Medium Toothbrush Research Articles

Comparative Efficacy of Medium and Soft Toothbrushes in Plaque Removal and Gingivitis Control.

BACKGROUND Regularly removing dental plaque is key to good oral hygiene and gingival health promotion. This study aimed to compare the effects of using soft and medium toothbrushes using the plaque index (PI), gingival index (GI), and bleeding on probing (BOP) index. MATERIAL AND METHODS A randomized parallel-group study design was used. Sixty-four participants were randomly assigned to 2 similar intervention groups (medium and soft toothbrush groups). The PI, GI, and BOP indexes were used. The median and median difference of PI, GI, and BOP were calculated. SPSS was used for data entry and analysis. Wilcoxon and Mann-Whitney U tests were used for data analysis. RESULTS The median scores of GI, PI, and BOP significantly decreased from 1.8, 1.7, and 2.0, respectively, before using medium toothbrushes to 0.0, 0.1, and 0.0, respectively, after using medium toothbrushes (all P<0.0001). Similarly, the median scores of GI, PI, and BOP significantly decreased from 2.0, 1.7, and 2.0, respectively, before using soft toothbrushes to 1.1, 0.9, and 1.0, respectively, after using soft toothbrushes (P<0.0001). The median differences in GI, PI, and BOP scores among those using medium toothbrushes were higher than the median differences among those using soft toothbrushes [(1.8 vs 0.9), (1.6 vs 0.8), and (2.0 vs 1.0), respectively]. These differences were statistically significant (P<0.0001). CONCLUSIONS This study concludes that medium and soft toothbrushes were effective in removing plaque and controlling gingivitis. Medium toothbrushes were more effective than soft toothbrushes in achieving these outcomes.

An In Vitro Study of the Abrasive Potential of Various Toothbrushes on the Surface of Aligner Attachments.

Background Attachments play a vital role in aligner-led orthodontic therapy, firstpassivelythrough retention of the appliance and secondly, through bringing about tooth movement, by virtue of its active surfaces, to achieve treatment goals. Additionally, irregularities on the surface of attachments attract plaque adhesion.Thus the effect of brushing with different toothbrushes on the surface of attachments is an important factor to study. This would allow clinicians to better advise patients who are undergoing aligner therapy. Four types of brushes are available commercially, namely hard, medium, soft, and ultra-soft. This study analyses the interaction between the kind of toothbrush used and the wear of the surface of the aligner attachment, to understand the impact of a toothbrush on the attachment. Aim To observe the surface wear and change in the shape of the aligner attachment on brushing with four varying hardness of toothbrush bristle (ultra-soft, soft, medium, and hard) over six months to three years. Material and methods One attachment was bonded to the buccal surface of extracted premolars. One tooth with attachment was subjected to SEM analysis and the rest were divided into four groups of five teeth each, based on the type of toothbrush to be used. Brushing with hard, medium, soft, and ultra-soft toothbrushes was carried out in a brushing simulator in two cycles simulating six months, one year, 18 months, and three years of brushing. A contact profilometer was used to evaluate surface roughness before and after brushing and pre- and post-surface roughness values were compared to quantitate changes after which SEM analysis was carried out for qualitative assessment of the surface of the samples. The Shapiro-Wilks test was applied to evaluate the normality of the data, followed by the one-way ANOVA, and statistical significance was applied at p<0.05. Results At six months, the samples brushed with the medium toothbrush showed the least surface roughness (0.2±0.192) and those brushed with the ultra-soft toothbrushes showed the highest surface roughness (1.9±0.159). At one year, the samples brushed with the soft toothbrush showed the least surface roughness (0.46 ±0.31) and those brushed with the ultra-soft toothbrushes showed the highest surface roughness (2.12 ±0.12). At the 1.5-year point, the surface roughness of the samples was lowest in the ultra-soft toothbrush group (0.43±0.39) and the highest in the soft toothbrush group (1.6± 0.41). At the three-year point, the surface roughness of the samples was lowest in the ultra-soft toothbrush group (0.28 ± 0.17) and the highest in the medium toothbrush group (1.6 ± 0.31). Conclusion Ultra-soft toothbrushes have a high abrasive potential, as seen by higher surface roughness values over six months and one year. Morphometric changes were the most noticeable for attachments brushed by hard-bristled toothbrushes and medium-bristled brushes.

Gingival Health and Periodontal Diseases during Puberty in Females Students in Maal High School in Omdurman, Sudan (2021 – 2022)

Background: Periodontal health and diseases are influenced by sex hormones, puberty, menses, pregnancy and menopause. Gingival diseases modified by systemic factors that contribute to gingivitis such as the endocrine changes associated with puberty, the menstrual cycle, pregnancy and diabetes that may exacerbate the gingival inflammatory response to plaque. Aim: To assess the effect of puberty on gingival health and periodontal diseases. Material and Methods: descriptive cross sectional study, among 85 students, in Maal high school in Omdurman, Sudan .Data collected via self administer questionnaire completed for each students. Collected data was entered into the SPSS software (version 26). Data was analyzed and results presented as proportions in table and figures Results: The results of this study showed that 95% of females students had a menstrual cycle, 60% had a good oral hygiene and 52.50% brush their teeth twice a day, majority of students86.25% brushed their teeth, gum and tongue, 62.50% used a medium tooth brush, and 50% of females students had an oral feeling during menstrual cycle, however about 50% of females did not observe any symptoms in oral cavity. Conclusion: This study indicated that hormonal changes occurring during the menstrual cycle influence the periodontium and induce inflammatory symptoms and signs.

Effect of Toothbrush Bristle Stiffness and Brushing Force on Cleaning Efficacy.

This study investigated the effect of toothbrush bristle stiffness and brushing force on the cleaning efficacy in vitro. Eighty bovine dentin samples were allocated to eight groups (n=10). Two custom-made toothbrushes of different bristle stiffness (soft and medium) were tested at four different brushing forces (1, 2, 3 and 4 N). Dentin samples were stained in black tea and brushed (60 strokes/min) for a total of 25 min in a brushing machine with an abrasive solution (RDA 67). Photographs were taken after 2 and 25 min of brushing time. Cleaning efficacy was measured planimetrically. After 2 min of brushing, the soft-bristle toothbrush did not cause statistically significantly different cleaning efficacy at different brushing forces, while the medium-bristle toothbrush cleaned statistically significantly less efficaceously only at 1 N. Comparing the two different toothbrushes, higher cleaning efficacy was observed only at 1 N for the soft-bristle brush. At 25 min brushing time, the soft-bristle cleaned statistically significantly better at 4 N compared to 1 N and 2 N and at 3 N compared to 1 N. Using the medium-bristle, cleaning efficacy increased with increasing brushing force. After 25 min of brushing, no statistically significant difference was observed between the two different toothbrushes. Irrespective the brushing force, the use of a soft or medium toothbrush results in comparable cleaning efficacy. At 2 min brushing time, increasing the brushing force does not increase the cleaning efficacy.

EFFECTIVENESS IN THE USE OF SOFT AND MEDIUM TOOTHBRUSH BRISTLES WITH FONE’S TECHNIQUE FOR PLAQUE REDUCTION

ABSTRACTBackground: Dental and oral hygiene of children in Indonesia is so alarming that serious awareness and attention are needed. Poor dental and oral hygiene is characterized by the presence of plaque deposits on tooth surface, forming an intercellular matrix that may instigate various dental and mouth problems. The prevalence of correct tooth brushing in Indonesia was very low at only 2.80%, in which South Kalimantan Province was 4.97% and Barito Kuala Regency was 3.55%. Objective: To determine the effectiveness of using soft and medium toothbrush bristles with fone’s technique to reduce plaque in students aged 10-11 years at SDN Berangas Timur 1, Barito Kuala Regency. Methods: The study used a true experimental method with a pretest-posttest with control group design consisting of pre-test and 8 post-test, and control group that was not given any treatment. Samples were randomly allocated by name sequence through simple random sampling technique of students aged 10-11 years at SDN Berangas Timur 1, Barito Kuala Regency. Inspection using PHPM plaque index was assessed on 6 index teeth. Research data were analysed using Mann Whitney's post hoc Friedman test. Results: The results for Friedman test in the treatment group showed p = 0.000. Mann Whitney test results in the treatment group with the control group showed p = 0.000 with a comparison of mean difference of 1.29 and 1.22 between the use of soft and medium toothbrush bristles with fone's technique. Conclusion: The use of soft toothbrush bristles with fone’s technique is the most effective in plaque reduction. Keywords : Effectiveness of brushing teeth, Fone’s technique, Plaque index, Soft and medium toothbrush dental

Changes in the Bristle Stiffness of Polybutylene Terephthalate Manual Toothbrushes over 3 Months: A Randomized Controlled Trial.

We previously reported that polybutylene terephthalate (PBT) toothbrushes become less effective for plaque removal after two months of use. However, it remains unknown how the bristle stiffness of PBT toothbrushes changes after several months of use. We performed a single-center randomized controlled trial to evaluate the bristle stiffness and bristle splaying of soft and medium manual toothbrushes among dental and medical students of Hiroshima University. Subjects were 80 participants who met the criteria. Participants were randomly assigned to the soft toothbrush group (n = 40) or the medium toothbrush group (n = 40). We collected toothbrushes immediately after first use (T0), after one month of use (T1), after two months of use (T2), and after three months of use (T3). Bristle stiffness was measured according to the International Organization for Standardization (ISO) 22254. The mean bristle stiffness (N/cm2) of soft and medium toothbrushes was significantly lower at T2 and T3 than at T0 (T2 vs. T0, soft; 3.63 vs. 3.89, P < 0.01 and medium; 4.33 vs. 4.52, P < 0.05, respectively, and T3 vs. T0, 3.62 vs. 3.89, p < 0.01 and 4.18 vs. 4.52, p < 0.001, respectively). Bristle stiffness was significantly reduced in soft and medium PBT toothbrushes after two months of use.

Erosive/Abrasive Enamel Wear While Using a Combination of Anti-Erosive Toothbrush/-Paste.

To investigate dental enamel wear caused by erosion and abrasion while using a combination of anti-erosive toothbrush/-paste. A total of 60 enamel specimens from bovine incisors were randomly assigned into five groups of 12 specimens each (G1-5, n = 12): (G1) control group (no treatment), (G2) standard medium toothbrush Paro M43 and standard toothpaste Elmex Caries Protection, (G3) standard medium toothbrush Paro M43 and anti-erosive toothpaste Elmex Protection Erosion, (G4) anti-erosive toothbrush Elmex Erosion Soft and standard toothpaste Elmex Caries Protection, (G5) anti-erosive toothbrush Elmex Erosion Soft and anti-erosive toothpaste Elmex Protection Erosion. Initially, surface baseline profiles were recorded using profilometry. In a total of 60 cycles, all specimens were exposed to hydrochloric acid (pH = 3) for 1 min, rinsed with tap water to stop the erosive attack and brushed according to the specific protocol of each group (15 brushing strokes per run). Enamel loss was determined by comparing the surface profiles before and after 60 cycles and the results were statistically analysed using analysis of variance (ANOVA). The significantly highest loss of enamel was observed in the control group G1(1.4 ± 0.20 µm) (p < 0.001). G2 turned out to be the most abrasive toothbrush/-paste combination (1.12 ± 0.15 µm), G3 the least invasive (0.40 ± 0.04 µm) (p < 0.001, respectively). All combinations of the investigated toothbrushes/-pastes reduce erosive/abrasive enamel wear. However, the highest reduction was observed for the combination of anti-erosive toothpaste and standard toothbrush (G3).

Measurement of bristle splaying of toothbrushes using digital imaging and evaluation of plaque removal efficacy over 3months: A randomized controlled trial (RCT).

The aim of this study was to develop an objective method to assess the degree of bristle splaying of used manual toothbrushes and to investigate their plaque removal efficacy. A randomized controlled trial targeting Hiroshima University students was performed to assess the plaque removal efficacy of polybutylene terephthalate (PBT) manual toothbrushes. Participants were randomly assigned to the soft toothbrush group (n=40) or the medium toothbrush group (n=40). A small number of participants discontinued the intervention for personal reasons in both the medium (n=6) and soft (n=2) toothbrush groups. Toothbrushes were collected immediately after first use (T0: baseline), after 1month of use (T1: month 1), after 2months of use (T2: month 3) and after 3months of use (T3: month 6), following the allocation of a new toothbrush. The bristle surface area was measured using digital software. The surface area of the bristles was significantly greater at T1, T2 and T3 than at T0 in the medium toothbrush group (n=34) and soft toothbrush group (n=38) (P<.001). Importantly, plaque removal efficacy, calculated from a modified plaque control record score and modified patient hygiene performance score, was significantly lower at T2 than at T0 in both groups. Our method for evaluation of bristle splaying is considered to be reliable and reproducible. PBT toothbrushes may become less effective after two months of use.

Assessment of gingival recession among adolescent of Jamshoro city.

Objectives: The aim of study to determine the occurrence of gingival recession in younger population of Jamshoro, also to identify its common cause, so that we can able to establish preventive measures. Study Design: Cross-sectional. Setting: Dental OPD at Liaquat University of Medical Health Sciences Jamshoro. Period: 4 months from May, 2017 to October 2017. Methodology: Study was done on (300) patients, between 18 to 30 years, before selection, they were examined, only those selected, who have gingival recession, this was done by Miller’s Classification, data was obtained by a questionnaire along with the clinical examination. Perform was consists of detailed information of habits and brushing method, scores were given for presence of gingival recession, using Miller's classification. Identification of faulty brushing technique was done by clinical examining. After the completion, all of them were also given suitable treatments also oral hygiene instructions. Results: Mean age of the was 21.09±6.178. Scores of recessions was done according to the classification of Miller, revealed that Class I were the commonest showed 78%, followed by Class II 16%, Class III 4.6% and Class IV 1.4%.Regarding brushing method (horizontal method, medium tooth brush) Statistical analysis revealed that the correlation between both toothbrush type and brushing method and gingival recession were statistically significant (P &lt; 0.001). Conclusion: The accumulation of plaque and wrong brushing method were the commonest causes of recession, educational program for oral health care should be done at community level to reduce its risk. The information from study would help us to made to prevent strategies and therapeutic methods.

Interplay between toothbrush stiffness and dentifrice abrasivity on the development of non-carious cervical lesions.

This study investigated the effect of toothbrush stiffness and dentifrice slurry abrasivity on the development and progression of simulated non-carious cervical lesions (NCCLs). Human maxillary premolars were allocated to 12 groups generated by the association between toothbrushes, soft, medium, and hard stiffness, and simulated dentifrice slurries, lower, medium, and higher; deionized water (DI) served as negative control. Teeth were mounted on acrylic blocks, and their root surfaces partially covered with acrylic resin to simulate gingiva, leaving a 2-mm area apical to the cemento-enamel junction exposed to toothbrushing. Specimens were brushed with the test slurries for 35,000 and 65,000 double strokes. Impressions taken at baseline and after both brushing periods were scanned by a 3D optical profilometer. Dentin volume loss (mm3) was calculated by image subtraction. Data were analyzed using three-way ANOVA and Fisher's PLSD tests. All toothbrushes caused higher volume loss when associated to higher abrasive slurry, compared to medium- and lower-abrasive slurries. Medium caused more volume loss than lower-abrasive slurry, which led to more volume loss than DI. Hard and medium toothbrushes were not different when used with medium- or higher-abrasive slurries. There were no differences among toothbrushes when used with DI and lower-abrasive slurry. Overall, 35,000 brushing strokes resulted in significantly less volume loss than 65,000. Toothbrush stiffness was an important factor on NCCL development, especially when brushing with medium- and higher-abrasive slurries. Medium and hard toothbrushes associated with medium- and high-abrasive toothpastes can yield more severe NCCLs.

Self-reported oral status and habits related to oral care in adult Poles: A questionnaire study.

Bacterial plaque control plays a key role in the prevention of caries and periodontal diseases. Hygiene negligence in this respect may influence the state of gingiva, and - in the long term - the number of lost teeth. The recommended method of mechanical control of dental plaque is tooth brushing twice a day. The aim of the study was to assess the frequency of tooth brushing, the use of various oral hygiene accessories, the number of preserved teeth, and the occurrence of gingival bleeding in adult Poles, based on a questionnaire study. The prepared questionnaire consisted of a general part, assessing the socioeconomic and general medical status of respondents, as well as of specific questions about behavioral actions related to oral hygiene. The study was conducted in 10 Polish cities in Mobile Medical Units as part of the "Health First" campaign in 2017. The study included 713 respondents: 447 females and 264 males at an average age of 51.1 ±17.6 years. During the previous 6 months, 448 females and 265 males had visited the dentist. The average number of teeth among the respondents aged 35-44 years was 27, and for subjects >65 years old -13. There were statistically significant differences in the frequency of tooth brushing depending on sex and place of residence. The respondents used manual soft and medium toothbrushes more often than electric brushes (p < 0.05). Inhabitants of larger cities, compared to rural residents, used dental floss and toothpicks more frequently (p < 0.05). In total, 271 (50%) of the respondents reported gingival bleeding during tooth brushing. There was a statistically significant association of gingival bleeding with genetic load, and with the use of a manual soft toothbrush and mouthwash. Pro-health behaviors of adult Poles in maintaining optimal oral hygiene are unsatisfactory and need improvement.

Comportamento do tecido peri-implantar no implante unitário imediato com provisionalização na zona estética: revisão de literatura

This study was designed to assess a newly developed toothbrush for efficacy in plaque removal, reduction of gingivitis and soft tissue bleeding, and retardation of stain formation over 30 days. Healthy adult subjects (N = 112) were admitted to the study, and randomly given a test toothbrush, (the elmex interX medium) or the control toothbrush, an ADA-Accepted flat-bristle profile toothbrush. Additionally, the subjects were randomly assigned to be given oral hygiene instruction, or no formal oral hygiene instruction. Examinations and assessments were performed at baseline, 15 and 30 days, and included gingivitis levels, stain levels, bleeding on probing, and plaque levels before and after brushing. No significant statistical differences were found between the two toothbrushes on gingivitis, nor on the stain index; however, over the course of the study the gingivitis decreased significantly (p = 0.012) for the test toothbrush group. For the bleeding index, a significant statistical difference (p = 0.027) was found at 30 days favoring the test toothbrush. There was also a significant decrease for the test toothbrush on bleeding over time (p = 0.004). Following overnight plaque formation, the before-brushing plaque levels were significantly different in favor of the test toothbrush at 15 days (p = 0.002), and again at 30 days (p = 0.001). Immediately after brushing, there was a significant statistical difference (p = 0.015) favoring the test toothbrush at 30 days. These results clearly indicate improved plaque removal and reduction of bleeding and gingivitis for the new elmex interX medium toothbrush compared to the ADA-Accepted control toothbrush.

Profilometric and Microradiographic Studies on the Effects of Toothpaste and Acidic Gel Abrasivity on Sound and Demineralized Bovine Dental Enamel

The objective of this study was to assess the abrasive effects of toothpastes and acidic F gels on sound and demineralized enamel. Pairs of enamel specimens were cut from bovine incisors, embedded in epoxy resin and polished. An artificial subsurface lesion of 80–90 µm depth was created in one specimen from each pair. The samples were covered with adhesive tape, thereby exposing the enamel for abrasivity testing. All samples were divided into six groups of 15 and brushed with a slurry (1:3) of F gel or toothpaste and human saliva. Brushing with water (control) or with slurry was carried out (16,000 strokes) using a medium toothbrush (load 275 g) mounted in a brushing machine. Abrasion was evaluated using laser profilometry, and was about 50% less on sound than on demineralized enamel (p < 0.001). In the latter, brushing with water (0.09 ± 0.03 µm) or with fluoride-free gel (0.08 ± 0.03 µm) resulted in negligible wear. With a medium-abrasive paste (1.76 ± 0.85 µm) and an acidic F gel (2.48 ± 0.72 µm), brushing abrasion was significantly greater (p < 0.001) than with a low-abrasive paste (0.84 ± 0.38 µm). The greatest wear (16.6 ± 10.8 µm) was observed with high-abrasive paste (p < 0.001), and here transversal microradiography revealed a complete loss of the pseudointact surface after brushing. In vitro formed caries-like lesions can be abraded (by toothbrushing) more easily than sound enamel; hence, initial white spot lesions should preferably be brushed with oral hygiene products of low abrasivity.

The Effect of Oral Hygiene Instructions On Diabetic Type 2 Male Patients With Periodontal Diseases

Periodontal disease and diabetes are two common chronic diseases affecting humans. The aim of this study was to assess the effect of oral hygiene instructions on periodontal disease among type 2 male diabetic Saudi subjects. Sixty subjects completed the study and were divided into three groups of 20: healthy (non-diabetic) with periodontal disease, type 2 diabetic with early or moderate periodontal disease, and type 2 diabetic with advanced periodontitis. The age ranged from 24-64 (42 +/- 13.60) years. The subjects were examined at King Saud University, College of Dentistry, Riyadh, Saudi Arabia. Oral hygiene practices and smoking habits were recorded. Oral hygiene instructions given to patients were to use an Oral B medium toothbrush and brush three times daily for 7 days using the by Bass technique for 2 minutes. Fasting blood glucose level (FBGL), gingival crevicular fluid (GCF), community periodontal index of treatment needs (CPITN), and plaque index (Pll) were used to assess patients' profiles at baseline and at recall visit after 7 days. The results showed there was a significant overall decrease in FBGL, baseline 172.67 mg/dl (+/-64.69) to recall visit 162.20 (+/-58.78) P = 0.000, and GCF volume decreased from.4041 micro l (+/-.1260) to .3698 micro l (+/-.1164) P = 0.000. There was a significant reduction in subjects' CPITN mean scores (from 13.98 (+/-8.24) to 13.32 (+/-8.97) P = 0.000), but there was no significant difference in Group 3 with advanced periodontitis, i.e., 22.25 (+/-1.37) to 22.30 (+/-1.38). There was more than a 47% reduction in the overall percentage of plaque scores. The decrease ranged from 82.27 (+/-19.34) to 34.45 (+/-17.04) at baseline and recall visit respectively. It is concluded oral hygiene instructions (a standardized regimen) has an effect on FBGL, GCF, CPITN, and PlI. It is also concluded CPITN is not very sensitive to assess change in periodontal status over a 7 days period. Further studies are needed among diabetic and healthy subjects with a larger sample size and over a longer period of time.

Dentin morphology and permeability after brushing with different toothpastes in the presence and absence of smear layer.

The purpose of this study was to evaluate the morphology and permeability of dentin after brushing with different toothpastes in the presence and absence of smear layers. Dentin discs were prepared from extracted third molars. Dentin permeability was measured using a hydraulic pressure apparatus working at 70 cm H2O pressure. Dentin was treated with 0.5 M EDTA for 5 minutes and washed to remove a smear layer and to establish the maximum permeability of each dentin disc, which was expressed as 100%. A new smear layer was then created on the upper surface using a #400 carbide paper under water for 30 seconds. Dentin permeability of the smear layer-covered dentin was measured and expressed as a percentage of the maximum permeability of that specimen, permitting each specimen to serve as its own control. Each sample was then brushed by a mechanical device under water for 3 minutes with constant pressure of 250 g using a medium toothbrush and permeability remeasured. Finally, 1 of 5 different toothpastes was applied on the dentin and brushed for 3 minutes. In another group, the same procedures were performed with the exception of the smear layer production, so it was possible to calculate changes in the permeability of dentin with open tubules following brushing. Scanning electron microscopic (SEM) examination of dentin was obtained before and after treatments with brushing and toothpastes. Dentin permeability was reduced by brushing procedures when the smear layer was absent, but it was increased when the smear layer was present. Toothpaste application reduced dentin permeability when no smear layer was present on the top of the surface, but modified and increased permeability of samples with smear layers. SEM observations demonstrated the presence of dentifrice particles on dentin surfaces and inside dentinal tubules, and this may be responsible for the observed reductions in permeability. Smear plugs produced during dentin brushing were not removed by the dentifrices. Dentin permeability and morphology are significantly affected by toothbrushing and by the type of dentifrice used. The presence of smear plugs in the dentin may decrease severity.