Nahed Ashri, Shaden Wafa, Reem Al Kattan.
The effect of Toothbrush design on plaque removal efficiency.
J Pak Dent Assoc Jan ;12(2):83-9.

OBJECTIVES: First to compare the plaque removal efficiency of a newly introduced cross action toothbrush (Oral B) with four other toothbrushes (Aquafresh, utler, Reach and Sensodyne) and secondly to examine the rounding of the bristles ends of the toothbrushes using the scanning electron microscope. MATERIALS AND METHODS: Fifty female dental students with an age range of 21-24 years from the College of Dentistry, King Saud University participated in this study. They were selected according to the following criteria: free from gross unrestored caries, no history of advanced periodontitis, no medical problems and no medications or antibiotic coverage taken for the last six months. This single-blind, short-term cross-over study followed the clinical protocol advocated by Rustogi et al. 1992. The 50 subjects were divided into five equal groups. The clinical examination was done in the Dental College, King Saud University by using a mouth mirror and a calibrated probe with William`s marking. All teeth were examined excluding third molars. Participants were instructed to refrain from toothbrushing for twenty-four hours before each evaluation period to allow for adequate plaque accumulation. On day one of each week, the plaque is scored for each participant using the Modified Navy Plaque Index, refined by Rustogi. Thirty dental students out of fifty selected students completed a single blind, short-term, cross-over clinical study. The participants were instructed to refrain from toothbrushing for twenty-four hours before each evaluation period. On day one of each week, the plaque is scored as pre-brushing (baseline) plaque index. The Participants were then allowed to brush with the assigned toothbrush. Then the post-brushing plaque was scored. On day five, the post-brushing plaque was scored,again. After a wash-out period of two days, the same process was repeated for all the five selected toothbrushes. The data was analyzed using SPSS program. RESULTS: No significant difference was detected between the five toothbrushes for any of the three scored areas (whole mouth, gingival margin and proximal areas). Scanning electron microscopy examination of bristles ends of the tested toothbrushes revealed a minimum presence of rounded ends in all brushes. CONCLUSION: The toothbrush design did not play a significant role in plaque removal with effective brushing being the most important factor. The new cross cross design was not superior to any of the tested toothbrushes.

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