Use Of Toothbrush Research Articles

Contaminated Toothbrushes and Potential COVID-19 Transmission: Concerns and Recommendations

AbstractSubstantial past evidence has demonstrated microbial contamination of oral devices and possible transmission of viral diseases, drawing attention to habits related to using and storing toothbrushes. Since toothbrushes are in intimate contact with the oral cavity, the question arises as to whether they can transmit COVID-19.An electronic search was performed in four databases to identify relevant literature about the possible contamination or transmission of SARS-CoV-2 through toothbrushes until May 2021. Forty-five records were retrieved, and after a thorough search, we found no articles reporting significant evidence. However, studies with other viral diseases have indicated that improper use and storage of toothbrushes could contribute to indirect disease transmission.Therefore, this narrative review supports the implementation of toothbrush disinfection and storage measures to minimize the risk of SARS-CoV-2 infection among cohabitants and community settings. Finally, recommendations and a suggested protocol to reduce the potential risk of transmission between cohabitants are provided.

Dependence in instrumental activities of daily living and its implications for older adults' oral health.

We aimed to assess the association between dependence in instrumental activities of daily living (IADL) and oral health in older adults. We conducted a cross-sectional study of 280 people aged ≥60 years served at public primary health care centers in Northeastern Brazil. Sociodemographic, oral discomfort and general health data were collected. The Lawton and Brody scale were used to assess IADL. This research adheres to the STROBE checklist. Most participants were married (n = 139; 49.6%), women (n = 182; 65.0%) and retired (n = 212; 75.7%). A total of 37 (13.2%) older adults had some degree of dependence in IADL. Dependence in IADL was associated with: retirement (p<0.040), poor general health (p = 0.002), speech problems (p = 0.014), use of medications (p = 0.021), difficulty chewing and swallowing food (p = 0.011), voice changes (p = 0.044), edentulism (p = 0.011), use of toothbrush (p<0.001), use of toothpaste (p<0.001), and visit to the dentist in the previous year (p = 0.020). Functional disability was associated with older age, cardiovascular diseases, speech problems, chewing and swallowing difficulties, use of medication and brushing deficiency. The functional dependence in IADL can be considered an indicator of oral health status in older adults.

Comparison Of Periodontal Health Of Orthodontic And Non-Orthodontic Patients

Objective: To compare the periodontal health status among orthodontic and non-orthodontic groups aged between 14-30 years of both genders. Study design And Setting: This comparative cross sectional study was conducted at Department of Orthodontics and Periodontics from January 2019-till June 2019 at dental Hospital of Bahria Dental College Karachi. Methodology: Those patients aged 14-30 under orthodontics treatment for about 3 months and were able to give consent were included in the study. Periodontal status among both groups (65 orthodontics and 65 non orthodontic) patients was evaluated with the help of CPITN probe on index teeth. To assess the oral hygiene status; the questionnaire was formulated regarding the use and frequency of toothbrush; use of interdental cleaners such as interdental brush, use of mouthwash, use of tongue cleaners and dental appointments. A single observer from periodontics department was appointed for observation and record data of patients coming to orthodontic department and to carry out a clinical examination. The data was scrutinized using SPSS 23, and using the chi-square test various other comparisons were performed. Results: Statistically significant association was observed in CPITN scores between the orthodontic and non-orthodontic patients (p &lt; 0.05). Patients who underwent orthodontic treatment had increased plaque accumulation and probing depth which resulted in periodontal tissue destruction. Conclusion: It was concluded that the periodontal condition of ortho patients was deteriorating as compare to non ortho patient. There was no noticeable attachment loss found that could lead to mobility of the tooth and its loss

Effect of electric, ultrasonic and manual toothbrushes on biofilm removal and gingivitis control

Aim: To evaluate the effect of manual (M), electric (E) and ultrasonic (US) toothbrushes on the removal of oral biofilm and control of gingivitis. Also, the roughness and tooth wear production were evaluated in vitro. Methods: For the in vitro analyses, thirty bovine dentin specimens were submitted to a 3-month brushing simulation (9 minutes) with the three types of toothbrushes (n = 10). Subsequently, a randomized controlled clinical trial was performed with 36 patients divided into 3 groups according to the toothbrushes used (n = 12). Gingival index, visible plaque index and the volume of crevicular fluid were evaluated at baseline and 3 months after the beginning of the toothbrush use. Furthermore, the performance of the biofilm removal per brushing cycle of 1 and 3 minutes with each toothbrush was made monthly until the end of the experiment. Results: The US group had the highest dentin wear. Clinically, the US group had a lower plaque index at 3 months than the M group. The M group also showed less biofilm removal efficiency from the second month of follow-up and more worn bristles at the end of the 3 month period than the E and US groups. Conclusion: The ultrasonic, electric and manual toothbrushes showed no differences in gingivitis control in the present study. The ultrasonic and electric toothbrushes had a more significant effect on biofilm removal than a manual toothbrush, but the ultrasonic toothbrush promoted greater dentin tissue wear.

Microbial biodiversity of natural toothbrushes in Mali

Different oral hygiene practices are used to overcome endemic diseases such as dental caries and oral infections. In Mali (Africa), natural plant-based toothbrushes are used for eliminating bacterial biofilm. The repertoire of microorganisms associated with natural toothbrushes is unknown. The aim of our study is to study microbial flora in particular the methanogenic archaea associated with natural toothbrushes recently recognized as responsible for periodontitis and peri-implantitis. We investigated the methanogens and bacteria associated with 15 different natural plant toothbrushes collected in Bamako local market (Mali). Microbiological investigations consisted in culturing the bacteria on agar plates and searching archaea using molecular techniques. No archaea were demonstrated by molecular biology but 50 bacterial species, including 33 aero-anaerobic and 17 aerobic species, were isolated from natural toothbrushes. We isolated Pseudomonas sp., Staphylococcus sp. and Klebsiella pneumoniae, which are acknowledged as opportunistic human pathogens. This study has highlighted the likely impact of the use of natural toothbrushes in the spread of potentially pathogenic bacteria in the human oral cavity.

Oral health conditions and correlates: a National Oral Health Survey of Rwanda

ABSTRACT Background: Dental diseases are chronic, lifelong and preventable yet affect over half the world’s population. Personal oral hygiene practices and socio-economic factors contribute to oral health outcomes affecting oral health quality of life. Integrating basic oral care within community level health systems increases accessibility and availability of oral health resources. Objective: National Oral Health Survey of Rwanda (NOHSR) data were investigated for associations of socio-demographic characteristics, personal oral hygiene practices, oral health outcomes, and oral health quality of life indicators. Methods: Data were analyzed and descriptive statistics calculated. Multivariable logistic regression models were developed to assess associations between untreated caries, calculus, and pain with various independent variables (demographics and personal oral hygiene practices). Additional logistic regression models examined associations between quality of life indicators and the aforementioned independent variables as well as untreated caries and pain. Results: Those who did not use a toothbrush (62.7%), or toothpaste (70.0%), and cleaned their teeth less than once per day (55.3%) had a higher prevalence of untreated caries. Approximately one-third of those in rural areas cleaned their teeth once per day or more compared to two-thirds of those in urban areas (35.4% vs. 71.2%). Those cleaning their teeth less than once daily were estimated to have 56.0% higher odds of caries than those who cleaned their teeth once a day or more (OR = 1.56, [95% CI 1.25–1.95]). Those with secondary education or higher and those with skilled jobs demonstrated more frequent teeth cleaning and higher toothbrush and toothpaste use. Quality-of-life indicators varied significantly with untreated caries and pain. Conclusion: Socio-economic, individual, and workforce characteristics are important considerations when assessing oral health outcomes. This study investigated social demographic disparities in relation to oral health related behaviors and outcomes. This information can help guide oral health care programming in Rwanda.

Interplay between different manual toothbrushes and brushing loads on erosive tooth wear

ObjectiveTo investigate the effect of different types of manual toothbrushes and brushing loads on the progression of erosive tooth wear (ETW) on enamel. MethodsBovine enamel specimens (n = 10) were submitted to a 5-day erosive-abrasive cycling model (0.3 % citric acid for 5 min, artificial saliva for 60 min, 4x/day). Toothbrushing was carried out 2x/day for 15 s, according to the toothbrushes tested (ultra-soft (a): Curaprox 5460; ultra-soft (b): Sensodyne Repair & Protect; soft (a): Colgate Slim Soft; soft (b): Oral-B Indicator Plus; medium: Johnson’s Professional; hard: Tek) and brushing loads (1.5 N, 3 N). Surface loss (SL, in μm) was assessed by optical profilometry on conclusion of the cycling. Some of the toothbrush characteristics were evaluated. Data were statistically analyzed (α = 0.05). ResultsFor the 1.5 N load, the hard brush showed the highest SL value, with statistical significance. The other toothbrushes did not differ significantly, except that ultra-soft (a) caused significantly higher SL than ultra-soft (b). For the 3 N load, hard and soft (a) exhibited the highest SL. Soft (b) and medium had the lowest SL value, with statistical significance. Only soft (a) and ultra-soft (b) showed significant difference between loads, with lower SL for the load of 1.5 N. None of the toothbrush characteristics were significantly correlated with SL. ConclusionsAlthough different degrees of enamel surface loss were observed with use of the different toothbrushes, no association was found between the toothbrush characteristics and SL. Depending on the toothbrush, the force of brushing was capable of modulating the ETW of enamel. Based on the brushing loads usually applied by healthy individuals, hard brushes are not recommended for use by patients with ETW. Clinical significanceThe use of hard bristle brushes is not recommended for use by individuals who exert healthy forces when brushing their teeth. The toothbrush characteristics are of secondary importance in terms of causing enamel loss in ETW.

Oral Health Status of Institutionalized Orphans and Non-Orphans Aged 6-12 Years in a Central Indian City: A Comparative Study

INTRODUCTION: Oral Health, like general health, is a basic fundamental right for all, and even more so for the underprivileged. AIM: To evaluate the oral health status of Institutionalized orphans aged 6-12 years and non-orphans in Indore, Madhya PradeshMATERIALS AND METHODS: The present descriptive cross-sectional study was conducted among various registered orphanages in Indore, Madhya Pradesh. Oral Examination was done by two standardized examiners (ADA type III examination) and data was entered using a pre-tested and pre-validated proforma. Data was transferred into MS excel and after application of descriptive statistics, the independent samples t-test and multiple logistic regression were applied (p value significant at ≤ 0.5). RESULTS: Of the total 263 study subjects, there were 132(50.2%) orphans and 131(49.8%) school children aged 6-12 years. Among orphans, males (62.9%) formed the majority; use of toothbrush with toothpaste was observed among 69.7% of orphans, while 6.1% did not use any oral hygiene aid. The most common observed hard lesion was dental caries (31.8%) as compared to 20.6% in school children and its presence revealed a significant association (p=0.02). CONCLUSION: It is recommended that a special emphasis should be made to promote oral health among the children residing in orphanages.

Impact of Powered Toothbrush Use and Interdental Cleaning on Oral Health

The long-term effectiveness of powered toothbrushes (PTBs) and interdental cleaning aids (IDAs) on a population level is unproven. We evaluated to what extent changes in PTB and IDA use may explain changes in periodontitis, caries, and tooth loss over the course of 17 y using data for adults (35 to 44 y) and seniors (65 to 74 y) from 3 independent cross-sectional surveys of the German Oral Health Studies (DMS). Oaxaca decomposition analyses assessed to what extent changes in mean probing depth (PD), number of caries-free surfaces, and number of teeth between 1) DMS III and DMS V and 2) DMS IV and DMS V could be explained by changes in PTB and IDA use. Between DMS III and V, PTB (adults: 33.5%; seniors: 28.5%) and IDA use (adults: 32.5%; seniors: 41.4%) increased along with an increase in mean PD, number of caries-free surfaces, and number of teeth. Among adults, IDA use contributed toward increased number of teeth between DMS III and V as well as DMS IV and V. In general, the estimates for adults were of lower magnitude. Among seniors between DMS III and V, PTB and IDA use explained a significant amount of explained change in the number of caries-free surfaces (1.72 and 5.80 out of 8.44, respectively) and the number of teeth (0.49 and 1.25 out of 2.19, respectively). Between DMS IV and V, PTB and IDA use contributed most of the explained change in caries-free surfaces (0.85 and 1.61 out of 2.72, respectively) and the number of teeth (0.25 and 0.46 out of 0.94, respectively) among seniors. In contrast to reported results from short-term clinical studies, in the long run, both PTB and IDA use contributed to increased number of caries-free healthy surfaces and teeth in both adults and seniors.

Oral hygiene habits and possible transmission of COVID-19 among cohabitants

BackgroundTo find out whether misuse of dental hygiene, in terms of certain dental habits, may facilitate the spread of COVID-19 among cohabiting individuals.Methods302 COVID-19 infected (PCR +) subjects cohabiting with someone else at home were selected for an observational cross-sectional study. An anonymous online questionnaire was developed using Google forms to avoid person-to-person contact. The structured questionnaire consisted of questions covering several areas: sociodemographic data, cross transmission to another person living together, oral hygiene habits during confinement, care and disinfection control behaviours in the dental environment like sharing toothbrush, sharing toothbrush container, sharing toothpaste, placing brush vertically, placing cap with hole for brush, disinfecting brush with bleach, closing toilet lid before flushing.ResultsTongue brushing was more used in the group where there was no transmission of the disease to other members (p < 0.05). Significant differences were found for shared toothbrush use (p < 0.05), although shared use was a minority in this group (4. 7%), significant differences were also found for the use of the same container (p < 0.01), shared use of toothpaste (p < 0.01), toothbrush disinfection with bleach (p < 0.01), brush change after PCR + (p < 0.05). The women performed significantly more disinfection with toothbrush bleach (p < 0.01), closing the toilet lid (p < 0.05) and changing the brush after PCR + (p < 0.05).ConclusionsThe use of inappropriate measures in the dental environment could contribute to the indirect transmission of COVID-19 between cohabitants.

The efficacy of two different oral hygiene regimens on the incidence and severity of oral mucositis in pediatric patients receiving hematopoietic stem cell transplantation: A prospective interventional study.

AimsThis prospective interventional study aimed to assess the efficacy of supersaturated calcium phosphate rinse and the use of an extra‐soft toothbrush twice a day when added to the existing oral hygiene protocol regimen (0.12% chlorhexidine gluconate + 3% sodium bicarbonate + nystatin 5000 U/mL) in reducing the severity of oral mucositis among pediatric patients receiving chemotherapy for the hematopoietic stem cell transplant.MethodsForty‐five patients that received chemotherapy for the hematopoietic stem cell transplant were randomly allocated to three groups of 15 patients each. Group A was advised to follow the existing oral hygiene protocol regimen (Control), group B was advised to brush their teeth twice daily using an extra‐soft toothbrush and to follow the control regimen, and lastly group C was advised to use supersaturated calcium phosphate rinse and to follow the control regimen. Oral mucositis was recorded according to World Health Organization criteria from the day of admission (day 1) to the day of discharge (day 28). The incidence of oral mucositis between the three groups was compared using the Kruskall‐Wallis test while the severity of oral mucositis between the three groups was compared using a one‐way ANOVA test.ResultsThe results of the study showed no significant difference in the incidence of oral mucositis between the three groups; however, there was a lower severity of oral mucositis in the supersaturated calcium phosphate rinse group when compared to the control group or the group who used an extra‐soft toothbrush with the control regimen.ConclusionAlthough marginally fewer cases and lower severity of oral mucositis was observed in the group using supersaturated calcium phosphate rinse, the lack of statistical significance suggests that the evidence for their use is not conclusive. The results of this study also showed that the introduction of an extra‐soft toothbrush into the oral hygiene regimen did not significantly reduce the incidence of oral mucositis and may actually be responsible for an increase in the severity of oral mucositis.

Effects of xylitol impregnated toothbrushes on periodontal status and microbial flora in orthodontic patients.

To investigate whether the use of xylitol-impregnated toothbrushes affects periodontal condition and microbial flora in orthodontic patients with poor oral hygiene. Forty-four patients with baseline mean Turesky plaque index scores ≥1.5 were randomly divided into two groups. Half received xylitol-containing toothbrushes and the other half, xylitol-free toothbrushes. The periodontal measurements and saliva samples were taken at baseline (T0), 1 month later (T1), and 3 months after brushing (T2) to evaluate periodontal health and microflora changes. Periodontal status was assessed with plaque index (PI), gingival index (GI), and bleeding on probing (BOP) scores. Data were statistically analyzed with Mann-Whitney U and Friedman tests. All periodontal parameters significantly decreased from T0 to T1 and from T0 to T2 in both groups. The PI and GI scores reduced significantly in the control group, while BOP scores reduced in both groups between T1 and T2. Intergroup comparisons showed significant differences for BOP, PI, and GI at T0, T1, and T2 times, respectively. For microbial parameters, there were no statistically significant differences within groups from T0 to T1. Total bacterial counts significantly decreased in the xylitol group between T1 and T2. Decreases in Streptococcus mutans and total bacteria were significant in both groups from T0 to T2. No significant differences were found between the groups in microbial flora at any time. A 3-month use of xylitol-containing toothbrushes showed almost the same changes and provided no positive effects on periodontal and microbial parameters compared to the control group.

Self-reported bleeding on brushing as a predictor of bleeding on probing: Early observations from the deployment of an internet of things network of intelligent power-driven toothbrushes in a supportive periodontal care population.

BackgroundBleeding on brushing (BoB) is an important sign of gingival inflammation. Recently, the use of intelligent toothbrushes and oral health Apps has shown potential to improve oral and periodontal health. In the context of the introduction of an Internet of things network of intelligent power‐driven toothbrushes in a supportive periodontal care programme, the aim of this study was (a) to audit the adoption and retention of this new technology; and (b) to preliminarily assess the feasibility to gather data on BoB and associate them with clinical periodontal parameters.Methods100 subjects with different periodontal case diagnoses participating in supportive periodontal care (SPC) were provided with and instructed on the use of an intelligent power‐driven toothbrush connected with an App (I‐Brush). Brushing sessions and occurrence of BoB were recorded through the App and stored in a data protection compliant backend. Subject retention was audited over time. BoB recorded in the two weeks before the SPC appointment was associated with clinical parameters observed by the clinician blind to App data.Results75% of subjects provided data from using the power toothbrush and the App for a minimum of 10 brushing sessions over an average period of 362 days. Compared with baseline, subjects’ oral hygiene, bleeding on probing and prevalence of residual pockets improved gradually while using the I‐Brush. The number of BoB episodes in the two weeks leading to the SPC appointment and the number of residual pockets predicted BOP (p < .001) detected during the examination. App use in the previous two weeks was associated with lower plaque scores at SPC.ConclusionsThese preliminary observations indicate good adoption and retention of a mobile health system built around an intelligent power toothbrush in a SPC population. The App was able to gather clinically relevant information predicting the observed degree of gingival inflammation. Deployment of mHealth systems seems feasible in dental practice and may bring significant oral health benefits. More investigations are needed in this area.

Effect of Duration of Use of a Toothbrush on its Filament’s Tapering and Plaque Removal Efficacy

Background and Objectives: Dental professionals often recommend changing toothbrushes every three months due to their wear and decreased plaque removal efficacy. This study aimed to assess the correlation of duration of use of a toothbrush and its wear and then the relationship of wear of toothbrush and Plaque Index (PI) of users and tapering of toothbrush filaments after three months of use was evaluated as well. Materials and Methods: In this study, 60 female students were enrolled according to the eligibility criteria and received a new set of toothbrush and toothpaste. They were requested to brush their teeth using the Bass technique twice a day for 2 minutes and the Ramfjord PI was measured at baseline and after 3 months. The wear of 47 toothbrushes after three months of use was evaluated using the Rawls index. Of collected 47 toothbrushes, 30 were randomly chosen and inspected under an electron microscope to determine the degree of tapering of bristles. Data were analyzed using SPSS version 20 via Spearman’s correlation coefficient, paired t-test and Pearson’s correlation coefficient (alpha=0.05). Results: After 3 months, the mean PI score significantly decreased (paired t-test, P=0.034). The PI at 3 months after use had no significant correlation with the toothbrush wear score (Spearman’s correlation coefficient, P=0.61) but the toothbrush wear score had a significant correlation with tapering of bristles (Spearman’s correlation coefficient, P=0.04). No significant association existed between PI at 3 months after use and tapering of bristles (Pearson’s correlation coefficient, P=0.69). Conclusion: The duration of use and wear of toothbrush alone do not affect the quality of plaque removal. Practicing Oral hygiene can affect the quality of plaque removal.

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

The importance of oral hygiene for patients on mechanical ventilation.

The importance of oral hygiene for patients on mechanical ventilation.

PERIODONTITIS AND OBESITY: A CROSS SECTIONAL SURVEY

Background: The objective of this study is to determine whether there is an association between periodontitis and obesity among adults involved in this study. Methods: In 2018, 200 subjects, &gt; 19 years of age, who participated in this study were selected for analysis from the Department of Periodontology, Government Dental College and Hospital Ahmedabad. Participants underwent periodontal examination and anthropometric measurements and were asked to complete a socioeconomic status and overall health status questionnaire. Body mass index (BMI) and waist circumference (WC) have been used as overall body fat and upper body fat measurements. As established by the World Health Organization (WHO), standard BMI and WC cut off points were used. The Community Periodontal Index assessed the periodontal status and defined periodontitis as "code 3". Multivariate logistic regression analyses were performed, adjusting to the following variables: sex; age; household income; bedtime toothbrushing habits; use of dental floss; use of interproximal toothbrush; presence of active tooth decay; number of permanent teeth decayed, missing or filled; diabetes mellitus and smoking status. Results: It was found that an association exit between periodontitis and high WC using the cut off points established by the WHO. Obese individuals with BMI average 25 had an adjusted odds ratio of 0.991 (0.806 to 1.220) for periodontitis. But it was found that a significant association between periodontitis and abdominal obesity. The adjusted odds ratio for periodontitis for obese subjects was 1.358 (confidence interval 1.003 to 1.839) after adjustment for all covariates. Conclusions: A high WC denoting abdominal obesity was found to be associated to periodontitis, while BMI which often tends to misclassify as obese does not, appears to be associated with periodontitis. This finding shows a significant correlation between abdominal obesity and periodontitis.

The Effects of Oral Health Instruction, and the Use of a Battery-Operated Toothbrush on Oral Health of Persons with Serious Mental Illness: A Quasi-Experimental Study.

People with a diagnosis of serious mental illness (SMI) have a greater incidence of poorer oral health as compared to the general population. The aim of this quasi-experimental study was to determine the effect that a combination of the use of a battery-operated toothbrush and a related educational intervention may have on the oral health of individuals with serious mental illness. Key findings include that the battery-operated toothbrush resulted in a significant improvement in the mean change in gingival index, a common indicator of oral health. The study also found that oral home care instructions, smoking and level of negative symptoms did not have an effect on the mean change in plaque or gingival indices. This project suggests that the implementation of a relatively simple, cost effective measures such as a battery-operated toothbrush may have a positive impact on the oral health in this population.

Adjunct use of mouth rinses with a sonic toothbrush accelerates the detachment of a Streptococcus mutans biofilm: an in vitro study

BackgroundThe aim of this in vitro study was to examine the possible enhancement of the biofilm peeling effect of a sonic toothbrush following the use of an antimicrobial mouth rinse.MethodsThe biofilm at a noncontact site in the interdental area was treated by sound wave convection with the test solution or by immersion in the solution. The biofilm peeling effect was evaluated by determining the bacterial counts and performing morphological observations. A Streptococcus mutans biofilm was allowed to develop on composite resin discs by cultivation with stirring at 50 rpm for 72 h. The specimens were then placed in recesses located between plastic teeth and divided into an immersion group and a combination group. The immersion group was treated with phosphate buffer, chlorhexidine digluconate Peridex™ (CHX) mouth rinse or Listerine® Fresh Mint (EO) mouth rinse. The combination group was treated with CHX or EO and a sonic toothbrush.ResultsThe biofilm thickness was reduced by approximately one-half compared with the control group. The combination treatment produced a 1 log reduction in the number of bacteria compared to the EO immersion treatment. No significant difference was observed in the biofilm peeling effect of the immersion group compared to the control group.ConclusionsThe combined use of a sonic toothbrush and a mouth rinse enhanced the peeling of the biofilm that proliferates in places that are difficult to reach using mechanical stress.

Toothbrushing for Dependent Neurological Patients in the Intensive Care Unit

Toothbrushing for Dependent Neurological Patients in the Intensive Care Unit