Plaque Remover Research Articles

Approximal brush head used on a powered toothbrush

This study was designed to test whether the approximal efficacy of a powered toothbrush (Braun Oral-B 3D Plaque Remover) can be improved when a pointed-shaped brush head (PBH) specifically designed for these approximal areas is used as compared with the standard cup-shaped brush head (CBH). Forty non-dental students were included. They all received the powered toothbrush and two different brush heads (CBH+PBH). Instructions were given to use each brush head twice every day (2 min. with the CBH followed by 1 min. with the PBH). Two weeks later they received an appointment for the first experiment (Exp 1), prior to which they abstained from all oral hygiene procedures for 48 h. Plaque was assessed at 6 sites/tooth. Next, the dental hygienist brushed for 2 min. (30 s/quadrant) with the CBH. Plaque was scored again. Subsequently, the dental hygienist brushed the approximal areas for another minute: in two randomly selected contra-lateral quadrants for 30 s with the CBH and in the opposing quadrants for 30 s with the PBH. The next approximal plaque was scored a third time. After 2-3 weeks, Exp 2 was carried out comparable to Exp 1; only this time the panelists brushed themselves. Exp 1 showed approximal plaque scores at the baseline of 1.70 and 1.72 and at post-brushing 0.21 and 0.26 for the CBH + PBH and CBH only, respectively (p<0.05). The additional increase in approximal plaque reduction after 30 s of brushing with PBH was 22% and for the CBH 19% (p<0.05). Exp 2 showed approximal plaque scores at baseline of 1.76 and 1.74 and post-brushing of 0.21 and 0.24 for the CBH+PBH and the CBH, respectively. The additional approximal plaque reduction of 30 s brushing with PBH was 19% and 18% with the CBH (no significant difference). An additional 1 min. showed minor differences (1-3%) between brush heads. The effect of the 1 min. extra brushing (+/-18%) itself was much larger. It seems therefore beneficial to advise the patient to brush longer. A second different brush head may stimulate to do so.

Does cavitation occur around powered toothbrushes?

The aim of this investigation was to determine if cavitational activity occurred around powered toothbrushes using a chemical dosimeter system based on terephthalic acid (TA). Five powered toothbrushes were used in this investigation: Braun Plaque Remover D8, Braun Oral-B 3D, Philips Jordan Sensiflex HX2520, Sonicare PS-1 and Sonicare Elite HX 7351/02. Each brush head was inserted into a conical flask containing 50 cm3 of aqueous TA solution. Brushes were operated for 10 and 20 min and a cuvette of the solution was placed in a fluorescence spectrometer (Perkin Elmer 3000). The fluorescence emitted at wavelength 425 nm, which is proportional to *OH radical concentration, was monitored. Any cavitational activity that may have been produced by the powered toothbrushes was below the limit of detection of the system (<10(-8) M) for the timescales investigated. This work has demonstrated that cavitational activity does not occur around powered toothbrushes. Operating the toothbrushes for periods up to 20 min resulted in no cavitational activity being detected.

Plaque removal with a novel manual toothbrush (X‐Active) and the Braun Oral‐B 3D Plaque Remover

The study was designed to test the efficacy in plaque removal of three toothbrushes: two manual brushes, the Butler GUM 311 and the Dr Best X-Active, and one electric toothbrush the Braun Oral-B 3D Plaque Remover (3D). The study was a split-mouth, single-blind, randomized clinical study consisting of three identical experiments testing three combinations of toothbrushes (experiment 1: 3D versus Butler; experiment 2: 3D versus Dr Best; experiment 3: Butler versus Dr Best), in which the teeth of the panellists were brushed by a dental hygienist. In a fourth experiment, the panellists brushed their own teeth (3D versus Dr Best). Thirty-five subjects participated in the study and received a professional prophylaxis prior to the first experiment. They were requested to refrain from brushing their teeth for 48 h prior to each experiment. Plaque was assessed according to the Silness & Löe plaque index at six sites per tooth. Next, the dental hygienist (experiments 1-3) or the panellist (experiment 4) brushed for 60 s with their first assigned brush in two randomly selected contralateral quadrants. Brushing was repeated (60 s) with the second brush in the opposing two contralateral quadrants. Prior to experiment 4, panellists were given two thorough hands-on professional instructions in the use of the 3D and the Dr Best toothbrushes. In experiment 1, the 3D showed a mean plaque reduction of 72% compared to 63% with the Butler (P<0.01). In experiment 2, the 3D showed a mean plaque reduction of 79% and the Dr Best 76% (P<0.05). In experiment 3, the Butler showed a mean plaque reduction of 81% and the Dr Best 85% (P=0.01). In the hands of the panellists (experiment 4), the 3D showed a mean plaque reduction of 88% and the Dr Best 84% (P<0.05). A 5-week training period with repeated hands-on instruction gives panellists the skill to perform brushing with efficacy comparable to that of professional brushing. In agreement with a previous study, the 3D was more effective than a flat-trimmed manual toothbrush (Van der Weijden et al. 1994). Brushing with the criss-cross resulted in small statistical differences with the 3D and the flat-trimmed manual toothbrush. The clinical relevance of these statistically significant results should be the subject of a longitudinal study.

The Clinical Effectiveness of a Novel Power Toothbrush and Its Impact on Oral Health

This review details the invention and clinical testing of a new power toothbrush designed to provide a low cost, effective toothbrush, which has a combination of a round oscillating head in conjunction with fixed bristles. The data demonstrate this power toothbrush (Crest SpinBrush) is an effective cleaning toothbrush with respect to plaque removal. Four independent 4-period crossover studies, where subjects used each brush twice, have demonstrated that brushing with this power toothbrush results in 10-40% greater plaque removal relative to a series of control manual toothbrushes. Separate research has confirmed that adults and children tend to brush longer, 35.8% and 38.3% respectively, when using this power toothbrush relative to manual toothbrushes. In addition, it has been shown to be superior to a battery-powered toothbrush (Colgate ActiBrush) in two independent studies and has demonstrated comparable efficacy to a leading powered toothbrush (Oral-B Ultra Plaque Remover). In parallel, this power toothbrush has also been shown to be safe relative to manual and power toothbrushes.

A clinical study to compare the efficacy of 2 electric toothbrushes in plaque removal

AbstractObjectives: To compare the cleaning efficacy of a powered toothbrush with 3‐dimensional brush head action (Braun Oral‐B 3D Plaque Remover D15) and a high‐speed “microtation” brush with an additional “microbrush®‐clip” (Rowenta Dentasonic MH921S).Material and Methods: 82 healthy subjects took part in the study. After a familiarization period of 8 days, the subjects abstained from all oral hygiene procedures for 48 h. After plaque was scored, the subjects brushed their teeth under supervision with the two brushes according to a split‐mouth design. Immediately after brushing, subjects completed a questionnaire and plaque was scored again.Results: The overall plaque scores were found to be significantly reduced from 3.05±0.60 to 1.96±0.63 by the D15 and from 3.02±0.58 to 2.24±0.64 by the Dentasonic (p&lt;0.05). The proximal surface plaque scores were reduced from 3.20±0.63 to 2.17±0.69 by the D15 and from 3.17±0.60 to 2.44±0.69 by the Dentasonic. The relative plaque reduction was overall 36.6±12.2% for the D15 compared to 26.1±13.5% for the Dentasonic and at proximal surfaces, 33.1±12.3% and 23.2±13.0%, respectively. 75% of the subjects stated that they would prefer to keep the D15.Conclusions: Both brushes were able to remove a significant amount of plaque, but the D15 was significantly more effective compared to the Dentasonic. The additional “microbrush®‐clip” for the proximal embrasures failed to improve plaque removal from these tooth surfaces, compared to the D15 alone.

Comparative study of 2 electric and 2 manual toothbrushes in patients with fixed orthodontic appliances

The objective of this prospective single-blind crossover clinical trial was to evaluate the efficacy of 4 toothbrushes in 33 children undergoing fixed appliance orthodontic therapy. The toothbrushes included in this study were the Braun Oral-B 3D Plaque Remover (Kronberg, Germany), the Philips-Jordan HP 510 (Philips Domestic Appliances, Groningen, The Netherlands), the Lactona orthodontic toothbrush (Bergen op Zoom, The Netherlands), and the Oral-B Advantage Control Grip (Braun); the first 2 are electric, and the last 2 are manual. Every patient tested each type of toothbrush in a randomly designed sequence. Plaque and gingival scores were recorded at baseline and after every 4-week test period. All patients received professional prophylaxis after each clinical evaluation. The data were analyzed with the Friedman test, which showed no significant differences among the 4 brushes for any of the parameters measured. The Wilcoxon signed rank test, comparing the plaque and the gingival scores between the upper and lower jaw for each brush, indicated that plaque removal was more efficient in the lower jaw than in the upper. (Am J Orthod Dentofacial Orthop 2001;120:353-60)

Efficacy of manual and powered toothbrushes (II). Effect on microbiological parameters

The purpose of the present investigation was to determine the effect of self-performed supragingival plaque removal using either manual (Crest Complete) or power (Braun 3D Plaque Remover) toothbrushing on supra and subgingival plaque composition. 47 periodontal maintenance subjects completed this single-blind 6 month longitudinal study. At baseline, samples of supra and separately subgingival plaque were taken from the mesial aspect of each tooth in each subject using sterile curettes and individually analyzed for their content of 18 bacterial taxa using checkerboard DNA-DNA hybridization. After random assignment to groups receiving either a manual (n=25) or power toothbrush (n=22), subjects received instruction in oral hygiene and used their assigned toothbrush 2x daily for 6 months. Clinical monitoring and microbiological sampling were repeated at 3 and 6 months. Significant differences in microbiological measures over time were sought using the Quade test and between brushing groups at each time point using the Mann-Whitney test. Mean total counts were significantly reduced for supra- and subgingival plaque samples in the manual group and subgingival samples in the powered brushing group. Actinomyces naeslundii and Actinomyces israelii/gerencseriae were the most numerous organisms detected at baseline and showed the greatest reductions in counts in both brushing groups. Streptococcus constellatus/intermedius was significantly reduced in both groups, while Streptococcus mitis/oralis/sanguis was significantly reduced in the manual toothbrushing group. Mean counts of species were more markedly altered in subgingival plaque. Major reductions occurred in both groups for A. naeslundii, A. israelii/gerencseriae, Peptostreptococcus micros, Veillonella parvula, Prevotella intermedia/nigrescens, S. mitis/oralis/sanguis and S. constellatus/intermedius. All taxa examined were reduced in prevalence (% of sites colonized) in the subgingival plaque samples for both brushing groups. The reductions in prevalence were greater for A. naeslundii, S. constellatus/intermedius, V. parvula, A. israelii/gerencseriae, S. mitis/oralis/sanguis, P. micros, Streptococcus mutans and P. intermedia/nigrescens. Mean prevalence was decreased more for Porphyromonas gingivalis, Campylobacter rectus/showae, Treponema denticola and Bacteroides forsythus in supragingival plaque than subgingival plaque. The major finding was the effect of supragingival plaque removal on the composition of the subgingival microbiota. Counts and prevalence of most taxa examined were markedly decreased in both toothbrushing groups. This reduction should translate to a decreased risk of periodontal disease initiation or recurrence. Further, the decreased prevalence of periodontal pathogens in supragingival plaque lowers potential reservoirs of these species.

Alzheimer's disease: amyloid beta-peptide antibody vaccine as plaque remover.

Alzheimer’s disease (AD) is a major cause of dementia. It is believed to affect 11% of all humans over 65 years of age and 50% over the age of 85 in caucasian populations. It is a chronic brain disorder with a lengthy preclinical phase followed by a malignant stage associated with neuronal degeneration, loss of specific synaptic connections and progressive erosion of cognitive ability. AD begins with a subtle failure of memory, slowly becoming more severe and eventually incapacitating the patient. Neuronal degeneration in AD is highly selective for certain brain regions and types of neurons and can lead to a profound atrophy of the cerebral cortex. The amygdala, hippocampus and parahippocampus show a high degree of neurodegeneration, whereas the striatum and cerebellum are less affected. Subcortical pathways involving catecholaminergic, seritonergic and cholinergic transmissions are affected, whereas neocortical interneurons such as GABAergic and inhibitory are relatively unaffected. A subset of pyramidal cells in layers II, III and V that use excitatory amino acids as transmitters are highly vulnerable in AD. The loss of neurons has a variable time course between individuals and it could take months to years for a neuron to degenerate. Neuronal degeneration in AD starts rapidly from the medial temporal lobe and gradually spreads to other neocortical areas (Vickers et al 2000).

A PRACTICE-BASED STUDY OF A POWER TOOTHBRUSH: ASSESSMENT OF EFFECTIVENESS AND ACCEPTANCE

The greater effectiveness of the power toothbrush compared with a manual toothbrush is well-documented. Despite this, acceptance by dental professionals is still low. This general practice study evaluated the effectiveness of a power toothbrush (Braun Oral-B Ultra Plaque Remover, Braun GmbH) in 16,903 patients, based on the clinical opinions of dental professionals in regard to patients' changing oral health status. In addition, a survey assessed the attitudes of dental professionals and patients toward the power toothbrush. The power toothbrush was considered by dental professionals to have had a positive effect on the oral health of 80.5 percent of their patients; the noticeable benefits with respect to a number of clinical criteria included plaque removal and improved gingival condition. Most patients in the study (88.9 percent) reported that they would continue using the power toothbrush once the study was completed. At the end of the study, many more dentists and hygienists considered the power toothbrush to be the most effective way of brushing, and almost 70 percent said that they would now be more likely to recommend a power toothbrush to their patients. The power toothbrush improved the oral health of patients in this practice-based study, and the number of dental professionals who said they would recommend a power toothbrush increased markedly during the study. Enabling dental professionals to evaluate the effect of a power toothbrush reinforces the findings from controlled clinical studies and increases their awareness of its potential to improve oral hygiene.

Comparison of oral hygiene efficacy of one manual and two electric toothbrushes

The purpose of the study was to compare the efficacy of two electric toothbrushes (Philips HP555 and the Philips Jordan 2-action Plaque Remover HP510). A manual toothbrush (Jordan V-shaped, medium) served as control. Fifty subjects, aged 18±60 years, participated in a randomized, single-blind, 3 x 3 weeks crossover study. Plaque was assessed according to the Turesky modification of the Quigley-Hein index (P.I.),while the Løe-Silness index was used for assessing gingivitis. Adverse effects were assessed according to the ADA specifications. Compliance and preference were assessed through questionnaires and interviews, respectively. All periods mean P.I. (all surfaces) were 2.79, 3.01, and 2.86 for the manual, the HP555, and the HP510 electric brushes and the corresponding gingivitis values were 1.19, 1.22, and 1.21. For both indices, only the difference between the manual and the HP555 yielded significance (P = 0.04 and P = 0.02). Most subjects (28/50) preferred the HP510 brush, as it felt more practical to use and was perceived to have better cleaning ability. In conclusion. no clinically relevant differences in plaque reducing and gingivitis controlling ability were observed.

Comparative study of electric and manual toothbrushes in patients with fixed orthodontic appliances

The objective of this three treatment, three period, single blind, cross-over trial was to evaluate the efficacy of three toothbrushes in a cohort of children undergoing fixed appliance orthodontic therapy. The brushes used were: (1) Dental Logic HP550 with regular brush head HP5924 (Philips, U.K.); (2) Braun Oral B Plaque Remover (D7) with dedicated orthodontic brush head OD5-1 (Braun AG, Germany); and (3) a manual dedicated orthodontic toothbrush (P35, Oral B Laboratories, Calif.). Sixty orthodontic patients, aged 10 to 16 years and wearing upper and lower fixed appliances, were screened and recruited with parental consent. After an oral soft tissue examination at baseline, the percentage of plaque-covered tooth surfaces and gingival bleeding sites were recorded using visible plaque and gingival bleeding indexes. Each subject was randomly allocated to one of three groups ( n = 20) with brushing sequences 1-2-3, 2-1-3, 3-2-1. The first brush was given 2 weeks after baseline (visit 1). The time interval for using each brush was 4 weeks at the end of which visible plaque and gingival bleeding indexes were recorded and a further prophylaxis given. Statistical analysis was undertaken with analysis of variance. Data were analyzed on a site-specific basis; buccal smooth and interproximal surfaces, lingual smooth and interproximal surfaces. At baseline the mean visible plaque index for all subjects were; buccal smooth, 52.5% (± 22.5%); buccal interproximal, 70.5% (± 18.5%); lingual smooth, 68.5% (± 21%); lingual interproximal, 76% (± 16%). At visit 1, the plaque scores at all surfaces had reduced significantly compared to baseline, but there had been no active treatment. This was attributed to a Hawthorne effect. Subsequently, there were no significant effects on visible plaque (or gingival bleeding) indexes with any toothbrush at any tooth surfaces. This suggests that the new HP550 is equally effective as specifically designed orthodontic toothbrushes in removing plaque from patients with fixed orthodontic appliances. (Am J Orthod Dentofacial Orthop 1998;114:45-49)

Effectiveness of three different types of electric toothbrushes compared with a manual technique in orthodontic patients

Patients undergoing orthodontic treatment with fixed appliances are at risk of developing carious white spot lesions and gingival inflammation because of the challenge of oral hygiene. The purpose of this study was to evaluate under home conditions the effectiveness of three different types of electric toothbrushes during active appliance therapy: Interplak (Bausch & Lomb, Berlin, Germany), Rota-dent (Rota-dent, Kusnacht, Switzerland), and Braun Oral-B Plaque Remover (Braun/Oral-B, Kronberg, Germany). A manual technique, which included normal toothbrush, interdental brush, and dental floss, served as reference. The study was structured as a single-blind "Latin square design" study. Thirty-eight orthodontic patients were randomly allocated to groups who, within the test period, alternately used the toothbrushes. Before getting a new toothbrush that was to be used for a period of 4 weeks, each patient received video and written instructions. For another 4 weeks, the patient returned to the usual oral hygiene procedures before receiving the next new toothbrush. Oral hygiene was evaluated at the start of a new test period and after 2 and 4 weeks. Clinical scores included a modified O'Leary Plaque Index and Ainamo Gingival Bleeding Index. Wilcoxon rank testing for aggregated surfaces revealed statistically significantly lower plaque scores for Rota-dent than for the manual technique (p < 0.01). For all other toothbrushes, no differences were found in comparison to the manual technique. For Plaque Indices of specific sites, statistical analysis revealed all electric toothbrushes to be equal to the manual technique. No differences in Gingival Bleeding Indices were found after 4 weeks with either toothbrush. Patients with poor oral hygiene who used Rota-dent and Braun Oral-B Plaque Remover OD5 had statistically significantly lower plaque scores compared with the manual technique (p < 0.01; p < 0.05); for patients with good oral hygiene, these differences were neutralized. It may be concluded that electric toothbrushes of the new generation are a real alternative to the often laborious manual tooth cleaning procedures used during active appliance therapy. Patients with poor oral hygiene may benefit from them especially because plaque removal can be achieved easier and faster.