Power Toothbrushing Research Articles

The Effects of Power Toothbrushing On C-Reactive Protein Levels in Nursing Home Residents: A Randomized Controlled Trial

The Effects of Power Toothbrushing On C-Reactive Protein Levels in Nursing Home Residents: A Randomized Controlled Trial

The Effects Of Power Toothbrushing On C-Reactive Protein Levels In Nursing Home Residents: A Randomized Controlled Trial

The Effects Of Power Toothbrushing On C-Reactive Protein Levels In Nursing Home Residents: A Randomized Controlled Trial

Bacteraemia of oral origin in children-A Systematic review and network meta-analysis.

To systematically review the prevalence of bacteraemia, triggered by dental intervention and home oral hygiene practices, in children. The network meta-analysis (NMA) quantitatively compared the risk of bacteraemia triggered by dental extractions and home and professional cleaning procedures. Clinical trials with the outcome "bacteraemia in children" were searched. The NMA was performed using the frequentist weighted least-squares approach comparing the odds ratios (OR) of different interventions. Among 11 of 13studies, dental treatment was performed under general anaesthesia. In 2,381 patients, bacteraemia occurred in 38.7%-56% patients following single-tooth extractions, in 22%-46% after manual toothbrushing (MTB), and in 26%-78% after power toothbrushing (PTB). When MTB was set as the reference (OR 1), rubber cup polishing showed a slightly higher risk (OR 1.26) of bacteraemia. PTB presented a higher risk (OR 1.79-2.27) than with single-tooth extractions (OR 1.55) but lower than that with multiple extractions (OR 2.55). Daily use of MTB and routine professional cleaning were associated with the lowest risk of developing bacteraemia in children with gingivitis, almost as much as with a single-tooth extractions. Improved plaque control with PTB increased the risk of bacteraemia. There is limited evidence on gingivitis-free and systemically-diseased children.

The effects of power toothbrushing on periodontal inflammation in a Canadian nursing home population: A randomized controlled trial.

The aim of this study was to investigate whether twice-daily use of a rotating-oscillating power toothbrush (Oral-B Professional Care 1000™ ) in nursing home (NH) residents over a 6-week period, compared to usual care (UC), would reduce periodontal inflammation. In this repeated measures single-blinded randomized controlled trial, 59 residents of one NH in Winnipeg, Canada, were randomized to receive either twice-daily tooth brushing with a rotating-oscillating power toothbrush (PB) or UC by caregivers. Consent was obtained from residents or their proxies. Participants had some natural teeth, periodontal inflammation, non-aggressive behaviour, no communicable diseases, were non-smokers and non-comatose. Outcomes were measured at baseline and 6weeks, which included: inflammation (MGI, Lobene), bleeding (PBI, Loesche) and Plaque (Turesky). Comparisons of group changes in outcomes were analysed using an ANOVA with a repeated measure. Of 59 original study participants, one withdrew, one died prior to study commencement and three died before study completion. All oral parameters improved significantly for the remaining 54 residents over time (P<.0001), with no differences between groups. These results demonstrate that it is possible for caregivers to improve periodontal inflammation of residents over a 6-week period. Despite no significant group differences, periodontal inflammation of all study participants improved significantly, particularly in the reduction of bleeding, a direct measure of periodontal inflammation, which is a unique finding.

Oral chlorhexidine in the prevention of ventilator-associated pneumonia in critically ill adults in the ICU : a systematic review

Purpose. The aim of this review was to evaluate the evidence on the effectiveness of oral chlorhexidine in the prevention of ventilator-associated pneumonia (VAP) in critically ill adult mechanically ventilated patients in intensive care units (ICUs). Methodology. An extensive literature search of studies published in English was undertaken between June 2010 and June 2011. Electronic databases searched were the Cochrane Central Register of Controlled Trials (CENTRAL), the Cumulative Index of Nursing and Allied Health (CINAHL) and MEDLINE. Reference lists of articles, textbooks and conference summaries were examined and hand searching was performed. Literature searches were done using the following Medical Subject Headings (MeSH) terms: ventilator-associated pneumonia, VAP, chlorhexidine, hospital-acquired pneumonia, nosocomial infections, mechanically ventilated patients, intensive care, mouthwash, mouth care, oral care, oral hygiene and dental care. Selection criteria. Two reviewers selected the studies independently. Eight randomised controlled trials investigating the efficacy of oral chlorhexidine versus power tooth brushing, Listerine, placebos, bicarbonate isotonic serum rinse and normal saline in the prevention of VAP in adult mechanically ventilated, critically ill patients in ICUs met the inclusion criteria. Data collection and analysis. All relevant data were entered into Review Manager (version 5.1) for analyses. The effect measure of choice was the risk ratio (RR) with 95% confidence intervals (CIs) for dichotomous data using the random effects (Mantel-Haenszel) model (p-value 0.05). Heterogeneity was assessed using the Cochrane Q statistic and I². Results. Eight randomised controlled trials met the inclusion criteria for this review. There was a 36% higher chance of VAP in the control group compared with the chlorexidine group (RR 0.64, 95% CI 0.44 - 0.91). The variation between the included studies was very small (χ²=0.24). Conclusion. Treatment with chlorhexidine decreased the risk of VAP by 36%. The use of 2% chlorhexidine may be most effective in reducing the incidence of VAP. There was no evidence of an effect of chlorhexidine on mortality.

Clinical Implications of Power Toothbrushing on Fluoride Delivery: Effects on Biofilm Plaque Metabolism and Physiology

Dental biofilms are implicated in the formation of caries and periodontal disease. A major constituent of the supragingival biofilm is Streptococcus mutans, which produces lactic acid from sucrose fermentation, enhancing enamel demineralization and eventual caries development. Caries prevention through F inhibits enamel demineralization and promotes remineralization. Fluoride also exerts effects on metabolic activities in the supragingival biofilm such as aerobic respiration, acid fermentation and dentrification. In experimental S. mutans biofilms, adding 1000 ppm F to an acidogenic biofilm resulting from 10% sucrose addition increased pH to pre-sucrose levels, suggesting inhibition of acid fermentation. F effects on metabolic activity and sucrose utilization in interproximal plaque biofilms were also recorded. Addition of 10% sucrose reduced pH from neutral to 4.2, but subsequent addition of 1000 ppm F increased pH by 1 unit, inhibiting acid fermentation. 10% Sucrose addition also stimulated denitrification, increasing production of nitrous oxide (N2O). Addition of 1000 ppm F suppressed denitrification, indicating an additional mechanism by which F exerts effects in the active interproximal biofilm. Finally, fluid dynamic activity by power tooth brushing enhanced F delivery and retention in an experimental S. mutans biofilm, suggesting a potential novel benefit for this intervention beyond mechanical plaque removal.

A Prospective Clinical Study to Evaluate the Effect of Manual and Power Toothbrushes on Pre-existing Gingival Recessions

To evaluate gingival recession changes after six months of brushing with an oscillating-rotating power toothbrush (PT) or an ADA reference manual toothbrush (MT). Healthy subjects with pre-existing recession were assigned to brush with either a PT (n=55) or an ADA reference MT (n=54) according to a prospective randomized, controlled, single-blind, parallel group design. Participants were asked to brush their teeth twice daily for two minutes each with the same fluoride toothpaste. Clinical attachment loss and probing pocket depths (PPDs) were measured at six sites per tooth to the nearest mm by one calibrated examiner at baseline and after six months. Gingival recession was calculated as the differences between clinical attachment loss and PPDs overall and separately at individual sites. As compared with baseline, overall recession at six months was reduced from 2.35 +/- 0.35 mm to 1.98 +/- 0.55 mm (p<0.001) in the PT group and from 2.26 +/- 0.31 mm to 1.90 +/- 0.45 mm (p<0.001) in the MT group. The data showed 40% (power) and 38% (manual) of all recession sites improved by at least 0.5 mm while 51% and 54% remained unchanged. Eight percent and 7% recessions increased over time. Differences between groups were not statistically significant at either timepoint. Both the PT and the MT significantly reduced pre-existing gingival recession after six months of brushing. This may have been due to improved brushing technique (i.e., Hawthorne effect). Based on these six-month data, concern that power tooth brushing results in a higher risk for gingival recession is not warranted.

Dental casting alloys behaviour during power toothbrushing with toothpastes of various abrasivities. Part II: corrosion and ion release

The purpose of this study was to evaluate the long term effect of abrasivity of toothpastes normally used over the corrosion behavior and ion release of the different dental casting alloys. Three dental casting alloys (Ni-Cr, Co-Cr and commercially pure Ti) were studied. Four specimens of each material were immersed, brushed without paste or brushed with one of four toothpastes of different Relative Dentine Abrasivity (RDA 50, 52, 80, and 114). An electric toothbrush with a load of 250 g was used for 420 min. Corrosion behavior was determined by means a potenciostat with high sensitivity and the ion release determined by Inductively Coupled Plasma-Mass Spectrometry. Two-way ANOVA and non-parametric tests were used to detect significant differences. Titanium specimens exhibited the best corrosion behavior after and before the toothbrushed, being the worst of the three alloys the Cr-Ni. Titanium oxide produced spontaneously on the Ti surface is the main cause of the high corrosion resistance of the material. However, the eutectoid of the CrNi with chemical composition between different phases produces pitting on the phases boundaries with an important decrease of the corrosion resistance. Besides, the CrNi produces high values of the Ni and Cr release. Slight increment in roughness were observed after toothbrushing and depended on the material but not on the toothpaste used. The increase of the microhardness (residual stresses) provokes a decrease of the corrosion resistance and an increase of the ion release.

Dental casting alloys behaviour during power toothbrushing with toothpastes with various abrasivities. Part I: wear behavior

The purpose of this study was to evaluate the long term effect of abrasivity of toothpastes normally used over the surface and mechanical properties of dental casting alloys. Three dental casting alloys (Ni-Cr, Co-Cr, c.p. Ti) and one ceramic were chosen. Four specimens of each material were immersed in artificial saliva, brushed without or with one of four toothpastes of different Relative Dentine Abrasivity (RDA 50, 52, 80, and 114). An electric toothbrush with a load of 250 g was used for 420 min. Mass loss was determined by difference in weight, microhardness and surface roughness were also measured. Two-way ANOVA and non-parametric tests were used to detect significant differences. Titanium specimens (478 microg/cm(2)) exhibited the most mass loss, whereas ceramic (282 microg/cm(2)) and Co-Cr (262 microg/cm(2)) exhibited the least. However, ceramic demonstrated the most volume loss (0.239 mm(3)). The abrasivity effect of the toothpaste correlated with the RDA values. Slight variations in microhardness were observed after toothbrushing and depended on the material but not on the toothpaste used. Material surfaces were slightly smoothed by toothbrushing but no significant differences were detected. Dental casting alloys and ceramic are susceptible to abrasion by brushing with an electric toothbrush depending on the RDA value of the toothpaste. Variations in microhardness and surface roughness were not clinically relevant.

Evaluation of the Benefits of Using a Power Toothbrush During the Initial Phase of Periodontal Therapy

Studies evaluating the efficacy of oral hygiene procedures typically focus on prevention or maintenance after periodontal therapy. Little is known about the specific benefit of a power toothbrush during therapy. The objective of this study was to evaluate the clinical efficacy of power toothbrushing compared to manual toothbrushing in patients undergoing the initial phase of periodontal therapy. This was an examiner-masked, randomized, two-arm parallel study involving 70 adults (range, 23 to 81 years) with untreated periodontitis. After an initial supragingival debridement, subjects were assigned to toothbrushing with a manual (group M) or power (group P) toothbrush. Subjects returned for evaluation after 7, 14, and 28 days. At day 28, the mean plaque index (PI) was significantly lower for subjects in group P than for those in group M (P = 0.006). The mean number of sites with PI >1 at days 14 and 28 and the mean number of sites with bleeding on probing at days 14 and 28 also were significantly lower in these subjects (P = 0.018 and P = 0.005, respectively, and P = 0.017 and P = 0.034, respectively). Differences in the mean gingival index, the number of sites with a gingival index >1, mean recession, mean probing depth, and the number of pockets >4 mm were not significant. Subjects using a power toothbrush during initial treatment reduced supragingival plaque to lower levels and showed significantly less bleeding on probing than subjects using a manual brush.

In vitro Evaluation of Abrasion of Eroded Enamel by Different Manual, Power and Sonic Toothbrushes

This study aimed to evaluate the susceptibility of eroded enamel to brushing abrasion performed by manual, power or sonic toothbrushes. Bovine enamel samples were subjected to 5 cycles, each consisting of 5 min demineralisation, 15 min remineralisation and 10 min brushing in a machine. Toothbrushing with the activated electric devices was supplemented with 20 linear strokes/min. Furthermore, enamel specimens were brushed with 20 linear strokes/min or 80 linear strokes/min with the electric toothbrushes without their individual operating action. A manual brush was applied at 100, 20 or 80 linear strokes/min. Specimens of the control group were not brushed after demineralisation. Loss of enamel was determined by profilometry. For all groups, substrate loss for linear brushing treatment applying 20 or 80 strokes/min did not differ significantly from the control (4.97 ± 1.49 µm). Three power toothbrushing treatments significantly increased abrasion compared to linear brushing treatment with 20 or 80 strokes/min in their inactivated condition. The results indicate that brushing treatment with power or sonic toothbrushes may lead to significantly higher loss of demineralised enamel compared to toothbrushing without power or sonic support.

Improvement of oral hygiene in patients with rheumatoid arthritis

Programs in power toothbrushing, manual toothbrushing with conventional fluoride toothpaste and with a chlorhexidine/fluoride gel has been evaluated for plaque removal in an observer blind cross-over clinical trial on 14 rheumatoid arthritis patients. All three regimens lead to considerable improvement in oral hygiene. The use of an electric toothbrush was slightly more effective than a manual brush. Brushing with a chlorhexidine/fluoride gel gave the best results, but its clinical use is limited by unacceptable taste, discoloration and possibly adverse soft tissue effects.

The effectiveness of a counterrotational-action power toothbrush on plaque control in orthodontic patients

This study compared counterrotational-action power toothbrushing with manual toothbrushing in effectiveness on plaque control and gingival health in 20 randomly selected orthodontic patients at the University of Missouri-Kansas City. A blind two-group crossover design was used. Gingival and plaque scores were recorded, and a prophylaxis was given to bring the plaque score to zero. Ten subjects received counterrotational power brushes, and ten subjects received manual brushes. Instructions appropriate to each brushing method were given by a hygienist. At 30 and 60 days, plaque and gingival scores were recorded and a prophylaxis was given. At 60 days the subjects who were using power brushes were switched to manual brushes, and the subjects who were using manual brushes were switched to power brushes. At 30 and 60 days, plaque and gingival scores were recorded and a prophylaxis was given. Plaque and gingival scores were significantly less (p less than 0.01) after brushing 2 months with the counterrotational power brush than with the manual brush. This finding was irrespective of the sequence in which the brushes were used.

Tissue changes with manual and electric brushes

Although manual and power toothbrushing seem equally effective, the latter has the advantage of being quicker. Although manual and power toothbrushing seem equally effective, the latter has the advantage of being quicker.