Effect of Toothbrush Bristle Stiffness and Brushing Force on Cleaning Efficacy

Bristle splaying and abrasive potential of different toothbrushes on the enamel and resin composite after brushing simulation

Background

Correct oral physiotherapy using toothbrushes is essential for mechanically removing biofilms to reduce caries and periodontal disease, but ideal toothbrush parameters have not yet been fully defined. The aim of this study was to evaluate the bristle splaying and abrasive potential of different toothbrushes on enamel and resin composites after simulated brushing for 30, 90, and 180 days.

Material and Methods

Seventy bovine flat tooth crowns containing a circular cavity on the enamel were restored using a resin composite (Forma, Ultradent) and brushed for 30, 90, and 180 days using seven toothbrushes (n = 10): Colorcare (Bianco Oral Care), Delicare (Bianco), Carbon-Magnetherapy (Bianco Oral Care), SlimSoft Advanced (Colgate), Pro Cuidado (Colgate), Curaprox CS5460 (Curaden), and Curaprox CS3960 (Curaden). The enamel and resin composite surface roughness (Ra) were evaluated at baseline and after brushing. The wear index and wear rate were evaluated using macrophotography and scanning electron microscopy (SEM). Data were analyzed using two-way repeated measurement analysis of variance and Kruskal Wallis followed by Tukey's and Duns tests (α = 0.05).

Results

The Ra of the resin composite significantly increased after 30 (using SlimSoft), 90 (using SlimSoft, Pro Cuidado, and Carbon), and 180 days (using Colgate Pro Cuidado and CS3960; P< 0.001). The Ra of enamel increased significantly after 90 days of using Pro Cuidado, and 180 days using Pro Cuidado and CS5460. Carbon exhibited the highest wear index variation.

Conclusions

CS5460, Carbon, and SlimSoft exhibited higher bristle volumes, narrow filament diameters, and higher wear rates and wear indices with lower Ra alterations. The Ra of the resin composite after 180 days was significantly higher for Pro Cuidado and CS3960. Enamel Ra was significantly higher in Pro Cuidado. Key words:Toothbrushing, dental abrasion, composite resins.

It is the habit not the handle that affects tooth brushing - a randomised counterbalanced cross over study with young and healthy adults

OBJECTIVE

To assess the effect of the toothbrush handle on video-observed toothbrushing behaviour and toothbrushing effectiveness.

METHODS

This is a randomized counterbalanced cross-over study. N = 50 university students and employees brushed their teeth at two occasions, one week apart, using either a commercial ergonomically designed manual toothbrush (MT) or Brushalyze V1 (BV1), a manual toothbrush with a thick cylindrical handle without any specific ergonomic features. Brushing behaviour was video-analysed. Plaque was assessed at the second occasion immediately after brushing. Participants also rated their self-perceived oral cleanliness and directly compared the two brushes regarding their handling and compared them to the brushed they used at home.

RESULTS

The study participants found the BV1 significantly more cumbersome than the M1 or their brush at home. (p < 0.05). However, correlation analyses revealed a strong consistency of brushing behavior with the two brushes (0.71 < r < 0.91). Means differed only slightly (all d < 0.36). These differences became statistically significant only for the brushing time at inner surfaces (d = 0.31 p = 0.03) and horizontal movements at inner surfaces (d = 0.35, p = 0.02). Plaque levels at the gingival margins did not differ while slightly more plaque persisted at the more coronal aspects of the crown after brushing with BV1 (d = 0.592; p 0.042).

DISCUSSION

The results of the study indicate that the brushing handle does not play a major role in brushing behavior or brushing effectiveness.

Cleaning performance of electric toothbrushes around brackets applying different brushing forces: an in-vitro study

Throughout treatment with fixed orthodontic appliances, effective plaque control is crucial to maintaining dental health. This in-vitro study evaluated the cleaning performance of eleven different brush heads of seven electric toothbrushes (oscillating-rotating and sonic motions) and varying brushing forces around orthodontic brackets. Six Mini Diamond® Twin brackets were placed on black-stained front teeth. Teeth were coated with white titanium oxide and brushed in a machine six times for one minute with two different brushing forces (1 N and 1.5 N). Eleven different brush heads were evaluated (either oscillating-rotating or sonic movements). The teeth were scanned and planimetrically evaluated after brushing. Three detailed plaque areas (DPAs) were created: proximal (< 1 mm to bracket), mid-tier (1-2 mm to bracket), and distant (> 2 mm to bracket). The proportion of contaminated proximal, mid-tier, and distant surfaces (white regions) in relation to the respective DPA was calculated. Independent of brushing forces, places with a higher distance (> 2 mm) to the orthodontic bracket had the least amount of residual contamination, followed by areas with a minor (1-2 mm) and proximal distance (< 1 mm). In all of the brushes tested and for both estimated brushing forces, the region with the highest residual contamination was the proximal area. The brush heads of the Paro® Sonic toothbrush left the least amount of residual contamination. The cleaning performance of electric toothbrushes around brackets on upper incisors varied across the brushes examined. The proximal area has the most residual contamination. Furthermore, 9 out of 11 toothbrushes cleaned more successfully with 1.5 N than with 1 N brushing force.