The minimum brushing time was 30 seconds but the children were unaware that they were being timed. Post- brushing plaque scores were measured.Results The response rate to the questionnaire was 100%. A chi-square test was carried out on the data. The results showed that if a child can exhibit the following skills/characteristics they were more likely to perform well in the brushing task• Never has poor handwriting• Always writes their address• Always ties their own shoes• Always cuts food into bite-sized pieces• Can cut out complex shapes.There was a positive correlation between pre-brushing scores and post-brushing scores .Conclusions Good handwriting and other motor/cognitive skills were linked to good tooth brushing and manual and electric toothbrushing were equally effective at removing plaque. If a child was able to play a musical instrument well, they were likely to have less plaque. The study also demonstrated that parents are good judges of their children's abilities and motor skills.

Comparing the plaque-removal ability of a triple-headed toothbrush versus a conventional manual toothbrush in adolescents with fixed orthodontic appliances: A single-center, randomized controlled clinical trial

The objective of this trial was to compare the plaque removal ability of a triple-headed toothbrush to a conventional manual toothbrush in adolescents with fixed orthodontic appliances. Sixty adolescent patients undergoing orthodontic treatment were randomly assigned to brush one time with either a conventional manual toothbrush or a triple-headed toothbrush. The main outcome was the post-brushing plaque index as measured by the Silness-Löe plaque index. Sixty patients (mean age, 14.2; standard deviation, 1.65) were randomized in a 1:1 ratio to either a manual toothbrush group or a triple-headed toothbrush group. Baseline characteristics were similar between the two groups. There were no dropouts. The mean post-brushing plaque index was 0.84 (95% CI, 0.67-1.02; SD, 0.60) for the conventional manual toothbrush group, and 0.31 (95% CI, 0.13-0.49; SD, 0.48) for the triple-headed toothbrush group. There was a statistically significant difference in the mean plaque index of 0.53 (95% CI, 0.28-0.78; P<0.001) between the two groups after brushing. No harms were observed. The results of this study indicate strong evidence that the triple-headed toothbrush leads to a significantly lower plaque index compared to the conventional manual toothbrush post-brushing.

Electric brushes improve outcomes in caregiver-assisted oral hygiene.

An effective means of maintaining oral health is imperative for the health of long-term-care patients. This article assesses oral hygiene using an electric toothbrush compared with a manual toothbrush.

How effective is a powered toothbrush as compared to a manual toothbrush? A systematic review and meta-analysis of single brushing exercises.

ObjectivesIn adult participants, what is, following a single brushing exercise, the efficacy of a powered toothbrush (PTB) as compared to a manual toothbrush (MTB) on plaque removal?MethodsMEDLINE‐PubMed and Cochrane‐CENTRAL were searched from inception to February 2019. The inclusion criteria were (randomized) controlled clinical trials conducted in human subjects ≥18 years of age, in good general health and without periodontitis, orthodontic treatment, implants and/or removable prosthesis. Papers evaluating a PTB compared with a MTB in a single brushing exercise were included. When plaque scores were assessed according to the Quigley‐Hein plaque index (Q&HPI) or the Rustogi modified Navy plaque index (RMNPI). From the eligible studies, data were extracted. A meta‐analysis and subanalysis for brands and mode of action being oscillating‐rotating (OR) and side‐to‐side (SS) were performed when feasible.ResultsIndependent screening of 3450 unique papers resulted in 17 eligible publications presenting 36 comparisons. In total, 28 comparisons assessed toothbrushing efficacy according to the Q&HPI and eight comparisons used the RMNPI. Results showed a significant effect in favour of the PTB. The difference of Means (DiffM) was −0.14 (P < 0.001; 95%CI [−0.19; −0.09]) for the Q&HPI and −0.10 (P < 0.001; 95%CI [−0.14; −0.06]) for the RMNPI, respectively. The subanalysis on the OR mode of action showed a DiffM −0.16 (P < 0.001; 95%CI [−0.22, −0.10]) for the Q&HPI. For the SS mode of action using RMNPI, the DiffM showed −0.10 (P < 0.001; 95%CI [−0.15; −0.05]). The subanalysis for brands showed for the P&G OR PTB using the Q&HPI a DiffM of −0.15 (P < 0.001; 95%CI [−0.22; −0.08]) and the Colgate SS for RMNPI showed a DiffM of −0.15 (P < 0.001; 95%CI [−0.18; −0.12]).ConclusionThere is moderate certainty that the PTB was more effective than the MTB with respect to plaque removal following a single brushing exercise independent of the plaque index scale that was used.

Efficacy of Manual Toothbrushes in Removing Dental Plaque

Efficacy of Manual Toothbrushes in Removing Dental Plaque

Oral hygiene interventions for people with intellectual disabilities.

Oral hygiene interventions for people with intellectual disabilities.